bluuebunny/crossref_metadata_2025 huggingface dataset:
Venous Thromboembolism Risk and Thromboprophylaxis in Pediatric Neurosurgery and Spinal Injury: Current Trends and Literature Review
Authors: Panagopoulos Dimitrios , Karydakis Ploutarchos , Noutsos Georgios , Themistocleous Marios
Published: October 2021

Although the entities of venous thromboembolism (VTE), deep venous thrombosis, pulmonary embolus, and thromboprophylaxis in adult patients undergoing brain tumor and spine surgery, traumatic brain injury and elective neurosurgical procedures are widely elucidated, the same is not valid when pediatric patients are under consideration. An attempt to review the peculiarities of these patients through a comprehensive bibliographic review is undertaken. We performed a narrative summary of the relevant literature dedicated to pediatric patients, centered on traumatic brain injury, the general incidence of thromboembolic disease in this patient population, the role of low molecular weight heparin (LMWH) in the treatment and prophylaxis of VTE, and its role in elective neurosurgical procedures, including spinal operations. Additionally, the risk of deep venous thrombosis in elective neurosurgical procedures is reviewed. Due to inherent limitations of the current studies, particularly a restricted number of patients, our data are underpowered to give a definitive protocol and guidelines for all the affected patients. Our current conclusions, based only on pediatric patients, argue that there is limited risk of VTE in pediatric patients suffering from brain tumors and that the possibility of VTE is very low in children undergoing elective neurosurgical procedures. There is no consensus regarding the exact incidence of VTE in traumatic brain injury patients. LMWH seems to be a safe and effective choice for the “at risk” pediatric patient population defined as being older than 15 years, venous catheterization, nonaccidental trauma, increased length of hospital stays, orthopaedic (including spinal) surgery, and cranial surgery.
Intraoperative and Postoperative Hemodynamic Predictors of Acute Kidney Injury in Pediatric Heart Transplant Recipients
Authors: Hollander Seth A. , Chung Sukyung , Reddy Sushma , Zook Nina , Yang Jeffrey , Vella Tristan , Navaratnam Manchula , Price Elizabeth , Sutherland Scott M. , Algaze Claudia A.
Published: October 2021

Acute kidney injury (AKI) is common after pediatric heart transplantation (HT) and is associated with inferior patient outcomes. Hemodynamic risk factors for pediatric heart transplant recipients who experience AKI are not well described. We performed a retrospective review of 99 pediatric heart transplant patients at Lucile Packard Children's Hospital Stanford from January 1, 2015, to December 31, 2019, in which clinical and demographic characteristics, intraoperative perfusion data, and hemodynamic measurements in the first 48 postoperative hours were analyzed as risk factors for severe AKI (Kidney Disease: Improving Global Outcomes [KDIGO] stage ≥ 2). Univariate analysis was conducted using Fisher's exact test, Chi-square test, and the Wilcoxon rank-sum test, as appropriate. Multivariable analysis was conducted using logistic regression. Thirty-five patients (35%) experienced severe AKI which was associated with lower intraoperative cardiac index (p = 0.001), higher hematocrit (p < 0.001), lower body temperature (p < 0.001), lower renal near-infrared spectroscopy (p = 0.001), lower postoperative mean arterial blood pressure (MAP: p = 0.001), and higher central venous pressure (CVP; p < 0.001). In multivariable analysis, postoperative CVP >12 mm Hg (odds ratio [OR] = 4.27; 95% confidence interval [CI]: 1.48–12.3, p = 0.007) and MAP <65 mm Hg (OR = 4.9; 95% CI: 1.07–22.5, p = 0.04) were associated with early severe AKI. Children with severe AKI experienced longer ventilator, intensive care, and posttransplant hospital days and inferior survival (p = 0.01). Lower MAP and higher CVP are associated with severe AKI in pediatric HT recipients. Patients, who experienced AKI, experienced increased intensive care unit (ICU) morbidity and inferior survival. These data may guide the development of perioperative renal protective management strategies to reduce AKI incidence and improve patient outcomes.
Patientenzimmer: Intelligenter Schutz vor Keimen
Authors: Lang Michael
Published: October 2021

Um das Infektionsrisiko für Patienten zu senken, hat ein interdisziplinäres Forscherteam ein Patientenzimmer völlig neu gestaltet und mit besonders leicht zu reinigenden Oberflächen ausgestattet.
Strategies for improving performance, lifetime, and stability in light-emitting diodes using liquid medium
Authors: Sadeghi Sadra , Eren Guncem Ozgun , Nizamoglu Sedat
Published: October 2021

The early form of light generation on Earth started with living liquid systems millions of years ago. Recently, artificial light-emissive devices using liquids have started to attract significant research interest for lighting and displays owing to their high-efficiency, flexibility, unique emission recovery, and tuning ability. Light-emitting diodes using liquids have emerged as an interesting and promising scientific and technological route for future lighting and display applications. The two main categories of light-emitting devices include LEDs with active and color conversion layers using liquids. In this review, we first present and discuss a wide variety of fluorophores used in these devices, including colloidal quantum dots, perovskites, fluorescent proteins, and organic compounds. Then, we review the working principle, structure, and fabrication of the organic LED and electrochemiluminescent devices with a liquid active layer, and highlight unconventional designs incorporating, for example, microfluidics, flexibility, and 3D emission tunability. Afterward, we discuss LEDs using a liquid color conversion layer with a special focus on their efficiency progress. Finally, we conclude the review by providing perspectives for the remaining challenges and open opportunities in the field of liquid light-emitting devices.
Hopping conduction in FeSi. I. The Hall, Seebeck, and Nernst effects due to hopping conduction in the top and bottom impurity Hubbard bands
Authors: Kajikawa Yasutomo
Published: October 2021

FeSi is known as a narrow-gap semiconductor showing peculiar temperature dependence of transport properties, which evoked debate for over 50 years. In this study, it is shown that the peculiar temperature dependence of the electrical conductivity σ, the Hall coefficient RH, the Hall mobility μH, the Seebeck coefficient S, and the Nernst coefficient Q of FeSi can be well explained in a model that includes the conduction and the valence band with parabolic dispersions together with the top and bottom impurity Hubbard bands. In particular, the coincidence of the hump of σ(T), the maximum of S(T), the minimum of μH(T), and the maximum of Q(T) can be attributed to the contribution from hopping conduction in the top impurity Hubbard band.
Gauge-free duality in pure square spin ice: Topological currents and monopoles
Authors: Nisoli Cristiano
Published: October 2021

We consider pure square spin ice, that is, square ice, where only nearest neighbors are coupled. The gauge-free duality between the perpendicular and collinear structure leads to a natural description in terms of topological currents and charges as the relevant degrees of freedom. That, in turn, can be expressed via a continuous field theory where the discrete spins are subsumed into entropic interactions among charges and currents. This approach produces structure factors, correlations, and susceptibilities for spins, monopoles, and currents. It also generalizes the height formalism of the disordered ground state to non-zero temperature. The framework can be applied to the zoology of recent experimental results, especially realizations on quantum annealers, and can be expanded to include longer range interactions.
Active disease-related compound identification based on capsule network
Authors: Yang Bin , Bao Wenzheng , Wang Jinglong
Published: October 2021

Pneumonia, especially corona virus disease 2019 (COVID-19), can lead to serious acute lung injury, acute respiratory distress syndrome, multiple organ failure and even death. Thus it is an urgent task for developing high-efficiency, low-toxicity and targeted drugs according to pathogenesis of coronavirus. In this paper, a novel disease-related compound identification model–based capsule network (CapsNet) is proposed. According to pneumonia-related keywords, the prescriptions and active components related to the pharmacological mechanism of disease are collected and extracted in order to construct training set. The features of each component are extracted as the input layer of capsule network. CapsNet is trained and utilized to identify the pneumonia-related compounds in Qingre Jiedu injection. The experiment results show that CapsNet can identify disease-related compounds more accurately than SVM, RF, gcForest and forgeNet.
Transcatheter aortic valve replacement for structural degeneration of previously implanted transcatheter valves (TAVR-in-TAVR): a systematic review
Authors: Gallo Michele , Fovino Luca Nai , Blitzer David , Doulamis Ilias P , Guariento Alvise , Salvador Loris , Tagliari Ana Paula , Ferrari Enrico
Published: October 2021

OBJECTIVES

Transcatheter aortic valve replacement (TAVR) represents a valid treatment for patients with aortic valve stenosis and high or intermediate surgical risk. However, biological transcatheter valves can also experience a structural degeneration after years, and a redo-TAVR procedure (TAVR-in-TAVR) can be a valid option. We revised the current available literature for indications, procedural and technical details and outcome on TAVR-in-TAVR procedures for degenerated TAVR valves.

METHODS

A systematic search was conducted in the public medical database for scientific articles on TAVR-in-TAVR procedures for degenerated transcatheter valves. Data on demographics, indications, first and second transcatheter valve type and size, mortality, complications and follow-up were extracted and analysed.

RESULTS

A total of 13 studies (1 multicentre, 3 case series, 9 case reports) were included in this review, with a total amount of 160 patients treated with TAVR-in-TAVR procedures for transcatheter valve failure. The mean age was 74.8 ± 7.8 with 84 males (52.8%). The mean elapsed time from the first TAVR procedure was 58.1 ± 23.4 months. Main indication for TAVR-in-TAVR was pure stenosis (38.4%, with mean gradient of 44.5 ± 18.5 mmHg), regurgitation (31.4%), mixed stenosis and regurgitation (29.5%) and leaflet thrombosis (8.8%). Procedural success rate was 86.8%, with second TAVR valve malposition occurred in 4 cases (2.5%). The hospital mortality rate was 1.25% (2/160). Post-procedural echocardiographic control showed moderate regurgitation in 5.6% of patients (9/160) and residual transvalvular mean gradient ≥20 mmHg in 5% of cases. Postoperative complications included major vascular complications (8.7%), new pacemaker implantation (8.7%), acute kidney failure (3.7%), stroke (0.6%) and coronary obstruction (0.6%). The mean follow-up time was 6 ± 5.6 months with 1 non-cardiovascular death reported.

CONCLUSIONS

TAVR-in-TAVR represents a valid alternative to standard surgery for the treatment of degenerated transcatheter valves in high-risk patients. Despite these promising results, further studies are required to assess durability and haemodynamic performances of the second TAVR valve.
Clinical Characteristics, Laboratory Profiles, And Treatment Modalities for Familial Hypercholesterolemia in Egypt
Authors: Reda Ashraf , Bendary Ahmed , Elserafy Ahmed Shawky , Ashraf Mohamed , Dawood Ehab , Emil Sameh , Elbahry Atef , Sanad Osama , Bendary Mohamed , Elhadidy Amro , Rafla Samir , Tabl Mohamed Abdelshafy , Khamis Hazem , Kazamel Ghada , Kamal Seif , Naguib Tarek , Sobhy Mohamed
Published: October 2021

Aims

The aim of the Familial Hypercholesterolemia Research Collaboration (FHRC) is to collect date about the clinical, laboratory phenotypes, and treatment strategies of patients with FH all over the world. We present the Egyptian data of this international registry.

Methods and Results

An online electronic case report form (e-CRF) was prepared to collect data matching the protocol of the FHSC of the European Atherosclerosis Soci- ety (EAS). From August 2017 to March 2021, a total of 228 cases with FH (46% males, mean age 48 ± 14 years) were enrolled. About 71% of whom came from urban areas. The mean Body Mass Index (BMI) was 30 ± 4.9 kg/m2. The most commonly reported concomitant risk factor was hypertension (39%), followed by smoking (22%), and then DM (18%). Median time from diagnosis to enrolment was 7 (range 0.5-20) years. The vast majority (99.1%) were diagnosed based on the Dutch Lipid Clinic criteria, with 14%, 11% and 75% in the definite, probable, and possible categories respectively. Genetic test was performed in only 1 patient, in which the defect was heterozygous FH (defective ApoB). Mean baseline levels for total cholesterol was 316±86 mg/dl, median (ranges) for triglycerides was 190 (38-1400) mg/dl, for LDL-C was 237±77 mg/dl and for HDL-C was 47±14 mg/dl. Importantly, the mean Lp(a) was 42±12 mg/dl. All but one patient received lipid lowering therapy. Statins were prescribed in 226 out of 228 patients enrolled (99.1%). Statin prescriptions were equally distributed between Atorvastatin and Rosuvastatin (41% for each). Forty five percent received monotherapy and 56% received combination therapy (most commonly with Ezetimibe [55.7%], then with Fibrates [7.9%], then with proprotein con- vertase subtilisin/kexin type 9 (PCSK-9 inhibitors) [2.6%], and finally with Omega-3 fatty acids [0.9%]). Only one patient received lipoprotein apheresis.

Conclusion

The Egyptian part of the FHRC, to the best of our knowledge, is the first FH registry in Egypt. Our data show that the e-CRF system is feasible and reliable. The phenotype of enrolled FH cases showed higher female preponderance, very high lipoprotein levels, and unfortunately inadequate therapeutic interventions (with un- derutilization of PCSK-9 inhibitors). This is a call to action in order to mitigate these management gaps for this high-risk group.
A Multi-Agent Platform to Explore Strategies for Age-Friendly Community Projects in Urban China
Authors: Xiang Liqun , Shen Geoffrey Q P , Li Dandan , Tan Yongtao , Jin Xin
Published: October 2021

Background and Objectives

Although numerous efforts have been made to promote age-friendly communities (AFCs) in urban China, challenges such as the engagement and management of stakeholders, budget constraints, and policy issues remain. This article describes the work of designing a multi-agent platform (MAP) for the briefing stage of AFC projects.

Research Design and Methods

The process to design the MAP is first described, and the components and variables are identified. Then, a case study of a stakeholder consensus formation process is conducted using an agent-based simulation. Next, according to the simulation results, strategies to handle the conflicts arising among the stakeholders of AFC projects are proposed.

Results

According to the agent-based simulation conducted, both the initial approval rate and the outside connection rate will affect the stakeholder consensus formation process. Although a higher initial approval rate and a lower outside connection rate may reduce the average convergence time, the results show that 3–5 rounds of information exchange are still needed before a consensus or dissent is formed.

Discussion and Implications

Investors are suggested to communicate with residents and alleviate their concerns regarding AFC projects to facilitate the consensus formation process during the briefing stage of AFC projects; they can also organize activities for residents to exchange information and ideas. The simulation conducted, together with the MAP built in this research, will serve as a reference to help researchers and practitioners further understand the briefing stage and explore efficient strategies for the successful implementation of AFC projects in urban China.
Blowing-up Solutions for 2nd-Order Critical Elliptic Equations: The Impact of the Scalar Curvature
Authors: Robert Frédéric , Vétois Jérôme
Published: October 2021

Given a closed manifold $(M^n,g)$, $n\geq 3$, Druet [5, 7] proved that a necessary condition for the existence of energy-bounded blowing-up solutions to perturbations of the equation $$ \begin{align*} &\Delta_gu+h_0u=u^{\frac{n+2}{n-2}},\ u>0 \ \textrm{in }M\end{align*}$$is that $h_0\in C^1(M)$ touches the Yamabe potential somewhere when $n\geq 4$ (the condition is different for $n=6$). In this paper, we prove that Druet’s condition is also sufficient provided we add its natural differentiable version. For $n\geq 6$, our arguments are local. For the low dimensions $n\in \{4,5\}$, our proof requires to introduce a suitable mass that is defined only where Druet’s condition holds. This mass carries global information both on $h_0$ and $(M,g)$.
Swarming Behavior in Anopheles gambiae (sensu lato): Current Knowledge and Future Outlook
Authors: Baeshen Rowida
Published: October 2021

Effective management of insect disease vectors requires a detailed understanding of their ecology and behavior. In Anopheles gambiae sensu lato (s.l.) (Diptera: Culicidae) mating occurs during swarming, but knowledge of their mating behavior under natural conditions is limited. Mosquitoes mate in flight over specific landmarks, known as swarm markers, at particular locations. Swarms consist of males; the females usually approach the swarm and depart following copulation. The number of mating pairs per swarm is closely associated with swarm size. The shape and height of swarm markers vary and may depend on the environmental conditions at the swarm’s location. Male–male interactions in mosquito swarms with similar levels of attractive flight activity can offer a mating advantage to some individuals. Flight tone is used by mosquitoes to recognize the other sex and choose a desirable mate. Clarifying these and other aspects of mosquito reproductive behavior can facilitate the development of population control measures that target swarming sites. This review describes what is currently known about swarming behavior in Anopheles gambiae s.l., including swarm characteristics; mating within and outside of swarms, insemination in females, and factors affecting and stimulating swarming.
Detection and Establishment of Aedes notoscriptus (Diptera: Culicidae) Mosquitoes in Southern California, United States
Authors: Metzger Marco E , Wekesa J Wakoli , Kluh Susanne , Fujioka Kenn K , Saviskas Robert , Arugay Aaron , McConnell Nathan , Nguyen Kiet , Krueger Laura , Hacker Gregory M , Hu Renjie , Kramer Vicki L
Published: October 2021

Aedes notoscriptus (Skuse), the Australian backyard mosquito, is a pestiferous daytime-biting species native to Australia and the surrounding southwestern Pacific region. It is suspected to play a role in the transmission of several arboviruses and is considered a competent vector of dog heartworm, Dirofilaria immitis (Leidy). This highly adaptable mosquito thrives in natural and artificial water-holding containers in both forested and urbanized areas, from tropical to temperate climates, and has benefitted from a close association with humans, increasing in abundance within its native range. It invaded and successfully established in New Zealand as well as in previously unoccupied temperate and arid regions of Australia. Ae. notoscriptus was discovered in Los Angeles County, CA, in 2014, marking the first time this species had been found outside the southwestern Pacific region. By the end of 2019, immature and adult mosquitoes had been collected from 364 unique locations within 44 cities spanning three southern California counties. The discovery, establishment, and rapid spread of this species in urban areas may signal the global movement and advent of a new invasive container-inhabiting species. The biting nuisance, public health, and veterinary health implications associated with the invasion of southern California by this mosquito are discussed.
Diverticulitis of the appendix—case report and literature review
Authors: Bujold-Pitre Kristopher , Mailloux Olivier
Published: October 2021

Appendiceal diverticulitis is a rare diagnostic most often mistaken for an acute appendicitis.

A 72-year-old man presented with a transfixing abdominal pain for 48 hours. Appendicitis was diagnosed on computed tomography scan, but a neoplasm could not be excluded. A laparoscopic hemicolectomy was performed after a surgical consensus considering the neoplastic appearance of the lesion and anatomical feature. Histopathology finally revealed an appendiceal diverticulitis.

Appendiceal diverticulum is a rare condition. Most will lead to an appendiceal diverticulitis, which present similarly to an appendicitis. Perforation rate and mortality rate are much higher in appendiceal diverticulitis than in appendicitis. Furthermore, appendiceal diverticular disease is strongly associated with neoplasms, especially mucinous neoplasms and thus pseudomyxoma peritonei.

Considering the high complication rate and malignant association, an appendicectomy in case of an appendiceal diverticulitis or of an incidental finding of appendiceal diverticulosis should be recommended to the patient.
Effectiveness and safety of subcutaneous abatacept in biologic-naïve RA patients at Week 52: A Japanese multicentre investigational study (ORIGAMI study)
Authors: Tamura Naoto , Azuma Takanori , Misaki Kenta , Yamaguchi Rei , Hirano Fuminori , Sugiyama Eiji , Kanai Daisuke , Murakawa Yohko , Oribe Motohiro , Kimata Takahito , Aoki Kazutoshi , Sugiura Tomoko , Takasugi Koji , Takakubo Yuya , Tomita Yasuyuki , Isozaki Takeo , Nanki Toshihiro , Katsuyama Naooki , Kuroiwa Takanori , Oshikawa Hideto , Kaneko Motohide , Fujinaga Hiroshi , Saito Kiwamu , Tanaka Eiichi , Inoue Eisuke , Yoshizawa Yuri , Matsumoto Shigeru , Yamanaka Hisashi , Harigai Masayoshi
Published: October 2021

Objectives

To evaluate the effectiveness and safety of abatacept over 52 weeks in biologic-naïve rheumatoid arthritis (RA) patients with moderate disease activity in the prospective, 5-year, observational study (ORIGAMI study) in Japan.

Methods

Abatacept (125 mg) was administered subcutaneously once a week. Clinical outcomes included Simplified Disease Activity Index (SDAI) remission at Week 52 (primary endpoint), Japanese Health Assessment Questionnaire (J-HAQ), EuroQol 5-Dimension Questionnaire (EQ-5D), treatment retention, and safety. The results were compared with those of conventional synthetic disease-modifying antirheumatic drug (csDMARD) controls from the ongoing Institute of Rheumatology, Rheumatoid Arthritis (IORRA) registry.

Results

Overall, 325 patients were enrolled, with a mean age of 66.9 ± 12.7 years. The proportion of patients achieving SDAI remission (≤3.3) at Week 52 was 18.9% (95% CI: 14.3–23.6) and low disease activity (≤11) was 53.3% (95% CI: 47.4–59.1). A significant improvement was observed in J-HAQ and EQ-5D over 52 weeks in both the abatacept and csDMARD groups. The probability of abatacept treatment retention at Week 52 was 69.9% (95% CI: 64.7–75.5). Adverse events and serious adverse events were reported in 50.0% and 12.1% of patients, respectively.

Conclusions

Abatacept significantly improved disease activity, physical disability, and quality of life for up to 52 weeks in RA patients in a real-world setting.
ESC: a comprehensive resource for SARS-CoV-2 immune escape variants
Authors: Rophina Mercy , Pandhare Kavita , Shamnath Afra , Imran Mohamed , Jolly Bani , Scaria Vinod
Published: October 2021

Ever since the breakout of COVID-19 disease, ceaseless genomic research to inspect the epidemiology and evolution of the pathogen has been undertaken globally. Large scale viral genome sequencing and analysis have uncovered the functional impact of numerous genetic variants in disease pathogenesis and transmission. Emerging evidence of mutations in spike protein domains escaping antibody neutralization is reported. We have built a database with precise collation of manually curated variants in SARS-CoV-2 from literature with potential escape mechanisms from a range of neutralizing antibodies. This comprehensive repository encompasses a total of 5258 variants accounting for 2068 unique variants tested against 230 antibodies, patient convalescent plasma and vaccine breakthrough events. This resource enables the user to gain access to an extensive annotation of SARS-CoV-2 escape variants which would contribute to exploring and understanding the underlying mechanisms of immune response against the pathogen. The resource is available at http://clingen.igib.res.in/esc/.
Case Series: Cystic Brain Metastases Managed With Reservoir Placement and Stereotactic Radiosurgery
Authors: Park David J , Unadkat Prashin , Goenka Anuj , Schulder Michael
Published: October 2021

BACKGROUND

Stereotactic radiosurgery (SRS) has become one of the mainstays of treatment for patients with metastatic brain tumors. However, metastatic tumors with a large cystic component often exceed the size limit for safe and effective SRS. In such cases, surgical resection may not be the preferred first method of treatment, due to tumor location, patient co-morbidities, and patient preference. In these patients, volume reduction by cyst aspiration (CA) followed by SRS may be a viable alternative treatment option.

OBJECTIVE

To present the treatment of patients with cystic metastases using reservoir placement followed by SRS.

METHODS

Nine patients were treated with this method. We performed reservoir insertion for the aspiration of cystic component in each patient and followed that with outpatient SRS.

RESULTS

Mean overall volume reduction from this treatment method was 78.5%. Mean volume reduction from the CA alone was 59.8%, and after SRS, a further 66.6%, accounting for some cyst reaccumulation between the time of surgery and SRS. Repeat reservoir aspiration was done a total of 10 times in 5 patients. Our study showed local tumor control in 7 of 9 patients (77.8%), while 2 patients required later surgical resection of their tumors.

CONCLUSION

CA with reservoir placement followed by SRS is a good option for patients with large cystic brain metastases. The reservoir allows for repeat aspiration if needed. Catheter placement at the center of the cyst, and SRS within 2 to 3 wk of surgery, can maximize the likelihood of a successful outcome.
Feasibility of SARS-CoV-2 Antibody Testing in Remote Outpatient Trials
Authors: Lofgren Sarah M , Okafor Elizabeth C , Colette Alanna A , Pastick Katelyn A , Skipper Caleb P , Pullen Matthew F , Nicol Melanie R , Bold Tyler D , Bangdiwala Ananta S , Engen Nicole W , Collins Lindsey , Williams Darlisha A , Axelrod Margaret L , Thielen Beth K , Hullsiek Kathy H , Boulware David R , Rajasingham Radha
Published: October 2021

Background

During the Covid-19 pandemic, clinical trials necessitated rapid testing to be performed remotely. Dried blood spot (DBS) techniques have enabled remote HIV virologic testing globally and more recently, antibody testing as well. We evaluated DBS testing for SARS-CoV-2 antibody testing in outpatients to assess seropositivity.

Methods

In 2020, we conducted three internet-based randomized clinical trials and offered serologic testing via self-collected DBS as a voluntary sub-study. COVID-19 diagnosis was based on CDC case definition with epidemiological link to cases. A minority reported PCR testing at an outside facility. We tested for anti-SARS-CoV-2 immunoglobulin via Antibody Detection by Agglutination-PCR (ADAP) and compared with ELISA.

Results

Of 2727 participants in the primary studies, 60% (1648/2727) consented for serology testing; 56% (931/1648) returned a usable DBS sample. Of those asymptomatic, 5% (33/707) had positive ADAP serology. Of participants with a positive PCR, 67% (36/54) had positive SARS-CoV-2 antibodies. None of those who were PCR-positive and asymptomatic were seropositive (0/7). Of 77 specimens tested for concordance via ELISA, 83% (64/77) were concordant.

Challenges of completing a remote testing program during a pandemic included sourcing and assembling collection kits, delivery and return of the kits, and troubleshooting testing. Self-collection was successful for >95% of participants. Delays in US mail with possible sample degradation and timing of DBS collection complicated the analysis.

Conclusion

We found remote antibody testing during a global pandemic feasible although challenging. We identified an association between symptomatic COVID-19 and positive antibody results at similar prevalence to other outpatient cohorts.
High-spatial resolution long-mid-infrared observations of massive star-forming regions: Local star formation sequence
Authors: Uchiyama Mizuho , Miyata Takashi , Sako Shigeyuki , Kamizuka Takafumi , Asano Kentaro , Nakamura Tomohiko , Yamashita Takuya , Fujiyoshi Takuya , Yoneda Mizuki , Konishi Masahiro , Koshida Shintaro , Motohara Kentaro , Tanabé Toshihiko , Kitagawa Yutaro , Tateuchi Ken , Yoshii Yuzuru
Published: October 2021

The formation of massive stars in dense and cold molecular clouds is a fundamental problem in star formation. In this work, we studied three compact massive star-forming regions, M8E, RAFGL 6366S, and IRAS 18317−0513, to investigate the environment of massive star formation, specifically the possibility of a local feedback process. Our new mid-infrared observations using miniTAO/MAX38 at 31 and 37 μm resolved individual objects in each region and allowed us to obtain their individual luminosities and masses. Together with existence/absence of ultra-compact H ii regions, it is suggested that less-massive objects are more evolved than the more-massive objects in two out of the three regions. Because the objects that are more massive evolve faster, those that are less massive form earlier. This formation trend of local mass-sequential star was first suggested in 0.1 pc-scale massive star-forming regions. Therefore, feedback, such as outflows, jets, or radiative heating, from previously formed lower-mass young stellar objects might affect the environment of parental clouds and lead to next-generation massive young stellar objects.
O002 Medical therapy for sleep disordered breathing in children: a randomised, double-blind placebo-controlled trial
Authors: Baker A , Grobler A , Davies K , Griffiths A , Hiscock H , Kubba H , Peters R , Ranganathan S , Rimmer J , Rose E , Rowe K , Simpson C , Davidson A , Nixon G , Perrett K
Published: October 2021

Background

Sleep Disordered Breathing (SDB) in children is characterised by snoring and breathing difficulties during sleep. Small clinical trials suggest intranasal corticosteroids reduce SDB severity as defined by polysomnography. We assessed the efficacy of intranasal corticosteroid for improving symptoms and quality of life (QOL) in children with SDB.

Methods

This is a double-blind, randomised, placebo-controlled trial of healthy children 3-12y referred to a specialist with SDB symptoms. Exclusions were previous adenotonsillectomy, obesity or severe SDB. Participants received daily intranasal mometasone furoate 50micrograms or normal saline for 6 weeks. The primary outcome was resolution of symptoms measured by SDB score. Secondary outcomes were SDB symptom scores, QOL, behaviour, parent and surgeon perceived need for surgery, and parent satisfaction with treatment.

Results

276 participants were recruited; 138 in each group. 127 and 123 participants had primary outcome data at 6 weeks in the mometasone and saline groups respectively. Baseline age, atopic history, symptom severity and QOL were similar between groups. Resolution of SDB symptoms occurred in 44% [95%CI 35–53] of the mometasone group and 40% [95%CI 32–49] of the saline group; risk difference 4% [95%CI -0.8–16] p=0.511. Secondary outcomes were not different between groups.

Discussion

This large RCT, using clinical rather than polysomnographic outcomes to investigate the efficacy of mometasone on symptoms of SDB, found substantial rates of symptom resolution after 6 weeks in both groups. However, we found no difference in treatment effect between 6 weeks of intranasal mometasone over saline, for management of SDB symptoms in childhood.
P118 The prevalence of self-reported sleep difficulties in wind farm noise, urban road traffic noise and quiet rural exposure areas in South Australia
Authors: Rawson G , Catcheside P , Zajamšek B , Hansen K , Lack L , Vakulin A , Lovato N , Bruck D , Taylor A , Gill T , Toson B , Dal Grande L , Scott H , Micic G
Published: October 2021

Introduction

The prevalence of sleep difficulties from wind farm noise (WFN) compared to road traffic noise (RTN) or other sources is unknown. This study investigated the prevalence, severity and source of sleep difficulties in WFN, RTN and quiet rural exposure areas.

Methods

Geographic sampling and computer assisted telephone interviews were used to evaluate sleep difficulties (falling or staying asleep, waking too early, or feeling unrefreshed) attributed to RTN, WFN or non-WFN and RTN related factors using 0–4 scales (none, mild, moderate, severe, very severe). Three groups were sampled; WFN exposed (n=38–84 in five 2 km bands <10 km from a wind farm; total 372), RTN exposed (n=87 <800 m from a busy road >50,000 vehicles/day) and quiet rural controls (n=83). Preliminary prevalence estimates and odds of moderate-to-very severe sleep difficulties attributed to RTN, WFN or other sources were evaluated.

Results

Few WFN exposed respondents attributed sleep difficulties to WFN (0.8%) compared to moderate-to-very severe difficulties from RTN (2.2%) or other sources (16.1%). Sleep difficulties were higher in RTN exposed (17.2%) compared to quiet (6% OR[95%CI] 4.1[1.3–13.0]) or WFN exposed (OR[95%CI] 9.5[3.9–23.3]) rural areas. Sleep difficulties attributed to other sources were not different between groups (Chi² p=0.054), but tended to be higher in urban RTN exposed residents (26.4%).

Conclusions

Preliminary findings do not support more prevalent sleep difficulties in WFN compared to RTN exposed or quiet rural area residents. Given low rates of WFN-attributed sleep difficulties, larger and/or more sensitive studies remain warranted to further clarify potential WFN effects on sleep.
Treatment and Prevention of Brain Metastases in Small Cell Lung Cancer
Authors: Rittberg Rebekah , Banerji Shantanu , Kim Julian O. , Rathod Shrinivas , Dawe David E.
Published: October 2021

Central nervous system (CNS) metastasis will develop in 50% of small cell lung cancer (SCLC) patients throughout disease course. Development of CNS metastasis poses a particular treatment dilemma due to the accompanied cognitive changes, poor permeability of the blood-brain barrier to systemic therapy and relatively advanced state of disease. Survival of patients with untreated SCLC brain metastases is generally <3 months with whole brain radiotherapy used as first-line management in most SCLC patients. To prevent development of CNS metastasis prophylactic cranial irradiation (PCI) is recommended in limited stage disease, after response to chemotherapy and radiation, while PCI may be considered in extensive stage disease after favorable response to upfront treatment. Neurocognitive toxicity with whole brain radiotherapy and PCI is a concern and remains difficult to predict. The mechanism of toxicity is likely multifactorial, but a potential mechanism of injury to the hippocampus has led to hippocampal sparing radiation techniques. Treatment of established non–small cell lung cancer CNS metastases has increasingly focused on using stereotactic radiotherapy (SRS) and it is tempting to extrapolate these results to SCLC. In this review, we explore the evidence surrounding the prediction, prevention, detection, and treatment of CNS metastases in SCLC. We further review whether existing evidence supports extrapolating less toxic treatments to SCLC patients with CNS metastases and discuss trials that may shed more light on this question.
Outcomes of open partial nephrectomy for renal cell carcinoma in the minimally invasive approach era
Authors: Shibamori Kosuke , Hashimoto Kohei , Shindo Tetsuya , Tabata Hidetoshi , Kyoda Yuki , Kobayashi Ko , Tanaka Toshiaki , Masumori Naoya
Published: October 2021

Background:

We investigated the characteristics and outcomes of patients who underwent open partial nephrectomy (OPN) in the minimally invasive approach era.

Materials and methods:

We retrospectively reviewed 52 patients (55 cases) who underwent OPN from May 2009 to March 2016. We assessed perioperative change in estimated glomerular filtration rate (eGFR), complications, and oncological outcomes. Tumor complexity was evaluated using the R.E.N.A.L nephrometry score (NS) and the modified NS.

Results:

Fifteen cases (27%) had imperative indications and 40 (73%) had elective indications. The elective cases were more likely to have adverse tumor complexity based on NS. The perioperative complication rate defined as a Clavien-Dindo grade ≥IIIa was 11%. The rate of postoperative decline in eGFR at 1 month, 1 year, and 2 years was 22%, 20%, and 21%, respectively. Multivariate analysis revealed that male gender (odds ratio [OR] 11.8, p = 0.03), NS ≥9 (OR 13.9, p = 0.02), modified NS ≥11 (OR 13.5, p = 0.01), and cold ischemic time ≥40 minutes (OR 7.9, p = 0.04) were significantly associated with worsening eGFR at 1 year after surgery. During a median follow-up period of 52 months, the 5-year overall survival and recurrence-free survival rates were 93% and 84%, respectively.

Conclusions:

OPN is acceptable with regard to oncological outcomes and complications in the minimally invasive surgery era. We propose that OPN should be the preferred approach in cases in which it is technically difficult to preserve maximum renal function via a minimally invasive approach.
Accuracy and Reliability of Self-measured Intraocular Pressure in Glaucoma Patients Using the iCare HOME Tonometer
Authors: Ogle Jeanne J. , Soo Hoo Wai Cheng , Chua Chun Hau , Yip Leonard W.L.
Published: October 2021

Précis:

The iCare HOME tonometer is a useful tool which can be used by patients for fairly accurate and reliable self-measurement of intraocular pressure (IOP).

Purpose:

The aim was to compare the accuracy of IOP measurements of trained glaucoma patients using the iCare HOME tonometer before and after a week of self-monitoring at home and study the repeatability of patient measurements done at home.

Materials and Methods:

A total of 40 glaucoma patients had IOPs measured using the Goldmann applanation tonometer and the iCare HOME. Patients were trained to use the iCare HOME and measured their IOP twice daily over a loan period of 7 days. Bland-Altman analysis was used to assess agreement between Goldmann applanation tonometer and iCare HOME readings. Intraclass correlation coefficient compared inter-rater reliability of iCare HOME measurements, and test-retest variability for the patient’s readings over the 7-day period were analyzed. A 5-point Likert scale questionnaire was used to assess the patient’s experience with the device.

Results:

Up to 32 patients (80%) were able to obtain IOP readings within 3 mm Hg of the glaucoma nurse clinician’s readings at the preloan visit, and up to 36 patients (90%) at the postloan visit. Good inter-rater reliability was observed between iCare HOME measurements by the glaucoma nurse clinician and patients. At the postloan visit, inter-rater reliability was good for right eye readings and excellent for left eye readings. No distinct trend in test-retest variability was identified over the 7-day period. 65% of patients agreed the device was easy to use and 89% would recommend the device to other glaucoma patients.

Conclusion:

Patients trained to use the iCare HOME device can do so with fair accuracy compared with trainers with accuracy improving within 1 week of usage.
A Decrease in Bruch’s Membrane Opening-Minimum Rim Area Precedes Decreased Retinal Nerve Fiber Layer Thickness and Visual Field Loss in Glaucoma
Authors: Choi Hyun Sup , Joo Chan Woong , Park Sung Pyo , Na Kyeong Ik
Published: October 2021

Précis:

A decrease in Bruch’s membrane opening-minimum rim area, which represents the optic nerve head (ONH), preceded a decrease in the peripapillary retinal nerve fiber layer thickness (RNFLT) and the visual field index (VFI).

Purpose:

This study aimed to investigate the relative comparison between a decrease in BMO-MRA, the peripapillary RNFLT, and the VFI, according to the severity of glaucoma.

Materials and Methods:

This retrospective cross-sectional study included 121 eyes (73 with open-angle glaucoma and 48 normal eyes). The ONH and retinal nerve fiber layer were analyzed using spectral domain optical coherence tomography, and VFI was obtained using the Humphrey Field Analyzer. The tipping points of RNFLT for VFI and BMO-MRA were estimated using broken-stick regression models. Polynomial regression analysis was performed, and the changes in the 3 parameters were expressed as a graph.

Results:

The tipping point of the RNFLT for the VFI was 88.62 μm [95% confidence interval (CI): 79.59-97.65; P=0.001]. The tipping point of the RNFLT for BMO-MRA was 60.00 μm (95% CI: 48.28-71.72; P=0.220). Above the tipping point, BMO-MRA decreased with a decrease in the RNFLT (slope=0.0135; 95% CI: 0.0115-0.0155; P<0.001); below the tipping point, BMO-MRA did not decrease significantly (slope=0.0002; 95% CI: −0.0177 to 0.0181; P=0.983). Polynomial regression analysis showed that with the progression of glaucoma, BMO-MRA decreased more rapidly, and this preceded a decrease in the RNFLT followed by a decrease in the VFI.

Conclusion:

The ONH parameter, BMO-MRA, showed a faster decrease than RNFLT and VFI in early glaucoma. BMO-MRA may help detect early glaucomatous damage and its progression.
Intraocular Pressure Changes in the Contralateral Eye After Glaucoma Surgery
Authors: Meshksar Aidin , Hajizadeh Maryam , Sharifipour Farideh , Yazdani Shahin , Pakravan Mohammad , Kheiri Bahareh
Published: October 2021

Précis:

Glaucoma surgery in 1 eye can result in significant intraocular pressure (IOP) elevation in the fellow eye in a significant percentage of subjects. This effect is more pronounced following glaucoma drainage device implantation and in subjects developing postoperative hypotony in the first eye.

Purpose:

The aim was to investigate the course and magnitude of IOP changes in contralateral eyes following glaucoma surgery.

Patients and Methods:

We studied 131 glaucoma patients undergoing surgery. IOP changes in fellow eyes and the number of glaucoma medications were recorded for 6 months. Both normal and glaucomatous fellow eyes were included. Patients on preoperative acetazolamide were analyzed separately. IOP change ≥4 mm Hg or 20% increase from baseline values was considered significant.

Results:

Baseline IOP in fellow eyes was 13.1±3.3 mm Hg which increased significantly at all-time points with a peak at 1 week (mean increase: 3.1±3.2 mm Hg) gradually decreasing up to 6 months (mean increase 0.9±2.1 mm Hg). The number of fellow eyes with clinically significant IOP elevation at 1 day, 1 week, and 1, 3. and 6 months was 47, 76, 47, 31, and 37 showing mean IOP rise of 4.5±2.3 (38.5%), 5.4±1.8 (48.5%), 4.8±1.6 (44.2%), 3.7±1.3 (36.5%), and 3.2±1.3 (32.6%) mm Hg, respectively. Medications were added to 18 fellow eyes (including 10 initially “normal” eyes) while 7 other fellow eyes required surgery.

Significant IOP elevation in fellow eyes was associated with tube shunt surgery (P<0.008 at all-time points), a diagnosis of glaucoma following cataract surgery, IOP ≤5 mm Hg on the first postoperative day (P=0.002) and use of preoperative acetazolamide.

Conclusion:

Glaucoma surgery was associated with IOP elevation in fellow eyes in a significant number of subjects and suggests that IOP in the unoperated eye should also be checked at postoperative visits.
Telehealth Education
Authors: Garber Kelli , Gustin Tina
Published: October 2021

Background:

COVID-19 propelled telehealth to the forefront of health care, forcing many advanced practice registered nurses (APRNs) to incorporate telehealth into their practice without sufficient education. Lack of training has been cited as a barrier to telehealth adoption.

Purpose:

This study evaluated provider adoption of telehealth based on the type of telehealth education received.

Methods:

A quantitative survey of telehealth providers (n = 224) was distributed through the listservs of 4 national organizations to determine whether there was a significant difference in provider levels of perceived usefulness, self-efficacy, perceived knowledge, satisfaction, and use of telehealth based on the type of telehealth education received.

Results:

Telehealth adoption was significantly associated with the type of telehealth education received (vendor, online, written instructions only, and on the spot).

Conclusion:

With telehealth utilization expected to endure postpandemic, faculty should incorporate the most effective telehealth education methods into APRN curricula, ensuring successful adoption by the future workforce.
HIV-associated wasting prevalence in the era of modern antiretroviral therapy
Authors: Siddiqui Javeed , Samuel Shanti K. , Hayward Brooke , Wirka Kelly A. , Deering Kathleen L. , Harshaw Qing , Phillips Amy , Harbour Michael
Published: October 2021

Objective:

To understand the prevalence of HIV-associated wasting (HIVAW) in the United States.

Design:

Medical and pharmacy claims study using IBM MarketScan Commercial, Medicare Supplemental and Medicaid Databases.

Methods:

Study period: July 2012–September 2018 (first HIV diagnosis claim = HIV index date). People with HIV (PWH) were excluded if they were aged less than 18 years, had any malignancy claim or had less than 6 months of enrollment data pre or post-HIV index date. HIVAW was defined by proxy using claims for weight loss–related diagnoses, appetite stimulant/nontestosterone anabolic agents or enteral/parenteral nutrition. Prevalence was reported cumulatively, by insurance type and antiretroviral therapy (ART) pharmacy claims (defined as ≥1 pharmacy claim of any ART within 12 months post-HIV index date). Statistical analysis assessed factors potentially associated with HIVAW.

Results:

The study population comprised 42 587 PWH (64.6% male, mean age 44 years, 67.5% on Medicaid, 63.9% on ART). Cumulative HIVAW prevalence (2012–2018) was 18.3% (n = 7804) for all PWH (17.9% on ART, 19.1% not on ART). HIVAW prevalence by payer was 7.5% for Commercial and Medicare Supplemental and 23.5% for Medicaid. The strongest associations with the likelihood of meeting the definition of HIVAW were for individuals with Medicaid and hospitalization(s) post-HIV index date; race and ART status were not associated.

Conclusions:

Findings suggest HIVAW remains prevalent in PWH. ART use was not found to be associated with HIVAW. HIVAW was highest among those with Medicaid coverage or any hospitalization(s). Further research is needed to better understand additional factors associated with and contributing to HIVAW.