bluuebunny/crossref_metadata_2025 huggingface dataset:
A wonderland for wolves: A sociography of the Chernobyl Exclusion Zone
Authors: Freeman Lindsey A.
Published: August 2022

I was writing about the Chernobyl Exclusion Zone when the global pandemic of Covid-19 hit. Everywhere I looked news articles crowded with infographics of the infected made me suspicious of spheres: curves needed flattening. No matter where I turned for information there were human shapes in rings marking distance. I was disturbed by how often the phrase ‘what goes around comes around’ popped into my head, like some kind of self-hazing ritual initiating me into a new normal. As I send this sociography to publication, Russia has invaded Ukraine. The Chernobyl Zone, along with the rest of the country, has become a battlefield. There is no other way for me to write this, from a distance, other than to do so through a looping disorientation. And so I write by turning paragraphs into zones that surround ideas, memories, facts, and feelings of place that are never stable, but always on the move.
Sociography: Writing Differently
Authors: Kilby Jane , Gilloch Graeme
Published: August 2022

Sociology is just as much an art form as it is a science. And while sociologists and those in cognate disciplines have long experimented with their writing, the search for new academic forms and practices has acquired new urgency and potentiality. How we write up our research is of paramount importance: our language can be used in experimental and innovative ways to offer nuanced, critical commentary without foreclosing alternative viewpoints, and without excluding others from dialogue. Sociography offers spaces for new sensibilities and sensitivities; unresolved or incomplete argument; multiple, multi-dimensional and multiplying possibilities: for writing differently. As an intervention in writing the social, our collection works to resist the ideological promotion of dry, dispassionate, and seemingly ‘objective’ discourse, one which has traditionally upheld a set of dominant, privileged voices. And in so doing, our collection explores the potential of new ways of writing the social for both a trans- and post-disciplinary academy and a wider reading public; and seeks forms of writing that do justice to the critical curiosity that animates sociology. In sum, the challenge embraced by this collection is to argue for and showcase a praxis that activates sociological knowledge and enlarges the sociological imagination.
India’s Tribal Communities, Remaining at the Margins
Authors: Ambagudia Jagannath
Published: August 2022

Vinay Kumar Srivastava, India’s Tribes: Unfolding Realities, SAGE Publications, Delhi, 2021, lviii + 294 pp., ₹1,295. ISBN: 978-93-5388-659-2 ( Hardcover).
Book review: Prabir Ghosh, Aloukik Nahay Loukik [Not Supernatural, but Logical], (Assamese), (R. Roy, Trans.)
Authors: Sharma Aparajita
Published: August 2022

Prabir Ghosh, Aloukik Nahay Loukik [Not Supernatural, but Logical], (Assamese), (R. Roy, Trans.), Bina Library, Guwahati, 2009 (Original work published 1990), 364 pp., ₹150 (Hardcover).
Mycoplasma Hominis: A Rare Case of Acute Otitis Media and Facial Nerve Paralysis
Authors: Sadhar Birkaran , Ko-Keeney Ellen , Fornelli Rick , Lipman Sidney
Published: August 2022

Facial paralysis secondary to acute otitis media (AOM) is rare in the post-antibiotic era.1,2 In immunosuppressed patients, atypical bacteria are more commonly encountered as the cause. Mycoplasma hominis, normally found in the genitourinary tract, uncommonly causes extragenital infection.3 We report a case of AOM secondary to M. hominis, complicated by facial paralysis in an immunosuppressed patient. A 24-year-old male with multiple sclerosis, on rituximab, presented to the emergency department with otalgia and facial paralysis. He was diagnosed with Bell’s palsy and subsequently referred to the otolaryngology service. Examination revealed right facial paralysis and purulent otorrhea. Computed tomography (CT) of the temporal bone showed right tympanic and mastoid opacification. The patient was admitted and started on IV ampicillin/sulbactam, IV dexamethasone, and ciprofloxacin/dexamethasone otic drops. Debridement and examination under anesthesia revealed a right tympanic membrane perforation and granulation tissue. Biopsy and cultures were obtained. Final cultures were positive for Mycoplasma hominis. Facial paralysis is an uncommon complication of AOM but typically resolves once appropriate antibiotic therapy is regimented. Because Mycoplasma can be missed on routine culture, clinicians should consider workup for atypical organisms in settings of immunosuppression so appropriate antibiotic therapy can be initiated.
Critical Junctures of Securitisation: The Case of the AK Party in Turkey
Authors: Sandal Nukhet Ahu , Ozturk Ahmet Erdi
Published: August 2022

Authoritarian leaders try to create an environment conducive to the maintenance of their own ontological security. In this study, we advance a theory of tripartite securitization marked by critical junctures that shed light on how authoritarian actors establish a sense of security for themselves when they govern. Using elite interviews with actors from Turkey’s different political parties, we argue that the three major steps towards authoritarianism in Turkey involved restructuring core institutions and ‘cleansing’ them of the perceived hostile elements; doubling down on securitising existing internal and external ‘enemy’ identities; and securitising rivals that cannot be co-opted in the political process. This tripartite securitization starts with what we call ‘desecuritisation of the self’ in cases where the party in power itself was once the target of securitising acts. We trace how tripartite securitisation has unfolded in Turkey under the AK Party government, and we identify three critical junctures associated with this securitisation process: The Ergenekon and Balyoz Trials, the KCK Trials and the 2016 Failed Coup Attempt.
Employer Value Propositions for Different Target Groups and Organizational Types in the Public Sector: Theory and Evidence From Field Experiments
Authors: Keppeler Florian , Papenfuß Ulf
Published: August 2022

Public employers struggle with recruiting talents and labor market competition. Research on the understudied topic of employer branding can help address this challenge. This study presents five large-scale, pre-registered field experiments ( n = 155,634) aimed at increasing the number of individuals initially interested in a job at a public employer. In social media ads, public sector values served as signaled employer value propositions (EVPs). The results show the importance of target groups and points of difference related to public employers’ organizational type. Significantly fewer women show interest in a job, and for a municipal administration, a fair pay EVP has a negative effect. This study enhances the understanding of potential recruits’ environment- and self-processing, bridges EVPs with public values theory, and provides a missing theoretical link between publicness and recruitment. It shows the importance of testing common assumptions about what works in recruitment in field studies with high external validity.
The Italian McGill Quality of Life Questionnaire-Revised (MQoL-R): Psychometrics in Neurological and Neoplastic Populations
Authors: Aiello Edoardo Nicolò , Pain Debora , Radici Alice , Filippelli Elvira , Ruvolo Stefania , Madonia Francesca , Caimi Annarita , Sguazzin Cinzia
Published: August 2022

Background

The McGill Quality of Life Questionnaire-Revised (MQoL-R) is the gold standard for assessing QoL in end-of-life, chronic patients; however, an Italian standardization is lacking.

Objective

This study aimed at assessing the psychometric properties of the Italian MQoL-R in patients with chronic neurological/oncological conditions.

Methods

177 inpatients with life-threatening, chronic neurological/oncological conditions were consecutively recruited in 8 clinics in Northern/Southern Italy were administered the MQoL-R and the Karnofsky Performance Status (KPS). Factorial structure (Confirmatory Factor Analysis, CFA), reliability (Cronbach's α) and construct validity against the KPS (Pearson's coefficients) were examined.

Results

The four-factor model (Physical, Psychological, Existential and Social subscales) was met (comparative fit index = .93; root mean square error of approximation = .07), with all items significantly loading on respective subscales. Internal consistency was good for both the whole scale (Cronbach's α = .83) and subscales ( range = .6-.85). The KPS was unrelated to MQoL-R measures, except for the Physical subscale ( r = .24).

Conclusions

The Italian MQoL-R is a valid and reliable tool to assess QoL in end-of-life, both neoplastic and neurological, chronic inpatients undergoing palliative care, whose adoption is thus encouraged in both clinical practice and research addressed to such populations.
A Single-Center Audit of BI-RADS 3 Assessment Category Utilization in Mammography and Breast Ultrasound
Authors: Common Jessica , Abdullah Peri , Alabousi Abdullah
Published: August 2022

Purpose: To evaluate outcomes of breast lesions assessed at our institution as probably benign (Breast Imaging Reporting and Data System [BI-RADS] category 3) with an expected malignancy rate of less than or equal to 2 %. Methods: Average-risk women with a BI-RADS 3 assessment following mammographic and/or ultrasound evaluation at our institution between January 1 and December 31, 2017 were included. Cancer yield was calculated within 90 days and at 6-month intervals up to 36 months. Results: Among 517 women (median age, 52 years; range, 13–89 years) with a BI-RADS 3 assessment, 349 (67.5 %) underwent biopsy or completed follow-up imaging up to 36 months. One hundred and 68 (32.5 %) were lost to follow-up. Thirty of 349 (8.6 %) had their imaging upgraded and underwent biopsy, yielding six cancers (cancer yield, 6 of 349 women [1.7 %]). Among 569 lesions assessed as BI-RADS 3, 92 (16.2 %) were characterized by morphologic features other than those validated as probably benign in prospective clinical studies. Fifty three of 517 women (10.3 %) had follow-up beyond 24 months, and 24 (4.6 %) had follow-up beyond 36 months. Conclusion: Overall utilization of the BI-RADS 3 assessment category at our institution is appropriate with a 1.7 % cancer yield. However, the rate of loss to follow-up, percentage of non-validated findings assessed as probably benign, and redundancy in follow-up protocols are too high, and warrant intervention. A patient handout explaining the BI-RADS 3 assessment category and automatic scheduling of follow-up studies have been implemented at our center to address loss to follow-up.
Mugs and Plants: Object Semantic Knowledge Alters Perceptual Processing With Behavioral Ramifications
Authors: Dubbelde Dick , Shomstein Sarah
Published: August 2022

Neural processing of objects with action associations recruits dorsal visual regions more than the neural processing of objects without such associations. We hypothesized that because the dorsal and ventral visual pathways have differing proportions of magno- and parvocellular input, there should be behavioral differences in perceptual tasks between manipulable and nonmanipulable objects. This hypothesis was tested in college-age adults across five experiments ( Ns = 26, 26, 30, 25, and 25) using a gap-detection task, suited to the spatial resolution of parvocellular processing, and an object-flicker-discrimination task, suited to the temporal resolution of magnocellular processing. Directly predicted from the cellular composition of each pathway, a strong nonmanipulable-object advantage was observed in gap detection, and a small manipulable-object advantage was observed in flicker discrimination. Additionally, these effects were modulated by reducing object recognition through inversion and by suppressing magnocellular processing using red light. These results establish perceptual differences between objects dependent on semantic knowledge.
Parkinson’s disease protein 7 protected against oxidative stress of myocardial infarction direct through p47phox and nicotinamide adenine dinucleotide phosphate oxidase 4
Authors: Pan Guozhong , Yang Shiwei , Han Xiaowan , Wang Xian , Kou Lanjun , Xie Jing , Li Chunyan
Published: August 2022

In the present study, we aimed to investigate the role and mechanism of Parkinson’s disease protein 7 (Park7) in myocardial infarction (MI). The Park7 expression in the serum and tissues was down-regulated in mice with MI. Recombinant Park7 protein protected against MI-induced injury and reduced oxidative stress in mice model. Conversely, knockout Park7 increased injury of MI and promoted oxidative stress in MI mice model. In embryonic rat cardiac myoblasts H9c2 cells, over-expression of Park7 reduced reactive oxygen species (ROS)-induced oxidative stress, while down-regulation of Park7 increased ROS-induced oxidative stress. Park7 combined nicotinamide adenine dinucleotide phosphate (NADPH) oxidase cytoplasmic subunit p47phox protein had direct effect on inducing NADPH activator. The inhibition of p47phox reduced the effects of Park7 in ROS production of H2O2-treated H9c2 cells. The regulation of NADPH participated in the effects of Park7 on ROS production of in both MI mice model and H2O2-treated H9c2 cells. Our data demonstrated that Park7 protects against oxidative stress in MI model direct through p47phox and NADPH oxidase 4.
Monetary Policy and Inequality Links: Should Central Banks be Concerned?
Authors: Magwedere Margaret Rutendo , Marozva Godfrey
Published: August 2022

In this article, the link between monetary policy and inequality is investigated using the vector auto regression based impulse response functions. The study was motivated by persistent high income inequality in South Africa and the COVID-19 pandemic has renewed the debate on the links between monetary policy and inequality. South African annual time series data from 1990 to 2021 was used to examine the relationship between monetary policy and inequality. The impulse response functions show that the overall income distribution is briefly improved following a monetary policy shock. The findings suggest a fluctuating effect of monetary policy on inequality of which after period six a shock to monetary policy has no effect to inequality since the relationship reaches a stable state. The policy implication is the countercyclical use of monetary policy to reduce inequality is only effective in the early phases and in the long term the effect of monetary policy on inequality is reduced. The policy suggestion is that monetary policy alone cannot tackle inequality in an economy with other structural challenges that are outside of the monetary system. Hence policy coordination between monetary policy and fiscal policy is essential.
India and Human Rights Diplomacy at the United Nations: The Discourse on Torture
Authors: Makhija Heena
Published: August 2022

Building on the ideals of pacifism, in the early years, India’s foreign policy posturing at international forums demonstrated its keen interest in promoting universal human rights. The agenda of eradicating torture emerged at the United Nations (UN) in 1945 in response to the state atrocities and war crimes committed during the Second World War. The UN acted as an arena for diplomatic deliberations between multifarious actors that led to the emergence and global recognition of the norm against torture. At the UN, India was ideationally inclined toward building a robust human rights regime and actively participated in the making of corresponding international norms. However, India’s diplomatic zeal toward ‘norm-making’ at the UN was often followed by a lukewarm approach toward human rights. Taking the case of the development of the norm against torture, the article aims to evaluate India’s evolving human rights diplomacy at the UN. By tracing India’s historical stance on human rights and examining its formal interactions at the UN on the issue of torture, it seeks to evaluate India’s role in the formation of an international regime against torture. The article further seeks to critically analyze India’s evasive response at the UN and the implications of its failure to ratify the Convention against torture and other cruel, inhuman or degrading treatment or punishment (1984) or the Torture Convention.
The Effects of Multimodal Elements on Success in Kickstarter Crowdfunding Campaigns
Authors: Carradini Stephen , Fleischmann Carolin
Published: August 2022

This article investigates multimodal elements—images, links, gifs, videos, and galleries—of crowdfunding campaigns on the platform Kickstarter to develop an understanding of characteristics of successful campaigns. The authors scraped 327,586 campaign pages, analyzing the multimodal elements of successful and unsuccessful campaigns. They found that successful campaigns featured more images, links, and gifs and more frequently included a project video than did unsuccessful campaigns. Images, links, and the presence of a project video had a positive impact on success while gifs and project galleries did not. These findings give business communicators practical guidance, develop theoretical aspects of Kickstarter research, and validate previous findings with a larger data set.
Comparison study of the dynamic behavior of a generally restrained beam structure attached with two types of nonlinear vibration absorbers
Authors: Zhao Yuhao , Du Jingtao , Chen Yilin , Liu Yang
Published: August 2022

Beam structures with nonlinear vibration absorbers (NVAs) are attracting great research attention. Nonlinear vibration absorbers can more effectively suppress the vibration response of beam structures over the traditional vibration absorbers. The existing studies mainly focus on the dynamic behavior of beam structures with NVAs and boundary rotational restraints of beam structures are typically ignored. Additionally, it is difficult to adjust the stiffness of NVAs, limiting their engineering applications. Motivated by such limitations, the dynamic model of a generally restrained beam attached with two types of NVAs is established. Stiffness coefficients of NVAs can be adjusted by changing the initial length of horizontal springs. Dynamic behavior of the beam structure is predicted via the Galerkin truncated method (GTM). Results calculated by the GTM are verified by the harmonic balance method. Based on this, the influence of these two types of NVAs on dynamic behavior and vibration suppression of the beam structure is investigated. Appropriate parameters of the NVA beneficially affect the vibration suppression of the beam structure. With the same varying range of parameters belonging to NVAs, dynamic responses of the beam structure are more sensitive to the type-A NVA.
Recording of body weight and body condition score of cats in electronic health records from UK veterinary practices
Authors: Taylor Samantha , Roberts Georgina , Evans Marcus , German Alexander J
Published: August 2022

Objectives

The aim of this study was to determine how frequently body weight, body condition score (BCS) and terms pertaining to weight status are recorded in the electronic health records (EHRs) of veterinary practices in the UK, as well as to examine the variables affecting recording and associated with body weight, where recorded.

Methods

Data recorded in EHRs were searched in two 3-month periods in 2019 and 2020. For each visit, variables including type and time of consultation, signalment, recording of body weight, recording of BCS, weight (kg), BCS value and whether an overweight or weight-loss term was used in free text were recorded. Linear mixed-effects models were created to examine associations between body weight and variables, while mixed-effects logistic regression was used to determine associations between the same variables and weight or BCS recording.

Results

The statistical data set comprised 129,076 visits from 129,076 cats at 361 practices. Weight was recorded at most (95.2%) visits, BCS was recorded at only 22.5% of visits, and terms associated with weight loss and overweight status were recorded in 10.0% and 7.2% of free-text records, respectively. Where BCS was recorded, approximately one-third of cats had an overweight score (8.0% of total visits). Using either an overweight term ( P <0.001) or weight-loss term ( P <0.001) was associated with increased odds of body weight being recorded, while being an out-of-hours ( P <0.001) or non-routine consultation ( P <0.001) were associated with decreased odds. Increasing age ( P <0.001), using a weight-loss term ( P <0.001) and using an overweight term ( P <0.001) were associated with increased odds of BCS being recorded, while being a non-routine consultation ( P <0.001) was associated with decreased odds. Recording BCS was negatively associated with recording body weight and vice versa.

Conclusions and relevance

Cats are regularly weighed in UK practice, but BCS is less frequently recorded, and both are less often recorded in non-routine consultations. To improve both the treatment and assessment of health and nutrition in cats, veterinary professionals should record body weight and BCS concurrently at every consultation.
Investigating the determinants of outbound long-haul tourist daily expenditure and length of stay
Authors: Gedecho Ermias Kifle , Masiero Lorenzo , Wavei Ernest Balutie , Qiu Richard Tianran , Kesande Provia
Published: August 2022

This study investigates the determinants of long-haul tourists’ daily expenditure and length of stay. Relative price competitiveness, travel party size, activity engagement in entertainment, and trip organization method affect both daily spending and length of stay. Income and engagement in outdoor activities further contribute to predict daily expenditure, whereas activity engagement in nature and culture activities significantly affects the length of stay. The study presents helpful information to stakeholders responsible for outbound long-haul tourist destination policy and planning in mature and emerging destinations.
Assessing the Effectiveness of a Primary Care Provider Office-Based Intervention for Increasing Organ Donor Registration Rates in Two New York State Counties
Authors: McCabe Michael , Dokus M. Katherine , Ryan Nancy J. , Shi Hangchuan , James Amy , Meadow Michael E. , Dolan James G. , Veazie Peter , Judge Stephen , Orloff Mark , McIntosh Scott , Kashyap Randeep
Published: August 2022

Introduction: Despite strong public support, organ donor registration rates (RR) continue to lag while need only grows. In the United States, the traditional registration site is the Department of Motor Vehicles (DMV), however Primary care provider (PCP) offices have been considered as alternate locations for increasing RR. Methods: Twelve PCP offices across 2 New York Counties were subjected to a control week where participants received only a registration opportunity and an intervention week with the addition of a motivational poster and informational brochure. Zip code level sociodemographic data were obtained for each site. RR from the DMV over the same period served as historical control. Results: There were 1292 participants in the control phase and 1099 in the experimental phase. New registration rate for the control was 33.8% (289/897); experimental phase 7.88% (61/769); DMV registration 21.02% (1902/9050). The intervention was associated with a significant decrease in registrations (OR 0.181 (95% CI 0.135-0.244, P < 0.001)). Offices were clustered based on sociodemographic factors and regressed in 2 clusters. Lower educational attainment was associated with lower registration in the first but not second cluster (OR = 0.948 (0.923-0.974, P < 0.001)). Conclusions: This study provided evidence that PCP offices were a feasible site for organ donor registration and calls into question the efficacy of written materials-only interventions for increasing organ donor RR. It reiterated the negative effect of lower educational attainment on registration and suggested future studies focus on more active methods of engagement.
Ginsenoside Rh2 Ameliorates Neuropathic Pain by inhibition of the miRNA21-TLR8-mitogen-activated protein kinase axis
Authors: Fu Yuan-Yuan , Cen Jian-Ke , Song Hao-Lin , Song Si-Yuan , Zhang Zhi-Jun , Lu Huan-Jun
Published: August 2022

Ginsenoside Rh2 is one of the major bioactive ginsenosides in Panax ginseng. Although Rh2 is known to enhance immune cells activity for treatment of cancer, its anti-inflammatory and neuroprotective effects have yet to be determined. In this study, we investigated the effects of Rh2 on spared nerve injury (SNI)-induced neuropathic pain and elucidated the potential mechanisms. We found that various doses of Rh2 intrathecal injection dose-dependently attenuated SNI-induced mechanical allodynia and thermal hyperalgesia. Rh2 also inhibited microglia and astrocyte activation in the spinal cord of a murine SNI model. Rh2 treatment inhibited SNI-induced increase of proinflammatory cytokines, including tumor necrosis factor-α, interleukin (IL)-1 and IL-6. Expression of miRNA-21, an endogenous ligand of Toll like receptor (TLR)8 was also decreased. Rh2 treatment blocked the mitogen-activated protein kinase (MAPK) signaling pathway by inhibiting of phosphorylated extracellular signal-regulated kinase expression. Finally, intrathecal injection of TLR8 agonist VTX-2337 reversed the analgesic effect of Rh2. These results indicated that Rh2 relieved SNI-induced neuropathic pain via inhibiting the miRNA-21-TLR8-MAPK signaling pathway, thus providing a potential application of Rh2 in pain therapy.
Rectal bleeding
Authors: Bonner Clare , Pickering George A E
Published: August 2022

This article aims to cover the presentation and management of rectal bleeding in adults, in sufficient breadth and depth for the GP trainee, recently qualified GPs, GP trainers and other allied health professionals consulting with patients in primary care. Rectal bleeding is a common reason for patients to consult their GP, urgent care centre or emergency department. The aetiology and variable presentations can pose a significant challenge to the primary care clinician. We hope this article will refresh background understanding and guide the assessment and management of these patients.
Tranexamic Acid Administration at Hospital Admission Decreases Transfusion Rates in Geriatric Hip Fracture Patients Undergoing Surgery
Authors: Moran Jay , Kahan Joseph B. , Morris Jensa , Joo Peter Y. , O’Connor Mary I.
Published: August 2022

Introduction

The timing of tranexamic acid (TXA) administration in fragility hip fracture patients is controversial. Prior studies have demonstrated reduction in transfusion requirements using the two-dose arthroplasty model. However, unlike arthroplasty patients whose bleeding starts at the time of surgical incision, hip fractures have an onset of bleeding at the time of the injury. The primary goal of this study was to evaluate the optimal timing of TXA administration and to determine its effect on red blood cell transfusions in fragility hip fracture patients.

Methods

All patients admitted to the fragility hip fracture service from April 1, 2019 to September 30, 2019 were prospectively screened for inclusion in the study. Eligible patients received 4 intravenous doses of TXA: Ineligible patients received no TXA. Patients with medical conditions precluding the use of TXA were deemed ineligible: allergy to TXA; creatinine clearance <30 mL/min; active malignancy; vascular event in the past year; anticoagulant use; fracture >48 hours prior to presentation. A subset of patients received only admission TXA dosing and a separate subset of patients received only incision and post op TXA dosing. Red blood cell transfusions, major adverse vascular events, and minor drug and infusion-related adverse events were recorded for all subgroups of patients.

Results

A total of 508 patients were eligible for analysis. In total, 180 patients received no TXA, 32 patients only received the admission doses of TXA, 112 patients received only the arthroplasty based (incision and post op) doses of TXA, and 183 patients received all 4 doses of TXA. The transfusion rate was significantly lower in patients who received all 4 doses of TXA (8.7%) and in those who only received one dose of TXA at admission (9.4%) compared to patients who received TXA at incision and recovery room (25.7%) or those patients who did not receive TXA prophylaxis (29.4%) (P = 0.001). Additionally, the transfusion rate for intramedullary nailing was higher compared to patients undergoing any other procedure (27% vs 13.8%, P < 0.001).

Conclusions

Patients with fragility hip fractures who received IV TXA at hospital admission have significantly lower transfusion rates compared to those who received no tranexamic acid or those who received two dose-TXA (at the operative incision and in the post-operative recovery room). These findings suggest that isolated dosing of TXA at hospital admission may be more effective at reducing post-operative bleeding than the traditional arthroplasty dosing (incision and post-op doses) and is equally as effective as the 4-dose TXA protocol in hip fracture patients undergoing surgery.
Risk Factors for 30-day Unplanned Readmission following Surgery for Lumbar Degenerative Diseases: A Systematic Review
Authors: Chen Liang-Yi , Chang Yu , Wong Chia-En , Chi Kuan-Yu , Lee Jung-Shun , Huang Chi-Chen , Lee Po-Hsuan
Published: August 2022

Study design

Systematic review.

Objectives

Surgical procedures for lumbar degenerative diseases (LDD), which have emerged in the 21-century, are commonly practiced worldwide. Regarding financial burdens and health costs, readmissions within 30days following surgery are inconvenient. We performed a systematic review to integrate real-world evidence and report the current risk factors associated with 30-day readmission following surgery for LDD.

Methods

The Cochrane Library, Embase, and Medline electronic databases were searched from inception to April 2022 to identify relevant studies reporting risk factors for 30-day readmission following surgery for LDD.

Results

Thirty-six studies were included in the review. Potential risk factors were identified in the included studies that reported multivariate analysis results, including age, race, obesity, higher American Society of Anesthesiologists score, anemia, bleeding disorder, chronic pulmonary disease, heart failure, dependent status, depression, diabetes, frailty, malnutrition, chronic steroid use, surgeries with anterior approach, multilevel spinal surgeries, perioperative transfusion, presence of postoperative complications, prolonged operative time, and prolonged length of stay.

Conclusions

There are several potential perioperative risk factors associated with unplanned readmission following surgery for LDD. Preoperatively identifying patients that are at increased risk of readmission is critical for achieving the best possible outcomes.
Association of Craniocervical Sagittal Alignment With the Outcomes of Cervical Disc Replacement
Authors: Shen Yi-Wei , Yang Yi , Hong Ying , Ding Chen , Rong Xin , Meng Yang , Wang Bei-Yu , Wu Ting-Kui , Liu Hao
Published: August 2022

Study Design

Retrospective cohort study.

Objective

To explore the association between craniocervical sagittal balance and clinical and radiological outcomes of cervical disc replacement (CDR).

Methods

Patients who underwent 1-level and 2-level CDR were retrospectively analyzed. Clinical outcomes were evaluated using scores on the Japanese Orthopaedic Association (JOA), Visual Analogue Scale (VAS), and Neck Disability Index (NDI). The craniocervical sagittal alignment parameters, including the C0-C2 Cobb angle, C2-C7 Cobb angle, C2 slope, T1 slope, C2-C7 sagittal vertical axis (SVA), C1-C7 SVA, the center of gravity of the head (CGH)-C7 SVA, and range of motion (ROM) at the surgical segments were measured.

Results

A total of 169 patients were involved. Significantly lower pre- and postoperative C2 slope and CGH-C7 SVA were found in arthroplasty levels with better ROMs. Patients with a higher preoperative C2 slope and CGH-C7 SVA had lower cervical lordosis and ROM after surgery. There were no significant differences in the clinical outcomes between patients with different sagittal balance statuses. C2-C7 SVA and CGH-C7 SVA were significantly associated with radiographic adjacent segment pathology (rASP).

Conclusion

Craniocervical sagittal balance is associated with cervical lordosis and ROM at the index level after CDR. A higher preoperative SVA is related to the presence and progression of rASP. A relationship between sagittal alignment and clinical outcomes was not observed.
Placebo response with subcutaneous injections in calcitonin gene-related peptide receptor monoclonal antibody migraine preventative trials – A systematic review and meta-analysis
Authors: Gorantla Sasikanth , Gopireddy Murali Mohan Reddy , Bhat Archana , Ayyasamy Lavanya , Jaishankar Sarath Kumar Jaganathan , Kherallah Bassil , Nersesyan Hrachya
Published: August 2022

Background:

The majority of CGRP monoclonal antibodies for migraine prevention are administered subcutaneously. Therefore, we attempted to calculate the pooled placebo response with subcutaneous placebo injections in this systematic review and meta-analysis.

Methods:

We identified 16 randomized controlled trials that met our inclusion and exclusion criteria through a comprehensive search in five electronic databases (PubMed Central, EMBASE, MEDLINE, Cochrane library and clinicaltrials.gov ). The risk of bias was assessed for all included studies. Random effects model was used to calculate pooled mean monthly migraine days and 50% response rates.

Results:

A total of 4240 subjects were included from 16 studies in this meta-analysis. The pooled mean monthly migraine day reduction with subcutaneous placebo injections was 2.15 (95% CI: 1.60–2.69). The pooled proportion of patients achieving a 50% reduction in mean monthly headache days was 26% (95% CI: 20%–31%). Placebo response accounted for more than 50% of therapeutic gain in our study.

Conclusion:

A substantial placebo response was noted with subcutaneous injections in migraine CGRP monoclonal antibody clinical trials. This meta-analysis may serve as a reference point to calculate sample size in clinical trials using subcutaneous interventions for migraine prevention. We registered our study at PROSPERO (CRD42020185300).
Sotatercept for the treatment of pulmonary arterial hypertension: PULSAR open-label extension
Authors: Humbert Marc , McLaughlin Vallerie , Gibbs J. Simon R. , Gomberg-Maitland Mardi , Hoeper Marius M. , Preston Ioana R. , Souza Rogerio , Waxman Aaron B. , Ghofrani Hossein-Ardeschir , Escribano Subias Pilar , Feldman Jeremy , Meyer Gisela , Montani David , Olsson Karen M. , Manimaran Solaiappan , de Oliveira Pena Janethe , Badesch David B.
Published: August 2022

Background

In participants with pulmonary arterial hypertension, 24 weeks of sotatercept resulted in a significantly greater reduction from baseline in pulmonary vascular resistance than placebo. This report characterises the longer-term safety and efficacy of sotatercept in the PULSAR open-label extension. We report cumulative safety, and efficacy at months 18–24, for all participants treated with sotatercept.

Methods

PULSAR was a phase 2, randomised, double-blind, placebo-controlled study followed by an open-label extension, which evaluated sotatercept on top of background pulmonary arterial hypertension therapy in adults. Participants originally randomised to placebo were re-randomised 1:1 to sotatercept 0.3 or 0.7 mg·kg−1(placebo-crossed group); those initially randomised to sotatercept continued the same sotatercept dose (continued-sotatercept group). Safety was evaluated in all participants who received ≥1 dose of sotatercept. The primary efficacy endpoint was change from baseline to months 18–24 in pulmonary vascular resistance. Secondary endpoints included 6-min walk distance and functional class. Two prespecified analyses, placebo-crossed and delayed-start, evaluated efficacy irrespective of dose.

Results

Of 106 participants enrolled in the PULSAR study, 97 continued into the extension period. Serious treatment-emergent adverse events were reported in 32 (30.8%) participants; 10 (9.6%) reported treatment-emergent adverse events leading to study discontinuation. Three (2.9%) participants died, none considered related to study drug. The placebo-crossed group demonstrated significant improvement across primary and secondary endpoints and clinical efficacy was maintained in the continued-sotatercept group.

Conclusion

These results support the longer-term safety and durability of clinical benefit of sotatercept for pulmonary arterial hypertension.
Nintedanib in children and adolescents with fibrosing interstitial lung diseases
Authors: Deterding Robin , Young Lisa R. , DeBoer Emily M. , Warburton David , Cunningham Steven , Schwerk Nicolaus , Flaherty Kevin R. , Brown Kevin K. , Dumistracel Mihaela , Erhardt Elvira , Bertulis Julia , Gahlemann Martina , Stowasser Susanne , Griese Matthias
Published: August 2022

Background

Childhood interstitial lung disease (ILD) comprises a spectrum of rare ILDs affecting infants, children and adolescents. Nintedanib is a licensed treatment for pulmonary fibrosis in adults. The primary objectives of the InPedILD trial were to determine the dose-exposure and safety of nintedanib in children and adolescents with fibrosing ILD.

Methods

Patients aged 6–17 years with fibrosing ILD on high-resolution computed tomography and clinically significant disease were randomised 2:1 to receive nintedanib or placebo for 24 weeks and then open-label nintedanib. Dosing was based on weight-dependent allometric scaling. Co-primary end-points were the area under the plasma concentration–time curve at steady state (AUCτ,ss) at weeks 2 and 26 and the proportion of patients with treatment-emergent adverse events at week 24.

Results

26 patients received nintedanib and 13 patients received placebo. The geometric mean (geometric coefficient of variation) AUCτ,ssfor nintedanib was 175 µg·h·L−1(85.1%) in patients aged 6–11 years and 167 µg·h·L−1(83.6%) in patients aged 12–17 years. In the double-blind period, adverse events were reported in 84.6% of patients in each treatment group. Two patients discontinued nintedanib due to adverse events. Diarrhoea was reported in 38.5% and 15.4% of the nintedanib and placebo groups, respectively. Adjusted mean±sechanges in percentage predicted forced vital capacity at week 24 were 0.3±1.3% in the nintedanib group and −0.9±1.8% in the placebo group.

Conclusions

In children and adolescents with fibrosing ILD, a weight-based dosing regimen resulted in exposure to nintedanib similar to adults and an acceptable safety profile. These data provide a scientific basis for the use of nintedanib in this patient population.
Family doctors’ attitudes toward peer support programs for type 2 diabetes and/or coronary artery disease: an exploratory survey among German practitioners
Authors: Majjouti K. , Küppers L. , Thielmann A. , Redaélli M. , Vitinius F. , Funke C. , van der Arend I. , Pilic L. , Hessbrügge M. , Stock S. , Weltermann B. , Wild D.
Published: August 2022

Background

Type 2 diabetes (T2D) and coronary artery disease (CAD) are chronic illnesses where adherence to a healthy lifestyle is crucial. If organisational and cultural factors are well managed, Peer support programs (PSP) can improve self-management, quality of life, and health outcomes. In preparation for launching a PSP, we surveyed family doctors (FD) about their attitudes toward such a program and about potential barriers, and facilitators.

Methods

In March 2020 we surveyed 896 FDs from five university teaching practice networks in North-Rhine Westphalia, Germany, via an anonymous web-based survey. The questionnaire addressed details of PSPs, including suitable patients and FDs‘role. Data were analysed using descriptive and inferential statistics; qualitative material underwent content analysis by two researchers.

Results

A total of 165 FDs responded (response rate: 18.4%), 97% were practice owners. Respondents viewed PSPs positively (T2D: 92.0%, CAD 89.9%), especially for patients with poor self-structuring (82.7%), low motivation (76.3%) and few social contacts (67.6%). On average, FDs were able to identify 4.0 ± 3.2 patients as potential group leaders. Major facilitators reported included motivation by peers (92.5%), exercise (79.1%), and social contacts (70.1%). Waning interest over time (73.1%) and poor motivation (70.9%) were considered barriers. The majority of FDs would recommend PSPs to their patients (89.5%). They considered such a program a valuable addition to current care (79.7%). The percentage of FDs’ who expected long-term benefits for their workload was relatively low (37.6%).

Conclusions

In an exploratory survey among German FDs on PSPs, respondents viewed PSPs as a valuable add-on for T2D and CAD patients, while not expecting a positive impact on their workload. Communication with FDs on PSPs may need to highlight anticipated implementation outcomes such as benefits of PSPs to the practice.
Medication risks in older patients (70 +) with cancer and their association with therapy-related toxicity
Authors: Ortland Imke , Mendel Ott Monique , Kowar Michael , Sippel Christoph , Ko Yon-Dschun , Jacobs Andreas H. , Jaehde Ulrich
Published: August 2022

Background

To evaluate medication-related risks in older patients with cancer and their association with severe toxicity during antineoplastic therapy.

Methods

This is a secondary analysis of two prospective, single-center observational studies which included patients ≥ 70 years with cancer. The patients’ medication lists were investigated regarding possible risks: polymedication (defined as the use of ≥ 5 drugs), potentially inappropriate medication (PIM), and relevant potential drug-drug interactions (rPDDI). The risks were analyzed before and after start of cancer therapy. Severe toxicity during antineoplastic therapy was captured from medical records according to the Common Terminology Criteria for Adverse Events (CTCAE). The association between grade ≥ 3 toxicity and medication risks was evaluated by univariate as well as multivariate regression adjusted by ECOG and age.

Results

The study cohort comprised 136 patients (50% female, mean age 77 years, 42% hematological malignancies). Before the start of cancer therapy, patients took on average 5 drugs as long-term medication and 52% of patients were exposed to polymedication. More than half of patients used at least one PIM. Approximately one third of patients exhibited rPDDI. The prevalence of medication risks increased after start of cancer therapy. rPDDI were significantly associated with severe overall toxicity (OR, 5.07; p = 0.036; 95% Confidence Interval (CI) 1.11–23.14; toxicity in patients with rPDDI 94.1% (32/34) vs 75.9% (60/79) in patients without rPDDI) and hematological toxicity (OR, 3.95; p = 0.010; 95% CI 1.38–11.29; hematological toxicity in patients with rPDDI 85.3% (29/34) vs 59.5% (47/79) in patients without rPDDI). In the multivariate analysis adjusted by ECOG and age, only the association for rPDDI with hematological toxicity remained statistically significant (OR, 4.51; p = 0.007; 95% CI 1.52–13.38). These findings should be further investigated in larger studies.

Conclusion

Medication risks are common in older patients with cancer and might be associated with toxicity. This raises the need for tailored interventions to ensure medication safety in this patient cohort.
Prevalence and management of dysphagia in nursing home residents in Europe and Israel: the SHELTER Project
Authors: Dell’Aquila Giuseppina , Peladic Nikolina Jukic , Nunziata Vanessa , Fedecostante Massimiliano , Salvi Fabio , Carrieri Barbara , Liperoti Rosa , Carfì Angelo , Eusebi Paolo , Onder Graziano , Orlandoni Paolo , Cherubini Antonio
Published: August 2022

Background

Dysphagia is a frequent condition in older nursing home residents (NHRs) which may cause malnutrition and death. Nevertheless, its prevalence is still underestimated and there is still debate about the appropriateness and efficacy of artificial nutrition (AN) in subjects with severe dysphagia. The aim is to assess the prevalence of dysphagia in European and Israeli NHRs, its association with mortality, and the relationship of different nutritional interventions, i.e. texture modified diets and AN—with weight loss and mortality.

Methods

A prospective observational study of 3451 European and Israeli NHRs older than 65 years, participating in the SHELTER study from 2009 to 2011, at baseline and after 12 months. All residents underwent a standardized comprehensive evaluation using the interRAI Long Term Care Facility (LTCF). Cognitive status was assessed using the Cognitive Performance Scale (CPS), functional status using Activities of Daily Living (ADL) Hierarchy scale. Trained staff assessed dysphagia at baseline by clinical observation. Data on weight loss were collected for all participants at baseline and after 12 months. Deaths were registered by NH staff.

Results

The prevalence of dysphagia was 30.3%. During the one-year follow-up, the mortality rate in subjects with dysphagia was significantly higher compared with that of non-dysphagic subjects (31.3% vs 17.0%,p = 0,001). The multivariate analysis showed that NHRs with dysphagia had 58.0% higher risk of death within 1 year compared with non-dysphagic subjects (OR 1.58, 95% CI, 1.31–1.91). The majority of NHRs with dysphagia were prescribed texture modified diets (90.6%), while AN was used in less than 10% of subjects. No statistically significant difference was found concerning weight loss and mortality after 12 months following the two different nutritional treatments.

Conclusions

Dysphagia is prevalent among NHRs and it is associated with increased mortality, independent of the nutritional intervention used. Noticeably, after 12 months of nutritional intervention, NHRs treated with AN had similar mortality and weight loss compared to those who were treated with texture modified diets, despite the clinical conditions of patients on AN were more compromised.
Diagnostic model based on bioinformatics and machine learning to distinguish Kawasaki disease using multiple datasets
Authors: Zhang Mengyi , Ke Bocuo , Zhuo Huichuan , Guo Binhan
Published: August 2022

Background

Kawasaki disease (KD), characterized by systemic vasculitis, is the leading cause of acquired heart disease in children. Herein, we developed a diagnostic model, with some prognosis ability, to help distinguish children with KD.

Methods

Gene expression datasets were downloaded from Gene Expression Omnibus (GEO), and gene sets with a potential pathogenic mechanism in KD were identified using differential expressed gene (DEG) screening, pathway enrichment analysis, random forest (RF) screening, and artificial neural network (ANN) construction.

Results

We extracted 2,017 DEGs (1,130 with upregulated and 887 with downregulated expression) from GEO. The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses showed that the DEGs were significantly enriched in innate/adaptive immune response-related processes. Subsequently, the results of weighted gene co-expression network analysis and DEG screening were combined and, using RF and ANN, a model with eight genes (VPS9D1, CACNA1E, SH3GLB1, RAB32, ADM, GYG1, PGS1, and HIST2H2AC) was constructed. Classification results of the new model for KD diagnosis showed excellent performance for different datasets, including those of patients with KD, convalescents, and healthy individuals, with area under the curve values of 1, 0.945, and 0.95, respectively.

Conclusions

We used machine learning methods to construct and validate a diagnostic model using multiple bioinformatic datasets, and identified molecules expected to serve as new biomarkers for or therapeutic targets in KD.