bluuebunny/crossref_metadata_2025 huggingface dataset:
A Search for the Heart of Teacher Education Through Curriculum
Authors: Koerner Mari
Published: December 2020

Most of the millions of teachers in public and private schools have gone through teacher preparation programs. Preparing a person to teach is a centrally important, complicated, and many-layered process that carries deep responsibilities for the people who prepare those teachers, namely, teacher educators. So, it is not surprising that, even in the face of over 1,400 research studies about its effectiveness, there are still ongoing debates about the impact of teacher preparation on teachers in classrooms. It is not uncommon to see claims that teacher preparation is vitally important and, at the same time, claims that teacher preparation makes little difference. Because of myriad philosophies and varied desired outcomes, experts who design the pedagogy and content have varying touchstones for excellence that are put into programs along with variation in courses, admission, and degree requirements. How is it possible to get to the “heart” of preparing knowledgeable and caring teachers? There seems to be no one curriculum for the thousands of people entering the classrooms across America, so how can educators design and implement the methods that will best serve students in classrooms all across the country? Many underlying philosophies and values, as well as research, steer this enterprise—which leads to more confusion and angst. There has always been the quest for a “one shoe fits all” model for definitive curriculum, so epochs in teacher preparation can be traced back to when ideas and practices shifted. Other, varied sources contribute to the implementation and goals of teacher education: state and federal governments, education college research faculty, and local Boards of Education. The necessary professional credentials should be a factor (and ideally the same in all states), but ways to obtain teaching credentials are currently multiplying as alternative pathways are being created at a rapid pace. Then, there is the central question: Who is speaking for the welfare of the children in a united voice? Certainly, everyone in this endeavor should never forget that the purpose of a free and public education, both in the United States and other countries, is to create a literate population who can support and sustain a democracy. The ongoing quest is to discover what constitutes the heart of teacher preparation.
Maroon Societies in the Americas
Authors: Price Richard
Published: December 2020

Communities formed by Maroons—self-liberated enslaved Africans and their descendants—dotted the fringes of plantation America, from Brazil to Florida, from Peru to Texas. Maroon communities, called palenques in the Spanish colonies and mocambos or quilombos in Brazil, ranged from tiny bands that survived less than a year to powerful states encompassing thousands of members that lasted for generations or, in some cases, centuries. Marronage represented a major form of slave resistance, whether accomplished by lone individuals, by small groups, or in great collective rebellions. Throughout the Americas, Maroon communities stood out as a heroic challenge to white authority, as the living proof of the existence of a slave consciousness that refused to be limited by the whites’ conception or manipulation of it.

In the 2020s, Maroons still form semi-independent communities in several parts of the Americas, for example, in Suriname, French Guiana, Jamaica, Belize, Colombia, and Brazil. As the most isolated of Afro-Americans (the descendants of enslaved Africans brought to the Americas), they have since the 1920s been an important focus of scientific research, contributing to theoretical debates about resistance to slavery, the heritage of Africa in the Americas, the process of creolization, and the nature of historical knowledge among nonliterate peoples.
Quantum Quench and Universal Scaling
Authors: Das Sumit R.
Published: December 2020

A quantum quench is a process in which a parameter of a many-body system or quantum field theory is changed in time, taking an initial stationary state into a complicated excited state. Traditionally “quench” refers to a process where this time dependence is fast compared to all scales in the problem. However in recent years the terminology has been generalized to include smooth changes that are slow compared to initial scales in the problem, but become fast compared to the physical scales at some later time, leading to a breakdown of adiabatic evolution. Quantum quench has been recently used as a theoretical tool to study many aspects of nonequilibrium physics like thermalization and universal aspects of critical dynamics. Relatively recent experiments in cold atom systems have implemented such quench protocols, which explore dynamical passages through critical points, and study in detail the process of relaxation to a steady state. On the other hand, quenches which remain adiabatic have been explored as a useful technique in quantum computation.
Implantation of three transcatheter aortic valves for embolization of two valves caused by under-expansion: a case report
Authors: Tsuda Masaki , Shutta Ryu , Nishino Masami , Tanouchi Jun
Published: December 2020

Background

Transcatheter aortic valve embolization is one of the serious complications of transcatheter aortic valve implantation (TAVI). We present a case of TAVI that needed implantation of three transcatheter aortic valves owing to the embolization of two self-expandable valves (SEVs).

Case summary

An 88-year-old woman underwent TAVI using a 26-mm SEV. After valve deployment, the SEV embolized to the ascending aorta during the removal of the delivery system (DS) of the SEV (DS-SEV) from the SEV. An additional SEV was implanted, which also embolized upwards. Multi-directional fluoroscopy revealed extreme under-expansion of the second SEV, which caused valve embolization due to catching of the DS-SEVs in the SEVs. Finally, a 23-mm balloon-expandable valve was successfully implanted, which was also under expanded on fluoroscopic assessment. The patient was stable without sequelae at the 1-month follow-up.

Discussion

Pre-procedurally predicting SEV under-expansions was difficult because pre-procedural computed tomography revealed no massive calcification on the aortic valve, and fluoroscopy indicated adequate expansion of the SEVs at the angle where the valves were deployed. We verified the possibility of catching of a DS-SEV in an under-expanded SEV in an in vitro test, which showed that the DS-SEV was caught in the extremely under-expanded SEV. Furthermore, balloon dilation might release the catch of the DS-SEV by changing the DS-SEV position. Therefore, we recommend performing multi-directional fluoroscopy to evaluate SEV expansion before DS-SEV removal from an SEV. Furthermore, if catching of a DS-SEV occurs, balloon dilation might be useful for releasing the catch and safely removing the DS-SEV.
Isolated right ventricular metastasis of hepatocellular carcinoma induced by epithelial–mesenchymal transition: a case report
Authors: Saku Kosuke , Tahara Nobuhiro , Fukumoto Yoshihiro , Tanaka Hiroyuki
Published: December 2020

Background

Hepatocellular carcinoma (HCC) that metastasizes to the right ventricle has rarely been reported. An important link between epithelial–mesenchymal transition (EMT) and the invasion and metastasis of cancer cells has recently been demonstrated. However, there are few reports on the relationship between HCC metastasized to the heart and EMT.

Case summary

We here report the case of a 74-year-old woman who had type C HCC referred to our hospital with general fatigue due to a right ventricular tumour diagnosed at a general hospital. Anticoagulation therapy was done, but the mass had rapidly grown. We performed surgical resection of the mass. Histopathological examination revealed that the tumour was diagnosed as a poorly differentiated HCC metastasis induced by EMT.

Discussion

Isolated metastasis of HCC to the right ventricle is extremely rare. The HCC with EMT has a potentially high risk of metastasizing to the heart and other organs, and the prognosis is poor.
The First Draft Genome of a Cold-Water Coral Trachythela sp. (Alcyonacea: Stolonifera: Clavulariidae)
Authors: Zhou Yang , Feng Chenguang , Pu Yujin , Liu Jun , Liu Ruoyu , Zhang Haibin
Published: December 2020

Cold-water corals (CWCs) are important habitats for creatures in the deep-sea environment, but they have been degraded by anthropogenic activity. So far, no genome for any CWC has been reported. Here, we report a draft genome of Trachythela sp., which represents the first genome of CWCs to date. In total, 56 and 65 Gb of raw reads were generated from Illumina and Nanopore sequencing platforms, respectively. The final assembled genome was 578.26 Mb, which consisted of 396 contigs with a contig N50 of 3.56 Mb, and the genome captured 90.1% of the metazoan Benchmarking Universal Single-Copy Orthologs. We identified 335 Mb (57.88% of the genome) of repetitive elements, which is a higher proportion compared with others in the Cnidarians, along with 35,305 protein-coding genes. We also detected 483 expanded and 51 contracted gene families, and many of them were associated with longevity, ion transposase, heme-binding nicotinamide adenine dinucleotide, and metabolic regulators of transcription. Overall, we believe this genome will serve as an important resource for studies on community protection for CWCs.
Starting Them Young: Introducing High School Students to Community Gerontology
Authors: Getz Marjorie , Morris Sherri
Published: December 2020

The Clinical Research Experience Internship Program (CREST) provides participants with foundations in scientific research appropriate for high school students interested in clinical careers in health-related disciplines (for example, nursing). The overall program goal is to provide research and career experiences to individuals from disadvantaged backgrounds, racial/ethnic minorities, and others who are underrepresented in these fields. The focus of this presentation is that part of the CREST program that has been ongoing since 2013. One program mentor has provided an internship experience to 22 high school students training in and work experience with community-based programs designed to improve health for older adults (identified as ‘community gerontology’). This poster presentation describes some of these experiences (e.g., preparation of caregiver support materials, preparation of nutrition based materials for congregate meal sites for older adults, coaches’ training and program implementation of several evidence-based community programs). Students have worked with older adults in senior housing facilities, supported housing complexes for veterans, and congregate meal sites for older adults. Because of the program experience, the CREST program helps dispel common stereotypes about older adults and encourages students exploring possible clinical career options to consider focusing on older adults as client populations. Program components are described which can allow conference participants to decide on the applicability of this type of programming for their own communities. Qualitative data are presented that provide insights into these experiences as these influence choice of college major and projected career paths and attitudes about working in community-based healthcare with older people.
Now You See Them, Now You Don’t: Age Differences in Risk Aversion
Authors: Sevi Barış , Wilson Jenna , Strough JoNell , Shook Natalie
Published: December 2020

Older age has often, but not always, been associated with greater risk aversion. Some have suggested that age differences in risk may reflect age-related declines in cognitive abilities. This study investigated the robustness of age differences in risk aversion across three different risk-taking measures, after controlling for cognitive abilities. Community-dwelling younger (n = 75; 25-36 years, M age = 29.01) and older (n = 74; 60-90 years, M age = 69.11) adults completed self-report and behavioral measures of risk aversion and several measures of cognitive abilities. Results showed that older adults reported significantly greater risk aversion than young adults on the behavioral measure of risk (Balloon Analogue Risk Task, BART), but not on the self-report measures (Framing Task and Choice Dilemmas Questionnaire). Greater risk aversion on BART was significantly associated with lower analytic thinking, slower processing speed, and worse shifting of attention. Therefore, we tested the relation between age and risk aversion on the BART while controlling for these three cognitive abilities. Age differences in risk aversion remained significant even after accounting for cognitive abilities. Our results suggest that the lack of consistent age differences in risk aversion in the literature may at least partly be due to measurement differences, which raises concerns about the construct validity of these measures of risk aversion. Moreover, cognitive decline may not explain age differences in risk. Further research is needed to understand factors that dampen and heighten risk aversion in people of diverse ages.
ECHO-CT: An Interdisciplinary Video-Conference Model for Identifying Post-Discharge Transition-of-Care Events
Authors: Gonzalez Mariana , Junge-maughan Lauren , Lipsitz Lewis , Moore Amber
Published: December 2020

Introduction: Discharge from the hospital to a post-acute care setting can be complex and potentially dangerous, with opportunities for errors and lapses in communication between providers. Data collected through the Extension for Community Health Outcomes-Care Transitions (ECHO-CT) model were used to identify and classify transitional care events (TCEs.) Methods: The ECHO-CT model employs multidisciplinary teleconferences between a hospital-based team and providers in post-acute settings; during this conference, concerns arising in the patient’s care transition were identified and recorded. Results: 675 patients were discussed during interdisciplinary videoconferences. A total of 139 TCEs were identified; 52 (37.4%) were classified as medication issues, and 58 (41.7%) involved discharge communication or coordination errors. Conclusions: These identified TCEs highlight areas in which providers can work to reduce issues arising in the course of discharge to post-acute facilities. Standardized processes to identify, record, and report transition of care events are necessary to provide high-quality, safe care for patients as they move across care settings.
CpG Methylation in Aging: Trajectories of Individual Sites
Authors: Meer Margarita , Levine Morgan
Published: December 2020

Age-related changes in methylation in a set of genomic CpGs have been shown to form a kind of molecular clocks of aging – DNA methylation (DNAm) clocks. These markers are usually based on a small set of CpGs in every case, but 1) they rarely overlap between different clocks and 2) they are interchangeable, meaning that one can remove all clock sites from a data set and make a new clock of similar precision selecting a new set from the remaining sites. Nonetheless, only a fraction of CpG sites would be suitable for DNAm clocks. We performed an extensive analysis of all CpG sites aging behavior. Previous studies were focused on identifying positions where changes in DNAm correlate with age, but in this case, some of CpGs where DNAm changes occur in a non-linear way can be overlooked. We assessed the aging trajectory of every CpG, clustered CpGs by the type of aging behavior and applied a machine learning approach to construct a new kind of DNAm clocks based on the DNAm of these clusters. Since every cluster is composed of multiple CpGs, it makes this marker resistant to a common problem of missing data. Using blood, brain, skin, colon and liver samples we were also able to investigate tissue specificity of CpGs trajectories.
Dementia Diagnosis and Challenges in Minority Populations
Authors: Amjad Halima , Blinka Marcela , Aufill Jennifer , Samus Quincy
Published: December 2020

Alzheimer’s disease and related dementias are underdiagnosed in the United States, with potentially higher rates of underdiagnosis among minority groups. Our objective was to examine perceptions of dementia, the utility and timeliness of diagnosis, and experiences obtaining diagnosis and care in minorities. We recruited 17 family caregivers of African American (n=11), Latino (n=3), and Asian (n=3) persons with dementia (PWD) to complete surveys and semi-structured interviews. Caregivers were mostly female (n=14), children of PWD (n=14), and had greater than high school education (n=16). Mean PWD age at diagnosis was 76 years (range 63-90) with mean 17 months from symptom observation to diagnosis (range 0.5-36 months). Interview themes were coded using a grounded theory approach. Emerging themes related to concerns prior to diagnosis, diagnosis experiences, timeliness of diagnosis, ways to improve diagnosis and care, familiarity with dementia, and stigma. Poor memory was the most common early concern; caregivers also noted behavioral symptoms, weight loss, family stress, and PWD vulnerability. Caregivers recalled key moments when they knew something was wrong. Primary care was the most frequent starting point in diagnosis; longstanding primary care relationships both facilitated and hindered diagnosis. Nine of the 17 caregivers felt diagnosis was delayed. Caregivers preferred clinicians who were forthcoming with the diagnosis and what to expect and noted the importance of family meetings or counseling. Prior experience or knowledge of dementia was common. Caregiver perspectives and experiences elicited in this study may be translated to interventions and clinical practices that proactively detect and address dementia in minorities.
Engaging Older Minority Adults in a Smartphone-Based Ecological Momentary Assessment Study of Sedentary Behavior
Authors: Kennedy-Malone Laurie , Hevel Derek , Sappenfield Kourtney , Scheer Heidi , Zecca Christine , Maher Jaclyn
Published: December 2020

Minority older adults engage in excessive levels of sedentary behavior (i.e., sitting). Smartphone-based ecological momentary assessment (EMA) methods can provide novel insights into the modeling and prediction of activity-related behaviors. Yet, minority groups report barriers to participating in mobile health research (e.g., distrust, lack of interest, underrepresentation in research). This abstract reports on strategies used to recruit minority older adults and acceptability of an 8-day smartphone-based sedentary behavior EMA study in this population. Researchers partnered with existing community organizations servicing the target population (i.e., independent living communities, congregate meals sites, and churches) and trusted individuals within these organizations to facilitate introduction of the research team/study. In total, 123 older minority adults were recruited, 102 met inclusion criteria and 91 completed the study. During the study, participants answered 6 electronic EMA questionnaires/day and wore an ActivPAL activity monitor continuously. Participants received one-on-one training on these procedures and received check-in calls to monitor progress. Open-ended questions administered at the end of the study revealed the most enjoyable aspects of the study were the ability to learn more about themselves, contributing to science and/or their community, engaging in a new activity followed by receiving financial compensation and having someone checking on their progress. Least enjoyable aspects of the study included frequency of EMA questionnaires, apprehension of missing EMA questionnaires, carrying the smartphone, and difficulty wearing the activity monitor. Almost all participants (95%) expressed interest being contacted for future studies. Implications for future technology-based research regarding minority older adults’ activity-related behaviors will be discussed.
Productive Aging and Work: Overcoming Barriers to Creating Age-Friendly Workplaces Among Older Workers in Nigeria
Authors: Omobowale Olubukola
Published: December 2020

Due to global demographic shifts, the issue of older workers’ health and productive aging is becoming much more pressing and Nigeria, the most populous country in Africa is not left behind. Productive aging involves providing a safe and healthy work environment for everyone using strategies that allow workers to function optimally at all ages, hence this study assessed the barriers to creating age friendly workplaces among older workers in Nigeria. A community based study was conducted among workers in Federal Government establishments aged 60 years and above. Using a Focus Group Discussion guide and an adapted checklist on age friendly workplaces, 16 strategic domains affecting older workers’ health and age friendly workplaces were explored. Data were analyzed thematically. A total of 150 older workers aged between 60-70 years were sampled. There is no formal older worker’s health initiative in all the establishments. Only two, of the sixteen domains checked were present. Other domains remain largely neglected by the management. Barriers to age-friendly workplaces include poor knowledge of the strategies, lack of political will and ageism. The concept of older workers’ health is a strange phenomenon among the respondents. Organizations need to invest in developing a robust package to help older workers use their skills and create age friendly workplaces that ensure safety, health and well-being of older workers, from their first day on the job to their last. Government policies targeted at productive aging and work should be put in place in order to create age-friendly workplaces for older workers.
Associations Between Cognitive Function, Balance, and Mobility in Community-Dwelling Older Adults With COPD
Authors: Gore Shweta , Blackwood Jennifer , Ziccardi Tyler
Published: December 2020

Older adults with chronic obstructive pulmonary disease (COPD) are at risk for physical and cognitive impairment. Cognitive function is associated with falls in older adults however it is unknown if a relationship exists between cognitive function and falls in COPD. The aim of this study was to examine the relationships between cognitive function and balance and mobility in older adults with COPD. A secondary analysis was performed using data from the 2010 wave of the Health and Retirement Study (HRS) (N=4051). Cognitive (immediate and delayed recall, executive function) and physical (gait speed, tandem balance time) measure data was extracted from older adults with COPD (N=382) and an age matched control group without COPD (N=382) who met inclusion/exclusion criteria. Multivariate linear regression modeling was performed to examine associations between cognitive function and mobility or balance while controlling for age, gender, BMI, grip strength, and education. We found that in COPD, immediate word recall, delayed word recall, orientation, and executive function (β ranging from 0.004-0.02) were significantly associated with gait speed while only delayed word recall (β = 0.122, p < .05) was associated with tandem balance. These same associations did not exist in those without COPD. In older adults with COPD, cognitive function is associated with balance and mobility. Screening for cognitive function, specifically delayed recall, should be a part of the management of falls in this population.
Understanding Food Consumption Frequencies Among U.S. Chinese Older Adults
Authors: Zheng Shenglin , Kong Dexia , Le Qun , Dong XinQi
Published: December 2020

A healthy diet is essential to various health outcomes that are common among minority aging populations. To explore frequencies and correlates of food consumption among U.S. Chinese older adults, this study used data from the Population-based Study of Chinese Elderly (PINE) collected in Chicago during 2015-2017 (N=3053). Food consumption frequencies of five food groups (vegetables, fruits, grains, protein foods, and dairy) were assessed by a validated 48-item food frequency questionnaire. All responses of consumption frequency were transformed to “times per day” and weighted by reported portion size. The average frequencies of vegetables, grains, and protein foods intake among the U.S. Chinese older adults were 2.02 (SD±1.32), 1.32 (SD±0.70), and 1.58 (SD±0.90) times/day, respectively. Fruits and dairy consumption frequencies were much lower: 0.76 (SD±0.70) and 0.48 (SD±0.53) times/day. In addition, higher levels of education were correlated with higher consumption of all five food groups. Being female was positively correlated with frequencies of fruits and dairy intake. In contrast, poorer life quality and having more children were correlated with less intake of all five food groups. Older age, preference to speak Cantonese/Taishanese compared to Mandarin/English, and poorer health status were also correlated with lower consumption frequencies of fruit and dairy. The study provides important dietary data of U.S. Chinese older adults and sheds light on significant socioeconomic correlates of food consumption. More in-depth investigations are needed to clarify the sociocultural determinants of dietary behavior and how they relate to different health outcomes among the U.S. Chinese population.
Skilled Home Health Care Agency Perspectives on Communication With Physicians: A National Survey
Authors: Norton Jonathan , Nkodo Amelie , Nangunuri Bhavana , Pierotti Danielle , Carl Kimberly , Sheehan Orla , Boyd Cynthia , Leff Bruce
Published: December 2020

BACKGROUND: Communication is important in the care of older adults receiving skilled home health care (SHHC). In a prior national survey, physicians viewed communication and care coordination with SHHC agencies as dismal. The views of SHHC personnel (Registered Nurses, Licensed Practical Nurses, Physical Therapists, Occupational Therapists, and Speech-Language Pathologists) on this issue have not been well studied. OBJECTIVE: To determine the effectiveness of communication between SHHC personnel and physicians who order SHHC services. METHODS: A nationally representative mailed survey of personnel from SHHC agencies identified through the 2016 Home Health Compare data set from the Centers of Medicare and Medicaid Services. RESULTS: 263 of 2000 surveys returned (13.2% response rate). Responding agencies were mainly proprietary (75.3%) and urban-based (83.7%). Most agencies were in the South (38.8%); 28.3% Midwest, 22.9% West, 12.1% Northeast. Only 62.2% of SHHC personnel completing start of care visits (n=202) reported being able to contact a physician when needed. The most common strategies used to contact physicians are phone (76.0%) and fax (11.2%). The greatest barriers to communication are having to communicate through a third party (64.9%) and a perception by SHHC personnel that “Physicians [are] not interested in communicating with SHHC Personnel” (45.1%). Failed communication resulted in delayed orders (70.8%) and sending a patient to the emergency room (37.1%). IMPLICATIONS: SHHC agency personnel experience significant barriers in communicating with physicians. Modes of communication remain rudimentary, and there are serious consequences of failed communication.
Depression and Psychological Well-Being as Distinct Constructs: Mutually Exclusive Associations With Biomarker
Authors: Ng Kheng Siang Ted , Wong Shu Cheng , Wong Glenn , Kua Ee Heok , Larbi Anis , Ho Roger C M
Published: December 2020

Despite increasing emphasis on assessing the mental health of older adults, there has been inconclusive evidence on whether depression and psychological well-being (PWB) are fundamentally distinct constructs or representations of the opposite ends of the mental health spectrum. To instantiate either hypothesis, investigation of the associations between mental health scales and biomarkers have been proposed. First, we assessed depressive symptoms and PWB in community-dwelling older adults (N=59, mean age=67) using the Self-Rating Depression Scale (SDS) and Ryff’s Scale of PWB (comprising six sub-scales). We measured a wide range of immune markers employing ELISA and flow cytometry. Subsequently, we used principal component analysis (PCA) to aggregate and derived biomarker factor scores. Lastly, multiple linear regressions were performed to examine the associations between the scales and the derived biomarker factor scores, controlling for covariates. PCA extracted six biomarker factors. Biomarker factor score 1 was significantly associated with PWB (β=-0.029, p=0.035) and the PWB sub-scale, self-acceptance (β=-0.089, p=0.047), while biomarker factor score 4 was significantly associated with the PWB sub-scale, purpose in life (β=-0.087, p=0.025). On the other hand, biomarker factor 6 was significantly associated with SDS (β=-0.070, p=0.008). There were mutually- exclusive associations between the scales with biomarker factor scores, supporting the hypothesis of distinct constructs. Our findings expanded the biomarkers of depression and PWB, deepening understanding of the biological underpinnings of depressive symptoms and PWB. These findings have implications in field work, since researchers could not infer one construct from the other, the examination of both constructs are essential.
Moving Online: A Pilot Clinical Trial of the Changing Talk Online Communication Education for Nursing Home Staff
Authors: Williams Kristine N , Coleman Carissa K , Perkhounkova Yelena , Beachy Tim , Hein Maria , Shaw Clarissa A , Berkley Amy
Published: December 2020

Background and Objectives

Staff–resident communication is a critical part of nursing home (NH) care. Reducing elderspeak and increasing person-centered communication has been shown to reduce behavioral symptoms experienced by persons living with dementia. An online version of a successful classroom-based communication-training program that reduced staff elderspeak and resident behavioral symptoms was evaluated. The objective of this study was to establish feasibility and determine the preliminary effects of the online program in preparation for a national pragmatic clinical trial.

Research Design and Methods

Seven NHs were randomized to immediate intervention or wait-list control conditions. The NHs were provided with the web-based training program that staff individually accessed. Primary outcomes were knowledge scores and communication ratings of a video-recorded interaction, using pre- to posttraining comparisons.

Results

Knowledge increased from a mean pretest score of 61.9% (SD = 20.0) to a mean posttest score of 84.6% (SD = 13.5) for the combined group. Knowledge significantly improved between Time 1 and Time 2 for the immediate intervention participants (p < .001), but not for the wait-list control participants (p = .091), and this difference was statistically significant (p < .001). Ability to recognize ineffective, inappropriate, nonperson-centered, and elderspeak communication improved after training (p < .001). The magnitude of improvement in communication recognition was comparable to that of the original classroom format.

Discussion and Implications

The adapted communication intervention was feasible and improved knowledge and communication. Online instruction can improve access to quality education and is an effective means to improve dementia care by overcoming barriers to in-person training.

Clinical Trials Registration Number: NCT03849937
Metal homeostasis in pathogenic Epsilonproteobacteria: mechanisms of acquisition, efflux, and regulation
Authors: Kelley Brittni R , Lu Jacky , Haley Kathryn P , Gaddy Jennifer A , Johnson Jeremiah G
Published: December 2020

Epsilonproteobacteria are a diverse class of eubacteria within the Proteobacteria phylum that includes environmental sulfur-reducing bacteria and the human pathogens, Campylobacter jejuni and Helicobacter pylori. These pathogens infect and proliferate within the gastrointestinal tracts of multiple animal hosts, including humans, and cause a variety of disease outcomes. While infection of these hosts provides nutrients for the pathogenic Epsilonproteobacteria, many hosts have evolved a variety of strategies to either sequester metals from the invading pathogen or exploit the toxicity of metals and drive their accumulation as an antimicrobial strategy. As a result, C. jejuni and H. pylori have developed mechanisms to sense changes in metal availability and regulate their physiology in order to respond to either metal limitation or accumulation. In this review, we will discuss the challenges of metal availability at the host–pathogen interface during infection with C. jejuni and H. pylori and describe what is currently known about how these organisms alter their gene expression and/or deploy bacterial virulence factors in response to these environments.
Effects of bisphosphonates on long-term kidney transplantation outcomes
Authors: Song Seung Hwan , Choi Hoon Young , Kim Ha Yan , Nam Chung Mo , Jeong Hyeon Joo , Kim Myoung Soo , Kim Soon I I , Kim Yu Seun , Huh Kyu Ha , Kim Beom Seok
Published: December 2020

Background

Bisphosphonates are administered to post-transplantation patients with mineral and bone disorders; however, the association between bisphosphonate therapy and long-term renal graft survival remains unclear.

Methods

This nested case–control study investigated the effects of bisphosphonates on long-term graft outcomes after kidney transplantation. We enrolled 3836 kidney transplant recipients treated from April 1979 to June 2016 and matched patients with graft failure to those without (controls). Annual post-transplant bone mineral density assessments were performed and recipients with osteopenia or osteoporosis received bisphosphonate therapy. The associations between bisphosphonate use and long-term graft outcomes and graft survival were analyzed using conditional logistic regression and landmark analyses, respectively.

Results

A landmark analysis demonstrated that death-censored graft survival was significantly higher in bisphosphonate users than in non-users in the entire cohort (log-rank test, P < 0.001). In the nested case–control matched cohort, bisphosphonate users had a significantly reduced risk of graft failure than did non-users (odds ratio = 0.38; 95% confidence interval 0.30–0.48). Bisphosphonate use, increased cumulative duration of bisphosphonate use >1 year and increased cumulative bisphosphonate dose above the first quartile were associated with a reduced risk of graft failure, after adjustments.

Conclusions

Bisphosphonates may improve long-term graft survival in kidney transplant recipients.
Les dons de lait humain pasteurisé et non pasteurisé
Authors: Pound Catherine , Unger Sharon , Blair Becky
Published: December 2020

Il est universellement reconnu que le lait humain est la source de nutrition exclusive optimale pour les nouveau-nés de 0 à six mois et qu’il peut faire partie du régime du nourrisson en santé jusqu’à l’âge de deux ans et même après. Malgré les avancées dans le secteur des préparations lactées pour nourrisson, le lait humain apporte tout un éventail d’avantages, en partie grâce à sa matrice bioactive qu’aucune autre source d’alimentation ne peut reproduire. Lorsque la mère produit une quantité de lait insuffisante pour son nouveau-né vulnérable, du lait pasteurisé de donneuses devrait être rendu disponible pour compléter le lait maternel et être le premier choix proposé, suivi des préparations lactées commerciales. La quantité de lait de ce type est limitée au Canada, et sa distribution est priorisée auprès des nouveau-nés malades et hospitalisés. Le partage informel de lait humain consiste à donner et recevoir du lait humain exprimé sans passer par une banque de lait humain. Il comporte un risque de transmission de bactéries et de virus en plus d’être lié à des irrégularités et des incertitudes à l’égard du dépistage des donneuses. Les pédiatres et les autres dispensateurs de soins doivent connaître les risques du partage informel de lait humain et être en mesure de proposer des possibilités plus sécuritaires aux familles.
Are telephone consultations here to stay in rheumatology?
Authors: Raizada Sabrina R , Cleaton Natasha , Bateman James , Mulherin Diarmuid M , Barkham Nick
Published: December 2020

Objectives

During the COVID-19 pandemic, face-to-face rheumatology follow-up appointments were mostly replaced with telephone or virtual consultations in order to protect vulnerable patients. We aimed to investigate the perspectives of rheumatology patients on the use of telephone consultations compared with the traditional face-to-face consultation.

Methods

We carried out a retrospective survey of all rheumatology follow-up patients at the Royal Wolverhampton Trust who had received a telephone consultation from a rheumatology consultant during a 4-week period via an online survey tool.

Results

Surveys were distributed to 1213 patients, of whom 336 (27.7%) responded, and 306 (91.1%) patients completed all components of the survey. Overall, an equal number of patients would prefer telephone clinics or face-to-face consultations for their next routine appointment. When divided by age group, the majority who preferred the telephone clinics were <50 years old [χ2 (d.f. = 3) = 10.075, P = 0.018]. Prevalence of a smartphone was higher among younger patients (<50 years old: 46 of 47, 97.9%) than among older patients (≥50 years old: 209 of 259, 80.7%) [χ2 (d.f. = 3) = 20.919, P < 0.001]. More patients reported that they would prefer a telephone call for urgent advice (168, 54.9%).

Conclusion

Most patients interviewed were happy with their routine face-to-face appointment being switched to a telephone consultation. Of those interviewed, patients >50 years old were less likely than their younger counterparts to want telephone consultations in place of face-to-face appointments. Most patients in our study would prefer a telephone consultation for urgent advice. We must ensure that older patients and those in vulnerable groups who value in-person contact are not excluded. Telephone clinics in some form are here to stay in rheumatology for the foreseeable future.
Venezuela
Authors: Tinker-Salas Miguel
Published: December 2020

Among the top ten oil exporters in the world and a founding member of OPEC, Venezuela currently supplies 11 percent of U.S. crude oil imports. But when the country elected the fiery populist politician Hugo Chavez in 1998, tensions rose with this key trading partner and relations have been strained ever since. In this concise, accessible introduction, Miguel Tinker-Salas--a native of Venezuela who has written extensively about the country--takes a broadly chronological approach to the history of Venezuela, but keeps oil and its effects on the country’s politics, economy, culture, and international relations a central focus. After an introductory section that discusses the legacy of Spanish colonialism, Tinker-Salas explores the “The Era of the Gusher,” a period which began with the discovery of oil in the early 1910s, encompassed the mid-century development and nationalization of the industry, and ended with a change of government in 1989 in response to widespread protests. Tinker-Salas also provides a detailed discussion of Hugo Chavez--his rise to power, his domestic, political and economic policies, and his high-profile forays into international relations. Arranged in helpful question-and-answer format that allows readers to search topics of particular interest, the book covers such questions as: Who is Simón Bolívar and why is he called the George Washington of Latin America? How did the discovery of oil change Venezuela’s relationship to the U.S.? What forces were behind the coups of 1992? Does Chavez really want to be president for life? How does Venezuela interact with China, Russia, and Iran? And much more. Convenient, engaging, and written by a leading expert on the country, Venezuela: What Everyone Needs to Know offers a lively look at an increasingly important player on the world stage.
An incidental finding of Dandy-Walker malformation
Authors: Hochberg Eric , Niles Erin
Published: December 2020

Dandy-Walker malformation is a rare congenital anomaly affecting the posterior fossa, occurring in one in 30,000 births. Its hallmark characteristics include hypoplasia of the vermis, dilation of the fourth ventricle, and an enlarged posterior fossa. This case study describes a finding of Dandy-Walker malformation during a workup of encephalopathy in a patient on veno-venous extracorporeal membrane oxygenation for acute respiratory distress syndrome.
Understanding the most commonly billed diagnoses in primary care
Authors: Rogers Julia , Schallmo Marianne
Published: December 2020

Abdominal pain affects nearly every person at some point in their lifetime. Abdominal pain may be vague or referred, often making the diagnosis elusive and challenging for NPs. This article reviews the pathophysiology of abdominal pain in relation to clinical manifestations, differential diagnoses, and treatment.
ACDF With Total En Bloc Resection of Uncinate in Foraminal Stenosis of the Cervical Spine
Authors: Mella Pierre , Suk Kyung-Soo , Kim HaK-Sun , Lee Hwan-Mo , Moon Seong-Hwan , Park Sang-Jun , Lee Byung-Ho , Shin Jae-Won
Published: December 2020

Study Design:

This was a prospective cohort study.

Objectives:

To find out any differences in clinical outcomes when adding an en bloc total uncinate process resection (TUPR) to conventional anterior cervical discectomy and fusion (ACDF) to relieve an impinged nerve root.

Summary of Background Data:

There has been a long debate on the extent of cervical decompression needed when ACDF is done for patients with foraminal stenosis.

Materials and Methods:

We included 606 patients who underwent ACDF due to foraminal stenosis. Minimum follow-up was 2 years. Patients with a soft disk herniation, myelopathy, anterior-posterior combined surgery or revision surgery were excluded. There were 275 patients (group U) who underwent ACDF with TUPR and 331 patients (group N) who underwent ACDF without TUPR. Clinical outcome measures were neck pain and arm pain, both assessed using Visual Analog Scale (VAS). We also measured Neck Disability Index (NDI) and patient-reported subjective improvement rate (PRSIR) in percentage. These parameters were measured preoperatively, immediately postoperatively, at 6 weeks as well as 3, 6, 9, 12 and 24 months. Statistical analysis was performed using independent sample t test and paired sample t test.

Results:

Preoperative neck and arm pain, and NDI were similar between the 2 groups. All 4 parameters in both groups improved significantly at 6 weeks follow-up and the improved outcomes were maintained up to the 24 month follow-up. There were no significant differences between the 2 groups in overall neck pain VAS, NDI, and PRSIR. There was a significant difference in arm pain VAS statistically all throughout the follow-up period, with group U having lesser arm pain.

Conclusions:

Overall clinical outcomes were significantly improved after the ACDF whether an en bloc uncinate process resection was added or not. However, arm pain VAS was significantly less statistically in the uncinate resection group at all times.
Clinical Outcomes With the Use of Prophylactic Versus Therapeutic Anticoagulation in Coronavirus Disease 2019
Authors: Motta Jishu Kaul , Ogunnaike Rahila O. , Shah Rutvik , Stroever Stephanie , Cedeño Harold V. , Thapa Shyam K. , Chronakos John J. , Jimenez Eric J. , Petrini Joann , Hegde Abhijith
Published: December 2020

Objectives:

To determine the impact of anticoagulation on inhospital mortality among coronavirus disease 2019-positive patients with the a priori hypothesis that there would be a lower risk of inhospital mortality with use of preemptive therapeutic over prophylactic dose enoxaparin or heparin.

Design Setting:

Retrospective cohort study from April 1, 2020, to April 25, 2020. The date of final follow-up was June 12, 2020 Two large, acute-care hospitals in Western Connecticut.

Patients:

Five hundred and one inpatients were identified after discharge as 18 years or older and positive for severe acute respiratory syndrome coronavirus 2. The final sample size included 374 patients after applying exclusion criteria. Demographic variables were collected via hospital billing inquiries, whereas the clinical variables were abstracted from patients’ medical records.

Exposure:

Preemptive enoxaparin or heparin at a therapeutic or prophylactic dose.

Main Results:

When comparing treatments through multivariable analysis, risk of inhospital mortality was 2.3 times greater in patients receiving preemptive therapeutic anticoagulation (95% CI = 1.0–4.9; p = 0.04). Additionally, the average treatment effects were higher (β = 0.11, p = 0.01) in the therapeutic group.

Conclusions:

An increase in inhospital mortality was observed among patients on preemptive therapeutic anticoagulation. Thus, in the management of coronavirus disease 2019 and its complications, we recommend further research and cautious use of preemptive therapeutic over prophylactic anticoagulation.
Tolerability of Nab-Paclitaxel Plus Gemcitabine as Adjuvant Setting in Japanese Patients With Resected Pancreatic Cancer
Authors: Ueno Makoto , Morinaga Soichiro , Hashimoto Yusuke , Umemoto Kumiko , Sasahira Naoki , Saiura Akio , Seyama Yasuji , Honda Goro , Ioka Tatsuya , Takahashi Hidenori , Miyamoto Atsushi , Nakamori Shoji , Unno Michiaki , Takadate Tatsuyuki , Mizuno Nobumasa , Shimizu Yasuhiro , Ueno Hideki , Sugiyama Masanori , Fukutomi Akira , Shimizu Satoshi , Okusaka Takuji , Furuse Junji
Published: December 2020

Objective

The combination of gemcitabine plus nab-paclitaxel (GnP) has not been studied in Japanese patients with resectable pancreatic cancer (PC). This study aimed to assess the tolerability of adjuvant GnP in Japanese patients with resected PC.

Methods

This was a Phase I, open-label, multicenter, single-arm study of patients with resected PC in Japan. Patients received 125 mg/m2 of nab-paclitaxel and 1000 mg/m2 of gemcitabine on days 1, 8, and 15 of a 28-day cycle for a total of 6 cycles. The primary end point was tolerability, defined as the absence of specific grade 3 or higher treatment-related adverse events by the end of cycle 2. Secondary end points included safety, disease-free survival, and overall survival.

Results

Forty-one patients were enrolled between June 2016 and February 2017 (median age, 68 years; 51% male; stage II, 95%). Gemcitabine plus nab-paclitaxel met the tolerability criteria in 39 of the 40 patients included in the tolerability analysis set (97.5%). The most common treatment-related adverse events were leukopenia, neutropenia, alopecia, and peripheral sensory neuropathy. After a follow-up of 30.1 months, median disease-free survival was 17.0 months and median overall survival was not reached.

Conclusions

These results show that adjuvant GnP is tolerable in Japanese patients with resected PC.

Clinical Trial Registration No.: JapicCTI-163179