bluuebunny/crossref_metadata_2025 huggingface dataset:
Differential Effects of Nicotine and Nicotine Withdrawal on Fear Conditioning in Male Rats
Authors: Robble Mykel A , Holloway Isaiah L , Ridener Elysia , Webber Chelsea J , Caine S Barak , Meloni Edward G , Desai Rajeev I , Carlezon William A
Published: April 2020

Background

Tobacco use is prevalent in individuals who are routinely exposed to stress. However, little is known about how nicotine affects responses to trauma. We examined in rats how nicotine exposure affects fear conditioning, a procedure often used to study stress-related psychiatric illness.

Methods

We examined 2 methods of nicotine exposure: self-administration, modeling voluntary use, and experimenter-programmed subcutaneous administration, modeling medicinal administration (nicotine patch). For self-administered nicotine, rats trained to self-administer nicotine i.v. were fear conditioned (via light cue preceding foot-shock) either immediately after a 12-hour self-administration session or 12 hours later during a period with somatic signs of nicotine withdrawal. For experimenter-delivered nicotine, rats were conditioned after 1–21 days of nicotine delivered by programmable (12 hours on) subcutaneous mini-pumps. Tests to evaluate acoustic startle responses to the conditioning environment (context-potentiated startle) and in the presence or absence of the light cue (fear-potentiated startle) occurred after a 10-day period.

Results

Rats fear conditioned immediately after nicotine self-administration showed reduced responses to the shock-associated context, whereas those trained during nicotine withdrawal showed exaggerated responses. Experimenter-programmed nicotine produced effects qualitatively similar to those seen with self-administered nicotine.

Conclusions

Self-administration or experimenter-programmed delivery of nicotine immediately before exposure to aversive events can reduce conditioned fear responses. In contrast, exposure to aversive events during nicotine withdrawal exacerbates fear responses. These studies raise the possibility of developing safe and effective methods to deliver nicotine or related drugs to mitigate the effects of stress while also highlighting the importance of preventing withdrawal in nicotine-dependent individuals.
Approximable Algebras as Subalgebras of Section Rings
Authors: Maclean Catriona
Published: April 2020

In [2], Huayi Chen introduced approximable graded algebras, which he uses to prove a Fujita-type theorem in the arithmetic setting, and asked if any such algebra is the graded ring of a big line bundle on a projective variety. This was proved to be false in [ 8]. Continuing the analysis started in [8], we show that while not every approximable graded algebra is a sub algebra of the section ring of a big line bundle, we can associate to any approximable graded algebra $\textbf{B}$ a projective variety $X(\textbf{B})$ and an infinite divisor $D(\textbf{B}) =\sum _{i=1}^\infty a_i D_i$ with $a_i\rightarrow 0$ such that $\textbf{B}$ is a subalgebra of $$\begin{equation*} R( D(\textbf{B}))=\oplus_n H^0(X(\textbf{B}), n D(\textbf{B})).\end{equation*}$$We also establish a partial converse to these results by showing that if an infinite divisor $D=\sum _i a_iD_i$ converges in the space of numerical classes, then any full-dimensional sub-graded algebra of $\oplus _mH^0(X, \lfloor mD \rfloor ))$ is approximable.
The Importance of Correct Measurement: A Response to Palmer, et al
Authors: Gibler Douglas M , Miller Steven V , Little Erin K
Published: April 2020

Palmer, D’Orazio, Kenwick, and McManus (PDKM) review a minority of changes we made to the CoW MID data, agree with most of those changes, but then argue that no scientific findings will be influenced by these or the thousands of changed values they ignore. We respond in two ways. First, we point out that principles of good science dictate that we discard dispute cases that either cannot be substantiated by the historical record or that do not meet dataset coding rules; we also discuss the ten-thousand-plus changed values PDKM still have not examined. Second, contrary to PDKM, we demonstrate how data differences greatly affect previous studies by returning again to the replications. There were substantial errors in both of PDKM’s replications, and these errors led them to incorrect inferences.
Electronic personal protective equipment: A strategy to protect emergency department providers in the age of COVID-19
Authors: Turer Robert W , Jones Ian , Rosenbloom S Trent , Slovis Corey , Ward Michael J
Published: April 2020

Emergent policy changes related to telemedicine and the Emergency Medical Treatment and Labor Act during the novel coronavirus disease 2019 (COVID-19) pandemic have created opportunities for technology-based clinical evaluation, which serves to conserve personal protective equipment (PPE) and protect emergency providers. We define electronic PPE as an approach using telemedicine tools to perform electronic medical screening exams while satisfying the Emergency Medical Treatment and Labor Act. We discuss the safety, legal, and technical factors necessary for implementing such a pathway. This approach has the potential to conserve PPE and protect providers while maintaining safe standards for medical screening exams in the emergency department for low-risk patients in whom COVID-19 is suspected.
A De Novo MITF Deletion Explains a Novel Splashed White Phenotype in an American Paint Horse
Authors: Magdesian K Gary , Tanaka Jocelyn , Bellone Rebecca R
Published: April 2020

Splashed white is a coat color pattern in horses characterized by extensive white patterning on the legs, belly, and face often accompanied by blue eyes and deafness. Three mutations in microphthalmia-associated transcription factor (MITF) and two mutations in Paired Box 3 (PAX3) have been identified that explain splashed white patterns (SW1–SW5). An American Paint Horse stallion with a splashed white phenotype and blue eyes, whose parents were not white patterned, was negative for the 5 known splashed white variants and other known white spotting alleles. This novel splashed white phenotype (SW6) was hypothesized to be caused by a de novo mutation in MITF or PAX3. Analysis of whole-genome sequencing using the EquCab3.0 reference genome for comparison identified an 8.7 kb deletion in MITF on ECA16 (NC_009159.3:g.21551060-21559770del). The deletion encompassed part of intron 7 through the 3′ UTR of exon 9 of MITF, including the helix-loop-helix DNA-binding domain (ENSECAT00000006375.3). This variant is predicted to truncate protein and impair binding to DNA. Sanger sequencing confirmed the stallion was heterozygous for the MITF deletion. No single nucleotide polymorphisms (SNPs) or structural variants were identified in PAX3 or any of the other candidate genes that were unique to the stallion or predicted to affect protein function. Genotyping five of the stallion’s splashed white offspring, including one all white foal, found that they were also heterozygous for the deletion. Given the role of MITF in producing white pattern phenotypes, and the predicted deleterious effect of this mutation, this 8.7 kb deletion is the likely causal variant for SW6.
Bengali Vaishnavism in Court: the Gaudiya Math’s Crisis of Succession
Authors: Sardella Ferdinando
Published: April 2020

The events that are the focus of the present investigation relate to a schism within the Gaudiya Math and Mission, a modern traditionalist Hindu religious institution dedicated to the revival of Chaitanya Vaishnava bhakti that was set in motion in 1918 in Mayapur, West Bengal, by the Bengali Vaishnava intellectual Swami Bhaktisiddhanta Saraswati (1874–1937). By the time of Bhaktisiddhanta’s passing in 1937, the Gaudiya Math and Mission had grown to be a dynamic and influential institution. Bhaktisiddhanta’s departure had nevertheless exposed palpable tensions within his fledgling movement that assumed the form of a dramatic crisis of succession that engulfed the institution soon after his passing. This article examines in some detail the first three months of the initial court case that ensued after Bhaktisiddhanta’s passing. The material to be examined herein has been acquired from the archives of the Calcutta High Court. These legal documents offer a unique glimpse into the complex inner dynamics of this modern Gaudiya Vaishnava schismatic conflict.
A Systematic Review of Estimating Breast Cancer Recurrence at the Population Level With Administrative Data
Authors: Izci Hava , Tambuyzer Tim , Tuand Krizia , Depoorter Victoria , Laenen Annouschka , Wildiers Hans , Vergote Ignace , Van Eycken Liesbet , De Schutter Harlinde , Verdoodt Freija , Neven Patrick
Published: April 2020

Background

Exact numbers of breast cancer recurrences are currently unknown at the population level, because they are challenging to actively collect. Previously, real-world data such as administrative claims have been used within expert- or data-driven (machine learning) algorithms for estimating cancer recurrence. We present the first systematic review and meta-analysis, to our knowledge, of publications estimating breast cancer recurrence at the population level using algorithms based on administrative data.

Methods

The systematic literature search followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We evaluated and compared sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of algorithms. A random-effects meta-analysis was performed using a generalized linear mixed model to obtain a pooled estimate of accuracy.

Results

Seventeen articles met the inclusion criteria. Most articles used information from medical files as the gold standard, defined as any recurrence. Two studies included bone metastases only in the definition of recurrence. Fewer studies used a model-based approach (decision trees or logistic regression) (41.2%) compared with studies using detection rules without specified model (58.8%). The generalized linear mixed model for all recurrence types reported an accuracy of 92.2% (95% confidence interval = 88.4% to 94.8%).

Conclusions

Publications reporting algorithms for detecting breast cancer recurrence are limited in number and heterogeneous. A thorough analysis of the existing algorithms demonstrated the need for more standardization and validation. The meta-analysis reported a high accuracy overall, which indicates algorithms as promising tools to identify breast cancer recurrence at the population level. The rule-based approach combined with emerging machine learning algorithms could be interesting to explore in the future.
Successful management of sternomanubrial joint septic arthritis with pectoralis muscle flap closure: a case series
Authors: Ali Barkat , Shetty Anil , Borah Gregory , Demas Christopher , Schwartz Jess D
Published: April 2020

Primary infection of the sternomanubrial joint (SMJ) is extremely rare. We present four consecutive cases who were all treated with SMJ resection (partial sternectomy), bilateral partial 2nd rib resection and immediate placement of temporary wound vacuum therapy followed by pectoralis major muscle flap closure. Average patient age was 35.5 years with male predominance (75%). All patients had intravenous drug use as underlying risk factor along with concomitant viral infections Hep C (75%) and HIV (25%). MSSA was identified in resection cultures in 75% of the patients. Delayed bilateral PMFC was achieved in all patients (average post-resection day 5). Response to treatment was excellent with no recurrent infections, no complications and zero 30-day mortalities. Our experience represents the largest reported case series in adults and would suggest that aggressive surgical resection followed by PMFC would appear to be the preferred treatment for all patients with SMJ infection.
Treat and trick: common regulation and manipulation of sugar transporters during sink establishment by the plant and the pathogen
Authors: Pommerrenig Benjamin , Müdsam Christina , Kischka Dominik , Neuhaus H Ekkehard
Published: April 2020

Sugar transport proteins are crucial for the coordinated allocation of sugars. In this Expert View we summarize recent key findings of the roles and regulation of sugar transporters in inter- and intracellular transport by focusing on applied approaches, demonstrating how sucrose transporter activity may alter source and sink dynamics and their identities. The plant itself alters its sugar transport activity in a developmentally dependent manner to either establish or load endogenous sinks, for example, during tuber formation and filling. Pathogens represent aberrant sinks that trigger the plant to induce the same processes, resulting in loss of carbon assimilates. We explore common mechanisms of intrinsic, developmentally dependent processes and aberrant, pathogen-induced manipulation of sugar transport. Transporter activity may also be targeted by breeding or genetic modification approaches in crop plants to alter source and sink metabolism upon the overexpression or heterologous expression of these proteins. In addition, we highlight recent progress in the use of sugar analogs to study these processes in vivo.
Constraining VLBI−optical offsets in high redshift galaxies using strong gravitational lensing
Authors: Spingola Cristiana , Barnacka Anna
Published: April 2020

We present a multiwavelength analysis of two highly magnified strong gravitationally lensed galaxies, CLASS B0712+472 and CLASS B1608+656, at redshifts 1.34 and 1.394, respectively, using new VLBI (very long baseline interferometry) and archival Hubble Space Telescope observations. We reconstruct the positions of the radio and optical emissions with their uncertainties using Monte Carlo sampling. We find that in CLASS B0712+472 the optical and radio emissions are co-spatial within 2 ± 5 mas (17 ± 42 pc at redshift of 1.34). But, in CLASS B1608+656, we reconstruct an optical–radio offset of 25 ± 16 mas (214 ± 137 pc at redshift of 1.394), among the smallest offsets measured for an AGN (active galactic nucleus) at such high redshift. The spectral features indicate that CLASS B1608+656 is a post-merger galaxy, which, in combination with the optical–VLBI offset reported here, makes CLASS B1608+656 a promising candidate for a high- z offset–AGN. Furthermore, the milliarcsecond angular resolution of the VLBI observations combined with the precise lens models allow us to spatially locate the radio emission at 0.05 mas precision (0.4 pc) in CLASS B0712+472, and 0.009 mas precision (0.08 pc) in CLASS B1608+656. The search for optical–radio offsets in high redshift galaxies will be eased by the upcoming synoptic all-sky surveys, including Extremely Large Telescope and Square Kilometre Array, which are expected to find ∼105 strongly lensed galaxies, opening an era of large strong lensing samples observed at high angular resolution.
ΛCDM periodic cosmology
Authors: Fay Stéphane
Published: April 2020

We examine the possibility that Universe expansion be made of some Λ-cold dark matter (ΛCDM) expansions repeating periodically, separated by some inflation- and radiation-dominated phases. This so-called ΛCDM periodic cosmology is motivated by the possibility that inflation and the present phase of accelerated expansion be due to the same dark energy. Then, in a phase space showing the variation of matter density parameter Ωm with respect to this of the radiation Ωr, the curve Ωm(Ωr) looks like a closed trajectory that Universe could run through forever. In this case, the end of the expansion acceleration of the ΛCDM phase is the beginning of a new inflation phase. We show that such a scenario implies the coupling of matter and/or radiation to dark energy. We consider the simplest of these ΛCDM periodic models i.e. a vacuum energy coupled to radiation. From matter domination phase to today, it behaves like a ΛCDM model, then followed by an inflation phase. But a sudden and fast decay of the dark energy into radiation periodically ends the expansion acceleration. This leads to a radiation-dominated Universe preceding a new ΛCDM type expansion. The model is constrained with Markov Chain Monte Carlo simulations using supernovae, Hubble expansion, Baryon Acoustic Oscillations (BAO), and cosmic microwave background data and fits the data as well as the ΛCDM one.
Viral Fitness Determines the Magnitude of Transcriptomic and Epigenomic Reprograming of Defense Responses in Plants
Authors: Corrêa Régis L , Sanz-Carbonell Alejandro , Kogej Zala , Müller Sebastian Y , Ambrós Silvia , López-Gomollón Sara , Gómez Gustavo , Baulcombe David C , Elena Santiago F
Published: April 2020

Although epigenetic factors may influence the expression of defense genes in plants, their role in antiviral responses and the impact of viral adaptation and evolution in shaping these interactions are still poorly explored. We used two isolates of turnip mosaic potyvirus with varying degrees of adaptation to Arabidopsis thaliana to address these issues. One of the isolates was experimentally evolved in the plant and presented increased load and virulence relative to the ancestral isolate. The magnitude of the transcriptomic responses was larger for the evolved isolate and indicated a role of innate immunity systems triggered by molecular patterns and effectors in the infection process. Several transposable elements located in different chromatin contexts and epigenetic-related genes were also affected. Correspondingly, mutant plants having loss or gain of repressive marks were, respectively, more tolerant and susceptible to turnip mosaic potyvirus, with a more efficient response against the ancestral isolate. In wild-type plants, both isolates induced similar levels of cytosine methylation changes, including in and around transposable elements and stress-related genes. Results collectively suggested that apart from RNA silencing and basal immunity systems, DNA methylation and histone modification pathways may also be required for mounting proper antiviral defenses and that the effectiveness of this type of regulation strongly depends on the degree of viral adaptation to the host.
Machine Learning With Feature Domains Elucidates Candidate Drivers of Hospital Readmission Following Spine Surgery in a Large Single-Center Patient Cohort
Authors: Martini Michael L , Neifert Sean N , Oermann Eric K , Gal Jonathan , Rajan Kanaka , Nistal Dominic A , Caridi John M
Published: April 2020

BACKGROUND

Unplanned hospital readmissions constitute a significant cost burden in healthcare. Identifying factors contributing to readmission risk presents opportunities for actionable change to reduce readmission rates.

OBJECTIVE

To combine machine learning classification and feature importance analysis to identify drivers of readmission in a large cohort of spine patients.

METHODS

Cases involving surgical procedures for degenerative spine conditions between 2008 and 2016 were retrospectively reviewed. Of 11 150 cases, 396 patients (3.6%) experienced an unplanned hospital readmission within 30 d of discharge. Over 75 pre-discharge variables were collected and categorized into demographic, perioperative, and resource utilization feature domains. Random forest classification was used to construct predictive models for readmission from feature domains. An ensemble tree-specific method was used to quantify and rank features by relative importance.

RESULTS

In the demographics domain, age and comorbidity burden were the most important features for readmission prediction. Surgical duration and intraoperative oral morphine equivalents were the most important perioperative features, whereas total direct cost and length of stay were most important in the resource utilization domain. In supervised learning experiments for predicting readmission, the demographic domain model performed the best alone, suggesting that demographic features may contribute more to readmission risk than perioperative variables following spine surgery. A predictive model, created using only enriched features showing substantial importance, demonstrated improved predictive capacity compared to previous models, and approached the performance of state-of-the-art, deep-learning models for readmission.

CONCLUSION

This strategy provides insight into global patterns of feature importance and better understanding of drivers of readmissions following spine surgery.
Models or Stars: The Role of Asset Pricing Models and Heuristics in Investor Risk Adjustment
Authors: Evans Richard B , Sun Yang
Published: April 2020

We examine the role of factor models and simple performance heuristics in investor decision-making using Morningstar’s 2002 rating methodology change. Before the change, flows strongly correlated with CAPM alphas. After, when funds are ranked by size and book-to-market groups, flows become more sensitive to 3-factor alphas (FF3). Flows to a matched institutional sample (same managers/strategies) follow FF3 before and after the change but are unrelated to the CAPM. Placebo tests with sector funds and other factor loadings show no effects. Our results imply that improvements in simple performance heuristics can result in more sophisticated risk adjustment by retail investors.
Taper Tantrums: Quantitative Easing, Its Aftermath, and Emerging Market Capital Flows
Authors: Chari Anusha , Dilts Stedman Karlye , Lundblad Christian
Published: April 2020

This paper examines the spillover effects of U.S. unconventional monetary policy (UMP) on emerging market capital flows and asset prices. Affine term structure model estimates show that U.S. monetary policy shocks, identified with high-frequency Treasury futures data, represent revisions to expected short-term yields and term premia, especially during the UMP period. The policy shocks exhibit sizable effects on U.S. holdings of emerging market assets. These effects disproportionately manifest through valuation changes versus physical flows, are more pronounced for equity relative to bond markets, and are asymmetric between the quantitative easing and tapering periods, with flows more important during the unwinding.
Early variation of ultrasound halo sign with treatment and relation with clinical features in patients with giant cell arteritis
Authors: Ponte Cristina , Serafim Ana Sofia , Monti Sara , Fernandes Elisabete , Lee Ellen , Singh Surjeet , Piper Jennifer , Hutchings Andrew , McNally Eugene , Diamantopoulos Andreas P , Dasgupta Bhaskar , Schmidt Wolfgang A , Luqmani Raashid Ahmed
Published: April 2020

Objectives

To compare the ultrasound characteristics with clinical features, final diagnosis and outcome; and to evaluate the halo size following glucocorticoid treatment in patients with newly diagnosed GCA.

Methods

Patients with suspected GCA, recruited from an international cohort, had an ultrasound of temporal (TA) and axillary (AX) arteries performed within 7 days of commencing glucocorticoids. We compared differences in clinical features at disease presentation, after 2 weeks and after 6 months, according to the presence or absence of halo sign. We undertook a cross-sectional analysis of the differences in halo thickness using Pearson’s correlation coefficient (r) and Analysis of Variance (ANOVA).

Results

A total of 345 patients with 6 months follow-up data were included; 226 (65.5%) had a diagnosis of GCA. Jaw claudication and visual symptoms were more frequent in patients with halo sign (P =0.018 and P =0.003, respectively). Physical examination abnormalities were significantly associated with the presence of ipsilateral halo (P <0.05). Stenosis or occlusion on ultrasound failed to contribute to the diagnosis of GCA. During 7 days of glucocorticoid treatment, there was a consistent reduction in halo size in the TA (maximum halo size per patient: r=−0.30, P =0.001; and all halos r=−0.23, P <0.001), but not in the AX (P >0.05). However, the presence of halo at baseline failed to predict future ischaemic events occurring during follow-up.

Conclusion

In newly diagnosed GCA, TA halo is associated with the presence of ischaemic features and its size decreases following glucocorticoid treatment, supporting its early use as a marker of disease activity, in addition to its diagnostic role.
FEASIBILITY OF DISPLAYED EXPOSURE INDEX IN IEC STANDARD FRAMEWORK AS A DOSE OPTIMISATION TOOL FOR DIGITAL RADIOGRAPHY SYSTEMS
Authors: Park Hyemin , Yoon Yongsu , Tanaka Nobukazu , Kim Jungsu , Kim Jungmin , Morishita Junji
Published: April 2020

International Electrotechnical Commission (IEC) established the framework for the use of exposure index (EI) for evaluating the exposure conditions with various digital systems. In this study, we investigated the feasibility of EI, as per the IEC, by comparing the EIs obtained through manual calculated and that displayed on the console of two computed radiography (CR) and digital radiography (DR) systems with radiation beam qualities of RQA3,5,7 and 9. As a result, both two systems indicated an uncertainty of less than 20% for both calculated and displayed EI with all beam qualities except displayed EI obtained by RQA3. However, the displayed EI values were different even under the same exposure conditions because of the characteristics of the imaging receptor materials, such as BaFI or CsI, of two systems. Therefore, when an operator attempts to introduce displayed EI for managing radiation dose, it is essential to understand the characteristics of the digital system.
Training Regimes and Skill Formation in France and Germany An Analysis of Change Between 1970 and 2010
Authors: Elbers Benjamin , Bol Thijs , DiPrete Thomas A
Published: April 2020

How do educational systems prepare workers for the labor market? Stratification research has often made a distinction between two ideal-types: “qualificational spaces,” exemplified by Germany with a focus on vocational education, and “organizational spaces,” exemplified by France with a focus on general education. However, most studies that investigated this distinction did so by focusing only on the size of the vocational sector, not on whether graduates with a vocational degree actually link strongly to the labor market. Moreover, they often studied male workers only, ignoring potential gender differences in how school-to-work linkages are established. In this paper, we map the change in education–occupation linkage in France and Germany between 1970 and 2010 using an approach that can distinguish between changes in rates and changes in the structure of school-to-work linkages. Surprisingly, we find that the German vocational system in 1970 was not, on average, substantially more efficient in allocating graduates to specific occupations than the French system. This finding is a major departure from earlier results, and it shows that the differences between 1970’s France and Germany, on which the qualificational-organizational distinction is based, are smaller than previously assumed. Partly, this is due to the fact that the female labor force was omitted from earlier analyses. We thus show that ignoring the female workforce has consequences for today’s conception of skill formation systems, particularly because a large share of educational expansion is caused by an increase in female enrollment in (higher) education.
“Me Perdía en la Escuela”: Latino Newcomer Youths in the U.S. School System
Authors: Szlyk Hannah Selene , Berger Cardoso Jodi , Barros Lane Liza , Evans Kerri
Published: April 2020

Unaccompanied minors, or “newcomer youths,” come to the United States from Mexico and Central America to escape violence and persecution, and to seek financial and academic opportunities. Many newcomer youths arrive with gaps in their formal education attributed to the immigration process and the heterogeneity of their pre-U.S. lives. Once they are enrolled in the U.S. school system, many educators struggle to accommodate the academic needs of these students. Drawing on the framework of social and cultural capital, this article aimed to expand the current knowledge on the experiences of Latino unaccompanied youths in the U.S. school system. A thematic analysis of semistructured interviews with 30 newcomer students and 10 key informants revealed six themes: socialización con los demás compañeros (getting along with the other students); poca confianza (little trust); no sé lo que decían (I do not know what they were saying); it is a hard landing; education, interrupted; and estoy agradecido (I am grateful). The article offers suggestions for school social workers and educators on how to promote academic success, student resilience, and school connectedness for a vulnerable youth population.
Building Competence in Practice with the Polyamorous Community: A Scoping Review
Authors: Katz Mycah Idan Laufer , Graham John R
Published: April 2020

The landscape of relationships, gender, and sexuality continues to change rapidly across the world. This includes recognition of relationship styles such as polyamory, in which individuals have multiple romantic relationships with the knowledge and consent of all involved. In the academic literature on polyamory, social work perspectives are noticeably absent. Thus, a scoping review concerning social work, counseling, and polyamory was conducted to assess knowledge from the last decade and to contribute to the field. The themes that arose were the need for clinicians to examine their biases toward monogamy and polyamory, including perceptions of insecure attachment and a lack of commitment in polyamorous relationships. The literature also recognizes that polyamorous individuals often have fluid identities and sexual orientations. Finally, social workers have a duty to create a safe environment for polyamorous clients because of widespread societal stigma. As social work values client self-determination and examination of societal discourses, the field would benefit from further research into polyamory; this article is just the beginning.
Development and Testing of the Danger Assessment for Law Enforcement (DA-LE)
Authors: Messing Jill Theresa , Campbell Jacquelyn , Dunne Kelly , Dubus Suzanne
Published: April 2020

One-third of women are victimized by intimate partner violence (IPV) in their lifetime; when women are killed, they are often murdered by a previously abusive intimate partner. Risk-informed collaborative interventions, such as domestic violence high risk teams (DVHRTs), use IPV risk assessment to identify and intervene in high-risk IPV cases. This study reports on the development and testing of the Danger Assessment for Law Enforcement (DA-LE), an IPV risk assessment intended for use with DVHRTs. Data were collected through structured telephone interviews from service-seeking survivors of IPV at two time points approximately seven to eight months apart. One sample (n = 570) was used to develop the DA-LE and another (n = 389) was used to test the predictive validity of the instrument using the receiver operating characteristic area under the curve (AUC). The DA-LE predicted near fatal IPV on follow-up with similar or better accuracy than most validated IPV risk assessment instruments (AUC = 0.6864–0.7516). There were no significant differences in predictive validity based on survivor/offender race or ethnicity. The DA-LE has the potential to identify high-risk police-involved IPV cases. Risk-informed collaborative interventions may enhance outcomes for survivors of IPV by holding offenders accountable, increasing help seeking, and reducing future assaults.
Linguistic Complexity of Speech Recognition Test Sentences and Its Influence on Children’s Verbal Repetition Accuracy
Authors: van der Hoek-Snieders Hanneke E.M. , Stegeman Inge , Smit Adriana L. , Rhebergen Koenraad S.
Published: April 2020

Objectives:

Speech recognition (SR)-tests have been developed for children without considering the linguistic complexity of the sentences used. However, linguistic complexity is hypothesized to influence correct sentence repetition. The aim of this study is to identify lexical and grammatical parameters influencing verbal repetition accuracy of sentences derived from a Dutch SR-test when performed by 6-year-old typically developing children.

Design:

For this observational, cross-sectional study, 40 typically developing children aged 6 were recruited at four primary schools in the Netherlands. All children performed a sentence repetition task derived from an SR-test for adults. The sentence complexity was described beforehand with one lexical parameter, age of acquisition, and four grammatical parameters, specifically sentence length, prepositions, sentence structure, and verb inflection. A multiple logistic regression analysis was performed.

Results:

Sentences with a higher age of acquisition (odds ratio [OR] = 1.59) or greater sentence length (OR = 1.28) had a higher risk of repetition inaccuracy. Sentences including a spatial (OR = 1.25) or other preposition (OR = 1.25) were at increased risk for incorrect repetition, as were complex sentences (OR = 1.69) and sentences in the present perfect (OR = 1.44) or future tense (OR = 2.32).

Conclusions:

The variation in verbal repetition accuracy in 6-year-old children is significantly influenced by both lexical and grammatical parameters. Linguistic complexity is an important factor to take into account when assessing speech intelligibility in children.
Utilization of Telemedicine Virtual Visits in Pediatric Spinal Deformity Patients: A Comparison of Feasibility and Patient Satisfaction at a Large Academic Center
Authors: Sultan Assem A. , Acuña Alexander J. , Samuel Linsen T. , Rabin Jacob M. , Grits Daniel , Gurd David P. , Kuivila Thomas E. , Goodwin Ryan C.
Published: April 2020

Background:

Telemedicine platforms have been developed to support the convenient delivery of health care services to their patients while maintaining appropriate quality of care. However, it is unclear whether they can be utilized effectively in patients with pediatric spinal deformity (PSD). Therefore, this study aimed to evaluate the feasibility and patient satisfaction associated with virtual visit (VV) utilization in PSD patients in comparison to general pediatric orthopaedic indications.

Methods:

Of the 482 VVs offered to pediatric orthopaedic patients at a large academic health care system between January 1, 2017, and December 31, 2018, a total of 189 VVs conducted by board-certified orthopaedic surgeons were included in the final analysis. Patient satisfaction scores were collected at the end of each VV by patient and parent rankings of the surgeon and the telemedicine service. Data on patients, visits, and connectivity sessions characteristics were collected and statistically compared between PSD visits (n=33) versus those conducted for general pediatric orthopaedic indications (n=156).

Results:

Although PSD patients were older (15±3.7 vs. 12±4.7 y; P<0.01), mostly female (76% vs. 47%, P=0.003), and had longer VVs (8±4.6 vs. 5±3.6 min; P=0.003) versus their general pediatric orthopaedic counterparts, they demonstrated similarly high satisfaction scores for surgeon performance (5±0 vs. 4.8±0.1 points; P=0.08) and overall satisfaction (3±2.4 vs. 3.5±2.1; P=0.23). Approximately 80% of all VVs were conducted over mobile devices. Wait time was substantially less for PSD VVs relative to subsequent office visits (13±10 vs. 41±30 min; P<0.001).

Conclusions:

Our analysis found that telemedicine VVs provided a convenient alternative to traditional in-office visits for PSD patients. Specifically, we found that PSD patients received faster care with comparable satisfaction. The findings of our present analysis should encourage health care systems to continually evaluate and implement telehealth platforms to improve both the accessibility and appropriate quality of care.

Level of Evidence:

Level IV.
Update on Spinal Cord Injury Management
Authors: Russo Glenn S. , Mangan John J. , Galetta Matthew S. , Boody Barrett , Bronson Wesley , Segar Anand , Kepler Christopher K. , Kurd Mark F. , Hilibrand Alan S. , Vaccaro Alexander R. , Schroeder Gregory D.
Published: April 2020

The management of acute spinal cord injury requires a multidisciplinary approach to maximize patient outcomes and potential. Treatment of this injury involves both surgical and medical intervention. Medical intervention in acute spinal cord injury is aimed at decreasing the neurotoxic environment that occurs as part of the secondary injury. New neuroregenerative therapies are being developed.
Successful Treatment of In-Transit Metastatic Melanoma in a Renal Transplant Patient With Combination T-VEC/Imiquimod Immunotherapy
Authors: Sunshine Joel C. , Sosman Jeffrey , Shetty Aneesha , Choi Jennifer N.
Published: April 2020

In the era of immunotherapy for cancer, solid organ transplant patients who go on to develop metastatic or locally advanced melanoma offer particularly difficult challenges. New approaches are needed for these patients. We present a case of in-transit metastatic melanoma in a renal transplant patient. The patient was initially managed with talimogene laherparepvec (T-VEC) injections alone with continued local progression. Addition of topical imiquimod 5% cream to intralesional T-VEC resulted in a rapid and dramatic response, with complete clearance of the cutaneous in-transit metastases and without any sign of organ rejection. In solid organ transplant patients who lack surgical options and are not eligible for treatment with a BRAF inhibitor, and for whom treatment with checkpoint inhibitors present risk of organ rejection, T-VEC either alone or in combination with topical imiquimod should be considered for patients with locally advanced disease. This combination should be a consideration, with close observation, in patients with a history of organ transplantation and immunosuppression.
Doxorubicin and Olaratumab Versus Doxorubicin, Ifosfamide, and Mesna for Treatment of Advanced Soft Tissue Sarcomas
Authors: Hammer Kathryn J. , Copeland Vanessa C. , Loggers Elizabeth T. , Pollack Seth M. , Wagner Michael J. , Cranmer Lee D.
Published: April 2020

Objective:

We compared the outcomes in soft tissue sarcoma (STS) treated with olaratumab and doxorubicin (OD) versus doxorubicin, ifosfamide, and mesna (AIM) to assess whether OD could supersede AIM in STS therapy.

Methods:

A single-institution, retrospective study of STS treated for advanced disease with OD or AIM in 2013 to 2017 was conducted. Demographic and clinical parameters were compared by Fisher’s exact test. Kaplan-Meier and Cox analyses examined progression-free survival (PFS) and overall survival (OS). Adverse events were compared.

Results:

Thirty patients (13 OD, 17 AIM) were included. OD was administered more commonly after first-line therapy (54% OD vs. 6% AIM, P=0.0005). The 2 groups did not differ in other parameters. Median OS [OD: 14.2 mo, 95% confidence interval (CI): 7.1-not reached; AIM 19.9 mo, 95% CI 9.5-35.5; hazard ratio: 0.99, 95% CI: 0.38-2.59, P=0.99] and PFS (OD: 2.6 mo, 95% CI: 1.3-7; AIM 6.4 mo, 95% CI: 1.5-14.5; hazard ratio: 0.57, 95% CI: 0.26-1.24, P=0.16) were not statistically different, although median values favored AIM. Grade 3 to 4 neutropenia, but not febrile neutropenia, was more frequent with OD.

Conclusions:

OD and AIM did not differ with respect to either OS or PFS. Although this study’s size initially appeared the most likely explanation, lack of significant activity of olaratumab was subsequently reported in the phase III trial of OD. Our results suggest that future conditional oncology drug approvals should be accompanied by mandated registries to monitor outcomes of patients treated after conditional approval, but before full approval.
Recurrence Rates Following Excision of Hidradenitis Suppurativa: A Systematic Review and Meta-analysis
Authors: Ovadja Zachri N. , Jacobs Wilco , Zugaj Mislav , van der Horst Chantal M.A.M. , Lapid Oren
Published: April 2020

BACKGROUND

Surgery is considered to be the best treatment for recurrent hidradenitis suppurativa (HS). Varying recurrence rates have been reported in the literature.

OBJECTIVE

To provide an up-to-date systematic review of the complete literature for different excision strategies and their recurrence rates in HS.

METHODS

A systematic literature search of the complete available literature and a meta-analysis of proportions were performed on the included studies.

RESULTS

Of a total of 1,593 retrieved articles, 125 were included in the analysis. Most of these studies were retrospective with 8 prospective analyses and one randomized controlled trial (RCT). The techniques described were divided into partial excision (PE) and wide excision (WE), described in 33 and 97 included studies, respectively. The average estimated recurrences were 26.0% (95% confidence interval [CI], 16.0%–37.0%) for PE and 5.0% (95% CI, 3.0%–9.0%) for WE (p < .01). Female sex (p = .016) and HS caudal of the umbilicus (p = .001) were significantly associated with the overall recurrence rate. Quality of evidence was poor, and the reporting of results was mostly heterogeneous.

CONCLUSION

This systematic review showed higher recurrence rates when it was not intended to resect affected HS tissue with a radical margin. There is a need for more RCT's and uniformly reported treatment outcomes.
The Epidemiology of Extrapulmonary Non-tuberculous Mycobacterial Infection in a Pediatric Population
Authors: Aliano Danielle , Thomson Rachel
Published: April 2020

Background:

Nontuberculous mycobacteria (NTM) are ubiquitous in the environment and a well-known cause of lymphadenitis, skin and soft tissue infections. The aim of this study was to evaluate the epidemiology of extrapulmonary pediatric NTM infections occurring from 2000 to 2017 in Queensland, Australia.

Methods:

All cases of NTM and TB are notifiable under the Queensland Public Health Act (2005) and associated regulations (2005). Data from 2000 to 2017 inclusive was collected from the Notifiable Conditions Database, a laboratory based notification system that covers private and public laboratory systems. Pediatric population demographic data were obtained from the Australian Bureau of Statistics by researching the number of children 0–14 years of age in Queensland from 2000 to 2017; both annual and averaged population was determined. The statistical software SPSS and Tableau was used for analysis.

Results:

The mean age of diagnosis was 2.5 years with a majority of the cohort being women. Mycobacterium avium was the most commonly diagnosed pathogen. Geographic regions with the highest numbers of cases were predominantly tropical and coastal areas. M. haemophilum emerged as a more common pathogen from 2011 following a period of major flooding.

Conclusion:

Characteristics of the cohort of children susceptible to NTM disease appears consistent with previous reports. However, changes in the epidemiology of NTM infection (such as incidence, species, and geographic distribution) in children may be linked to environmental and weather factors.
Risk Stratification and Personal Protective Equipment Use in Pediatric Endoscopy During the Coronavirus Disease 2019 Outbreak
Authors: Say Daphne S. , de Lorimier Arthur , Lammers Cathleen R. , Natale JoAnne , Lakshminrusimha Satyan , Wiedeman Jean , Partridge Elizabeth
Published: April 2020

SARS‐CoV‐2, the novel coronavirus causing coronavirus disease 2019 (COVID‐19), is now a global pandemic. Human‐to‐human transmission has been documented to occur through respiratory secretions, feces, aerosols, and contaminated environmental surfaces. Pediatric patients present a unique challenge as they may have minimal symptoms and yet transmit disease. Endoscopists face risk for infection with viruses like SARS‐CoV‐2, as the aerosol generating nature of endoscopy diffuses respiratory disease that can be spread via an airborne and droplet route. We describe our center's methodology for pediatric patient risk stratification to facilitate responsible use of endoscopic resources during this crisis. We also describe our recommendations for use of personal protective equipment by endoscopists, with the goal of ensuring the safety of ourselves, our anesthesiology and endoscopy staff, and our patients.
Understanding the Increasing Role and Value of the Professional Case Manager
Authors: Tahan Hussein M. , Kurland MaryBeth , Baker Michelle
Published: April 2020

Purpose:

The purpose of the national role and function study was to identify the essential activities and necessary knowledge areas for effective professional case management practice from the perspective of those currently functioning in such roles in various care settings and across diverse professional disciplines.

Primary Practice Settings:

The national study covered the diverse case management practices and/or work settings across the full continuum of health and human services.

Methodology and Sample:

This cross-sectional descriptive study used the practice analysis method and online survey research design. It employed a purposive sample of case managers, in which an open participation link was e-mailed to nearly 60,000 case managers, both certified and not yet certified. A total of 5,416 responses were received, of which 2,810 were found to be acceptable for consideration in the study. A representative group of individuals engaged in case management completed the survey in sufficient numbers to meet the requirements for conducting meaningful statistical analyses including subgroup comparisons.

Results:

The study identified the common activities (6 domains) and knowledge areas (5 domains) necessary for competent and effective performance by professional case managers, as highlighted in this article, which is the first of a 2-part series on the 2019 role and function study. The results informed the needed update of the test specifications for the Certified Case Manager (CCM) certification examination, as will be delineated in Part II of this article series. The update was necessary because case management practice has continued to evolve and to ensure the examination reflects current practices.

Implications for Case Management Practice:

The study identified essential activities and knowledge topics at both the micro- and macro levels that define competent and effective professional case management practice, also referred to as the substantive evidence of practice. It helps keep the CCM credentialing examination evidence-based and maintain its validity for evaluating the competency of professional case managers. In addition, the findings document how the practice has evolved over the past 5 years since the conduct of the last national study. Moreover, findings inform the development of programs and curricula for the training and advancement of case managers. The study instrument also is beneficial for further research into professional case management practice—most importantly linking the roles and functions of case managers to client care outcomes.