bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and initial validation of the parent-report Academic Behavior Scale in a Chinese context
Authors: Guo Mingchun , Guo Qianqian , Wang Long , Morawska Alina
Published: November 2020

This study aimed to develop and evaluate a new parent-report measure to assess primary schoolchildren’s academic behaviors in the home context. We developed the Academic Behavior Scale (ABS) and administered it to Chinese parents of primary schoolers along with other measures. Six hundred and forty-five parents and 170 primary schoolchildren in Grades 4–6 were recruited from a public primary school and completed a set of questionnaires. After that, the psychometric properties of the ABS including factorial validity, convergent and concurrent validity, as well as internal consistency were evaluated using confirmatory factor analysis and correlation analysis in Mplus v.8.3. The results confirmed a two-factor structure for the scale, with satisfactory convergent and concurrent validity and internal consistency. This study provides preliminary evidence for the satisfactory psychometric properties of the ABS among Chinese parents.
Prosocial behaviors of children with autism spectrum disorder (ASD) during interactions with their typically developing siblings
Authors: Rum Yonat , Zachor Ditza A. , Dromi Esther
Published: November 2020

This observational study focuses on prosocial behaviors of children with autism spectrum disorder (ASD) during an interaction with their older, typically developing sibling (TD-Sibs). Twenty-eight sibling dyads, in which the younger sibling was diagnosed with ASD (ASD-Sibs), were video-recorded at home playing a game of their choice. Video recordings were microanalyzed, measuring frame-by-frame observational indices of prosocial behaviors. Siblings’ interactions were mostly collaborative. During the interaction, the older TD-Sibs initiated more actions and the younger ASD-Sibs imitated more. The frequency of the prosocial behaviors of the ASD-Sib was associated with the frequency of the TD-Sib’s prosocial behaviors. The findings emphasize the importance of sibling interactions as an opportunity for children with ASD to practice prosocial behaviors.
Attitudes toward Technology-Based Cancer Support Programs Among Korean American Breast Cancer Survivors
Authors: Im Eun-Ok , Kim Sangmi , Jang Mia , Chee Wonshik
Published: November 2020

Despite the increasing usages of technology-based programs, few technology-based support programs are currently available for racial/ethnic minority cancer survivors including Korean-American cancer survivors. The purpose of this study was to explore the attitudes toward technology-based cancer support programs among Korean-American cancer survivors from a feminist perspective. In-person focus group interviews were held with 17 Korean-American cancer survivors. All the interviews were recorded by writing memos. Then, the written memos were analyzed using a content analysis. Four major themes reflecting their attitudes toward technology-based cancer-support programs were identified: (a) “easy to access”; (b) “good for peer and family support,” (c) “overcoming language barriers,” and (d) “providing Korean-specific and personalized trustable information.” Future technology-based cancer support groups for this specific population need to incorporate peer support, support for family members, Korean language, and Korea-specific information and intervention components.
The role of sexual passion in romantic relationship functioning: A dyadic analysis
Authors: Beaudoin Jessica , Bouizegarene Nabil , Fortin Annabelle , Philippe Frederick L. , Vallerand Robert J.
Published: November 2020

The dualistic model of sexual passion defines sexual passion as a strong motivational drive to engage in various types of partnered and non-partnered sexual activities and distinguishes two types of sexual passion that lead to distinct consequences, obsessive sexual passion (OSP) and harmonious sexual passion (HSP). The purpose of the present research was to examine the associations between these two types of sexual passion and relationship functioning in partners of romantic relationships using dyadic analyses. Heterosexual participants (132 couples; n = 264) completed an online survey which included three indicators of relationship functioning: relationship quality, sexual satisfaction, and level of conflict. An actor-partner interdependence model analysis (APIM) revealed that, for both men and women, HSP was positively associated with relationship functioning, whereas OSP was negatively associated with it. In addition, results unveiled significant partner effects, such that both men’s and women’s HSP were associated with their partners’ perceptions of relationship functioning, but not for OSP. Finally, there were a significant moderation between men’s HSP and women’s OSP on women’s relationship functioning, suggesting that men’s HSP can buffer the negative effect of women’s OSP. The present results provide evidence that sexual passion can either facilitate or hinder relationship functioning through multiple personal and dyadic pathways.
Internal compression therapy, a novel method in the treatment of deep venous insufficiency: 18-month clinical results
Authors: Eroğlu Erdinc , Yasim Alptekin , Doganer Adem , Acipayam Mehmet , Kocarslan Aydemir , Kabalci Mehmet , Kara Hakan
Published: November 2020

Objective

To present 18-month clinical results for internal compression therapy (ICT) applied percutaneously and as a novel method in the treatment of primary deep venous insufficiency.

Material and Method

Thirty patients diagnosed with isolated primary femoral vein (FV) insufficiency between October 2017 and February 2018 were included in the study. Pre-procedural femoral vein diameters and reflux durations were measured. CEAP classification and Venous Clinical Severity Score (VCSS) were recorded. Pre-procedural CEAP classifications were CEAP 4 in nine patients and CEAP 3 in 21. Quality of life assessments were carried out using a Chronic Venous Insufficiency Questionnaire (CIVIQ-2). FV diameters were then reduced, and valve coaptation was established with the percutaneous application of hyaluronic acid and cyanoacrylate injected adjacent to a valve with non coapting leaflets. Venous diameters and reflux duration were again measured immediately after the procedure. Patients were followed-up at months 1, 6, and 18, at which times all parameters were re-evaluated.

Results

Eighteen of the 30 patients were women, and 12 were men. The mean duration of the procedure was 22.7 ± 2.9 (20–30) min. Patients’ FV diameters were 12.8 (11–14.7) mm before the procedure, 9.9 (9–11.5) mm immediately after, and also 9.9 (9–11.2) mm after 1.5 years (p < 0.001). Pre-procedural reflux duration ranged between 2 and 6 (median: 3) sec, and no reflux was observed in any patient immediately or one month after the procedure (p < 0.001). At 18-month follow-up, reflux lasting only 1 sec was determined in two patients. VCSS scores were 11 (10–12) pre-procedurally and 6 (4–9) at 18 months (p < 0.001). Venous Quality of Life scores were 32 (30–36) before the procedure and 18 (14–24) at 18 months (p < 0.001).

Conclusion

Preliminary investigation of the injection of cyanoacrylate and hyaluronic acid around one valve in an incompetent FV can result in improved hemodynamics, CEAP, VCSS and patient QOL at 18 months, without complications.
Blood Flow Restriction Training for Athletes: A Systematic Review
Authors: Wortman Ryan J. , Brown Symone M. , Savage-Elliott Ian , Finley Zachary J. , Mulcahey Mary K.
Published: November 2020

Background:

Blood flow restriction (BFR) is a novel technique involving the use of a cuff/tourniquet system positioned around the proximal end of an extremity to maintain arterial flow while restricting venous return.

Purpose:

To analyze the available literature regarding the use of BFR to supplement traditional resistance training in healthy athletes.

Study Design:

Systematic review.

Methods:

A systematic review was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. From November to December 2018, studies that examined the effects of BFR training in athletes were identified using PubMed and OVID Medline. Reference lists from selected articles were analyzed for additional studies. The inclusion criteria for full article review were randomized studies with control groups that implemented BFR training into athletes’ resistance training workouts. Case reports and review studies were excluded. The following data were extracted: patient demographics, study design, training protocol, occlusive cuff location/pressure, maximum strength improvements, muscle size measurements, markers of sports performance (eg, sprint time, agility tests, and jump measurements), and other study-specific markers (eg, electromyography, muscular torque, and muscular endurance).

Results:

The initial search identified 237 articles. After removal of duplicates and screening of titles, abstracts, and full articles, 10 studies were identified that met the inclusion criteria. Seven of 9 (78%) studies found a significant increase in strength associated with use of BFR training as compared with control; 4 of 8 (50%) noted significant increases in muscle size associated with BFR training; and 3 of 4 (75%) reported significant improvements in sport-specific measurements in the groups that used BFR training. Occlusive cuff pressure varied across studies, from 110 to 240 mm HG.

Conclusion:

The literature appears to support that BFR can lead to improvements in strength, muscle size, and markers of sports performance in healthy athletes. Combining traditional resistance training with BFR may allow athletes to maximize athletic performance and remain in good health. Additional studies should be conducted to find an optimal occlusive pressure to maximize training improvements.

Registration:

CRD42019118025 (PROSPERO).
Remarks on conspiracy theory entrepreneurs
Authors: Campion-Vincent Véronique
Published: November 2020

This note presents an outline of the social and intellectual conditions accounting for the rise of “conspiracy entrepreneurs”, that is these heterodox thinkers who make a living from their denunciations and revelations on the malevolent organisations and characters who really lead the universe. A special attention has been focused on the reports concerning conspiracy entrepreneurs in the media, which describe them as eccentric and thus entertaining. After the presentation of some studies of David Icke's reptilian hypothesis, a question is raised: is it not legitimate to assert that academics studying conspiracy theories are themselves conspiracy entrepreneurs through their role in the spread of the subject of their studies.
Rate of Profit in the United States and in China (2007–2014): A Look at Two Trajectories and Strategic Sectors
Authors: Marquetti Adalmir Antonio , Chaves Catari Vilela , Ribeiro Leonardo Costa , Albuquerque Eduardo da Motta e
Published: November 2020

This paper investigates the turbulent behavior that might exist under a national average rate of profit. We use a database—ORBIS—that allows our investigation to start from the level of the firm, with data from 2007 to 2014. A comparison between the United States and China organizes the statistical description of the rates of profit in those countries. Three issues are investigated: the trajectories of the national average rate of profit and their disaggregation; the distribution of different rates of profit by firms, economic sectors, and manufacturing sectors, and the stability of those distributions over time.
Reduction in Tamoxifen Metabolites Endoxifen and N-desmethyltamoxifen With Chronic Administration of Low Dose Cannabidiol: A CYP3A4 and CYP2D6 Drug Interaction
Authors: Parihar Vikas , Rogers Annarita , Blain Allison Marie , Zacharias Samuel Ramesh Kumar , Patterson Lisa Laureen , Siyam Mahmoud Abdel-Magid
Published: November 2020

Background:

Cannabidiol (CBD) serves as a promising medicine, with few known adverse effects apart from the potential of drug interactions with the cytochrome P450 system. It has been hypothesized drug interactions may occur with chemotherapeutic agents, but no supporting evidence has been published to date.

Case:

A 58-year-old female with a history of bilateral breast carcinoma in remission, was treated with tamoxifen for breast cancer prevention for over 6 years. CBD was instituted to treat persistent postsurgical pain, inadequately managed by alternate analgesics. It was postulated that CBD may diminish tamoxifen metabolism by CYP3A4 and 2D6 to form active metabolite endoxifen, which exerts the anticancer benefits. Endoxifen, tamoxifen, N-desmetyltamoxifen and 4-hydroxytamoxifen levels were collected while the patient chronically received CBD 40 mg/day, and after a 60-day washout. Upon discontinuation of CBD 40 mg/day, it was observed that endoxifen levels increased by 18.75% and N-desmethyltamoxifen by 9.24%, while 4-hydroxytamoxifen remained unchanged.

Conclusion:

CBD at a low dose of 40 mg/day resulted in the potential inhibition of CYP3A4 and/or CYP2D6. Patients receiving CBD and interacting chemotherapeutic drugs, such as tamoxifen, require monitoring to identify possible subtherapeutic response to treatment. Further pharmacokinetic studies are required to ascertain the dynamics of this drug interaction.
Non-dimensional thermoelastic model of a compound annular cylinder in a stress-free state with internal heat generation
Authors: Govindarajan Srisharan G , Solbrekken Gary L
Published: November 2020

A non-dimensional, axisymmetric, thermal-stress model for a three-layer cylinder with internal heating has been developed. Such a geometry is encountered in an annular target for isotope production. The middle cylinder is the heat generating source with an assumed thermal expansion coefficient that is smaller than that of the other two cylinders enclosing it. Hence, the development of the solution is based on the assumption that interfacial separation occurs at the interface of the middle cylinder and the outer cylinder, while contact is reinforced between the middle cylinder and the inner cylinder. The commercial finite element code Abaqus FEA is used to obtain a numerical model which is validated using the developed analytical solution. The non-dimensional analytical solution has been presented in a simplified, generalized form, and can be applied to either of the cylinders by adjusting a few parameters. The non-dimensional variable groupings allow physical insight into how the stresses and temperature distributions evolve. A detailed solution procedure along with a discussion of the results has been provided.
Examining the Role of General Cognitive Skills in Language Processing: A Window Into Complex Cognition
Authors: Federmeier Kara D. , Jongman Suzanne R. , Szewczyk Jakub M.
Published: November 2020

When we use language, we combine sounds, signs, and letters into words that then form sentences, which together tell a story. Both language production and language comprehension rely on representations that need to be continuously and rapidly activated, selected, and combined. These representations are specific to language, but many processes that regulate their use, such as inhibition of competitors or updating of working memory, are domain-general abilities that apply across different kinds of tasks. Here, we provide an overview of the behavioral and neurophysiological evidence for domain-general abilities underpinning language skills and describe which aspects of production and comprehension draw on such cognitive resources. We discuss how this line of research reveals important similarities between production and comprehension and also helps establish links between language and other cognitive domains. Finally, we argue that studying how domain-general abilities are used in language leads to important insights into the highly dynamic communication between brain networks that is necessary to successfully go from sounds to stories.
The connections between crisis and war preparedness in Sweden
Authors: Larsson Oscar L
Published: November 2020

Contemporary liberal and democratic states have ‘securitized’ a growing number of issues by advancing the notion of societal security. This is coupled with a proactive stance and the conception of building societal resilience in order to withstand future crises and disturbances. The preemptive logic of contemporary security and crisis management calls for a new type of resilient neoliberal subject who is willing to accept uncertainty and shoulder greater individual responsibility for her own security. This article offers a genealogical analysis of this development in Sweden since the end of the Cold War, highlighting the role now assigned to citizens within social and national security planning. I argue that seeking a return to a more traditional notion of ‘total defence’ blurs the previously important war/peace and crisis/security distinctions. While war preparedness in previous eras was an exceptional aspect of human life and citizenship, the conceptions of security now evolving bind together societal and national security such that civil and war preparedness are merged into an ever-present dimension of everyday existence. The analysis also reveals that the responsibilization of individuals introduces a moral dimension into security and generates new forms of citizen–citizen relations. These extricate the sovereign powers of the state and the liberalist social contract between the state and its citizens.
Non-Squamous, Non-Basal Cell Cancers of the Skin: Exploring Associations Between Site of Disease and Depression
Authors: Almodallal Yahya , Lee Minji K. , Le-Rademacher Jennifer G. , Smith Caleb J. , Carroll Jamie L. , Robinson Steven I. , Jatoi Aminah
Published: November 2020

Background:

Earlier studies report a direct association between diseases of the skin—particularly those on the face—and depression. However, to our knowledge, such associations have not been examined in patients with non-squamous, non-basal call skin cancers.

Methods:

The primary goal was to assess whether malignant skin disease—specifically on the face as opposed to other sites—was associated with depression. The medical records of patients with cutaneous cancer (either primary or metastatic but non-squamous, non-basal cell) were reviewed for the relevant data.

Results:

One hundred and sixty-five patients were studied. Only 23 patients (14%) had metastases to the face, and 115 (70%) had a readily viewable skin cancer. Twenty-one patients (13%) developed depression after a diagnosis of cutaneous cancer (of note, the rate of missing data for depression was 37%). Only one patient with facial cutaneous cancer manifested depression, yielding an odds ratio for not developing depression (95% confidence interval (CI)) of 4.4 (0.5,35); p = 0.13. Depression appeared to occur more often in women (62% versus 43%), patients with a history of depression (52% versus 6%), and younger patients (median age with and without depression 55 years and 67 years, respectively).

Conclusion:

In contrast to other cutaneous diseases, no association was found between cutaneous cancer to the face and depression. Nonetheless, high rates of missing data underscore the need to focus on depression in patients with cutaneous cancers in the future.
Direct Oral Anticoagulants Versus Warfarin in the Treatment of Left Ventricular Thrombus
Authors: Willeford Andrew , Zhu Wenhong , Stevens Craig , Thomas Isac C.
Published: November 2020

Background

Use of direct oral anticoagulants (DOACs) for the treatment of left ventricular (LV) thrombus has gained considerable interest.

Objective

We aimed to evaluate if DOACs are effective in the treatment of LV thrombus compared with warfarin.

Methods

We evaluated the medical records of patients diagnosed with a new LV thrombus at a tertiary medical center. The primary outcome was the composite of thrombus persistence, stroke, or systemic embolism. We adjusted for potential confounders using multiple logistic regression. The safety outcome was the composite of hemorrhagic stroke or bleeding requiring blood transfusion.

Results

A total of 129 patients were treated with warfarin and 22, with a DOAC. In unadjusted analysis, 54.3% of patients treated with warfarin met criteria for the efficacy outcome as compared with 40.9% of patients treated with a DOAC ( P = 0.25). In adjusted analysis, no difference between groups was observed (odds ratio = 0.39; 95% CI = 0.14-1.06; P = 0.07 for DOAC vs warfarin). In all, 3.9% of patients treated with warfarin met safety criteria as compared with 4.5% of patients treated with a DOAC. A total of 8 patients in the warfarin group had a stroke or systemic embolism as compared with 0 patients in the DOAC group ( P = 0.37).

Conclusion and Relevance

Our data suggest that DOACs may be reasonable alternatives for treatment of LV thrombus. When added to the totality of available studies, this study demonstrates that the effectiveness of DOACs in LV thrombus remains uncertain. Randomized clinical trials are needed.
Current Condition of Home Environment and Necessary Home Modifications for Elderly in Community
Authors: Gu Won-Hoe , Kim Yong-Sup , Lee Seong-A
Published: November 2020

This study aimed to investigate the home environment conditions of the elderly living in the community and to confirm the needs of the residential environment. This study was conducted from January 15th to 25th, 2018, in 12 elderly households in Chungcheongnam-do, using a structured questionnaire and a home environment checklist. The elderly did not feel uncomfortable with their current home, but they wanted to modify their home environment to improve their quality of life. Investigation using home environment checklists showed that demands for supportive design were lacking in the overall areas. On the results of this study, it was confirmed that it is essential to reflect the residents’ occupation, physical characteristics, and needs when constructing the home environment for the healthy life of the elderly in the community.
Academic and family disruptions during the COVID-19 pandemic: A reflexive from social work
Authors: Donoso Gabriela Rubilar , Valderrama Caterine Galaz , LaBrenz Catherine A
Published: November 2020

This article presents a reflection of how processes to reconcile work-life balance among academic mothers have changed during COVID-19. We present three autobiographical narratives that explore adapting and adjusting to research and teaching during remote work, confinement, and caring for one’s children. Intertwined in these narratives are themes of disruptions, responsibilities, and discoveries through these processes to adapt to COVID-19 and ongoing social and political crises.
Photovoice as a creative coping tool with the COVID-19 crisis in practical training seminar for social work students
Authors: Malka Menny
Published: November 2020

The Coronavirus-19 crisis has led university professors, social workers, students and social service consumers to shift to online methods of communication and teaching. In this novel, shared reality, the present paper introduces a new initiative based on implemented photovoice methodology as a tool for documenting BSW students' professional daily lives. This tool was used at a practical training seminar for 16 third year students at the School of Social Work, Sapir Academic College.
Reframing facemasks as tools to balance individualism and social responsibility
Authors: Lee Othelia EunKyoung
Published: November 2020

Facemasks become a significant metaphor to reflect individual values and social responsibilities. As an Asian immigrant woman with disabilities, the author shares her personal disruptions, distractions, and discoveries brought by this pandemic. As a social work educator, the author also envisions positive changes in the post-COVID-19 era and its discusses implications.
Covid-19, social distancing and the ‘scientisation’ of touch: Exploring the changing social and emotional contexts of touch and their implications for social work
Authors: Green Lorraine , Moran Lisa
Published: November 2020

In this paper, we reflect on ‘scientific’ governmental and media responses to Covid-19 in the UK, illuminating their negative impacts on complex and emergent touch forms/practices and people’s related emotions. The scientisation of the pandemic led to the government initially placing the country in lockdown and enforcing social distancing. It thereby regulated and proscribed routine and normative touch practices in order to save lives. However, such strategies were not accompanied by an awareness that increased touch deprivation could be emotionally harmful, that lockdown could exacerbate abusive touch in the privatised familial domestic sphere, and that paid care-giver touch in other contexts, such as care homes for the elderly, could also be potentially lethal. These negative consequences are important for social workers to understand and appropriately respond to, as they disproportionately impact vulnerable and marginalised groups and are heightened for service users, who are frequently members of many disadvantaged groups simultaneously.
Beyond a shared experience: Queer and trans youth navigating COVID-19
Authors: Paceley Megan S , Okrey-Anderson Sloan , Fish Jessica N , McInroy Lauren , Lin Malcolm
Published: November 2020

As queer scholars engaged in research and practice with queer and trans youth across the United States and internationally, we are deeply concerned about the impact of the COVID-19 pandemic on this vulnerable population. Physical distancing, social isolation, and school closures create challenges for adolescents as they navigate increasing independence from caregivers and more intimate relationships with peers. The challenges related to the ongoing pandemic are exacerbated for queer and trans youth as they negotiate their sexuality and gender identit(ies) in addition to typical developmental activities. Simultaneously, social work practices that provide critical and lifesaving support for queer and trans youth have been hindered by the closures and other pandemic-related changes to schools and community programs. We present this reflexive essay to deconstruct the notion of a shared experience during this pandemic and elevate the voices of queer and trans youth during this unprecedented moment in time. Through engagement with a small, local group of queer and trans youth, we share the challenges they are facing–particularly the consequences of social isolation and lack of identity-affirming support caused by physical distancing measures. We end by sharing their ideas for social work practice and how they can best be supported during this time. We do this to emphasize variations in the shared experience of a global pandemic and ensure the experiences of queer and trans youth are documented during this moment in history.
The Gender Wage Gap in Hospitality: New Evidence From Spain
Authors: Casado-Díaz José M. , Driha Oana , Simón Hipólito
Published: November 2020

This article examines the gender wage gap in the Spanish hospitality industry versus the rest of the economy. Decomposition techniques are applied to a nationwide representative sample that includes matched employer–employee data allowing an accurate quantification of the phenomenon and its determinants. The methodologies used allow us to examine the average gender wage gap and also how this gap behaves throughout the wage distribution. According to the results, the gender wage gap in hospitality is rather significant (although slightly lower compared with the rest of the economy) and exhibits a steeper profile along the wage distribution. A large part of the gap is explained by observable characteristics, as female hospitality workers have lower levels of seniority than men, are overrepresented in low-skilled occupations, have less supervisory responsibilities, and are segregated into low-wage firms. Although potentially direct discrimination seems to be lower in hospitality, it is not a negligible problem, as, in its most conservative measure (namely, when observationally identical male and female employees working in the same firm are compared), it accounts for as much as 0.05 log points or 30% of the raw gender wage gap. The evidence also shows that the particularly intense gender wage gap observed in the uppermost part of the wage distribution in the hospitality industry arises because more qualified women in the sector are doubly penalized by an intense segregation into comparatively worse jobs and by an unfavorable wage treatment with respect to comparable men, which is consistent with the glass-ceiling phenomenon.
Anxiety Modulates Preference for Immediate Rewards Among Trait-Impulsive Individuals: A Hierarchical Bayesian Analysis
Authors: Haines Nathaniel , Beauchaine Theodore P. , Galdo Matthew , Rogers Andrew H. , Hahn Hunter , Pitt Mark A. , Myung Jay I. , Turner Brandon M. , Ahn Woo-Young
Published: November 2020

Trait impulsivity—defined by strong preference for immediate over delayed rewards and difficulties inhibiting prepotent behaviors—is observed in all externalizing disorders, including substance-use disorders. Many laboratory tasks have been developed to identify decision-making mechanisms and correlates of impulsive behavior, but convergence between task measures and self-reports of impulsivity are consistently low. Long-standing theories of personality and decision-making predict that neurally mediated individual differences in sensitivity to (a) reward cues and (b) punishment cues (frustrative nonreward) interact to affect behavior. Such interactions obscure one-to-one correspondences between single personality traits and task performance. We used hierarchical Bayesian analysis in three samples with differing levels of substance use ( N = 967) to identify interactive dependencies between trait impulsivity and state anxiety on impulsive decision-making. Our findings reveal how anxiety modulates impulsive decision-making and demonstrate benefits of hierarchical Bayesian analysis over traditional approaches for testing theories of psychopathology spanning levels of analysis.
Alignment Between Children’s Numeracy Performance, the Kindergarten Common Core State Standards for Mathematics, and State-Level Early Learning Standards
Authors: Litkowski Ellen C. , Duncan Robert J. , Logan Jessica A. R. , Purpura David J.
Published: November 2020

The current study examined preschoolers’ (N = 801) age-related performance on one measure of verbal counting and two measures of cardinality (“how many” and “give n”) aligned with the kindergarten Common Core State Standards for Mathematics (CCSSM) and included in the majority of states’ early learning guidelines for mathematics. Children were grouped into five age categories (3, 3.5, 4, 4.5, 5, 5.5), and within-age-group average rates of correct responses for each item within these three measures were calculated. Results demonstrated that the majority of children were already successfully meeting the CCSSM standards for both cardinal number knowledge tasks (86.5% and 53.3%, respectively) prior to kindergarten entry but that only 18.9% of the children were meeting the standard for verbal counting. Findings indicate potential misalignment between children’s existing capabilities and the CCSSM standards for cardinality and underscore the need to conduct large, nationally representative studies measuring children’s abilities on items that more closely assess the specific mathematics skills included in the CCSSM and early learning guidelines.
Survival prediction models since liver transplantation - comparisons between Cox models and machine learning techniques
Authors: Kantidakis Georgios , Putter Hein , Lancia Carlo , Boer Jacob de , Braat Andries E. , Fiocco Marta
Published: November 2020

Background

Predicting survival of recipients after liver transplantation is regarded as one of the most important challenges in contemporary medicine. Hence, improving on current prediction models is of great interest.Nowadays, there is a strong discussion in the medical field about machine learning (ML) and whether it has greater potential than traditional regression models when dealing with complex data. Criticism to ML is related to unsuitable performance measures and lack of interpretability which is important for clinicians.

Methods

In this paper, ML techniques such as random forests and neural networks are applied to large data of 62294 patients from the United States with 97 predictors selected on clinical/statistical grounds, over more than 600, to predict survival from transplantation. Of particular interest is also the identification of potential risk factors. A comparison is performed between 3 different Cox models (with all variables, backward selection and LASSO) and 3 machine learning techniques: a random survival forest and 2 partial logistic artificial neural networks (PLANNs). For PLANNs, novel extensions to their original specification are tested. Emphasis is given on the advantages and pitfalls of each method and on the interpretability of the ML techniques.

Results

Well-established predictive measures are employed from the survival field (C-index, Brier score and Integrated Brier Score) and the strongest prognostic factors are identified for each model. Clinical endpoint is overall graft-survival defined as the time between transplantation and the date of graft-failure or death. The random survival forest shows slightly better predictive performance than Cox models based on the C-index. Neural networks show better performance than both Cox models and random survival forest based on the Integrated Brier Score at 10 years.

Conclusion

In this work, it is shown that machine learning techniques can be a useful tool for both prediction and interpretation in the survival context. From the ML techniques examined here, PLANN with 1 hidden layer predicts survival probabilities the most accurately, being as calibrated as the Cox model with all variables.

Trial registration

Retrospective data were provided by the Scientific Registry of Transplant Recipients under Data Use Agreement number 9477 for analysis of risk factors after liver transplantation.
High-density lipoprotein cholesterol is a predictor of survival in cirrhotic patients with acute gastrointestinal bleeding: a retrospective study
Authors: Cheng Ran , Tan Ning , Kang Qian , Luo Hao , Chen Hongyu , Pan Jiali , Han Yifan , Yang Yuqing , Xu Xiaoyuan
Published: November 2020

Background

Lipid profiles are declined in patients with viral liver cirrhosis and correlated with severity of liver disease. Hepatitis B virus (HBV) is the leading cause of liver cirrhosis in China. Our primary aim was to investigate whether serum lipids and lipoproteins associate with survival in patients with HBV-related cirrhosis and acute gastrointestinal bleeding, and develop a 6-week mortality risk score that incorporates it.

Methods

From January 2008 to December 2015, consecutive cirrhotic patients with acute gastrointestinal bleeding admitted to our hospital were evaluated and randomly divided into the derivation (n = 629) and validation (n = 314) cohorts. A logistic regression model was established to confirm the association between lipoprotein cholesterol and mortality. Accuracy to predict mortality were assessed by area under the receiver operating characteristic curves (AUROCs) and compared using the Hanley and McNeil test.

Results

Among study subjects, the 6-week mortality rate was 10.6%. High-density lipoprotein cholesterol (HDL-C) level was found to correlate most strongly with prognostic scores. On ROC analysis, HDL-C showed excellent diagnostic accuracy for 6-week mortality. Logistic regression analysis provided a simple algorithm based on the combined use of 4 variables (total bilirubin (TBIL), HDL-C, International normalized ratio, and hemoglobin), allowing accurate discrimination of 3 distinct prognostic subgroups with 1.7% (low risk), 12.3% (intermediate risk), and 56.9% (high risk) mortality. Its accuracy was significantly better than that of Child–Pugh, model of end-stage liver disease, albumin-bilirubin score, D’Amico model, Augustin model, AIMS65 score and Glasgow-Blatchford score. Baseline HDL-C values ≤ 0.54 mmol/L were associated with markedly lower 6-week survival. Comparable results were found in the validation set.

Conclusion

HDL-C is a potential indicator for the prognosis of patients with cirrhosis and acute gastrointestinal bleeding. The new algorithm based on HDL-C allowed an accurate predictive assessment of 6-week mortality after bleeding attack.
Effect of a patient-centred deprescribing procedure in older multimorbid patients in Swiss primary care - A cluster-randomised clinical trial
Authors: Zechmann Stefan , Senn Oliver , Valeri Fabio , Essig Stefan , Merlo Christoph , Rosemann Thomas , Neuner-Jehle Stefan
Published: November 2020

Background

Management of patients with polypharmacy is challenging, and evidence for beneficial effects of deprescribing interventions is mixed. This study aimed to investigate whether a patient-centred deprescribing intervention of PCPs results in a reduction of polypharmacy, without increasing the number of adverse disease events and reducing the quality of life, among their older multimorbid patients.

Methods

This is a cluster-randomised clinical study among 46 primary care physicians (PCPs) with a 12 months follow-up. We randomised PCPs into an intervention and a control group. They recruited 128 and 206 patients if ≥60 years and taking ≥five drugs for ≥6 months. The intervention consisted of a 2-h training of PCPs, encouraging the use of a validated deprescribing-algorithm including shared-decision-making, in comparison to usual care. The primary outcome was the mean difference in the number of drugs per patient (dpp) between baseline and after 12 months. Additional outcomes focused on patient safety and quality of life (QoL) measures.

Results

Three hundred thirty-four patients, mean [SD] age of 76.2 [8.5] years participated. The mean difference in the number of dpp between baseline and after 12 months was 0.379 in the intervention group (8.02 and 7.64; p = 0.059) and 0.374 in the control group (8.05 and 7.68; p = 0.065). The between-group comparison showed no significant difference at all time points, except for immediately after the intervention (p = 0.002). There were no significant differences concerning patient safety nor QoL measures.

Conclusion

Our straight-forward and patient-centred deprescribing procedure is effective immediately after the intervention, but not after 6 and 12 months. Further research needs to determine the optimal interval of repeated deprescribing interventions for a sustainable effect on polypharmacy at mid- and long-term. Integrating SDM in the deprescribing process is a key factor for success.

Trial registration

Current Controlled Trials, prospectively registered ISRCTN16560559 Date assigned 31/10/2014.

The Prevention of Polypharmacy in Primary Care Patients Trial (4P-RCT).
Features of Streptococcus agalactiae strains recovered from pregnant women and newborns attending different hospitals in Ethiopia
Authors: Ali Musa Mohammed , Woldeamanuel Yimtubezinash , Asrat Daniel , Fenta Demissie Assegu , Beall Bernard , Schrag Stephanie , McGee Lesley
Published: November 2020

Background

Streptococcus agalactiae(Group B Streptococcus, GBS) serotypes, sequence types, and antimicrobial resistance profile vary across different geographic locations affecting disease patterns in newborns. These differences are important considerations for vaccine development efforts and data from large countries in Africa is limited. The aim of this study was to determine serotypes and genotypes of GBS isolates from pregnant women and their newborns in Ethiopia.

Methods

A hospital based cross-sectional study was conducted at three hospitals in Ethiopia from June 2014 to September 2015. Out of 225 GBS isolates, 121 GBS were recovered, confirmed and characterized at CDC’s Streptococcus Laboratory using conventional microbiology methods and whole genome sequencing.

Results

Of the 121 isolates, 87 were from rectovaginal samples of pregnant women, 32 from different body parts of their newborns and 2 from blood of newborns with suspected sepsis. There were 25 mother-infant pairs and 24 pairs had concordant strains. The most prevalent serotypes among mothers and/or their babies were II, Ia and V (41.5, 20.6, 19.5 and 40.6%, 25 and 15.6%, respectively). Multilocus sequence typing (MLST) on 83 isolates showed ST10 (24; 28.9%) and ST2 (12; 14.5%) as most predominant sequence types. All GBS strains were susceptible to penicillin, cefotaxime and vancomycin, which correlated to the presence of wildtype PBP2x types and the lack of known vancomycin-resistance genes. Tetracycline resistance was high (73; 88%, associated primarily withtetM, but alsotetOandtetL). Five isolates (6%) were resistant to erythromycin and clindamycin and 3 isolates were fluoroquinolone-resistant, containing associated mutations ingyrAandparCgenes. All isolates were positive for one of four homologous Alpha/Rib family determinants and 1–2 of the three main pilus types.

Conclusions

Predominant serotypes were II, Ia, and V. A limited number of clonal types were identified with two STs accounting for about half of the isolates. All strains collected in this study were susceptible to beta-lactam antibiotics and vancomycin. Typical of most GBS, these isolates were positive for single alpha-like family protein, serine-rich repeat gene, as well as 1–2 pilus determinants.
Endophthalmitis caused by Mycobacterium houstonense: case report
Authors: Che Xin , Li Qingjian , Wang Luoziyi , Jiang Jing , Shen Xuzhong , Qian Yiwen , Wang Zhiliang
Published: November 2020

Background

Mycobacterium houstonense is rapidly growing mycobacteria (RGM) that belongs to M. fortuitum group. So far, there have been few associated reports of human diseases induced by M. houstonense worldwide.

Case presentation

We present a delayed-onset postoperative endophthalmitis caused by M. houstonense after glaucoma drainage implant (GDI) surgery. The ocular infection lasted for 2 months without appropriate treatment that developed into endophthalmitis and the patient underwent an emergency enucleation.

Conclusion

Implant erosion and a delay in diagnosis of ocular infection could lead to irreversible damage as observed in our case. Ophthalmologists should be alert for ocular RGM infection, and prompt laboratory diagnosis with initiation of effective multidrug therapy might prevent loss of vision.
Paternity in male kidney transplant recipients: a French national survey, the PATeRNAL study
Authors:   On behalf of the Spiesser transplant group, Boyer Annabel , Lobbedez Thierry , Ouethrani Mohamed , Thuillier Lecouf Angélique , Bouvier Nicolas , Châtelet Valérie , Hurault de Ligny Bruno
Published: November 2020

Background

There is concern about the impact of immunosuppressive agents taken by male kidney transplant (KT) recipients on the risk of foetal malformations. The aim of our survey was to estimate the paternity rate and the outcomes of pregnancies fathered by kidney transplanted males.

Methods

This survey analysed 1332 male KT recipients older than 18 years, followed in 13 centres in France. A self-reported questionnaire was used to collect data on the patients, treatments at the time of conception and the pregnancy outcomes.

Results

The study included data on 349 children from 404 pregnancies fathered by 232 male KT recipients. The paternity rate was 17% (95% CI [15–20]). There were 37 (9%, 95% CI [7–12]) spontaneous abortions, 12 (3%, 95% CI [2–5]) therapeutic abortions, 2 (0.5%, 95% CI [0.1–1]) still births, and 13 (4%, 95% CI [2–6]) malformations reported. Compared to the general population, there was no difference in the proportion of congenital malformations nor unwanted outcomes whether the father was exposed or not to immunosuppressive agents.

Conclusions

This survey does not provide any warning signal that pregnancies fathered by male patients exposed to immunosuppressive agents, notably the debated MMF/MPA, have more complications than pregnancies in the general population.
Effect of changing treatment to high-flux hemodialysis (HFHD) on mortality in patients with long-term low flux hemodialysis (LFHD): a propensity score matched cohort study
Authors: Liu Shuxin , Liu Hong , Wang Zhihong , Teng Lanbo , Dong Cui , Gui Tingting , Zhang Yu
Published: November 2020

Background

The purpose of this study was to explore the effect of changing treatment to high-flux hemodialysis (HFHD) on mortality rate in patients with long-term low flux hemodialysis (LFHD).

Methods

The patients with end-stage renal disease (ESRD) who underwent LFHD with dialysis age more than 36 months and stable condition in our hospital before December 31, 2014 were included in this study. They were divided into control group and observation group. Propensity score matched method was used to select patients in the control group. The hemodialysis was performed 3 times a week for 4 h. The deadline for follow-up is December 31, 2018. End-point event is all-cause death. The survival rates of the two groups were compared and multivariate Cox regression analysis was carried out.

Results

K-M survival analysis showed that the 1-year, 2-year, 3-year and 4-year survival rates of HFHD group were 98, 96, 96 and 96%, respectively. The 1-year, 2-year, 3-year and 4-year survival rates of LFHD group were 95, 85, 80 and 78%, respectively. Log-rank test showed that the survival rate of HFHD group was significantly higher than that of LFHD group (x2= 7.278,P = 0.007). Multivariate Cox regression analysis showed that male, age, hemoglobin and low-throughput dialysis were independent predictors of death (P < 0.05). Compared with LFHD, HFHD can significantly reduce the mortality risk ratio of patients, as high as 86%.

Conclusion

The prognosis of patients with ESRD who performed long-term LFHD can be significantly improved after changing to HFHD.
Retrospective cohort study of nanoparticle albumin-bound paclitaxel plus ramucirumab versus paclitaxel plus ramucirumab as second-line treatment in patients with advanced gastric cancer
Authors: Okunaka Mashiro , Kotani Daisuke , Demachi Ken , Kawazoe Akihito , Yoshino Takayuki , Kawasaki Toshikatsu , Shitara Kohei
Published: November 2020

Background

Nanoparticle albumin-bound paclitaxel (nab-PTX) has shown non-inferiority to paclitaxel (PTX) as second-line therapy for advanced gastric cancer (AGC) with fewer infusion-related reactions. The efficacy and safety of nab-PTX plus ramucirumab (RAM) was reported in a phase II trial; however, there is no randomized trial comparing this regimen with PTX plus RAM in patients with AGC. This retrospective study aimed to investigate the efficacy and safety of nab-PTX plus RAM versus PTX plus RAM in patients with AGC.

Methods

This study included patients with AGC who received nab-PTX plus RAM from September 2017 to January 2019 or PTX plus RAM from June 2015 to August 2017 as second-line chemotherapy in our hospital.

Results

A total of 113 and 138 patients who received nab-PTX plus RAM and PTX plus RAM, respectively, were analyzed. Median progression-free survival (PFS) was 3.9 months (95% confidence interval [CI]: 3.4–4.3) in the nab-PTX plus RAM group and 3.9 months (95% CI: 3.1–4.7) in the PTX plus RAM group (hazard ratio [HR]: 1.08; 95% CI: 0.83–1.40; P = 0.573). Median overall survival (OS) was 10.9 months (95% CI: 9.3–12.7) in the nab-PTX plus RAM group and 10.3 months (95% CI: 8.5–12.0) in the PTX plus RAM group (hazard ratio: 0.82; 95% CI: 0.61–1.10; P = 0.188). In patients with moderate/massive ascites, favorable outcomes for progression-free survival were observed in the nab-PTX plus RAM group compared with the PTX plus RAM group. Although anemia and fatigue (any grade) were more frequent in the nab-PTX plus RAM group, discontinuation of study treatment was not increased in the nab-PTX plus RAM group. There was no occurrence of hypersensitivity reaction in the nab-PTX plus RAM group, while two patients (1.4%) experienced grade 3 hypersensitivity reactions in the PTX plus RAM group.

Conclusions

The combination of nab-PTX plus RAM showed a similar efficacy and safety profile to PTX plus RAM as second-line treatment for patients with AGC.