bluuebunny/crossref_metadata_2025 huggingface dataset:
Low Donor Site Morbidity Associated With Tricortical Calcaneal Bone Graft
Authors: Ferreira Gabriel Ferraz , Costa João Henrique Almeida , Domingues Giancarlo , Lima João Paulo Bacellar Costa , Sanhudo José Antônio Veiga , Pereira Filho Miguel Viana
Published: July 2021

Background:

Autologous grafting is widely used in orthopaedic surgery because of its high osteogenic capacity, immunologic compatibility, for the absence of risk of disease transmission, and for not requiring a bone bank. The posterior-superior calcaneal tuberosity is an option for obtaining a cortical and cancellous structural bone. This study aims to describe the operative technique and complications observed at the donor site of the posterior-superior calcaneal tuberosity.

Methods:

Patients who underwent graft harvesting from the posterior-superior calcaneal tuberosity were retrospectively evaluated by pain outcomes, imaging tests, and intra- and postoperative complications.

Results:

Twenty patients with a median age of 69 years (range 48-77) and follow-up of 16 months (12-26) were assessed. Median postoperative pain at the donor site was 0 (0-6), with 2 patients reporting persistent local pain. No case of Achilles tendon rupture or intra- or postoperative calcaneal fracture were identified. One patient developed a superficial infection that was quickly resolved using oral antibiotic therapy.

Conclusion:

The posterior-superior calcaneal tuberosity is an alternative source of autologous graft with low donor site morbidity.

Level of Evidence

Level IV, case series.
Psychometric Evaluation of the Posttrauma Risky Behaviors Questionnaire: Item Response Theory Analyses
Authors: Natesan Batley Prathiba , Contractor Ateka A. , Weiss Nicole H. , Compton Sidonia E. , Price Matthew
Published: July 2021

The Posttrauma Risky Behaviors Questionnaire (PRBQ) assesses extent of engagement in posttrauma reckless and self-destructive behaviors (RSDBs). Given PRBQ’s recent development with limited psychometric investigations, we used item response theory to examine (a) item analysis, (b) person fit, and (c) differential item functioning (DIF) across gender-based groups and two different samples. One sample included 464 participants reporting potentially traumatic experiences (Mechanical Turk [MTurk], recruited online), and the other sample included 171 trauma-exposed women reporting current intimate partner violence and substance use (recruited in-person). All PRBQ items contributed to the RSDB scale, and all PRBQ items and the PRBQ scale provided maximum information for high levels of the RSDB latent trait. Seven and 11 items were conceptualized as low information items in the MTurk and intimate partner violence samples, respectively. Eight MTurk participants’ responses did not fit the overall pattern of responses as expected. Seven items were flagged for DIF between the two samples, and eight items were flagged for DIF between men and women in the MTurk sample. However, all effect sizes were <8%. Conclusively, results suggest good psychometric properties for the PRBQ and support its use to compare RSDBs across different samples and gender-based groups.
Correction of lower eyelid retraction combined with entropion in thyroid eye disease patients of East Asian ancestry
Authors: Ma Yue , Tang Meiting , Kikkawa Don O , Lu Wei
Published: July 2021

Purpose:

This study evaluates causes and treatment of lower eyelid retraction with co-existing entropion in Thyroid Eye Disease (TED) patients of East Asian ancestry.

Methods:

The medical records for 25 eyelids from 15 TED patients with lower eyelid retraction and entropion who had undergone combined orbital decompression and lower eyelid retraction correction surgery at the Second Hospital of Dalian Medical University from January 2017 to December 2018 were prospectively reviewed. We build a numerical model of biomechanics to analyze von Mises stress and displacement at the lower eyelid.

Results:

The mean follow-up duration was 6 ± 2 months. The difference of mean exophthalmos was 5.16 ± 1.21 mm ( t = 21.26, p = 4.479E-17 < 0.05). The difference of mean MRD2 was 1.9 ± 0.14 mm ( t = 67.57, p = 6.751E-29 < 0.05). About 2 of 25 eyelids entropion recurred postoperatively; the overall success rate was 92%. The biomechanical analysis results reveal that the eyelid margin is given more stress and caused more displacement in East Asian ancestry under the same force of pressure.

Conclusions:

This study shows that the lower eyelid retraction with coexistent entropion is attributable to the unique anatomical features of patients of East Asians ancestry. We corrected the lower eyelid retraction and entropion during the orbital decompression operation. The results show that this method is safe and effective. It can simultaneously improve the symptoms of TED patients such as exophthalmos, lower eyelid retraction, and entropion, with minimal complications.
Spontaneous resolution of inflammatory epiretinal membrane: Case series and review of the literature
Authors: Guemes-Villahoz Noemi , Diaz-Valle David , Fonollosa Alex , Jimenez-Santos Maria , Narvaez-Palazon Carlos , Adan Alfredo
Published: July 2021

Epiretinal membrane (ERM) represents a common complication of uveitis that may contribute independently to vision loss in patients with uveitis. Although spontaneous idiopathic ERM separation has been previously reported, to the best of our knowledge there are only two case reports in the scientific literature that depicts spontaneous regression of an inflammation-associated ERM. Spontaneous ERM separation is a rare but possible event, which occurs most often subsequent to posterior vitreous detachment. We present a case series of three patients with uveitis that exhibit the formation and subsequent spontaneous resolution of an inflammatory ERM.
Assessment of Patient Safety Culture in Public General Hospital in Capital City of Vietnam
Authors: Huong Tran Lien , Thanh Pham Quoc , Nguyen Dinh Hung , Tran Thi Nhi Ha , Bui Thi Thu Ha
Published: July 2021

Patient safety culture is a vital component in ensuring high quality and safe patient care. Assessment of staff perception on existing hospital patient safety culture (PSC) is the first step to promote PSC. This paper is aimed to assess the patient safety culture in 1 big public autonomous general hospital in Hanoi, Vietnam. This cross-sectional study surveyed 638 healthcare professional utilizing the validated (Hospital Survey on Patient Safety Culture [HSOPSC]) in an online format. This study adhered to STROBE guidelines. The positive response rate was high, with a percentage of 74.2. The strongest areas are teamwork within units (91.3%) and organizational learning/continuous improvement (88.4%). The areas for improvement are staffing (49.4%) and non-punitive response to error (53.1%). Hospital administrators should strengthen the culture of patient safety by formulating strategies and implementing interventions with emphasis on adequate staffing and promoting blame-free working environment.
Dripping Technology Use Among Young Adult E-Cigarette Users
Authors: Massey Zachary B , Brockenberry Laurel O , Murray Tori E , Harrell Paul T
Published: July 2021

Background:

Young adults are increasingly using electronic nicotine delivery systems (ENDS). The standard ENDS device involves an electric coil that heats a wick to vaporize an e-liquid solution. “Dripping” is another method that involves applying e-liquid directly to the coil. Dripping increases risk of harmful toxic compounds in vapor aerosols. Despite evidence of high levels of dripping among adolescents, young adult prevalence is unknown.

Methods:

Young adults aged 18 to 24 completed an online survey assessing vaping and dripping status, type of devices used, tobacco use, and vaping expectancies. Among ever-vapers, univariate and multivariate logistic regression models assessed whether demographics predicted dripping and use of dripping devices. Multivariate Analysis of Variance compared never- and ever-drippers on expectancies for vaping outcomes.

Results:

Over 2 in 5 young adult ever-vapers (43.7%) reported dripping. A multivariate regression model found that male gender (AOR = 1.83), identifying as White (AOR = 2.37), and use of other tobacco products (hookah; AOR = 1.91; cigars; AOR = 2.26; cigarettes; AOR = 2.51) were associated with dripping. E-cigarette users who reported lifetime dripping were more likely to consider vaping stimulating, socially facilitating, and flavorful. They ascribed lower health risks to vaping and felt it could reduce negative affect, weight gain, nicotine cravings, and boredom (all P < .05).

Conclusion:

Dripping was a highly prevalent behavior among this sample of young adults, particularly among White males. These findings point to the importance of gaining a greater understanding of the drivers and consequences of vaping and dripping behavior.
Contribution tracing for organisational-wide planning, improved collaboration and evaluative thinking
Authors: Romo Ramos Yulye Jessica
Published: July 2021

In 2015, The Wellcome Trust launched a new strategic approach to its work and created a framework to measure success. This article focuses on a particular dimension of this framework: research impact linked to the Trust’s pool of research award holders. This article describes why contribution tracing was chosen as an evaluation approach. It also describes how it was used in innovative ways to handle a large number of cases with potential for impact and develop an organisation-wide evaluation plan that makes the most out of data science techniques while increasing understanding of evaluation and facilitating collaboration and joint planning with colleagues across the organisation.
MuzLink: Connected beeswarm timelines for visual analysis of musical adaptations and artist relationships
Authors: Lévesque François , Hurtut Thomas
Published: July 2021

The rise of open data in the cultural domain is democratizing access to complex datasets usually presented as large multivariate and multilayered graphs. However, the exploration of such datasets is challenging for laypersons. The objective of this work is to develop and evaluate a new method for exploring and understanding a specific type of multilayered graph that combines a large bipartite graph with a set of tree structures. This paper proposes MuzLink, an interactive visualization tool that allows the user to navigate, search, locate, and compare collaborative and influential relationships between musical artists through the exploration of musical adaptations. The proposed tool is based on a set of connected timelines visualizing how an artist’s collaborations, inspirations, and influences evolved over time. This design study is conducted in close collaboration with BAnQ, the national library and archives agency of the Quebec government. A controlled user study, done with a group of BAnQ users, and two case studies, show how the proposed approach is capable of performing a considerable set of analytical and exploratory tasks.
A new lighting method for cultural materials using selective chromatic light
Authors: Gargano M , Scotuzzi S , Angelin EM , Santilli O , del Hoyo-Meléndez JM , Ludwig N
Published: July 2021

Lighting is a critical component in a museum environment because, together with temperature, relative humidity and pollutants, it is one of the damaging factors able to produce long‐term, cumulative and irreversible photodegradation processes. To correctly preserve artworks, limiting illuminance and exposure is recommended, allowing on one side the preservation of the object, but on the other limiting the display of the object, especially for sensitive materials. The aim of this research was to develop, evaluate and compare a new lighting method for paintings and other cultural materials to improve the experience of the objects whilst reducing the risks from exposure. The idea is based on the use of selective chromatic light where the component of the spectrum absorbed by the materials is removed. This absorption is the principal cause of photodegradation. The proposed lighting system can be obtained by combining different types of projection systems together with filtering using an appropriate light source. Six methods of light projection have been compared for two mock-ups simulating real artworks with high and medium light sensitivity. The efficiency of illumination increased from 30% to 111% compared to standard lighting systems. Light stability tests were additionally performed, finding reduced colour changes compared to traditional lighting systems.
A Mixed Media Campaign to Promote Bystander Intervention and Reduce Alcohol Use Among College Students: A Pilot Study
Authors: Schipani-McLaughlin Anne Marie , Salazar Laura F. , Muilenburg Jessica L. , Lauckner Carolyn , Swartzendruber Andrea , Walters Deanna
Published: July 2021

This study examined the limited efficacy of a mixed media campaign that promoted bystander intervention as a sexual violence (SV) prevention strategy and aimed to decrease alcohol use. A quasi-experimental design was used to assess the limited efficacy of the Be a Watch Dawg mixed media campaign implemented at a large Southeastern public university in 2017. Social marketing along with social cognitive theory, social norms theory, and theory of planned behavior were utilized as the framework for the campaign. Be a Watch Dawg promoted bystander intervention in SV risk situations and targeted bystanders’ alcohol use via social media (e.g., Facebook, Instagram, and Twitter) and printed materials (e.g., posters, stickers, and handbills). Participants included 244 undergraduate students 18 to 24 years of age. Study outcomes included bystander intervention, intentions to intervene, and alcohol use. Adjusted linear regression and logistic regression models were used to examine differences in outcomes between pre and postcampaign samples as well as associations with campaign exposure. Significant increases in bystander intervention were observed between the pre and postcampaign samples. Campaign exposure was marginally related to intentions to intervene but was not significantly associated with bystander intervention. Social media analytics revealed that the campaign reached 39,466 social media users and received 50,854 impressions and 19,523 views. A mixed media campaign may be a promising and low-resource approach to increase bystander intervention as a strategy to combat campus SV.
Documentation of Firearm Safety Screening During Emergency Department Visits for Assault-Related Injury
Authors: Mulcahy Lauren B. , Goyal Monika K. , Cohen Joanna
Published: July 2021

Assault-injured youth have an increased risk of future violence. Identifying firearm access among youth in the emergency department (ED) creates an opportunity for interventions aimed at reducing future violent events. We performed this study to determine the extent to which children with assault-related injuries are screened for access to firearms in the ED. We performed a retrospective chart review of all medical records from adolescent ED visits to an academic, tertiary care pediatric hospital in Washington DC with ICD-10 codes related to assault in a 3-month period. We found that among 252 assault-related encounters, none had any documentation of firearm access in the provider note, social work note, or psychiatry consultant note. Therefore, we concluded that firearm access screening is rarely documented in ED visits among patients who present for an assault, highlighting an important missed opportunity for firearm access screening among this high-risk group.
Serum C-Reactive Protein-to-Body Mass Index Ratio Predicts Overall Survival in Patients With Resected Colorectal Cancer
Authors: Huang Lingxu , Liu Jungang , Huang Xiaoliang , Wei Chunyin , Mo Xianwei , Zhong Huage , Meng Yongsheng , Lai Hao , Zhang Lihua , Liang Dingyu , Liu Haizhou , Tang Weizhong
Published: July 2021

Background and Purpose:

Systemic inflammation and nutritional status have been shown to be associated with the prognosis of colorectal cancer. The purpose of this study was to evaluate the impact of the serum C-reactive protein-to-body mass index ratio on the prognosis of patients with curatively resected colorectal cancer.

Methods:

We conducted a retrospective analysis of a database of 2,471 eligible patients with colorectal cancer who underwent curative resection at our hospital between 2004 and 2019. The optimal cut-off for CPR-to-BMI ratio was determined using maximally selected rank statistics. Patients were divided into 2 groups according to the cut-off value of the serum C-reactive protein-to-body mass index ratio. Kaplan-Meier curves and Cox regression analysis were used to compare overall survival. A two-sided P-value < 0.05 was considered statistically significant.

Results:

The proportion of patients with a high C-reactive protein-to-body mass index ratio increased with increasing age, male sex, right-sided colon cancer, poorly differentiated tumors, advanced-stage disease, local/distant metastases, tumor–node–metastasis stage, and microsatellite instability. In subgroup analysis according to tumor–node–metastasis stage, the overall survival of the high C-reactive protein-to-body mass index ratio group was significantly shorter than that of the low C-reactive protein-to-body mass index ratio group ( P < 0.001). Multivariate analysis identified age, differentiation, tumor–node–metastasis stage, carcinoembryonic antigen level, and the C-reactive protein-to-body mass index ratio as independent poor prognostic factors for overall survival.

Conclusions:

The C-reactive protein-to-body mass index ratio predicts the prognosis of patients with curatively resected colorectal cancer and is an independent risk factor for overall survival in patients with colorectal cancer.
Mechanism of Autonomic Exercise Improving Cognitive Function of Alzheimer’s Disease by Regulating lncRNA SNHG14
Authors: He Yuchen , Qiang Yi
Published: July 2021

This paper studied the influence of exercise on the cognitive ability of AD patients and elucidated potential mechanisms. The expression of SNHG14 was validated by qRT-PCR. The cognitive impairment of mice was examined by MWM Test. ELISA tests were applied to discover the influence of SNHG14 on inflammation. Overexpression of SNHG14 was found in AD patients and underexpression of SNHG14 was identified in these AD patients after exercise. In APP/PS1 double transgenic mice, SNHG14 reversed the protective impacts of exercise on escape latency and distance moved. The upregulation of SNHG14 also inhibited the effects of exercise on the percentage of time spent in the target quadrant and times of platform crossing. Besides, overexpression of SNHG14 reversed the repressed expression of IL-6, IL-1β, and TNF-α. In total, exercise could ameliorate cognitive disorder and inflammation activity by reducing the levels of SNHG14.
Research on time synchronization of linear pulse-coupled oscillators model with delay in nearest neighbor wireless multi-hop networks
Authors: Cui Lizhen , Cao Jian , An Zhulin , Yang Yong , Guo Qianqian
Published: July 2021

Time synchronicity works as a popular requirement in wireless sensor networks. Pulse-coupled oscillators similar to firefly flashing and synchronization via discrete pulse coupling are widely used in wireless sensor networks. In this article, we have studied the time synchronization with communication delay in the nearest neighbor network of distributed sensors, based on the pulse-coupled oscillators model of synchronicity achieved by biological systems. First, we present a linear pulse-coupled oscillators model with coupling delay and the model is used to analyze the wireless sensor networks synchronization with communication delay. Second, we mathematically analyze the firing behaviors in the linear pulse-coupled oscillators network using the delayed excitatory coupling and track the synchronization process of the two and multi-oscillators and obtain the synchronization conditions from the regression mapping. Finally, through the proposed model implementation in the wireless sensor networks simulation framework, we demonstrate that the multi-oscillators system can be synchronized from a random starting stage distribution under linear phase responding functions and the nearest neighbor communication. The results show that our approach can achieve clock synchronization in wireless sensor networks with delayed nearest neighbor communication.
Distributed sensing units deploying on group unmanned vehicles
Authors: Chang Bao Rong , Tsai Hsiu-Fen , Lyu Jyong-Lin , Huang Chien-Feng
Published: July 2021

This study aims to use two unmanned vehicles (aerial vehicles and ground vehicles) to implement multi-machine cooperation to complete the assigned tasks quickly. Unmanned aerial/ground vehicles can call each other to send instant inquiry messages using the proposed cooperative communication protocol to hand over the tasks between them and execute efficient three-dimensional collaborative operations in time. This study has demonstrated integrating unmanned aerial/ground vehicles into a group through the control platform (i.e. App operation interface) that uses the Internet of Things. Therefore, pilots can make decisions and communicate through App for cooperative coordination, allowing a group of unmanned aerial/ground vehicles to complete the tasks flexibly. In addition, the payload attached to unmanned air/ground vehicles can carry out multipurpose monitoring that implements face recognition, gas detection, thermal imaging, and video recording. During the experiment of unmanned aerial vehicle, unmanned aerial vehicle will plan the flight path and record the movement trajectory with global positioning system when it is on duty. As a result, the accuracy of the planned flight path achieved 86.89% on average.
Transformativist Measurement Development Methodology: A Mixed Methods Approach to Scale Construction
Authors: Leach Sankofa Nicole
Published: July 2021

Social justice research is popular in education, but social scientists have limited emancipatory methodological procedures, especially in scale construction approaches that empower marginalized communities in defining their own lived experience. Therefore, this study develops the Transformativist Measurement Development Methodology, exemplified using the development of the peer bonds scale. The sample (167 students across two democratic school communities) was randomly selected, then purposive sampled for optimal diversity. Across Transformativist Measurement Development Methodology’s six stages, mixed methods were used to check assumptions, set parameters, inductively operationalize the construct, qualitatively generate items, quantitatively examine psychometric properties, and examine trustworthiness. This work contributes to mixed methods social justice efforts that apply transformativist approaches to research processes for emancipatory social science procedures while enhancing rigor in scale construction methodology.
Outcomes of Surface Replacement Arthroplasty in Metacarpophalangeal Joints Affected by Noninflammatory Arthritis
Authors: Claxton Matthew R. , Wagner Eric R. , Rizzo Marco
Published: July 2021

Background

The purpose of this study was to investigate the outcomes of surface replacement arthroplasty (SRA) for noninflammatory arthritis of the metacarpophalangeal (MCP) joint.

Methods

Records from 20 SRAs performed between 1995 and 2017 in 17 patients with noninflammatory arthritis affecting the MCP joint were retrospectively reviewed. The mean follow up was 6.6 years.

Results

Three arthroplasties (15%) underwent 4 revision operations. The 2-, 5-, 10-, and 15-year rates of survival from surface replacement implant revision were 90%, 90%, 79%, and 79%, respectively. Major complications occurring in revised joints included arthrodesis (n = 1) and amputation (n = 1). The overall reoperation rate was 35%. The 2-, 5-, 10-, and 15-year rates of overall reoperation-free survival were 75%, 69%, 60%, and 60%, respectively.

Conclusions

Pain ratings and MCP arc of motion significantly improved following arthroplasty. Metacarpophalangeal SRA for noninflammatory arthritis can improve arc of motion and pain. Revision is uncommon; however, 1 in 3 joints requires reoperation.
Preliminary Study on the Effect of 4DCT-Ventilation-Weighted Dose on the Radiation Induced Pneumonia Probability (RIPP)
Authors: Bai Han , Li Wenhui , Xia Yaoxiong , Li Lan , Gao Jingyan , Liu Xuhong
Published: July 2021

Purpose:

The purpose of the present study was to evaluate the feasibility of using 4-dimensional computed tomography (4DCT)-ventilation-weighted dose analysis to predict radiation-induced pneumonia probability (RIPP).

Methods and Materials:

The study population for this retrospective analysis included 16 patients with stage III lung cancer. Each patient’s 4DCT images, including end-inhale and end-exhale sequences, were used for the deformable image registration, and the Hounsfield units (HU) density-change was used to calculate the ventilation. A previously established equation was used to convert the original dose (OD) D 0, i in the lungs in the original plan (OP) to the weighted-dose (WD) D w, i in the weighted plan (WP). The patients were divided into 2 groups, one with radiation-induced pneumonia (RIP), and one without. The Spearman correlation analysis was used to analyze the correlation of RIP with ΔV20 (ΔV x = V w, x in the WP – V 0, x in the OP), ΔMLD (ΔMLD = mean lung dose (MLD) in the WP – MLD in the OP), and ΔV5.

Results:

The results showed that 5 of the 16 patients were suffering from acute RIP, 4 of which had higher ΔV20 and ΔMLD values than the rest of the patients. The results of the Spearman correlation analysis for those 4 patients were as follows: RIP vs. ΔV20, r = 0.5123; RIP vs. ΔMLD, r = 0.5119; RIP vs. ΔV5, r = 0.1904.

Conclusions:

The 4DCT-ventilation-based weighted-dose analysis showed some correlation between RIPP and both ΔV20 and ΔMLD, when comparing the weighted-dose and the conventional dose-volume histogram (DVH) analyses.
Does chronic dietary exposure to the mycotoxin deoxynivalenol affect the porcine hepatic transcriptome when an acute-phase response is initiated through first or second-pass LPS challenge of the liver?
Authors: Dänicke Sven , Heymann Ann-Katrin , Oster Michael , Wimmers Klaus , Tesch Tanja , Bannert Erik , Bühler Susanne , Kersten Susanne , Frahm Jana , Kluess Jeannette , Kahlert Stefan , Rothkötter Hermann-Josef , Billenkamp Fabian
Published: July 2021

The sensitivity of pigs to deoxynivalenol (DON) might be increased by systemic inflammation (SI), which also has consequences for hepatic integrity. Liver lesions and a dys-regulated gene network might hamper hepatic handling and elimination of DON whereby the way of initiation of hepatic inflammation might play an additional role. First and second-pass exposure of the liver with LPS for triggering a SI was achieved by LPS infusion via pre- or post-hepatic venous route, respectively. Each infusion group was pre-conditioned either with a control diet (0.12 mg DON/kg diet) or with a DON-contaminated diet (4.59 mg DON/kg diet) for 4 wk. Liver transcriptome was evaluated at 195 min after starting infusions. DON exposure alone failed to modulate the mRNA expression significantly. However, pre- and post-hepatic LPS challenges prompted transcriptional responses in immune and metabolic levels. The mRNAs for B-cell lymphoma 2-like protein 11 as a key factor in apoptosis and IFN-γ released by T cells were clearly up-regulated in DON-fed group infused with LPS post-hepatically. On the other hand, mRNAs for nucleotide binding oligomerization domain containing 2, IFN-α and eukaryotic translation initiation factor 2α kinase 3 as ribosomal stress sensors were exclusively up-regulated in control pigs with pre-hepatic LPS infusion. These diverse effects were traced back to differences in TLR4 signalling.
Progressive multifocal leukoencephalopathy and immune reconstitution inflammatory syndrome in seven patients with sarcoidosis: a critical discussion of treatment and prognosis
Authors: Dohrn Maike F. , Ellrichmann Gisa , Pjontek Rastislav , Lukas Carsten , Panse Jens , Gold Ralf , Schulz Jörg B. , Gess Burkhard , Tauber Simone C.
Published: July 2021

Progressive multifocal leukoencephalopathy (PML) is a subacute brain infection by the opportunistic John Cunningham (JC) virus. Herein, we describe seven patients with PML, lymphopenia, and sarcoidosis, in three of whom PML was the first manifestation of sarcoidosis. At onset, the clinical picture comprised rapidly progressive spastic hemi- or limb pareses as well as disturbances of vision, speech, and orientation. Cerebral magnetic resonance imaging showed T2-hyperintense, confluent, mainly supratentorial lesions. Four patients developed punctate contrast enhancement as a radiological sign of an immune reconstitution inflammatory syndrome (IRIS), three of them having a fatal course. In the cerebrospinal fluid, the initial JC virus load (8–25,787 copies/ml) did not correlate with interindividual severity; however, virus load corresponded to clinical dynamics. Brain biopsies ( n = 2), performed 2 months after symptom onset, showed spotted demyelination and microglial activation. All patients had lymphopenia in the range of 270–1150/µl.

To control JC virus, three patients received a combination of mirtazapine and mefloquine, another two patients additionally took cidofovir. One patient was treated with cidofovir only, and one patient had a combined regimen with mirtazapine, mefloquine, cidofovir, intravenous interleukin 2, and JC capsid vaccination. To treat sarcoidosis, the four previously untreated patients received prednisolone. Three patients had taken immunosuppressants prior to PML onset, which were subsequently stopped as a potential accelerator of opportunistic infections. After 6–54 months of follow up, three patients reached an incomplete recovery, one patient progressed, but survived so far, and two patients died. One further patient was additionally diagnosed with lung cancer, which he died from after 24 months. We conclude that the combination of PML and sarcoidosis is a diagnostic and therapeutic challenge. PML can occur as the first sign of sarcoidosis without preceding immunosuppressive treatment. The development of IRIS might be an indicator of poor outcome.
IMbrave 151: a randomized phase II trial of atezolizumab combined with bevacizumab and chemotherapy in patients with advanced biliary tract cancer
Authors: Hack Stephen P. , Verret Wendy , Mulla Sohail , Liu Bo , Wang Yulei , Macarulla Teresa , Ren Zhenggang , El-Khoueiry Anthony B. , Zhu Andrew X.
Published: July 2021

Background:

Biliary tract cancers (BTCs) are heterogenous, highly aggressive tumors that harbor a dismal prognosis for which more effective treatments are needed. The role of cancer immunotherapy in BTC remains to be characterized. The tumor microenvironment (TME) of BTC is highly immunosuppressed and combination treatments are needed to promote effective anticancer immunity. Vascular endothelial growth factor (VEGF) drives immunosuppression in the TME by disrupting antigen presentation, limiting T-cell infiltration, or potentiating immune-suppressive cells. Many VEGF-regulated mechanisms are thought to be relevant to repressed antitumor immunity in BTC, making dual targeting of VEGF and programmed cell death protein 1 (PD-1)/PD-L1 pathways a rational approach. Gemcitabine and Cisplatin (Gem/Cis) can also modulate anticancer immunity through overlapping and complementary mechanisms to those regulated by VEGF. Anti-PD-L1/VEGF inhibition, coupled with chemotherapy, may potentiate antitumor immunity leading to enhanced clinical benefit.

Methods:

IMbrave 151 is a randomized, double-blind, placebo-controlled, multicenter, international phase II study to evaluate atezolizumab (a PD-L1 inhibitor) in combination with chemotherapy (gemcitabine and cisplatin) and bevacizumab (an anti-VEGF monoclonal antibody) as a first-line treatment for advanced BTC. Approximately 150 patients with previously untreated, advanced BTC will be randomized to either Arm A (atezolizumab + bevacizumab + Gem/Cis) or Arm B (atezolizumab + placebo + Gem/Cis). Randomization is stratified by the presence of metastatic disease, primary tumor location, and geographic region. The primary efficacy endpoint is investigator-assessed progression-free survival (PFS) per RECIST 1.1. Secondary endpoints include objective response rate (ORR), duration of response (DoR), disease control rate (DCR), overall survival (OS), and safety and patient reported outcomes (PROs). Tissue, blood, and stool samples will be collected at baseline and on-treatment in order to perform correlative biomarker analyses.

Discussion:

IMbrave 151 represents the first randomized study to evaluate combined PD-L1/VEGF blockade on a chemotherapy backbone in BTC.

Trial registration:

NCT identifier: NCT04677504; EUDRACT number: 2020-003759-14
There and back again: analyzing the effect of outpatient readmission on the quality of life of patients attending a rheumatology clinic
Authors: Madrid-García Alfredo , Montuenga-Fernández Isabel , Font-Urgelles Judit , León-Mateos Leticia , Pato Esperanza , Jover Juan A , Fernández-Gutiérrez Benjamín , Abasolo Lydia , Rodríguez-Rodríguez Luis
Published: July 2021

Aims:

The aim of this study was to assess the effect of “outpatient readmissions” on the health-related quality of life (HR-QoL) of outpatients from a rheumatology clinic, meaning the effect of the patient’s return to the outpatient clinic after having received care and been discharged.

Methods:

We conducted an observational longitudinal retrospective study, with patients selected from the Hospital Clínico San Carlos Musculoskeletal cohort, based on having received at least one discharge from the outpatient clinic and having returned (readmission) at least once after the discharge. The main outcomes were the patients’ baseline HR-QoL (measured on the first visit of each episode) and the ΔHR-QoL (difference between the HR-QoL in the last and the first visit of each episode). Successive episodes of admission and readmission were chronologically ordered, paired and analyzed using nested linear mixed models, nested by patients and by admission–readmission tandem. We carried out bivariable and multivariable analyses to assess the effect of demographic, clinical, treatment and comorbidity-related variables in both main outcomes.

Results:

For the first main outcome, 5887 patients (13,772 episodes) were analyzed. Based on the multivariable level, readmission showed no significant marginal effect on the baseline HR-QoL ( p-value = 0.17). Conversely, when analyzing the ΔHR-QoL, we did observe a negative and significant marginal effect ( p-value = 0.028), meaning that readmission was associated with a lower gain in the HR-QoL during the follow-up, compared with the previous episode.

Conclusion:

In the outpatient setting, readmission exerts a deleterious effect in patients undergoing this process. Identification of outpatients more likely to be readmitted could increase the value of the care provided.
Working memory content guides attention
Authors: Luo Yu , Zhou Jiarong , Bao Wei , Qiu Jing , Nian Jingqing , Zhang Yu
Published: July 2021

Previous studies showed that working memory (WM) content can guide attention; however, whether working memory capacity (WMC) and state anxiety could affect this remains unclear. This study aimed to examine the effect of WMC and state anxiety on attention guided by WM content. Participants with high and low WMC were assigned to either a neutral or an anxiety condition. They were asked to perform a modified change detection task with irrelevant singletons while their event-related potentials were recorded. N2pc and Pd were observed in the low-WMC and anxiety group, and Pd was observed in both the high-WMC and anxiety and the high-WMC and control groups, whereas neither N2pc nor Pd was found in the low-WMC and control group. These findings suggest that attention is guided or suppressed by WM content, depending on the WMC and anxiety level of the individual. This study provides a new perspective on WM content-guided attention.
A Guide to the Bayesian Analysis of Consumer Behavior Experiments With BANOVA Using Worked Examples
Authors: Wedel Michel , Kopyakova Anna
Published: July 2021

This article provides a step-by-step guide for the analysis of experiments using Bayesian methods, using the BANOVA R package. We provide two worked examples. First, we reanalyze data from research by Romano and Balliet, which examined reciprocity and conformity as alternative mechanisms for cooperation between partners. The study has a between-subjects design and Poisson dependent variable, and we use Bayesian floodlight analysis to explore the interaction between reciprocity/conformity and two continuous covariates. Second, we reanalyze data from a study by Perfecto, Donnelly, and Critcher, who investigated whether mental simulation could be the psychological mechanism that explains how people make volume judgments of three-dimensional objects. The study has a mixed between- and within-subjects design with a Normal dependent variable, and we use Bayesian simple effects to explore the interactions between mental simulation and the shape and orientation of cups. The applications demonstrate the versatility of BANOVA (Bayesian Analysis of Variance) in analyzing a wide range of experimental designs and reveal that the results of the Bayesian analyses differ to some degree from those of the original studies.
Ecological Momentary Assessment of Positive and Negative Affect and Associations with Blood Glucose in Teens with Type 1 Diabetes
Authors: Shapira Amit , Volkening Lisa K. , Borus Joshua S. , Laffel Lori M.
Published: July 2021

Background:

Affect (i.e., emotions) can be associated with diabetes self-care and ambient glucose in teens with type 1 diabetes (T1D). We used momentary sampling to examine associations of daily affectwithblood glucose (BG) monitoring,BG levels,and BG variability in teens with T1D.

Method:

Over 2 weeks, 32 teens reported positive and negative affect (Positive and Negative Affect Scale) and BG levels on handheld computers 4x/day, coordinated with planned daily BG checks. BG values were classified as: in-range (70-180 mg/dL); low (<70 mg/dL); severe low (<54 mg/dL); high (>180 mg/dL); severe high (>250 mg/dL). Daily BG variability was derived from BG coefficient of variation (BGCV). To determine associations of positive and negative affect with BG checks, BG levels, and BGCV, separate generalized estimating equations were performed, adjusting for demographic and diabetes-related variables, for the overall sample and stratified by HbA1c (≤8%, >8%).

Results:

Teens (44% male, ages 14-18, 63% pump-treated, HbA1c 8.8 ± 1.4%) reported 51% in-range, 6% low (2% severe low), and 44% high (19% severe high) BG. In teens with HbA1c ≤8%, positive affect was associated with in-range BG (OR = 1.08, 95% CI = 1.04-1.13, P = .0002), reduced odds of very low glucose (OR = 0.35, 95% CI = 0.16-0.74, P = .006), and less daily BGCV (β = −0.9; 95% CI = −1.6, −0.2; P = .01). In teens with HbA1c >8%, negative affect was associated with less likelihood of checking BG (OR = 0.75, 95% CI = 0.64-0.87, P = .0003).

Conclusions:

Our findings shed light on individual differences in metabolic reactivity based on glycemic levels and the importance of incorporating affect into automated insulin delivery systems.
Human Platelet Lysate as an Alternative to Autologous Serum for Human Chondrocyte Clinical Use
Authors: Philippe Virginie , Laurent Alexis , Abdel-Sayed Philippe , Hirt-Burri Nathalie , Ann Applegate Lee , Martin Robin
Published: July 2021

Objective

A pivotal aspect of cartilage tissue engineering resides in cell culture medium supplementation, in view of maximizing in vitro cell proliferation and preserving cellular functionality. Autologous human serum (aHS) is commonly used as an inducive supplement for safe human articular chondrocyte (HAC) proliferation prior to clinical implantation. However, practical clinical use of aHS is hindered by constraining manufacturing requirements and quality assurance-driven downstream processing. The present study investigated potential alternative use of commercial human platelet lysate (hPL) supplements in HAC manufacturing workflows related to clinical therapeutic pathways.

Design

Differential effects of hPL, aHS, and fetal bovine serum were assessed on primary cultured HAC parameters (viability, proliferative rates, and morphology) in 2-dimensional in vitro systems. A 3-dimensional HAC pellet model served for postexpansion assessment of cellular functionality, by visualizing proteoglycan production (Alcian blue staining), and by using qRT-PCR relative quantification of chondrogenic marker ( SOX9, COL2-A1, and ACAN) genetic expression.

Results

We found that monolayer HAC culture with hPL or aHS supplements presented similar characteristics (elongated cell morphology and nearly identical growth kinetics). Chondrogenic activity appeared as conserved in HACs expanded with human or bovine supplements, wherein histologic analysis indicated a progressive sGAG accumulation and SOX9, COL2-A1, ACAN gene expression was upregulated in 3-dimensional HAC pellet models.

Conclusion

This study therefore supports the use of hPL as a functional equivalent and alternative to aHS for cultured HAC batch preparation, with the potential to effectively alleviate pressure on clinical and manufacturing bottlenecks in cell therapy approaches for cartilage regeneration.
Reference values of glomerular filtration rate for healthy adults in southern China: a cross-sectional survey
Authors: Ma Yaohui , Zhan Jinfeng , Xu Gaosi
Published: July 2021

Background:

Currently the global data on the glomerular filtration rate of healthy adults are insufficient, with relatively little data for other races and countries. Especially in China, there are no such figures.

Methods:

In this cross-sectional study, we included healthy Han adults in southern China. Participants completed a lifestyle and medical history questionnaire and had their blood pressure measured, and blood and urine samples collected. Serum creatinine was measured and used to estimated glomerular filtration rate (eGFR) by the Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulae. The normal range of eGFR is described, and the influence of gender and age on eGFR is analyzed by the statistical method.

Results:

We provided the largest sample size of eGFR research in China at present. The mean age of the 20,930 healthy individuals was 40.9 ± 12.3 years, 58.8% were women. The eGFRMDRD for women and men were 111.3 ± 17.4 mL/min per 1.73 m2 and 103.3 ± 15.9 mL/min per 1.73 m2, respectively. The eGFRCKD-EPI for women and men were 110.3 ± 12.1 mL/min per 1.73 m2 and 103.8 ± 13.3 mL/min per 1.73 m2, respectively. The eGFRMDRD of women and men in all age groups decreased continuously by 7.3 ml/min/1.73 m2/decade and 4.4 ml/min/1.73 m2/decade, respectively. The eGFRCKD-EPI of women and men in all age groups decreased continuously by 8.4 ml/min/1.73 m2/decade and 6.9 ml/min/1.73 m2/decade.

Conclusions:

The eGFR of women is higher than men and with the increasing age, the eGFR of women declines faster than men.
The possible impact of increased physical intimate partner violence during the COVID-19 pandemic on ocular health
Authors: Hicks Patrice M , Murtaugh Maureen A , DeAngelis Margaret M
Published: July 2021

During the COVID-19 outbreak, sheltering at home has led to an increase in physical intimate partner violence cases. Intimate partner violence–sustained ocular injuries may be higher during the pandemic due to the increase in physical intimate partner violence. Left untreated, intimate partner violence–related ocular or orbital trauma can lead to permanent vision loss. Even with treatment, patients often lose vision from intimate partner violence–related traumatic ocular injuries. Eye care providers and eye care facilities should understand the community services available to intimate partner violence survivors to better care for these patients. Due to the potential lasting economic burden and social strain of this pandemic, eye care providers and facilities should stay vigilant as there may still be a sustained increase in intimate partner violence even after the global COVID-19 pandemic.
Perioperative nutrition care and dietetic practices in the scope of bariatric surgery in Saudi Arabia using adapted protocols for evaluation
Authors: Aljaaly Elham Abbas
Published: July 2021

Objectives:

This study evaluates the availability of perioperative nutritional care protocols and the practices of bariatric registered dietitians in Saudi Arabia. The primary outcomes of the study were conducted using an adapted American survey “with permission.”

Methods:

A cross-sectional survey of a selected 32 dietitians providing bariatric services completed a self-administered online questionnaire from 12 hospitals in Jeddah, Saudi Arabia.

Results:

All surveyed dietitians were females, mainly Saudi nationals (93.9%, n = 30), and accredited by the Saudi Commission for Health Specialties (93.8%, n = 30). Only 37.5% (n = 6) of the dietitians were specialized in bariatric surgery. Perioperative common practices of dietitians included a conduct of screening for nutrition risk before (44%, n = 14) and after surgery (62.5%, n = 20) and applied a nutrition management protocol that is mainly based on the application of nutrition care process (62.5%, n = 20). Dietitians (81%, n = 26) reported the importance of having standardized protocols for nutritional management of patients undoing bariatric surgery, where 69% (n = 22) confirmed the availability of pre-operative written protocols in hospitals and 75% (n = 24) confirmed the existence of post-operative protocols. Pre-operative practices included using approaches for weight loss before surgery, for example, very low and low-calorie diet. Dietitians (25%, n = 8) see two to ten patients per month. The sleeve gastrectomy procedure is the most often performed surgery.

Conclusion:

This is the first study to evaluate the perioperative nutrition care protocols and practices related to bariatric surgery in Saudi Arabia. Perioperative bariatric protocols are available, but some dietitians are not aware of their availability and contents. Researchers emphasize the importance of creating national protocols by the Saudi Credentials Body to standardize practices within the field.