bluuebunny/crossref_metadata_2025 huggingface dataset:
Reasons for unsuccessful research submissions to JAAPA
Authors: Reed Harrison , Dehn Richard W. , Bushardt Reamer L.
Published: April 2022

Objective:

PA authors face many barriers to publication and may benefit from additional transparency in the editorial decision-making process. This study examined the most common reasons for rejection of original research submissions to JAAPA.

Methods:

Senior JAAPA editors conducted a thematic analysis of reviewer and editor comments and used these broad themes to classify the reasons for rejection of original research manuscripts submitted to JAAPA.

Results:

From October 2015 through December 2018, 77 research manuscripts were submitted to JAAPA. Fifty-six manuscripts were rejected, resulting in an overall rejection rate of 73.7%. Common reasons for rejection included: methodologic issues (55.4%), content outside the journal's scope (42.9%), poor writing quality (17.9%), guideline nonadherence (3.6%), lack of novelty (3.6%), and author(s) declining to revise the manuscript (1.8%).

Conclusion:

The most common reasons for manuscript rejection can be overcome through research planning and manuscript preparation.
Psychologic wellness of PA, NP, and physician hospitalists during the COVID-19 pandemic
Authors: Dugani Sagar B. , Fischer Karen M. , Geyer Holly L. , Maniaci Michael J. , Croghan Ivana T. , Burton M. Caroline
Published: April 2022

Objectives:

Hospitalists, comprising PAs, NPs, and physicians, manage patients hospitalized with COVID-19. To guide the development of support programs, this study compared the psychologic wellness of hospitalist PAs, NPs, and physicians during the COVID-19 pandemic.

Methods:

We surveyed hospitalists in 16 hospitals at Mayo Clinic, from May 4 to 25, 2020. We used PROMIS surveys for self-reported global well-being (two single-item measures), anxiety, social isolation, and emotional support, before and during the pandemic. Linear and logistic regression models were adjusted for personal and professional factors.

Results:

The response rate was 52.2% (N = 154/295). In adjusted linear regression models, the change in scores (before minus during pandemic) for anxiety, social isolation, and emotional support was similar for PAs and NPs compared with physicians. In adjusted logistic regression models, physicians, compared with PAs and NPs, had a higher odds of top global well-being for mental health (adjusted odds ratio [95% confidence interval]: 2.82 [1.12, 7.13]; P = .03) and top global well-being for social activities and relationships (adjusted odds ratio 4.08 [1.38, 12.08]; P = .01).

Conclusions:

During the COVID-19 pandemic, global well-being was lower for PAs and NPs compared with physician hospitalists. These results can guide support programs for hospitalists.
Dynamic Changes on Video-capillaroscopy and Potential Microsurgical Application: Temperature and Skin Surface Readings
Authors: Matsui Chihiro , Lao William W. , Tanaka Takakuni , Escandón Joseph M. , Mohammad Arbab , Tsuji Nao , Matsui Yuki , Mizuno Hiroshi
Published: April 2022

Video-capillaroscopy is being explored as a potential tool for microsurgical flap monitoring. A detailed examination of the effect of temperature on capillary changes using video-capillaroscopy is yet to be investigated. We analyzed the video-capillaroscopy findings on different skin areas often used for flap harvest at normal body temperatures and at lower temperatures. Skin capillaries at the lateral thigh, anterior forearm, mid-axillary line, abdomen, and fingertips were observed using video-capillaroscopy in 20 healthy Japanese individuals. Further, ImageJ software was used to measure the blood vessel area and blood flow velocity, and comparisons were drawn between normal body temperature and lower body temperature states. All measures of blood vessel area and average blood flow velocity for the different anatomical regions were significantly different before and after cooling (P < 0.001). The mean reduction rate of the vessel area was significantly different among anatomic regions (P < 0.001). Post-hoc analysis revealed a significant difference in the vessel area reduction rate between anatomic areas (P < 0.05); except when comparing the thigh versus finger, the forearm versus abdomen, and the mid-axillary line versus abdomen. The mean blood flow velocity was significantly different among anatomic regions (P < 0.001). Post-hoc analysis revealed a significant difference between the thigh and forearm (P = 0.009), the forearm and fingertip (P = 0.001), and the abdomen and fingertip (P = 0.004). Decreasing the skin temperature resulted in a significant vasoconstriction and reduction in capillary flow velocity. It is imperative to keep the monitored area warm during video-capillaroscopy assessment to avoid false diagnosis of vascular occlusion.
COVID-19 Outcomes: Does the Use of Psychotropic Drugs Make a Difference? Accumulating Evidence of a Beneficial Effect of Antidepressants—A Scoping Review
Authors: Bonnet Udo , Juckel Georg
Published: April 2022

Purpose/Background

Studies for repurposed drugs in severe acute respiratory syndrome coronavirus type 2–infected and coronavirus disease 2019 (COVID-19) patients are ongoing. According to preclinical research, antidepressants (ADs) might be useful in the treatment of COVID-19.

Methods/Procedures

We conducted a scoping review including clinical studies on AD effects on SARS-CoV-2 infection and COVID-19.

Finding/Results

As of January 2, 2022, we found 14 clinical studies, which could be included into this review. Among them, there were 2 randomized, placebo-controlled studies and 2 prospective parallel-group studies about the efficacy/effectiveness and tolerability of fluvoxamine. The remaining studies were mainly retrospective studies considering COVID-19 hospital populations predominantly exposed to fluoxetine (N = 3), other selective serotonin reuptake inhibitors (SSRI), selective norepinephrine reuptake inhibitors (SNRI), and trazodone. The vast majority were hospital studies and assessed COVID-19 severity (morbidity) and mortality as primary endpoints. The only outpatient study (fluvoxamine) investigated the COVID-19–related hospitalization rate, and 1 psychiatric hospital study (SSRI, SNRI, trazodone) focused on the SARS-CoV-2 infection rate.

Implications/Conclusions

At present, the best evidence of an “anti–COVID-19” potential of ADs exists for fluvoxamine and, to a lesser extent, for fluoxetine. Preliminary evidence had found that patients exposed to SSRI or SNRI substance classes might have a reduced mortality risk and that trazodone might reduce SARS-CoV-2 infection rates. Three studies found no relevant influence of ADs on COVID-19 morbidity and mortality, and 1 study described increased mortality. The latter study, however, did not differentiate between psychotropic medication and ADs. Tricyclics and monoamine oxidase inhibitors are still absolute “dark zones” in COVID-19 research. Further controlled studies testing the effectiveness/efficacy and tolerability/safety (as well as the treatment timing and duration) of different AD substance classes in COVID-19 and post/long-COVID patients of various populations are warranted.
Certain Voicing Tasks Improve Balance in Postpartum Women Compared With Nulliparous Women
Authors: Rudavsky Aliza , Hickox Lauren , Frame Megan , Philtron Daisy , Massery Mary
Published: April 2022

Background:

Postpartum women are at an increased risk of falls. Maintaining standing balance is multifactorial, involving abdominal wall/pelvic floor muscle responsivity, quick generation of intra-abdominal pressure, and glottis position.

Objective:

To identify whether using voicing tasks improves balance in postpartum women.

Study Design:

Research report.

Methods:

Eleven postpartum women and 10 age-matched nulliparous controls stood on a force plate when balance was perturbed to the front or back of their bodies while performing 6 different breathing and voicing tasks. Tasks modified glottis position and lung volume. Primary outcome measure was maximal displacement of center of pressure immediately following perturbation.

Results:

When comparing the 2 groups' responses, postpartum women showed worse balance during the “Ah” sound and “normal exhale without breath hold” (P = .049 and P = .031, respectively). When comparing all responses to each task, participants in both groups showed no significantly different response to any tasks when they were perturbed anteriorly. The nulliparous group also had no significantly different responses when perturbed posteriorly. Postpartum women showed a significant difference in response to “normal exhale without breath hold” compared with “counting” (P = .01), with better balance for “counting.”

Conclusion:

Postpartum women showed improved balance during the “counting” task, which incorporates the glottis into the balance mechanism. Tasks that did not incorporate the glottis (exhalation) and relied more on the abdominal wall/pelvic floor produced worse balance in postpartum women. For recently postpartum women, counting may be a helpful strategy to improve balance and reduce fall risk.
Computational Modeling of the Penn State Fontan Circulation Assist Device
Authors: Good Bryan C. , Ponnaluri Sailahari V. , Weiss William J. , Manning Keefe B.
Published: April 2022

To address the increasing number of failing Fontan patients, Penn State University and the Penn State Hershey Medical Center are developing a centrifugal blood pump for long-term mechanical support. Computational fluid dynamics (CFD) modeling of the Penn State Fontan Circulatory Assist Device (FCAD) was performed to understand hemodynamics within the pump and its potential for hemolysis and thrombosis. CFD velocity and pressure results were first validated against experimental data and found to be within the standard deviations of the velocities and within 5% of the pressures. Further simulations performed with a human blood model found that most of the fluid domain was subjected to low shear stress (<50 Pa), with areas of highest stress around the rotor blade tips that increased with pump flow rate and rotor speed (138–178 Pa). However, the stresses compared well to previous CFD studies of commercial blood pumps and remained mostly below common thresholds of hemolysis and platelet activation. Additionally, few regions of low shear rate were observed within the FCAD, signifying minimal potential for platelet adhesion. These results further emphasize the FCAD’s potential that has been observed previously in experimental and animal studies.
A quality improvement initiative to improve the appropriateness of candidemia management by the implementation of a comprehensive candidemia care bundle at a tertiary care hospital in South India
Authors: Moni Merlin , Sidharthan Neeraj , Sudhir Sangita , Prabhu Binny , Nampoothiri Vrinda , James Jini , Philip Jeslyn Mary , Thomas Jisha , Antony Remya , Mohamed Zubair Umer , Kumar Anil , Prasanna Preetha , Edathadathil Fabia , Singh Sanjeev , Sathyapalan Dipu
Published: April 2022

Management of candidemia in developing countries like India encounters laxity in appropriate clinical management and challenges in terms of healthcare capacity, despite its association with high morbidity and mortality. Our study aims to evaluate the impact of a comprehensive candidemia care bundle implementation on appropriateness of therapy and major clinical outcomes.

The single-center, quasi-experimental study conducted at a south Indian tertiary care center included adult patients diagnosed with candidemia. Following a retrospective review of candidemia patients of the pre-implementation period (January 2013–December 2015), the hospital antifungal stewardship team instituted a clinical pharmacist driven comprehensive candidemia care bundle for candidemia patients during the post-implementation period (October 2017–2019) and its impact on appropriateness of antifungal prescriptions and inpatient mortality was evaluated.

The study included 175 patients with candidemia, comprising of 103 patients in the pre-implementation period and 72 patients in the post-implementation period. Appropriateness of antifungal prescriptions rose to 65% during post-implementation period from 30% observed in pre-implementation phase (P = .0005). The inhospital mortality rate reduced from 40% in the pre-implementation phase to 36% in the post-implementation phase, recording a 10% reduction over 2 years post-implementation (P = .26). No significant difference was observed in terms length of stay (P = .17).

Our study demonstrates the successful implementation of an antifungal stewardship led comprehensive care bundle in a low middle income countries setting. The results of our study will have profound implications in improving the appropriateness of management of candidemia and feasibility of scaling up to wider settings could be explored.
What is the better choice for nurses? Alternating air pressure mattresses versus static air mattresses to prevent pressure ulcers in elderly hospitalized patients
Authors: Li Yinxi , Zeng Xuemei , Wang Jianyuan , Wang Chunlei
Published: April 2022

Background:

Evidence on the comparative effectiveness between commercially available support surfaces in preventing pressure ulcer development is lacking. The purpose of this study was to compare the efficacy and safety of alternating air pressure mattresses (AAPMs) versus static air mattresses to prevent pressure ulcers in elderly hospitalized patients and to provide evidence for clinical practice.

Methods:

The electronic databases of Cochrane Library, EMBASE, PubMed, and Web of Science will be searched in April 2022 using the following key terms: “pressure ulcers,” “support surface,” and “pressure mattresses,” for all relevant studies. Only English publications are included. The primary outcome is the incidence of pressure ulcers; secondary outcomes include patient satisfaction, cost, and other bedridden complications. The Cochrane risk of bias tool will be independently used to evaluate the risk of bias of included randomized cohort studies by 2 reviewers. A modified version of the Downs and Black tool is adopted to evaluate the quality of nonrandomized cohort studies. All outcomes are pooled on random-effect model.

Results:

We hypothesized that group with AAPMs will provide better therapeutic benefits compared with control group.

Conclusions:

It is worthy to critically review the evidence of the assessment of AAPMs and static air mattresses to inform clinical practice.

OSF registration number:

10.17605/OSF.IO/MYPZ2.
Influence of aromatic essential oil nursing on mental state of patients undergoing laparoscopic cholecystectomy
Authors: Liu Xin , Luan Yingni , Zhang Lin , Li Yanli
Published: April 2022

Background:

There are no evidence-based data to confirm the efficacy of aromatic essential oil nursing in patients after laparoscopic cholecystectomy (LC). Therefore, in order to provide new evidence-based medical evidence for clinical treatment, we undertook this protocol for systematic review and meta-analysis to assess the effectiveness and safety of aromatic essential oil nursing on mental state of patients undergoing LC.

Methods:

The retrieval strategy will be developed by the evidence-based medicine librarians for the US Library of Medicine database, the Cochrane Database of Systematic Reviews, and the Excerpta Medica database. The databases will be searched between June 2022 and July 2022. Studies will be included according to the following criteria: study population undergoing LC; group with aromatic essential oil nursing compared to a control group; outcome measures including anxiety, salivary cortisol, alpha amylase, and patient satisfaction; randomized controlled trials. All data will be analyzed using R version 3.4.3 to calculate pooled standardized mean differences for outcomes. The Cochrane Collaboration's tool will be used to assess the risk of bias for each included article.

Results:

The results of this paper will fill a gap in the literature regarding this project.

Conclusion:

We assume that the aromatic essential oil nursing has a positive effect.

Registration number:

10.17605/OSF.IO/E5WC9.
Clinical assessment of levamlodipine besylate combination therapy for essential hypertension
Authors: Dai Guo-Yao , Zhu Ye-Hua
Published: April 2022

Background:

Essential hypertension has been regarded a significant risk factor for cardiovascular disease across the globe, and a significant escapable causation of early death as well as morbidity in the U.S. When angiotensin II receptor blockers and calcium channel blockers are used to treat essential hypertension, most patients will have inadequate blood pressure management. As a result, including a diuretic in the regimen is necessary. The current study's aim is to investigate the effectiveness as well as safety of levamlodipine besylate combination therapy in treating essential hypertension at varying degrees of severity.

Methods:

In establishing the effectiveness and safety of the mix of levamlodipine besylate and dihydropyridine for essential hypertension, the authors will conduct a systematic review and, where applicable, a meta-analysis of randomized controlled clinical trials. A total of 8 electronic databases will be used in the search, including 4 English databases (PubMed, Web of Science, EMBASE, and Cochrane Library) and 4 Chinese databases (China National Knowledge Infrastructure, Chinese BioMedical Literature database, Chinese Scientific Journal database, and WanFang database). All articles published in the databases will be considered between their inception and January 18, 2022. Only articles published in English or Mandarin Chinese will be picked. A group of writers will independently evaluate each reference to see if it is eligible and whether there are any duplicates. The same authors will do data extraction for all eligible studies and use the Cochrane risk of bias tool to evaluate the risk of bias in the trials chosen for inclusion.

Results:

The analysis will evaluate the efficiency and level of safeness of levamlodipine besylate combined treatment for essential hypertension.

Conclusions:

Our systematic review will offer evidence for judging whether levamlodipine besylate combination therapy can be considered an effective intercession for essential hypertension.

Ethics and dissemination:

Ethical approval will not be required as no original data will be collected as part of this review.

Registration number:

DOI 10.17605/OSF.IO/H8ZR2.
Trends & predictors of non-AIDS comorbidities among people living with HIV and receiving antiretroviral therapy in Lebanon
Authors: Abou Hassan Farouk F. , Bou Hamdan Mirna A. , El Asmar Khalil , Mokhbat Jacques E. , Melhem Nada M.
Published: April 2022

Combined antiretroviral therapy (cART) increased the life expectancy of people living with Human Immunodeficiency Virus (HIV) (PLHIV) and remarkably reduced the morbidity and mortality associated with HIV infection. Consequently, PLHIV are experiencing non-acquired immunodeficiency syndrome (AIDS) associated comorbid conditions including diabetes, hyperlipidemia, hypertension, and cardiovascular disease. The aim of this study is to determine the frequency of non-AIDS associated comorbid conditions among a cohort of PLHIV on cART in Lebanon.

Data were collected between November 2018 and December 2019 from 105 voluntary participants. A standardized questionnaire was used to collect demographic and behavioral data including lifestyle, smoking, physical activity, substance use and abuse in addition to co-infections and family history of non-communicable diseases. Moreover, data on occurrence and treatment of cardiovascular disease, hypertension, diabetes, lipid and metabolic disorders as well as mental health were collected. Blood samples were used to assess the levels of fasting blood sugar (FBS), glycosylated hemoglobin (HbA1C), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein, total cholesterol, and serum creatinine.

Hypertension (29.5%) and hyperlipidemia (29.5%) followed by diabetes (23.7%) and cardiovascular disease (9.7%) were mainly reported among study participants. Higher rate of comorbid conditions was observed among participants >40 years of age than those ≤40 years with both hypertension and hyperlipidemia most commonly reported. Older age (odds ratio [OR] 7.6; 95% CI: 1.83-31.98; P = .005) is associated with higher odds of having hyperlipidemia. Moreover, participants on cART for ≥10 years are 5 times more likely to have hyperlipidemia (OR 5; 95% CI: 1.08-22.73; P = .039). Our results also showed that study participants did not experience anxiety, depression or somatic symptoms and that there was no association between these mental disorders and older age or comorbidities.

Our results provide important information on HIV trends and associated comorbidities in Lebanon and can be used to improve the management of non-communicable diseases among PLHIV.
Medicaid Expansion Associated With Reduction in Geospatial Breast Cancer Stage at Diagnosis Disparities
Authors: Dong Weichuan , Rose Johnie , Kim Uriel , Cooper Gregory S. , Tsui Jennifer , Koroukian Siran M.
Published: April 2022

Context:

Prior studies demonstrate that Medicaid expansion has been associated with earlier-stage breast cancer diagnosis among women with low income, likely through increased access to cancer screening services. However, how this policy change has impacted geospatial disparities in breast cancer stage at diagnosis is unclear.

Objective:

To examine whether there were reductions in geospatial disparities in advanced stage breast cancer at diagnosis in Ohio after Medicaid expansion.

Design:

The study included 33 537 women aged 40 to 64 years diagnosed with invasive breast cancer from the Ohio Cancer Incidence Surveillance System between 2010 and 2017. The space-time scan statistic was used to detect clusters of advanced stage at diagnosis before and after Medicaid expansion. Block group variables from the Census were used to describe the contextual characteristics of detected clusters.

Results:

The percentage of local stage diagnosis among women with breast cancer increased from 60.2% in the pre-expansion period (2010-2013) to 62.6% in the post-expansion period (2014-2017), while the uninsured rate among those women decreased from 13.7% to 7.5% during the same period. Two statistically significant (P < .05) and 6 nonsignificant spatial clusters (P > .05) of advanced stage breast cancer cases were found in the pre-expansion period, while none were found in the post-expansion period. These clusters were in the 4 largest metropolitan areas in Ohio, and individuals inside the clusters were more likely to be disadvantaged along numerous socioeconomic factors.

Conclusions:

Medicaid expansion has played an important role in reducing geospatial disparities in breast cancer stage at diagnosis, likely through the reduction of advanced stage disease among women living in socioeconomically disadvantaged communities.
Associations of Reduced Sympathetic Neural Activity and Elevated Baroreflex Sensitivity With Non–Rapid Eye Movement Sleep: Evidence From Electroencephalogram- and Electrocardiogram-Based Sleep Staging
Authors: Tsai Hsin-Jung , Yang Albert C. , Tsai Shih-Jen , Ma Yan , Kuo Terry B.J. , Yang Cheryl C.H. , Peng Chung-Kang
Published: April 2022

Objective

Autonomic neural controls in sleep regulation have been previously demonstrated; however, whether these alternations can be observed by different sleep staging approaches remains unclear. Two established methods for sleep staging—the standardized visual scoring and the cardiopulmonary coupling (CPC) analysis based on electrocardiogram—were used to explore the cardiovascular profiles of sleep.

Methods

Overnight polysomnography was recorded together with continuous beat-to-beat blood pressure. Cortical activity, heart rate variability, blood pressure variability, and baroreflex sensitivity during sleep stages from 24 nights of sleep were obtained from 15 normotensive participants and analyzed.

Results

Non–rapid eye movement sleep (NREM) from visual scoring and restful sleep (RS) of CPC both showed the highest delta power of electroencephalogram (EEG) and lowest beta activity of EEG in comparison with other sleep stages (p < .001); likewise, the lowest total power of heart rate variability and suppressed vascular-sympathetic activity, reflected by low-frequency power of blood pressure variability, as well as a trend in elevated baroreflex sensitivity, were observed in the NREM or RS. This suppressed vascular-sympathetic activity during stable sleep further exhibited a significant correlation with increased slow-wave activity (NREM: r = −0.292 ± 0.34, p = .002; RS: r = −0.209 ± 0.30, p = .010).

Conclusions

Autonomic nervous system is evidently associated with stable sleep, as indicated by the similar findings obtained from sleep stages categorized by standardized visual scoring or CPC analysis. Such association between cardiovascular neural activity and sleep EEGs can be observed regardless of the sleep staging approach followed.
Diminished Cellular Immunity and Executive Cognitive Functioning Among Middle-Aged and Elderly Adults
Authors: Murdock Kyle W. , Stowe Raymond P. , Engeland Christopher G.
Published: April 2022

Objective

Within the field of psychoneuroimmunology, much attention has been given to immune dysregulation and its impact on cognitive functioning. Some of this work has focused on the association between high levels of basal proinflammatory cytokines and poorer performance on measures of executive functioning; however, effect sizes have been quite small in human studies.

Methods

We investigated whether Epstein-Barr virus (EBV) antibody titers, a marker of immune dysregulation related to cellular immunity, may be associated with executive functioning while also attempting to replicate prior studies using two markers of proinflammatory cytokine production (i.e., circulating and lipopolysaccharide [LPS]-stimulated cytokines [interleukin 6, interleukin 1β, interferon-γ]). A total of 71 community-dwelling adults (mean [standard deviation] age = 60.87 [6.26] years) who were seropositive for EBV infection participated in the study.

Results

Findings indicated that greater EBV antibody titers were associated with poorer performance on measures of the executive functions of inhibition (B = −2.36, standard error = 1.06, p = .028) and cognitive flexibility (B = −2.89, standard error = 1.13, p = .013) when including circulating and LPS-stimulated cytokines and other relevant covariates (i.e., age, sex, and body mass index) in linear regression analyses. Neither circulating nor LPS-stimulated cytokines were associated with performance on the cognitive tasks in the regression analyses.

Conclusions

These results suggest that EBV antibody titers may be an indicator of immune dysregulation that is more relevant to executive functioning performance than either circulating or stimulated proinflammatory cytokines among community-dwelling adults.
Targeting Anxiety to Improve Sleep Disturbance: A Randomized Clinical Trial of App-Based Mindfulness Training
Authors: Gao May , Roy Alexandra , Deluty Alana , Sharkey Katherine M. , Hoge Elizabeth A. , Liu Tao , Brewer Judson A.
Published: April 2022

Objective

Sleep disturbance is experienced by nearly 20% of Americans and is highly comorbid with anxiety. Sleep disturbances may predict the development of anxiety disorders. Mindfulness training (MT) has shown efficacy for anxiety yet remains limited by in-person-based delivery. Digitally delivered MT may target habitual worry processes, yet its effects on sleep have not been studied. This study tested if app-based MT for anxiety could reduce worry and improve sleep and examined the underlying mechanisms.

Methods

Individuals reporting worry interfering with sleep were randomized to treatment as usual (TAU; n = 40) or TAU + app-based MT (n = 40). Treatment-related changes in worry-related sleep disturbances (WRSDs), worry, nonreactivity, and anxiety were evaluated via self-report questionnaires at 1 and 2 months after treatment initiation. Fitbit devices were used to record total sleep time and estimate sleep efficiency. At 2 months, TAU received access to app-based MT, and both groups were reassessed at 4 months.

Results

In a modified intent-to-treat analysis, WRSD scores decreased by 27% in TAU + MT (n = 36) and 6% in TAU (n = 35) at 2 months (median [IQR] change = 11 [4.3] versus 15 [5.0], p = .001). These WRSD reductions were mediated by decreased worry, particularly improved nonreactivity (p values < .001). At 4 months, TAU reported a significant 29% reduction after beginning app-based MT at 2 months and TAU + MT maintained its gains. No significant between-group differences in average estimated total sleep time or sleep efficiency were found after 2 months of using the app.

Conclusions

Few mindfulness-related apps have been evaluated for clinical efficacy and/or mechanism. Results from this study demonstrate a mechanistic link between MT and increased emotional nonreactivity, decreased worry, and reduction in reported sleep disturbances, suggesting that app-based MT may be a viable option to help individuals who report that worry interferes with their sleep.

Trial Registration: ClinicalTrials.gov identifier: NCT03684057.
Evaluation of Liver Stiffness After Atrial Septal Defect Closure
Authors: Pekoz Burcak Cakir , Koc Mevlut , Kucukosmanoglu Mehmet , Koc Ayse Selcan , Koca Hasan , Dönmez Yurdaer , Sumbul Hilmi Erdem
Published: April 2022

In this study, we aimed to evaluate the liver stiffness (LS) values and the right ventricle (RV) functions after atrial septal defect (ASD) closure treatment. Sixty-six patients were included (38 female, 28 male) in the study. Patients were grouped into 3 subgroups (group I = 21 patients without ASD closure, group II = 38 patients who underwent ASD closure, and group III = 11 patients with ASD and Eisenmenger syndrome). After 1-year follow-up of the patients who underwent ASD closure, LS was assessed using the liver elastography technique. Echocardiographic changes and LS changes over time were compared. Absolute Δ-LS and Δ-liver size were found to be significantly decreased in group II compared with the other groups. While liver size, LS levels, RV and left ventricle (LV) dimensions, and tricuspid regurgitation pressure gradient were found to be significantly decreased; the tricuspid annular plane systolic excursion and the LV ejection fraction were significantly increased in group II. In addition, Δ-LV and Δ-RV dimensions and Δ–tricuspid regurgitation pressure gradient values were statistically significant and Δ–tricuspid annular plane systolic excursion and LV ejection fraction values were statistically higher in group II compared with the other groups. In conclusion, our study demonstrates that the LS is another parameter, which significantly decreases in patients treated with ASD occluder devices and can be used as an objective follow-up parameter in addition to classic echocardiographic measurements.
Feasibility and Research Insights From a Randomized Controlled Trial for Recurrent Urinary Tract Infection Prevention in Postmenopausal Women Using Vaginal Estrogen Therapy
Authors: Lenger Stacy M. , Chu Christine M. , Ghetti Chiara , Durkin Michael J. , Jennings Zoe , Sutcliffe Siobhan , Lowder Jerry L.
Published: April 2022

Objective

The aim of the study was to inform feasibility parameters (eligibility, enrollment, and retention) for a recurrent urinary tract infection (rUTI) prevention randomized controlled trial (RCT).

Methods

We assessed feasibility parameters of an RCT of postmenopausal women with uncomplicated rUTIs using vaginal estrogen. Participants were randomized to either d-mannose or a control arm. All participants were required to be using vaginal estrogen and to have a negative urine culture before 90-day trial participation. An RCT exit survey and separate survey for UTI patients (N = 196) were added to inform feasibility parameters and patient preferences for rUTI prevention and study participation after slower enrollment than anticipated.

Results

At the time of interim and subsequent futility analyses, 545 patients had been evaluated for frequent/recurrent UTIs from March 1, 2018, to January 18, 2020. Of these, 213 (39.1%) had culture-proven rUTIs and 71 (33.3% of those with culture-proven rUTIs) were eligible for the RCT. Reasons for ineligibility included complicated UTIs, premenopausal/perimenopausal status, or existing UTI prevention regimen. Of the 71 eligible participants, 57 (80.3%) enrolled, and 44 began their planned 90-day study period (77.2%; 80.0% after excluding 2 participants awaiting negative urine cultures at the time of analysis). The study was halted before conclusion. Study retention (76.0%–83.7%) was slightly lower than expected. Urinary tract infection survey patients demonstrated significant interest in rUTI research participation.

Conclusions

We learned several important lessons that can benefit future research. Many patients with frequent/recurrent UTIs are interested in research, but rigorous eligibility criteria and referral urine culture documentation made recruitment challenging.
Antipsychotic-Induced Hypothermia After Starting Aripiprazole for Posttraumatic Agitation Management: A Case Report
Authors: Diaz-Segarra Nicole , Edmond Arline , Yonclas Peter
Published: April 2022

Objectives

Antipsychotic-induced hypothermia is an uncommon type of secondary hypothermia resulting from neurotransmitter derangements within the nervous system thermoregulation pathway. The most common causative medications include olanzapine, haloperidol, and risperidone, with one published report of aripiprazole. Most individuals who develop antipsychotic-induced hypothermia receive neuroleptic treatment for psychiatric disorder management, with significantly fewer occurrences in those with neurologic disorders. There are currently no reports of antipsychotic-induced hypothermia after a traumatic brain injury (TBI), where antipsychotics are used for the off-label management of posttraumatic agitation.

Methods

A retrospective chart review of the patient's medical record was performed.

Results

We present a case of a 56-year-old man with a moderate TBI who developed recurrent episodes of antipsychotic-induced hypothermia after starting aripiprazole for posttraumatic agitation management.

Conclusions

To our knowledge, this is the first publication detailing antipsychotic-induced hypothermia occurring in a TBI patient. Clinicians who initiate antipsychotics for posttraumatic agitation in a TBI patient should be aware of this potential adverse effect, as well as clinical presentation, evaluation, and management strategies.
Venezuelan equine encephalitis complex, Madariaga and Eastern equine encephalitis viruses genome detection in human and mosquito populations
Authors: Carrera Jean-Paul , Araúz Dimelza , Rojas Alejandra , Cardozo Fátima , Stittleburg Victoria , Claro Ingra Morales , Galue Josefrancisco , Lezcano-Coba Carlos , Rebello Moreira Filipe Romero , Felipe-Rivera Luis , Chen-Germán Maria , Moreno Brechla , Capitan-Barrios Zeuz , López-Vérges Sandra , Pascale Juan Miguel , Sabino Ester C. , Valderrama Anayansi , Hanley Kathryn A. , Donnelly Christl A. , Vasilakis Nikos , Faria Nuno R. , Waggoner Jesse J.
Published: April 2022

Eastern equine encephalitis virus (EEEV), Madariaga virus (MADV) and Venezuelan equine encephalitis virus complex (VEEV) are New World mosquito-borne alphaviruses and cause severe neurological disease in human and equine hosts. However, their detection during the acute phase is complicated by non-specific clinical manifestations and lack of available diagnostic tools. To develop and clinically evaluate rRT-PCRs for VEEV complex, MADV and EEEV, primers and probes were designed from publicly available whole-genome sequences. The rRT-PCRs were validated using 15 retrospective serum samples from febrile patients collected during the 2015 and 2017 alphavirus outbreaks in Panama. In addition, the protocol was validated with 150 mosquito pools from 2015, and with 118 samples from prospective disease surveillance from 2021 and 2022. The rRT-PCRs detected VEEV complex RNA in 10 samples (66.7%) from the 2015 and 2017 outbreaks, and in one of these ten samples, both VEEV complex and MADV RNAs were detected. Additionally, VEEV complex RNA was detected in 5 suspected dengue from prospective disease surveillance. The rRT-PCR assays detected VEEV complex RNA in 3 fromCulex(Melanoconion)vomeriferpools, 2 of which yielded VEEV isolates. Untargeted sequencing and phylogenetic analysis identified VEEV ID subtype in seven VEEV complex RNA positive sample. The VEEV complex, MADV and EEEV rRT-PCRs provide accurate detection while yielding significant benefits over currently available molecular methods. Our results suggest that 11.9% of suspected dengue cases in Panama are VEEV infections.
Epidemiology of infections with SARS-CoV-2 Omicron BA.2 variant in Hong Kong, January-March 2022
Authors: Mefsin Yonatan , Chen Dongxuan , Bond Helen S. , Lin Yun , Cheung Justin K. , Wong Jessica Y. , Ali Sheikh Taslim , Lau Eric H. Y. , Wu Peng , Leung Gabriel M. , Cowling Benjamin J.
Published: April 2022

Hong Kong reported 12,631 confirmed COVID-19 cases and 213 deaths in the first two years of the pandemic but experienced a major wave predominantly of Omicron BA.2.2 in early 2022 with over 1.1 million reported SARS-CoV-2 infections and more than 7900 deaths. Our data indicated a shorter incubation period, serial interval, and generation time of infections with Omicron than other SARS-CoV-2 variants. Omicron BA.2.2 cases without a complete primary vaccination series appeared to face a similar fatality risk to those infected in earlier waves with the ancestral strain.
EMS responses to hospice patients: a qualitative study
Authors: Kukol Whitney , Ryan Christopher W.
Published: April 2022

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In the palliative care community, multiple emergency department visits and hospitalizations are considered an indicator of poor-quality end of life care. There is substantial research on the events surrounding ED visits, and subsequent hospitalizatons, by hospice patients. It is important however to understand that these hospital arrivals often begin with an ambulance response to the home. Emergency medical services (EMS) responses to hospice patients have been less well-studied. We conducted a retrospective study of 170 consecutive electronic patient care reports produced contemporaneously by EMS providers in several US counties during the normal course of their responses to hospice patients. We summarized descriptive epidemiology of the patients and of the incidents, and we explored the provider narratives for recurring themes. To our knowledge this is the first study to explore the contemporaneously-documented on-scene circumstances of pre-hospital care for patients enrolled in a hospice program.

The median patient age was 76. Cancer, chronic lung disease, and heart failure were the most common hospice-qualifying diagnoses. Transportation of the patient from the scene occurred in 111 cases (65.3%). Consistent with previous studies based on interviews of EMS providers, the most common chief complaints included pain, dyspnea, and altered mental status. EMS was frequently called for confirmation of death, a finding not previously reported.

Transitions of care, such as from curative medical care to hospice care, and from hospital to home, were a recurring theme. Gaps in care around these transitions were often evident, with EMS being called upon to fill them. Care transitions around weekends were prominent. Also emerging from the narratives was the concept that hospice enrollment is not a single event but rather a step-wise process; we developed a preliminary coding taxonomy to classify those enrollment stages.

The hospice-EMS interface can be complex. Although all care by EMS providers is with the literal or implied consent of the patient, the arrival of an ambulance to a scene where emotions are running high carries a certain momentum and could lead to a cascade of interventions that, in retrospect and given other options, the patient may not have wanted. A better understanding of the hospice-EMS interface might illuminate changes that could be made to improve it, with a goal of ensuring that hospice patients and their families receive emergency medical services when they need and can benefit from them but receive other, non-EMS, services when those are more suitable to their needs. It might also improve the efficiency of an already overburdened EMS system.
Structural and biochemical mechanism for increased infectivity and immune evasion of Omicron BA.1 and BA.2 variants and their mouse origins
Authors: Xu Youwei , Wu Canrong , Cao Xiaodan , Gu Chunyin , Liu Heng , Jiang Mengting , Wang Xiaoxi , Yuan Qingning , Wu Kai , Liu Jia , Wang Deyi , He Xianqing , Wang Xueping , Deng Su-Jun , Xu H. Eric , Yin Wanchao
Published: April 2022

The Omicron BA.2 variant has become a dominant infective strain worldwide. Receptor binding studies reveal that the Omicron BA.2 spike trimer have 11-fold and 2-fold higher potency to human ACE2 than the spike trimer from the wildtype (WT) and Omicron BA.1 strains. The structure of the BA.2 spike trimer complexed with human ACE2 reveals that all three receptor-binding domains (RBDs) in the spike trimer are in open conformation, ready for ACE2 binding, thus providing a basis for the increased infectivity of the BA.2 strain. JMB2002, a therapeutic antibody that was shown to have efficient inhibition of Omicron BA.1, also shows potent neutralization activities against Omicron BA.2. In addition, both BA.1 and BA.2 spike trimers are able to bind to mouse ACE2 with high potency. In contrast, the WT spike trimer binds well to cat ACE2 but not to mouse ACE2. The structures of both BA.1 and BA.2 spike trimer bound to mouse ACE2 reveal the basis for their high affinity interactions. Together, these results suggest a possible evolution pathway for Omicron BA.1 and BA.2 variants from human-cat-mouse-human circle, which could have important implications in establishing an effective strategy in combating viral infection.
SARS-CoV-2 Delta breakthrough infections in vaccinated patients
Authors: Zou Jing , Xie Xuping , Liu Mingru , Shi Pei-Yong , Ren Ping
Published: April 2022

The continuous emergence of SARS-CoV-2 variants with increased transmission and immune evasion has caused breakthrough infections in vaccinated population. It is important to determine the threshold of neutralizing antibody titers that permit breakthrough infections. Here we tested the neutralization titers of vaccinated patients who contracted Delta variant. All 75 patients with Delta breakthrough infections exhibited neutralization titers (NT50) of less than 70. Among the breakthrough patients, 76%, 18.7%, and 5.3% of them had the NT50 ranges of <20, 20-50, and 50-69, respectively. These clinical laboratory results have implications in vaccine strategy and public health policy.
Evolution of cell size control is canalized towards adders or sizers by cell cycle structure and selective pressures
Authors: Proulx-Giraldeau Félix , Skotheim Jan M. , Francois Paul
Published: April 2022

Cell size is controlled to be within a specific range to support physiological function. To control their size, cells use diverse mechanisms ranging from ‘sizers’, in which differences in cell size are compensated for in a single cell division cycle, to ‘adders’, in which a constant amount of cell growth occurs in each cell cycle. This diversity raises the question why a particular cell would implement one rather than another mechanism? To address this question, we performed a series of simulations evolving cell size control networks. The size control mechanism that evolved was influenced by both cell cycle structure and specific selection pressures. Moreover, evolved networks recapitulated known size control properties of naturally occurring networks. If the mechanism is based on a G1 size control and an S/G2/M timer, as found for budding yeast and some human cells, adders likely evolve. But, if the G1 phase is significantly longer than the S/G2/M phase, as is often the case in mammalian cells in vivo, sizers become more likely. Sizers also evolve when the cell cycle structure is inverted so that G1 is a timer, while S/G2/M performs size control, as is the case for the fission yeast S. pombe. For some size control networks, cell size consistently decreases in each cycle until a burst of cell cycle inhibitor drives an extended G1 phase much like the cell division cycle of the green algae Chlamydomonas. That these size control networks evolved such self-organized criticality shows how the evolution of complex systems can drive the emergence of critical processes.
Patching Science – amending the literature through version control
Authors: Kane Adam , Amin Bawan
Published: April 2022

The ideal of self-correction in science is not well served by the current culture and system surrounding amendments to published literature. Here we report on a survey (N = 132) that highlights academics’ dissatisfaction with the status quo and their support for an alternative approach. We then describe our view of how amendments could and should work by drawing on the idea of an author-led version control system. Here authors would include a link in their published manuscripts to an updatable website (e.g. a GitHub repository or similar) that could be disseminated in the event of any amendment. Such a system is already in place for computer code and, as such, requires nothing but buy-in from the scientific community - a community that is already evolving towards various open science frameworks. This would remove a number of frictions that discourage amendments thus leading to an improved scientific literature and a healthier academic climate.
Epitope Mapping of SARS-CoV-2 Spike Protein Reveals Distinct Antibody Binding Activity of Vaccinated and Infected Individuals
Authors: Felbinger Nathaniel , Trudil David , Loomis Lawrence , Ascione Richard , Siragusa Gregory , Haba Seiji , Rastogi Shruti , Mucci Aidan , Claycomb Mark , Snowberger Sebastian , Luke Brian , Francesconi Stephen , Tsang Shirley
Published: April 2022

Previous studies have attempted to characterize the antibody response of individuals to the SARS-CoV-2 virus on a linear peptide level by utilizing peptide microarrays. These studies have helped to identify epitopes that have potential to be used for diagnostic tests to identify infected individuals, however, the immunological responses of individuals who have received the currently available Moderna mRNA-1273 or Pfizer BNT162b2 mRNA vaccines have not been characterized. We aimed to identify linear peptides of the SARS-CoV-2 spike protein that elicited high IgG or IgA binding activity and to compare the immunoreactivity of infected individuals to those who received both doses of either vaccines by utilizing peptide microarrays. Our results revealed peptide epitopes of significant IgG binding among recently infected individuals. Some of these peptides are located near functional domains implicated in the high infectivity of SARS-CoV-2. Vaccinated individuals lacked these distinct markers despite overall binding activity being similar.