bluuebunny/crossref_metadata_2025 huggingface dataset:
Metformin Is Associated With a Lower Risk of Atrial Fibrillation and Ventricular Arrhythmias Compared With Sulfonylureas
Authors: Ostropolets Anna , Elias Pierre A. , Reyes Michael V. , Wan Elain Y. , Pajvani Utpal B. , Hripcsak George , Morrow John P.
Published: February 2021

Background:

Type 2 diabetes is one of the most common chronic disorders worldwide and is an important cause of cardiovascular disease. Studies investigating the risk of atrial and ventricular arrhythmias in diabetic patients taking different oral diabetes medications are sparse.

Methods:

We used IBM MarketScan Medicare Supplemental Database to examine the risk of arrhythmias for patients on different oral diabetes medications by propensity score matching.

Results:

We found that patients on metformin monotherapy had significantly reduced risk of atrial arrhythmias, including atrial fibrillation, compared with monotherapy with DPP4 (dipeptidyl peptidase 4 inhibitor) or thiazolidinedione medications. Patients on metformin monotherapy had significantly reduced risk of atrial arrhythmias, ventricular arrhythmias, and bradycardia compared with monotherapy with sulfonylureas. Combination therapy with sulfonylureas and metformin had an increased risk of atrial arrhythmias compared with some other combinations.

Conclusions:

Different oral diabetes medications have significantly different long-term risk of arrhythmia. Specifically, metformin is associated with reduced risk of atrial fibrillation and ventricular arrhythmias compared with sulfonylureas.
Empagliflozin Effects on Pulmonary Artery Pressure in Patients With Heart Failure
Authors: Nassif Michael E. , Qintar Mohammed , Windsor Sheryl L. , Jermyn Rita , Shavelle David M. , Tang Fengming , Lamba Sumant , Bhatt Kunjan , Brush John , Civitello Andrew , Gordon Robert , Jonsson Orvar , Lampert Brent , Pelzel Jamie , Kosiborod Mikhail N.
Published: February 2021

Background:

Sodium glucose cotransporter 2 inhibitors (SGLT2 inhibitors) prevent heart failure (HF) hospitalizations in patients with type 2 diabetes and improve outcomes in those with HF and reduced ejection fraction, regardless of type 2 diabetes. Mechanisms of HF benefits remain unclear, and the effects of SGLT2 inhibitor on hemodynamics (filling pressures) are not known. The EMBRACE-HF trial (Empagliflozin Evaluation by Measuring Impact on Hemodynamics in Patients With Heart Failure) was designed to address this knowledge gap.

Methods:

EMBRACE-HF is an investigator-initiated, randomized, multicenter, double-blind, placebo-controlled trial. From July 2017 to November 2019, patients with HF (regardless of ejection fraction, with or without type 2 diabetes) and previously implanted pulmonary artery (PA) pressure sensor (CardioMEMS) were randomized across 10 US centers to empagliflozin 10 mg daily or placebo and treated for 12 weeks. The primary end point was change in PA diastolic pressure (PADP) from baseline to end of treatment (average PADP weeks 8–12). Secondary end points included health status (Kansas City Cardiomyopathy Questionnaire score), natriuretic peptides, and 6-min walking distance.

Results:

Overall, 93 patients were screened, and 65 were randomized (33 to empagliflozin, 32 to placebo). The mean age was 66 years; 63% were male; 52% had type 2 diabetes; 54% were in New York Heart Association class III/IV; mean ejection fraction was 44%; median NT-proBNP (N-terminal pro B-type natriuretic peptide) was 637 pg/mL; and mean PADP was 22 mm Hg. Empagliflozin significantly reduced PADP, with effects that began at week 1 and amplified over time; average PADP (weeks 8–12) was 1.5 mm Hg lower (95% CI, 0.2–2.8;
P
=0.02); and at week 12, PADP was 1.7 mm Hg lower (95% CI, 0.3–3.2;
P
=0.02) with empagliflozin versus placebo. Results were consistent for PA systolic and PA mean pressures. There was no difference in mean loop diuretic management (daily furosemide equivalents) between treatment groups. No significant differences between treatment groups were observed in Kansas City Cardiomyopathy Questionnaire scores, natriuretic peptide levels, and 6-min walking distance.

Conclusions:

In patients with HF and CardioMEMS PA pressure sensor, empagliflozin produced rapid reductions in PA pressures that were amplified over time and appeared to be independent of loop diuretic management.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03030222.
Reverse Dipping of Systolic Blood Pressure Is Associated With Increased Dementia Risk in Older Men
Authors: Tan Xiao , Sundström Johan , Lind Lars , Franzon Kristin , Kilander Lena , Benedict Christian
Published: February 2021

A lower day-to-night systolic blood pressure (BP) dip has previously been associated with poor brain health and cognitive functions. Here, we sought to examine whether reduced (nighttime/daytime ratio of systolic BP >0.9 and ≤1) and reverse (nighttime/daytime ratio of systolic BP >1) dipping of systolic BP is associated with the prospective risk of being diagnosed with any dementia in Swedish older men. Twenty-four-hour ambulatory BP monitoring was used to estimate the nocturnal systolic BP dipping status of men at mean age 71 (n=997; 35% on antihypertensive medication) and 77.6 (n=611; 41% on antihypertensive medication). Dementia incidence during the observational period up to 24 years (n=286 cases) was determined by reviewing participants’ medical history and independently confirmed by at least 2 experienced geriatricians. Using time-updated Cox regression (ie, time-updated information on covariates and exposure), we found that reverse systolic BP dipping was associated with a higher risk of being diagnosed with any dementia (adjusted HR, 1.64 [95% CI, 1.14–2.34],
P
=0.007) and Alzheimer’s disease (1.67 [1.01–2.76],
P
=0.047) but not vascular dementia (1.29 [0.55–3.06],
P
=0.559). In contrast, reduced dipping of nocturnal systolic BP was not associated with a higher risk of being diagnosed with dementia. Our findings suggest that reverse systolic BP dipping may represent an independent risk factor for dementia and Alzheimer’s disease in older men. Future studies should decipher whether therapies lowering nocturnal systolic BP below daytime levels, such as bedtime dosing of antihypertensive medication, can meaningfully curb the development of dementia.
SingHealth Radiology Archives pictorial essay Part 2: gastroenterology, musculoskeletal, and obstetrics and gynaecology cases
Authors: Tan MBW , Tan KP , Beh JCY , Chan EYK , Chin KFW , Chin ZY , Chua WM , Chong AWL , Gu TG , Hou W , Lai AL , Lee RZ , Liew JRP , Lim M , Lim JLL , Tan Z , Tan E , Tan GSL , Tan TSE , Tan EJ , Tan ASM , Yan YY , Lim WEH
Published: February 2021

The Singapore Health Services cluster (SingHealth) radiology film archives are a valuable repository of local radiological cases dating back to the 1950s. Some of the cases in the archives are of historical medical interest, i.e. cerebral angiography in the workup of patients with hemiplegia. Other cases are of historical social interest, being conditions seen during earlier stages of Singapore’s development, i.e. bound feet. The archives form a unique portal into the development of local radiology as well as the national development of Singapore. A selection from the archives is published in commemoration of the International Day of Radiology in 2020, as well as the 200th anniversary of the Singapore General Hospital in 2021. This pictorial essay comprises gastroenterology, musculoskeletal and obstetrics and gynaecology cases from the archives.
The International Criminal Court and the Issue of Intersectionality—A Conceptual and Legal Framework for Analysis
Authors: Maučec Gregor
Published: February 2021

A survey of relevant case law of the International Criminal Court (icc or Court) reveals inconsistencies, as well as conceptual flaws and limitations in the Court’s mainly uni-sectional approach to mass atrocities that involve multiple and intersecting forms discrimination, in particular with regard to the cornerstones of such cases—the identification of the protected groups and their members. This has resulted in discrepancies and low levels of legal protection against intersectional targeting. Such a cautious, selective and inconsistent approach of the icc to this issue is unsurprising given that the application of intersectionality in practice is a radical and transformative project. Espousing a more consistent and intersectional approach of the icc in considering mass atrocities against different protected groups and their members, this article discusses the Court’s legal framework and major conceptual and statutory concerns surrounding the icc prosecutor’s and judges’ enhanced engagement—through more progressive law interpretation—with the phenomena of intersectionality and key concepts related to it. The main purpose of this contribution is thus two-fold: (1) to demonstrate and explain why, in practice, the focus on intersectional dimensions of such situations and cases in their selection, prosecution and adjudication does not interfere with strict adherence to the principle of legality underlying the Rome Statute, and (2) to analyse the legal grounds and avenues for the Court to implement intersectionality when dealing with atrocities involving intersectional discrimination. It is ultimately suggested that Article 21(3) of the Rome Statute offers a proper and solid legal basis for interpreting and applying pertinent international criminal law in light of intersectionality.
Studies on sexual compatibility and or incompatibility among Psidium species and their hybridity confirmation through ssr markers
Authors: Mulagund Jagadeesha , Dinesh M.R. , Vasugi C. , Rekha A. , Ravishankar K.V.
Published: February 2021

The present investigation was carried out with an aim to determine the cross compatibility between Psidium species (P. chinensis, P. guineense, P. cattleianum and P. molle) and commercial guava cultivars (Arka Kiran, Arka Rashmi, Arka Mridula and Allahabad Safed). The results revealed that, P. chinensis and P. guineense were found to be good cross compatible male parents whereas, Allahabad Safeda and Arka Kiran were found to be good cross compatible female parents. However, no fruit set and seed set were obtained when P. cattleianum and P. molle were used as male parent indicating the cross incompatibility of these species with commercial guava cultivars which is reconfirmed using florescence microscopy technique to understand the pollen-pistil interaction between incompatible P. cattleianum and P. molle species with P. guajava cv. Allahabad Safeda. Result indicated that low fluorescence intensity along with poor pollen germination and improper pollen-tube growth could be the reason for incompatibility. In order to break this incompatibility, a modified pollination technique called stigma maceration technique was followed wherein stigma of the male parent macerated with different chemicals viz., carbohydrate source (2% sucrose), growth regulators (50 ppm GA3 and iaa) and micronutrients (50 ppm of each Boric acid, MgSO4, CaNO3 and KNO3) and pollinated twice i.e., on the day of flower opening and the same time of next day resulted in cross compatibility of P. cattleianum and P. molle with commercial guava cultivars. Further hybridity confirmation of interspecific hybrids using ssr markers revealed that, 8 markers were found to be co-dominant and confirmed the hybridity of interspecific hybrid combinations.
The Obesity Paradox in Emergency General Surgery Patients
Authors: Maloney Sean R. , Reinke Caroline E. , Nimeri Abdelrahman A. , Ayuso Sullivan A. , Christmas A. Britton , Hetherington Timothy , Kowalkowski Marc , Sing Ronald F. , May Addison K. , Ross Samuel Wade
Published: February 2021

Background

Operative management of emergency general surgery (EGS) diagnoses involves a range of procedures which can carry high morbidity and mortality. Little is known about the impact of obesity on patient outcomes. The aim of this study was to examine the association between body mass index (BMI) >30 kg/m2 and mortality for EGS patients. We hypothesized that obese patients would have increased mortality rates.

Methods

A regional integrated health system EGS registry derived from The American Association for the Surgery of Trauma EGS ICD-9 codes was analyzed from January 2013 to October 2015. Patients were stratified into BMI categories based on WHO classifications. The primary outcome was 30-day mortality. Longer-term mortality with linkage to the Social Security Death Index was also examined. Univariate and multivariable analyses were performed.

Results

A total of 60 604 encounters were identified and 7183 (11.9%) underwent operative intervention. Patient characteristics include 53% women, mean age 58.2 ± 18.7 years, 64.2% >BMI 30 kg/m2, 30.2% with chronic obstructive pulmonary disease, 19% with congestive heart failure, and 31.1% with diabetes. The most common procedure was laparoscopic cholecystectomy (36.4%). Overall, 90-day mortality was 10.9%. In multivariable analysis, all classes of obesity were protective against mortality compared to normal BMI. Underweight patients had increased risk of inpatient (OR = 1.9, CI = 1.7-2.3), 30-day (OR = 1.9, CI = 1.7-2.1), 90-day (OR = 1.8, CI 1.6-2.0), 1-year (OR = 1.8, CI = 1.7-2.0), and 3-year mortality (OR = 1.7, CI = 1.6-1.9).

Conclusions

When stratified by BMI, underweight EGS patients have the highest odds of death. Paradoxically, obesity appears protective against death, even when controlling for potentially confounding factors. Increased rates of nonoperative management in the obese population may impact these findings.
Implementation of Electronic Clinical Decision Support Tools for Antibiotic Stewardship in Pediatric Appendicitis
Authors: Marulanda Kathleen , Willis Zachary , Wilson William , Koonce Robin D. , Lamm Amy , McLean Sean E. , Hayes-Jordan Andrea , Phillips Michael R.
Published: February 2021

Background

The efficacy of clinical decision support (CDS) tools to promote antibiotic stewardship in pediatric appendicitis remains poorly understood. Here, we developed an electronic order panel (OP) to assist with decreased utilization of extended spectrum antibiotics.

Methods

Retrospective review of patients (≤18 years) at a single institution from May 2018 to October 2019 treated with ≥1 dose of preferred (narrow) or nonpreferred (broad-spectrum) antibiotics was performed, and they were categorized as pre- (PIC) or postimplementation cohorts (PISC).

Results

Of 234 encounters, 170 (73%) and 107 (46%) received preferred and nonpreferred antibiotics, respectively. Postimplementation cohort encounters had a sustained 50% increase in preferred antibiotic use compared to PIC (92% vs 42%, P = .014). Order panel utilization accounted for 31% of overall encounters and 44% of PISC encounters.

Conclusion

Despite sustained improvement in antibiotic stewardship, OP utilization remains low. The use of CDS tools may not be a good process measure for quality improvement.
A Short Note on Optimizing Cost-Generalizability via a Machine-Learning Approach
Authors: Jiang Zhehan , Shi Dexin , Distefano Christine
Published: February 2021

The costs of an objective structured clinical examination (OSCE) are of concern to health profession educators globally. As OSCEs are usually designed under generalizability theory (G-theory) framework, this article proposes a machine-learning-based approach to optimize the costs, while maintaining the minimum required generalizability coefficient, a reliability-like index in G-theory. The authors adopted G-theory parameters yielded from an OSCE hosted by a medical school, reproduced the generalizability coefficients to prepare for optimizing manipulations, applied simulated annealing algorithm to calculate the number of facet levels minimizing the associated costs, and conducted the analysis in various conditions via computer simulation. With a given generalizability coefficient, the proposed approach, virtually an instrument of decision-making supports, found the optimal solution for the OSCE such that the associated costs were minimized. The computer simulation results showed how the cost reductions varied with different levels of required generalizability coefficients. Machine learning–based approaches can be used in conjunction with psychometric modeling to help planning assessment tasks more scientifically. The proposed approach is easy to adopt into practice and customize in alignment with specific testing designs. While these results are encouraging, the possible pitfalls such as algorithmic convergences’ failure and inadequate cost assumptions should also be avoided.
Laboratory tests of the hydraulic pump operating load with monitoring of changes in the physical properties
Authors: Hujo Lubomir , Nosian Jozef , Zastempowski Marcin , Kosiba Jan , Kaszkowiak Jerzy , Michalides Matej
Published: February 2021

The present article deals with the physical properties monitoring of the transmission-hydraulic fluid, and changes of those properties due the operating load of the hydraulic pump in laboratory conditions. Tests of the transmission-hydraulic fluid were performed in laboratory conditions with the simulation of the operating load, so as to simulate the real conditions under which hydraulic circuit of the agricultural tractors operates. The universal transmission-hydraulic fluid was subjected to analysis, where the samples of the fluid were taken sequentially according to the chosen methodology at intervals of 250 and 500 h. The results of the present article include the evaluation of the physical properties of the fluid and the flow efficiency change of the hydraulic pump after 250 and 500 h of operation, while simulating the operation load. Based on a laboratory test, we found that after working for 500 h, the dynamic viscosity of the examined hydraulic fluid at 40°C decreased by 2.92 mPa.s and at 100°C decreased by 0.64 mPa.s. When determining the kinematic viscosity of the hydraulic fluid after working for 500 h, we recorded its decrease, namely, at a temperature of 40°C by a value of 3.37 mm2/s and at a temperature of 100°C, its value decreased by 0.77 mm2/s. In the analysis of the test oil samples, we found that the level of water contamination of the hydraulic fluid decreases with increasing number of hours worked. Specifically, the water concentration in the hydraulic fluid decreased by 0.031%. At the same time, we recorded a slight decrease in the flow efficiency of the hydraulic pump, specifically by a value of 0.03% after 500 h worked. After working 500 h, we found that the range of abrasion particles in the transmission-hydraulic fluid is within the prescribed range, which is determined by the standard D6595-00.
Music Education Opportunities in Ohio K–12 Public and Charter Schools
Authors: Shaw Brian P.
Published: February 2021

The purpose of this study was to examine which Ohio schools offered curricular music courses and the rates at which students participated in those courses. The analysis involved descriptive statistics, analysis of variance, logistic regression, and partially nested multilevel modeling using data from the Ohio Department of Education ( N = 3,222 schools). The investigation revealed that charter schools offered music courses far less often than public schools. However, in charter schools that did offer music, students participated at higher rates than those in public schools. Nearly all public schools featured music classes. The exception was high schools in the highest poverty urban neighborhoods, 31% of which had no curricular music. Students identified as Black, Hispanic, or indigenous were more likely to attend schools without music programs. Elementary students enrolled in an average of 1.00 music classes per year, whereas middle and high school students enrolled in 0.67 and 0.35 music classes per year, respectively. Suburban districts saw the greatest decline in music participation as students progressed to high school. Urban schools with greater percentages of white, non-Hispanic students had higher music enrollment rates.
Double Effect Donation
Authors: Camosy Charles C. , Vukov Joseph
Published: February 2021

Double Effect Donation claims it is permissible for a person meeting brain death criteria to donate vital organs, even though such a person may be alive. The reason this act is permissible is that it does not aim at one’s own death but rather at saving the lives of others and because saving the lives of others constitutes a proportionately serious reason for engaging in a behavior in which one foresees one’s death as the outcome. Double Effect Donation, we argue, opens a novel position in debates surrounding brain death and organ donation and does so without compromising the sacredness and fundamental equality of human life.

Recent cases and discussion have raised questions about whether brain death criteria successfully capture natural death. These questions are especially troubling since vital organs are often retrieved from individuals declared dead by brain death criteria. We therefore seem to be left with a choice: either salvage brain death criteria or else abandon current organ donation practices. In this article, we present a different way forward. In particular, we defend a view we call Double Effect Donation, according to which it is permissible for a person meeting brain death criteria to donate vital organs, even though such a person may be alive. Double Effect Donation, we argue, is not merely compatible with but grows out of a view that acknowledges the sacredness and fundamental equality of human life.
Painting with data: Alternative aesthetics of qualitative research
Authors: Balmer Andrew
Published: February 2021

In this article I outline an original creative method for qualitative research, namely the painting with data technique. This is a participatory methodology which brings creativity and participation through to the analytical phase of qualitative research. Crucially, I acknowledge but also challenge the dominant aesthetic that currently shapes qualitative research and renders life in a monochromatic palette. The painting with data method evidences an alternative aesthetic to the predominant one and I argue that we can understand this methodology by adapting Jennifer Mason’s concept of ‘layering’ to conceptualise how different aesthetics help us to see the different shapes, forms and moulds that make us, our relationships and our worlds. The process moves away from traditional ways of treating transcribed data, and prioritises addition above extraction; juxtaposition over thematisation; and collaging rather than ordering. This alternative aesthetic for qualitative research offers an evocative form and a conceptual schema through which to interpret the world, providing a route to novel insights, that enlivens the interpretative work of the analyst and offers opportunities to make and witness potent connections.
Automatic weaving method for three-dimensional composite preforms using vision system
Authors: Li Siyuan , Shan Zhongde , Du Dong , Zhan Li , Li Zhikun , Liu Yunzhi
Published: February 2021

Three-dimensional composite preform is the main structure of fiber-reinforced composites. During the weaving process of large-sized three-dimensional composite preform, relative rotation or translation between the fiber feeder and guided array occurs before feeding. Besides, the weaving needles can be at different heights after moving out from the guided array. These problems are mostly detected and adjusted manually. To make the weaving process more precise and efficient, we propose machine vision-based methods which could realize accurate estimation and adjustment of the relative position-pose between the fiber feeder and guided array, and make the needles pressing process automatic by recognizing the position of the weaving needles. The results show that the estimation error of relative position-pose is within 5%, and the rate of unrecognized weaving needles is 2%. Our proposed methods improve the automation level of weaving, and are conducive to the development of preform forming toward digital manufacturing.
The Effect of Question Positioning on Data Quality in Web Surveys
Authors: Neuert Cornelia Eva
Published: February 2021

The quality of data in surveys is affected by response burden and questionnaire length. With an increasing number of questions, respondents can become bored, tired, and annoyed and may take shortcuts to reduce the effort needed to complete the survey. In this article, direct evidence is presented on how the position of items within a web questionnaire influences respondents’ focus of attention. In two experiments, part of an eye-tracking study and an online survey, respectively, a variety of indicators show that data quality is lower if the experimental question is positioned at the end rather than at the beginning of a questionnaire. Practical implications are discussed.
Role of demographic and clinical factors in survival of HIV patients on antiretroviral therapy
Authors: Desai Kanan T , Patel Fenil , Patel Prakash B , Bansal RK
Published: February 2021

Our retrospective cohort study assesses the survival probability and identifies the demographic and clinical predictors of mortality in HIV patients taking antiretroviral therapy using an antiretroviral therapy centre data in Western India. Secondary data on 7532 registered HIV-infected individuals between September 2006 and January 2013 were analysed. The probability of survival at 75 months was 84.9%. Significant indicators of poor chances of survival were greater age, lower occupation class, lower CD4 count, poor functional status; higher stage of disease, lower weight, the presence and type of opportunistic infections, co-trimoxazole therapy and poor adherence to antiretroviral therapy. We thus find that, in addition to pre-ART, antiretroviral therapy clinical status and treatment adherence, socioeconomic status plays an important influence on ultimate survival of HIV patients on antiretroviral therapy.
Can Teaching Data Analysis In-House Improve Psychology Students’ Skills?
Authors: Vittengl Jeffrey R. , Vittengl Karen L.
Published: February 2021

Background:

Acquisition and generalization of data analysis skills are perennial challenges for psychology students. Teaching advanced data analysis in a psychology-specific context might improve students’ learning.

Objective:

At a mid-sized public university, we evaluated student outcomes after a new quantitative psychology course taught in the psychology department compared to upper-level statistics courses taught in the statistics department.

Method:

Undergraduate psychology majors ( N = 80) completed quantitative psychology and/or upper-level statistics courses in preparation for their capstone research course. Participants also completed a brief data analysis skills assessment and the Major Field Test for Psychology.

Results:

Controlling for prerequisite grades and ACT composites, participants who completed quantitative psychology compared to upper-level statistics had significantly better academic outcomes, on average (standardized mean difference = 0.37).

Conclusions:

Psychology students completing an upper-level data analysis course within versus outside the department demonstrated better learning outcomes in psychology.

Teaching Implications:

Psychology programs that outsource data analysis courses should consider whether teaching these skills in-house holds potential to improve student outcomes. Alternatively, statistics departments might consider developing psychology-themed courses taught by faculty with expertise in psychological science.
Diagnostic yield and safety of percutaneous CT-guided biopsy of retroperitoneal lesions and analysis of imaging features
Authors: Singh Anil Kumar , Neyaz Zafar , Verma Ritu , Gupta Anshul , Mishra Richa , Mishra Prabhakar
Published: February 2021

Background

Computed tomography (CT)-guided biopsy is emerging as a preferred method for obtaining tissue samples from retroperitoneal lesions due to clear visualization of needle and vessels.

Purpose

To assess diagnostic yield and safety of CT-guided biopsy of retroperitoneal lesions and compare CT findings in different disease categories.

Material and Methods

This retrospective analytical study included 86 patients with retroperitoneal lesions who underwent CT-guided biopsy from December 2010 to March 2020. All procedures were performed with co-axial technique and multiple cores were obtained and subjected to histopathology. Additional tests like immunohistochemistry or microbiological analysis were done depending on clinical suspicion. Diagnostic yield calculation and comparison of imaging findings was done by one-way ANOVA, chi-square, and Fisher’s exact tests.

Results

CT-guided biopsy was technically successful in all cases with a diagnostic yield of 91.9%. Minor complications in the form of small hematomas were seen in two patients. Major disease categories on final diagnosis were lymphoma, tuberculosis, and metastases. A variety of malignant and benign soft-tissue neoplasms were also noted less commonly. With help of immunohistochemistry, lymphoma subtype was established in 88.8% of cases. Addition of microbiological tests like the GeneXpert assay helped in the diagnosis of tuberculosis in some cases. A mass-like appearance and vascular encasement was common in metastatic group and lymphoma.

Conclusion

Percutaneous CT-guided biopsy is a safe method for the sampling of retroperitoneal lesions with high diagnostic yield. Imaging findings are mostly overlapping; however, some features are more common in a particular disease condition.
Blastic plasmacytoid dendritic cell neoplasm with genetic mutations in multiple epigenetic modifiers: a case report
Authors: Dang Xinmei , Zhou Di , Meng Lingjun , Bi Lintao
Published: February 2021

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare, aggressive hematodermic malignancy derived from plasmacytoid dendritic cell precursors. Despite advances in our understanding of tumor cell surface markers, the pathogenesis of BPDCN remains largely unknown. No standard or optimal treatments are available for BPDCN, and the prognosis is usually poor. We report herein a case of BPDCN that harbored multiple genetic mutations in epigenetic modifiers such as TET2 and ZRSR2. Genetic studies in patients with BPDCN may provide insights into the underlying pathogenesis, prediction of clinical prognosis, and development of better targeted therapeutics for this rare clinical entity.
Progression of Danon disease with medical imaging: two case reports
Authors: Wang Shuai , Wang Qinglei , Zhai Ning , Wang Xin , Li Zhihua , Gan Lijun , Cui Yinghua
Published: February 2021

Danon disease is a rare X-linked dominant genetic disorder caused by loss-of-function mutations in the lysosome-associated membrane protein 2 gene. Progression of Danon disease is unknown because of its rare incidence in a diverse ethnic population. We report longitudinal data from two patients who were diagnosed with Danon disease by a genetic test. The evaluation protocol included electrocardiographic monitoring, echocardiography, and magnetic resonance imaging. Progression of hypertrophic cardiomyopathy to dilated cardiomyopathy was observed in the first patient. He died from sudden cardiac arrest. The second patient is currently suffering from hypertrophic cardiomyopathy. Development of the hypertrophic phase progressing into the dilated phase in Danon disease may provide useful information for early identification and clinical decisions in patients with this disease.
Primary gastric Ewing sarcoma/primitive neuroectodermal tumor
Authors: Ye Yu , Qiu Xiaoming , Mei Jixin , He Dongyun , Zou Ailing
Published: February 2021

A rare and highly malignant small round cell tumor, Ewing sarcoma/primitive neuroectodermal tumor (ES/PNET) usually occurs in the pelvis, long-axis bones, and femur. In contrast, extraosseous ES is more often found in the paraspinal region, limbs, and retroperitoneum, but is extremely rare in the stomach. We report a case of a 55-year-old woman who presented with fatigue, fever, and black stool. Preoperative computed tomography (CT) imaging showed a large ulcerative lesion of approximately 5.5 × 5.0 cm in the stomach and irregular thickening of the ulcer wall. Upper endoscopy revealed a large, irregular ulcer in the posterior wall of the stomach. Histopathological examination suggested that the mass with the largest diameter (7.5 cm) was ES. Immunohistochemistry indicated positivity for CD99. Enhanced CT of the whole body was performed but no definite masses were found in other organs, and the patient was diagnosed with primary gastric ES. The patient underwent radical distal gastrectomy with Roux-en-Y gastrojejunostomy, but refused chemoradiotherapy.
Missed diagnosis of POEMS syndrome with onset of progressive fatigue and numbness: a case report
Authors: Shi Huan , Jiang Xiaohong , Wang Long , Zhou Jiayan
Published: February 2021

POEMS syndrome is a rare multisystem disease associated with an underlying plasma cell disorder. Its name is an acronym for peripheral neuropathy (P), endocrinopathy (E), organomegaly (O), monoclonal plasma cell proliferative disorder (M), and skin changes (S). This case report describes a patient with POEMS syndrome who presented with progressive fatigue and numbness in the lower extremities. Initially, the patient was erroneously diagnosed with diabetes and diabetic peripheral neuropathy because of the endocrinopathy associated with POEMS syndrome. After a second hospitalization, the patient was diagnosed with POEMS syndrome and recovered with alkylator therapy and a peripheral blood stem cell transplant. The patient’s overall condition was improved at the 1-year follow-up. POEMS syndrome should be considered if a patient presents with endocrinopathy and unexplained peripheral neuropathy.
Emergency craniotomy in patient with intracranial metastatic choriocarcinoma: a case report
Authors: Zhang Tian-Jiao , Shen Zhen , Li Min , Zhu Jing , Li Yue-Bo , Wei Wei , Zhou Hang-Cheng , Zhao Wei-Dong , Wu Da-Bao , Zhou Ying
Published: February 2021

Choriocarcinoma is a highly malignant gynaecological tumour. This disease becomes life-threatening once brain haemorrhage or brain herniation occurs. Timely and accurate brain surgery can gain treatment time for patients that have a large number of cerebral haemorrhages and/or brain herniation. This current report describes a case of choriocarcinoma secondary to a hydatidiform mole in a 55-year-old woman that presented with neurological symptoms. Following admission to hospital, computed tomography examination found that lung and brain metastases were accompanied by cerebral haemorrhage. Cerebral hernia occurred during induction chemotherapy treatment and emergency surgery was performed. The patient recovered after individual chemotherapy and rehabilitation treatment. Patients with a very high risk of choriocarcinoma with brain metastasis should be referred to a comprehensive medical centre. Necessary surgical treatment and individualized chemotherapy can reduce the mortality of patients with choriocarcinoma brain metastasis.
Clinical analysis of adenovirus pneumonia with pulmonary consolidation and atelectasis in children
Authors: Lou Qing , Zhang Sheng-xin , Yuan Lin
Published: February 2021

Objective

To assess the clinical characteristics of 168 children with adenovirus pneumonia complicated by pulmonary consolidation and atelectasis.

Methods

We retrospectively studied patients with adenovirus pneumonia complicated by pulmonary consolidation and atelectasis admitted to Xiamen Children’s Hospital from March 2019 to August 2019. In total, 168 patients were recruited and divided into a severe group and non-severe group according to disease severity. Clinical results were assessed.

Results

All children had fever and cough, 29 had wheezing, and 82 had dyspnea. Pleural effusion was found in 53 patients. Mixed infections were present in 95 patients. A total of 105 patients received hormone therapy, 72 received intravenous gamma globulin, and 103 underwent bronchoscopy, among whom 6 were found to have bronchial casts. Of the 168 children, 166 were cured and two died. The patients were divided by disease severity, with 82 in the severe group and 86 in the non-severe group. The two groups showed significant differences in the fever course, pleural effusion, mixed infections, hemoglobin concentration, procalcitonin concentration, and lactate dehydrogenase concentration.

Conclusion

A long fever course, mixed infection, pleural effusion, decreased hemoglobin concentration, and increased procalcitonin and lactate dehydrogenase concentrations may be associated with more severe adenovirus pneumonia.
Effects of different vaginal mould use approaches after vaginoplasty with artificial dermis in patients with Mayer–Rokitansky–Küster–Hauser syndrome
Authors: Wang Wenli , Chen Fang , Cheng Jiumei , Peng Shuyan , Ye Hong
Published: February 2021

Objective

To assess the therapeutic effects of different vaginal mould use approaches after vaginoplasty in patients with Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome.

Methods

Patients with MRKH syndrome who underwent surgery from 2010 to 2015 in our hospital were retrospectively evaluated. Vaginoplasty was performed with artificial dermis, and vaginal moulds were used for 6 months postoperatively. The patients were divided into an intermittent group and continuous group according to the vaginal mould approach.

Results

Thirty-five patients were evaluated (intermittent group, 19 patients; continuous group, 16 patients). One month postoperatively, the mean vaginal length and width in the intermittent group were 9.26 ± 0.56 and 3.82 ± 0.25 cm, respectively, and those in the continuous group were 9.44 ± 0.51 and 3.86 ± 0.22 cm, respectively. Six months postoperatively, the mean vaginal length and width in the intermittent group were 8.94 ± 0.71 and 3.76 ± 0.26 cm, respectively, and those in the continuous group were 8.69 ± 0.48 and 3.65 ± 0.30 cm, respectively. The mean Female Sexual Function Index scores in the intermittent and continuous groups were 28.61 ± 0.71 and 28.4 80 ±0.79 respectively, after normal sexual life.

Conclusion

Both intermittent and continuous use of postoperative vaginal moulds may be effective.
On the Structure of Wealth-Holding in Pre-Famine Ireland
Authors: Cummins Neil , Ó Gráda Cormac
Published: February 2021

Very little is known about wealth-holding and its distribution in Ireland in the past. Here we employ death duty register data to analyse and identify a sample of the top wealth-holders in Ireland between the early 1820s and late 1830s. We examine the sources of their wealth and its regional spread, and compare them with their British counterparts. We also discuss the share of Catholics and Quakers among top wealth-holders.
A Systematic Review of How Peer-Mediated Interventions Impact Students Without Disabilities
Authors: Travers Hilary E. , Carter Erik W.
Published: February 2021

Peer-mediated interventions (PMIs) offer substantial academic and social benefits to adolescents served under the special education categories of intellectual disability, autism, and multiple disabilities (i.e., intellectual and developmental disabilities [IDD]). However, limited attention has focused on the impact of PMI on participating peers without disabilities. This systematic review identified all experimental (e.g., single case, group experimental) and descriptive (e.g., qualitative, survey) studies addressing PMIs implemented at the secondary level with students with IDD. Among the 98 PMI studies that we identified in this review, 66 (67.3%) studies included some qualitative or quantitative measure of peer impact. Across these studies, the impact on peers was addressed in 10 different areas. This review provides new insights into the ways peer impact has been evaluated and how peers have been impacted by their PMI experience. Recommendations for research and practice aimed at addressing the benefits of involving peers without disabilities in these interventions are provided.
Validation of the French-Canadian Version of a Short Questionnaire to Assess Knowledge in Cardiac Patients (CADE-Q SV)
Authors: Ghisi Gabriela L. M. , Oh Paul
Published: February 2021

Background

The long-term success of cardiac rehabilitation programs rests in part on the patient’s ability to maintain health behaviors, which is influence by the patient education received. Therefore, a short and reliable tool to assess patients' knowledge is warranted. The aim of this study was to translate, culturally-adapt and psychometrically validate the French-Canadian version of the Coronary Artery Disease Education Questionnaire Short Version (CADE-Q SV).

Methods

The French CADE-Q SV – translated and culturally-adapted - was reviewed by 3 bilingual experts in cardiovascular disease. This version was then psychometrically tested in 115 CR patients in two Canadian provinces (Québec and New Brunswick). The questionnaire was completed at patients’ first CR session and in the end of their 6-month program to assess interpretability. The internal consistency was assessed using Kuder-Richardson-20 (KR-20) and Cronbach's alpha, factor structure using confirmatory factor analysis, and criterion validity regarding level of education and family income.

Results

KR-20 was 0.72. Factor analysis revealed 5 factors, all internally consistent. Criterion validity was supported by significant differences in total scores by educational level and family income (p < 0.05). Results showed that increases in knowledge can moderately increase mean steps per day and peakVO2, with an MCID of 3.00. The overall mean was 15.7 ± 2.0. The area with the highest knowledge was risk factors and the lowest was psychosocial risk.

Conclusion

The French-Canadian CADE-SV was demonstrated to have good validity and reliability.
Can Early Warning Systems Enhance Detection of High Risk Patients by Rapid Response Teams?
Authors: Reardon Peter M. , Seely Andrew J. E. , Fernando Shannon M. , Didcote Simon , Strachan Iain , Baudino Jean-Loup , Kyeremanteng Kwadwo
Published: February 2021

Purpose:

We sought to evaluate if incorporating an early warning system (EWS), the Visensia Safety Index (VSI) and the National Early Warning Systems 2 (NEWS2), may lead to earlier identification of rapid response team (RRT) patients.

Methods:

This was a retrospective study (2015-2018) of patients experiencing RRT activation within a tertiary care network. We evaluated the proportion of patients with an EWS alert prior to RRT activation and their associated outcomes (primary: hospital mortality).

Results:

There were 6,346 RRT activations over the study period. Of these, 2042 (50.8%) patients would have had a VSI alert prior to RRT activation, with a median advanced time of 3.6 (IQR 0.5-12.8) hours, compared to 2351 (58.4%) patients and 9.8 (IQR 2.0-18.7) hours for NEWS2. Patients with a potential alert prior to RRT activation had an increased odds of mortality for both VSI (OR 1.2, 95%CI 1.1-1.3) and NEWS2 (OR 2.7, 95% CI 2.4-3.1). Prognostic accuracy for hospital mortality was similar between groups.

Conclusion:

Utilization of an EWS by an RRT has potential to provide earlier recognition of deterioration and mortality risk among hospitalized inpatients.
Female Youth Convicted of Sex Offenses: Public Opinion on Public Notification
Authors: Budd Kristen M. , Johnston Shannon
Published: February 2021

Throughout the United States, sex offender registration laws in many states and the federal government have expanded to include juveniles. Once juveniles are registrants, they can potentially be subjected to required or discretionary public notification (PN). Given the documented detrimental effects of PN on juveniles and the prevalence of sexual offending by juvenile females, this study investigated public opinion on applying PN to juvenile females who were convicted of a sexual offense. Participants were 947 individuals recruited using Amazon’s Mechanical Turk who completed an online survey. Multivariate logistic regression found support for PN increased when the public felt law enforcement was effective in investigating these crimes and there were increased public safety concerns. Support for PN decreased when the public supported plea bargaining and supported the law distinguishing between adults and juveniles who commit sex crimes. Implications of these results are discussed.
Adolescent–Parent Career Congruence as a Predictor of Job Search Preparatory Behaviors: The Role of Proactivity
Authors: Sawitri Dian Ratna , Creed Peter A.
Published: February 2021

Based on social cognitive career theory, we examined the mediating roles of job search self-efficacy and outcome expectations in the relationship between adolescent–parent career congruence and job search preparatory behaviors and investigated the influence of proactivity as a moderator in these direct and indirect relationships. Participants were 236 Grade 10 and 11 Indonesian students (mean age 16 years, 67% male), who were attending a vocational education school and would not be progressing to post–high school study. After controlling for educational achievement, we found congruence to be associated with self-efficacy (24% of variance explained), outcome expectations (23%), and job search preparatory behaviors (46%). Self-efficacy, but not outcome expectations, was related to more preparatory behaviors, and self-efficacy fully mediated between congruence and preparatory behaviors. Proactivity moderated the direct relationships between congruence and self-efficacy and outcome expectations, but not preparatory behaviors, and did not moderate any of the indirect relationships.
Managing Strong Emotions: Nurses’ Recognition and Responses to Personal Emotions When Approaching Parents With Cancer and Their Dependent Children
Authors: Tafjord Trine
Published: February 2021

Care for sick parents and their dependent children (<18 years) has become a pertinent issue in health care. Nurses play an important role in caring for parents with cancer as well as their children. By utilizing a constructivist grounded theory approach, the aim of this study was to expand the research-based knowledge of nurses’ experiences of personal emotions in this research field and to develop a subsequent explanatory theory extending the existing concept of emotional labor. Interviews with 12 nurses were conducted and analyzed. The nurses experienced this area of work as particularly emotionally challenging and attempted to manage personal emotions through regulating and processing strategies. Through this process, they sought for emotional strength by balancing their private lives and work lives to manage work-related emotions. An increased awareness of emotional labor may strengthen nurses’ emotional competence in nursing.
Comparing Instructional Approaches in Caregiver-Implemented Intervention: An Interdisciplinary Systematic Review and Meta-Analysis
Authors: Sone Bailey J. , Lee Jordan , Roberts Megan Y.
Published: February 2021

Family involvement is a cornerstone of early intervention (EI). Therefore, positive caregiver outcomes are vital, particularly in caregiver-implemented interventions. As such, caregiver instructional approaches should optimize adult learning. This study investigated the comparative efficacy of coaching and traditional caregiver instruction on caregiver outcomes across EI disciplines. A systematic search for articles was conducted using PRISMA guidelines. Meta-analysis methodology was used to analyze caregiver outcomes, and a robust variance estimate model was used to control for within-study effect size correlations. Seven relevant studies were ultimately included in the analysis. A significant, large effect of coaching on caregiver outcomes was observed compared to other models of instruction ( g = 0.745, SE = 0.125, p = .0013). These results support the adoption of a coaching framework to optimize caregiver outcomes in EI. Future research should examine how coaching and traditional instruction can be used in tiered intervention models with a variety of populations.