bluuebunny/crossref_metadata_2025 huggingface dataset:
Systemic effect of radiotherapy before or after nivolumab in lung cancer: an observational, retrospective, multicenter study
Authors: Bassanelli Maria , Ricciuti Biagio , Giannarelli Diana , Cecere Fabiana Letizia , Roberto Michela , Giacinti Silvana , Barucca Viola , Santarelli Mario , Ruggeri Enzo Maria , Marchetti Paolo , Cognetti Francesco , Gelibter Alain , Cortesi Enrico , Chiari Rita , Milella Michele , Ceribelli Anna
Published: April 2021

Background:

The combination of radiotherapy (RT) and programmed death 1 inhibitors seems to increase antitumor immune responses.

Objective:

To assess the outcome and the role of the best combination sequence, i.e. immunotherapy given before, during, and/or after RT, in patients with non-small cell lung cancer (NSCLC).

Methods:

We conducted an observational, retrospective analysis of 95 consecutive patients with advanced NSCLC who received any radiotherapy treatment and nivolumab, as clinically indicated. Median overall survival (OS) and the 95% confidence interval (CI) were estimated with the Kaplan-Meier method. Cox model was used to obtain hazard ratio (HR) and associated 95% CI with statistical inference by log-rank statistic.

Results:

Median OS was 11.9 months (95% CI, 6.6–17.2). Patients who received radiotherapy during an immune checkpoint inhibitor treatment started more than 60 days before showed a better outcome than patients who started immunotherapy over 60 days after RT ending (HR, 2.90 [1.37–6.12], p = 0.005; median OS, 22.4 months vs 8.6 months, p = 0.005). Median progression-free survival was 6.3 months (95% CI, 4.6–8.0).

Conclusions:

This study shows that combining irradiation with nivolumab for the treatment of advanced NSCLC leads to improved OS. The optimal time window for the combination of RT and immunotherapy seems to play a critical role for therapeutic antitumor response derived by abscopal effect.
Herpesvirus-Associated Proliferative Skin Disease in Frogs and Toads: Proposed Pathogenesis
Authors: Origgi Francesco C. , Otten Patricia , Lohmann Petra , Sattler Ursula , Wahli Thomas , Lavazza Antonio , Gaschen Veronique , Stoffel Michael H.
Published: April 2021

A comparative study was carried out on common and agile frogs ( Rana temporaria and R. dalmatina) naturally infected with ranid herpesvirus 3 (RaHV3) and common toads ( Bufo bufo) naturally infected with bufonid herpesvirus 1 (BfHV1) to investigate common pathogenetic pathways and molecular mechanisms based on macroscopic, microscopic, and ultrastructural pathology as well as evaluation of gene expression. Careful examination of the tissue changes, supported by in situ hybridization, at different stages of development in 6 frogs and 14 toads revealed that the skin lesions are likely transient, and part of a tissue cycle necessary for viral replication in the infected hosts. Transcriptomic analysis, carried out on 2 naturally infected and 2 naïve common frogs ( Rana temporaria) and 2 naturally infected and 2 naïve common toads ( Bufo bufo), revealed altered expression of genes involved in signaling and cell remodeling in diseased animals. Finally, virus transcriptomics revealed that both RaHV3 and BfHV1 had relatively high expression of a putative immunomodulating gene predicted to encode a decoy receptor for tumor necrosis factor in the skin of the infected hosts. Thus, the comparable lesions in infected frogs and toads appear to reflect a concerted epidermal and viral cycle, with presumptive involvement of signaling and gene remodeling host and immunomodulatory viral genes.
Extraction of Construction Quality Requirements from Textual Specifications via Natural Language Processing
Authors: Jeon JungHo , Xu Xin , Zhang Yuxi , Yang Liu , Cai Hubo
Published: April 2021

Construction inspection is an essential component of the quality assurance programs of state transportation agencies (STAs), and the guidelines for this process reside in lengthy textual specifications. In the current practice, engineers and inspectors must manually go through these documents to plan, conduct, and document their inspections, which is time-consuming, very subjective, inconsistent, and prone to error. A promising alternative to this manual process is the application of natural language processing (NLP) techniques (e.g., text parsing, sentence classification, and syntactic analysis) to automatically extract construction inspection requirements from textual documents and present them as straightforward check questions. This paper introduces an NLP-based method that: 1) extracts individual sentences from the construction specification; 2) preprocesses the resulting sentences; 3) applies Word2Vec and GloVe algorithms to extract vector features; 4) uses a convolutional neural network (CNN) and recurrent neural network to classify sentences; and 5) converts the requirement sentences into check questions via syntactic analysis. The overall methodology was assessed using the Indiana Department of Transportation (DOT) specification as a test case. Our results revealed that the CNN + GloVe combination led to the highest accuracy, at 91.9%, and the lowest loss, at 11.7%. To further validate its use across STAs nationwide, we applied it to the construction specification of the South Carolina DOT as a test case, and our average accuracy was 92.6%.
Evaluating Pedestrian Crash-Prone Locations to Formulate Policy Interventions for Improved Safety and Walkability at Sidewalks and Crosswalks
Authors: Patil Mallikarjun , Majumdar Bandhan Bandhu , Sahu Prasanta K.
Published: April 2021

This study presents a methodology for evaluating a set of crash-prone sidewalk and crosswalk locations in an urban area with respect to their existing walkability condition and recommending improvement needs. Initially, a set of 15 sidewalk specific and 10 crosswalk specific attributes relevant to India were identified from the literature. Subsequently, the analytical hierarchy process was used to estimate relative weights associated with the attributes from the perspective of relevant experts. A weighted sum method was then used to formulate a Sidewalk Condition Index (SCI) and Crosswalk Condition Index (CCI) for evaluating the condition of the existing pedestrian sidewalks and crosswalk infrastructures. Ten locations across Hyderabad with the highest pedestrian fatalities during the last three calendar years were selected as study locations. The location specific SCI and CCI estimates were used to prioritize the locations with regard to their existing condition and infrastructural requirements. Results indicated that sidewalk attributes such as sidewalk lighting, cleanliness, physical separation of traffic, and traffic speed, and crosswalk attributes such as conflicts with crossing traffic, crosswalk illumination, and intersection control, influenced safety and walkability significantly. Measures such as the provision of exclusive right-of-way for pedestrians, maintaining the sidewalk quality, enforcing no jaywalking, re-design of signal timing with pedestrian phase, and provision of zebra crossings and refuge islands, would improve walkability at pedestrian crash-prone locations across Hyderabad. This proposed methodology and the research findings could act as a critical tool to improve the overall safety and walkability of sidewalks and crosswalks in Indian cities.
Travel Patterns of Frequent and Non-Frequent Users on I-66 High-Occupancy Toll Lanes and Implications for the Value of Time Estimation
Authors: Cetin Mecit , Zhu Shanjiang , Yang Hong , Sahin Olcay
Published: April 2021

Based on a three-month toll transaction data set that includes an anonymized unique identifier for each vehicle, this paper presents an in-depth analysis of traffic volumes and tolls on the I-66 High-Occupancy Toll (HOT) express lanes in Northern Virginia. The unique identifiers allow quantification of how frequently each vehicle travels through the corridor. Vehicles observed in selected time intervals are categorized into frequent and non-frequent groups based on the total number of trips made by each vehicle. For the morning commute, the analyses show that those traveling frequently on the HOT lanes are more sensitive to high tolls and typically travel earlier in the morning to avoid higher tolls. In other words, when tolls are relatively high (e.g., over $20), the fraction of frequent users in the traffic is much smaller as compared with that of non-frequent users (e.g., 25% versus 75%). To estimate how much toll the HOT-lane users are paying per unit of travel time saved, that is, value of travel time saving (VTTS), speeds on alternative routes parallel to the I-66 corridor are computed from probe data and compared with those on I-66 express lanes. The results show that the mean VTTS is $45.37 and $61.78 for frequent and non-frequent users, respectively, during the morning peak period. Whereas for the afternoon peak, the mean VTTS is $38.14 and $37.64 for frequent and non-frequent users. The implications of the difference in these value of time distributions for dynamic tolling are discussed.
Testing an Integrated Theory: Distancing Norms in the Early Months of Covid-19
Authors: Horne Christine , Johnson Monica Kirkpatrick
Published: April 2021

We draw on norms theory to develop hypotheses about norms regulating social distancing during the Covid-19 pandemic. We identify two theoretical approaches—the consequentialist and social cues approach—and argue that understanding norms will be enhanced by integrating these two approaches. We apply these general theoretical approaches to the Covid-19 pandemic to suggest concrete hypotheses regarding distancing norms. We test our hypotheses using two vignette experiments. We find that when the consequences of behavior are clear, both behavior consequences and social cues independently affect norms. But when the consequences of a behavior are ambiguous, behaviors and social cues interact to affect norms. Theoretically, our results provide the first empirical test of an integrated theory of norms, showing that in ambiguous situations an integrated approach produces more accurate predictions than either the behavior consequences or social cues approach alone. Substantively, our paper helps to explain Covid-19 distancing norms and variation in those norms across political orientation. Our findings have implications for understanding support for and compliance with public health directives.
Experimental investigation of quasi-static behavior of composite and fiber metal laminate panels modified by graphene nanoplatelets
Authors: Fathi Azadeh , Liaghat Gholamhossein , Sabouri Hadi , Chizari Mahmoud , Hadavinia Homayoun , Chitsaz Charandabi Sahand
Published: April 2021

The current study investigated the influence of incorporation of graphene nanoplatelets (GNPs) on quasi-static behavior of composite and fiber metal laminate (FML) panels. The unmodified and modified composite specimens and FML panels with 2/1 configuration were fabricated using a hand lay-up method and investigated through a quasi-static punch and indentation testing. The two sets of tests were conducted with a flat-ended indenter and the loading conditions were the same for all samples, except support spans which were varied. Following experimental testing, possible damages at the punch region were closely investigated and localized and global damages were observed. The results revealed that adding 0.2 wt% GNPs improved the strength and fracture toughness of specimens by delaying the failure modes. On the contrary, GNPs made the bonding between the aluminum and composite interface to weaken.
A Home-Based Care Research Agenda by and for Homebound Older Adults and Caregivers
Authors: Leff Bruce , Sheehan Orla C. , Harrison Krista L. , Eaton England Ashley , Mickler Alex , Basyal Pragyashree Sharma , Garrigues Sarah K. , Schuchman Mattan , Perissinotto Carla , Garrett Sarah B. , Ritchie Christine S.
Published: April 2021

Homebound older adults have not had a voice in establishing a research agenda relevant to their needs and perspectives. We engaged homebound older adults receiving home-based primary care and caregivers to serve as stakeholder advisors to develop a patient- and caregiver-centered research agenda for home-based care. Over 9 months, we facilitated eight tablet-enabled videoconference meetings. We oriented advisors to patient-centered outcome research and research question development. Advisors developed and prioritized a list of 14 research domains and 127 associated research questions. The top three prioritized research domains in descending rank order (number of associated research questions) were out-of-pocket costs of caregiving (10), access to home-based care and related policy issues (19), and relationship with doctors (15). This research agenda can guide researchers’ efforts to focus on areas of importance to the ultimate end users of their research.
The Influence of Geography, Religion, Religiosity and Institutional Factors on Worldwide End-of-Life Care for the Critically Ill: The WELPICUS Study
Authors: Sprung Charles L. , Jennerich Ann L. , Joynt Gavin M. , Michalsen Andrej , Curtis J. Randall , Efferen Linda S. , Leonard Sara , Metnitz Barbara , Mikstacki Adam , Patil Namrata , McDermid Robert C. , Metnitz Philipp , Mularski Richard A. , Bulpa Pierre , Avidan Alexander
Published: April 2021

Objective:

To evaluate the association between provider religion and religiosity and consensus about end-of-life care and explore if geographical and institutional factors contribute to variability in practice.

Methods:

Using a modified Delphi method 22 end-of-life issues consisting of 35 definitions and 46 statements were evaluated in 32 countries in North America, South America, Eastern Europe, Western Europe, Asia, Australia and South Africa. A multidisciplinary, expert group from specialties treating patients at the end-of-life within each participating institution assessed the association between 7 key statements and geography, religion, religiosity and institutional factors likely influencing the development of consensus.

Results:

Of 3049 participants, 1366 (45%) responded. Mean age of respondents was 45 ± 9 years and 55% were females. Following 2 Delphi rounds, consensus was obtained for 77 (95%) of 81 definitions and statements. There was a significant difference in responses across geographical regions. South African and North American respondents were more likely to encourage patients to write advance directives. Fewer Eastern European and Asian respondents agreed with withdrawing life-sustaining treatments without consent of patients or surrogates. While respondent’s religion, years in practice or institution did not affect their agreement, religiosity, physician specialty and responsibility for end-of-life decisions did.

Conclusions:

Variability in agreement with key consensus statements about end-of-life care is related primarily to differences among providers, with provider-level variations related to differences in religiosity and specialty. Geography also plays a role in influencing some end-of-life practices. This information may help understanding ethical dilemmas and developing culturally sensitive end-of-life care strategies.
Pediatric N-Methyl-d-Aspartate (NMDA) Receptor Encephalitis, With and Without Herpes Encephalitis
Authors: Marcus Lydia , Ness Jayne M.
Published: April 2021

Objective:

To compare clinical, diagnostic, management, and outcome factors in children with anti– N-methyl-d-aspartate receptor (NMDAR) encephalitis and a history of herpes simplex encephalitis (HSE) to children with NMDAR encephalitis without a history of HSE.

Methods:

All patients with anti-NMDAR antibodies in cerebrospinal fluid treated at our institution between 2012 and 2019 were identified and divided into those with a history of HSE (HSE+NMDAR group) and those without a history of HSE (NMDAR-only group). Demographic data, clinical characteristics, immunotherapy, and outcome data were collected on all patients and compared between the 2 groups.

Results:

Seventeen patients were identified with anti-NMDAR antibodies in cerebrospinal fluid, 6 of whom had a history of HSE. Mean age in the HSE+NMDAR cohort was significantly younger in the HSE+NMDAR cohort, as 5 of the 6 patients were infants. Of HSE+NMDAR patients, 50% had behavioral symptoms, 67% had movement disorders, and 100% had seizures at disease nadir. In the NMDAR-only group, 100% had behavioral symptoms, 73% had movement disorders, and 73% had seizures at nadir. HSE+NMDAR patients received a median of 1 immunotherapy, compared to a median of 4.5 immunotherapies in the NMDAR-only group.

Conclusion:

Behavioral symptoms were more common in NMDAR-only patients, whereas seizures were more common in HSE+NMDAR patients. Both groups had significant disability at disease nadir, with more improvement in disability over time in the NMDAR-only group. HSE+NMDAR patients received fewer immunotherapies than NMDAR-only patients. Outcomes of infants with HSE appear to primarily reflect sequelae from HSE.
Bioconvection in a porous square cavity containing gyrotactic microorganisms under the effects of heat generation/absorption
Authors: Jamuna Bodduna , Balla Chandra Shekar
Published: April 2021

In this paper, the bioconvective nanofluid flow in a porous square cavity containing gyrotactic microorganisms in the presence of heat generation/absorption is investigated. The bioconvection flow in porous medium is formulated based on Darcy model of Boussinesq approximation. Galerkin finite elements method is employed to solve the governing equations. The numerical results are obtained and discussed the effect of parameters such as Rayleigh number Ra, bioconvection number Rayleigh number Rb, Peclet number Pe, Lewis number Le, Brownian motion Nb, Thermophoresis Nt, Schmidt number Sc, Prandtl number Pr, heat generation/absorption Q and buoyancy ratio Nr. Also, the average Sherwood number, average Nusselt number and average density number are discussed. The present solutions are validated with existing studies under limited cases. It is found that Peclet number and buoyancy ratio show a significant increasing effect on the streamlines, isotherms, isoconcentrations of nanoparticles and microorganisms. The heat generation/absorption reverses the patterns of the flow, temperature distribution and isoconcentrations of nanoparticles and microorganisms.
Adaptive feedforward control for crosswind landing with variable step size
Authors: Bian Qi , Zhang Menghan , Ma Jian
Published: April 2021

In this article, a modified Steiglitz–McBride (SM) structure with variable step size is proposed for aircraft feedforward control to reduce lateral landing deviation in the presence of crosswind disturbance. Currently, most of the aircraft landing studies focus on the trajectory tracking problems in the longitudinal plane and seldom focus on lateral disturbances. This article develops a modified SM structure–based feedforward control system to online estimate both the primary path and the control path (secondary path), where a fuzzy logic–based variable step size strategy is implemented to ensure fast convergence rate and strong robustness under complex crosswind scenarios. As a consequence, the lateral deviation during crosswind landing could be largely reduced as fast as possible while the stability of the flight control system is maintained. A Boeing 747 model is used as a test bed, and the simulations are carried out on two different crosswind conditions to demonstrate the feasibility and effectiveness of the proposed method.
The coexistence of familial Mediterranean fever (FMF) in systemic lupus erythematosus (SLE) patients – A cross sectional study
Authors: Klein Tamar Laytman , Tiosano Shmuel , Gilboa Yafit , Shoenfeld Yehuda , Cohen Arnon , Amital Howard
Published: April 2021

Background

Systemic lupus erythematosus (SLE) is a systemic autoimmune inflammatory disease characterized by antibody production against a myriad of autoantigens. Familial Mediterranean fever (FMF) is a genetic autoinflammatory disorder, triggered by FMF-associated point genes mutations. It has been hypothesized that the two conditions rarely coexist.

Aim

The aim of this study was to examine the proportions of FMF among SLE patients compared with the general population without SLE. We hypothesized that the proportion of FMF among SLE patients might be higher than the general population.

Methods

To conduct this cross-sectional study, data of adult patients with a physician diagnosis of SLE were retrieved from Clalit Health Services database, the largest Health Maintenance Organization in Israel, serving 4,400,000 members. Chi-square and T-test was used for univariate analysis.

Results

The study population included 4,886 SLE patients and 24,430 age and sex matched controls. Within the SLE group we detected a significantly higher proportion of FMF patients compared with non-SLE controls (0.68% and 0.21% respectively; p < 0.001).

Conclusions

Our study indicated that FMF is more prevalent in an Israeli population of SLE patients.
Status and Determinants of Treatment Outcomes Among New Tuberculosis Patients in South Korea: A Retrospective Cohort Study
Authors: Son Hyunjin , Mok Jeongha , Lee Miyoung , Park Wonseo , Kim Seungjin , Lee Joosun , Choi Bo Youl , Kim Changhoon
Published: April 2021

This is a retrospective cohort study using notification data in South Korea. We evaluated the nationwide status, regional differences, and the determinants of treatment outcomes among tuberculosis patients. Treatment success rate improved from 77.0% in 2012 to 86.0% in 2015. The lost to follow-up rate was higher among older people, males, and foreign nationals. Health care facilities designated for the Public-Private Mix (PPM) project showed higher success rate and lower rate of lost to follow-up. Moreover, municipalities with low regional deprivation index had higher PPM project coverage. Since there is a large regional difference in the coverage of the PPM project, an additional community-based support program should be implemented, especially for tuberculosis patients residing in region with low PPM project coverage.
Stochastic recruitment control of shape memory alloy cellular actuators based on multi-state Markov chain model
Authors: Zhang Chen , Cui Jianjiang
Published: April 2021

A new broadcast stochastic recruitment approach to the control of shape memory alloy (SMA) cellular actuators is proposed. The control design is based on a Markov chain model of multi-state cells, which is able to better characterize the inherent hysteresis of SMA in phase transition. The closed-loop and open-loop control laws are derived from random Lyapunov stability analysis and the stability conditions are analyzed. Simulation experiments demonstrate the effectiveness of the proposed method.
Living a Calling and Work–Family Interface: A Latent Profile Analysis
Authors: Zhang Chunyu , Dik Bryan J. , Dong Zengyun
Published: April 2021

The positive outcomes of calling have been examined in a large and growing number of studies, yet little is known about how calling relates to the work-family interface. In this study, we adopted a person-centered approach using latent profile analysis to explore how living a calling relates to different work-family interface profiles. With a sample of 267 Chinese university counselors, we found three work-family interface profiles: slightly conflictual (51%), experiencing slightly higher than average levels of work-to-family conflict (WFC) and family-to-work conflict (FWC) and slightly lower than average levels of work-to-family enrichment (WFE) and family-to-work enrichment (FWE); work-to-family conflictual (15%), with higher levels of WFC and lower levels of FWC, WFE, and FWE; and enriched (34%), indicated by higher levels of WFE and FWE and lower levels of WFC and FWC. The results revealed that the greater the extent to which participants were living their calling, the more likely they were to be classified into the enriched profile. Our findings contribute to the literature on calling by offering person-centered insights on the relation between calling and the work-family interface.
The Lived Experience of Older Women Who Are Sexually Abused in the Context of Lifelong IPV
Authors: Band-Winterstein Tova , Avieli Hila
Published: April 2021

The present study explores the lived experience of older women who are sexually abused in the context of lifelong intimate partner violence (IPV). An interpretive phenomenological analysis was used, and semi-structured interviews were performed with 19 older women survivors of lifelong IPV and sexual violence. Three themes emerged: sexual violence shaping lifelong IPV, the occurrence of sexual violence in old age in the context of lifelong IPV, and cumulative insights and reflections on being a survivor of lifelong IPV and sexual violence. The transition to aging has a profound impact on the violent relationship dynamics and this should be considered in practical interventions.
How to Study Well-Being: A Proposal for the Integration of Philosophy With Science
Authors: Prinzing Michael
Published: April 2021

There are presently two approaches to the study of well-being. Philosophers typically focus on normative theorizing, attempting to identify the things that are ultimately good for a person, while largely ignoring empirical research. The idea is that empirical attention cannot be directed to the right place without a rigorous theory. Meanwhile, social scientists typically focus on empirical research, attempting to identify the causes and consequences of well-being, while largely ignoring normative theorizing. The idea is that conceptual and theoretical clarity will come with time and more data. This article argues that neither is a good approach to the study of well-being. The traditional philosophical approach underappreciates the vital importance of empirical investigation, whereas the atheoretical empirical approach underappreciates the vital importance of normative theorizing. The proposed solution is to bring these methods together. Well-being research should be interdisciplinary. The article proposes a “conceptual engineering” approach as a novel alternative. This approach involves an iterative process of normative theorizing, empirical investigation, and conceptual revision, with the aim of articulating concepts and theories of well-being that optimally suit particular interests and purposes.
Proposal to Eliminate Urethane-Treated Positive Control Dose Groups in 26-Week Tg.rasH2 Carcinogenicity Studies
Authors: Paranjpe Madhav G. , Rudmann Daniel , Sargeant Aaron , Morse Mark , Yonpiam Rossalin , Bonnette Kimberly , Albretsen Jay , Papagiannis Christopher
Published: April 2021

Short-term (26 weeks) Tg.rasH2 mouse carcinogenicity studies have been conducted as an alternative model to the conventional 2-year mouse carcinogenicity studies, using urethane as a positive control material. In these studies, urethane was used at a dose of 1,000 mg/kg/dose, administered intraperitoneally on days 1, 3, and 5. Urethane consistently produces lung adenomas and carcinomas and hemangiosarcomas of the spleen, proving validity of the assay. We conducted 3 pilot studies at 3 different sites of Charles River Laboratories using a lower dose of urethane (500 mg/kg/dose), administered on days 1, 3, and 5, followed by a 12-week observation period. Our results demonstrate that a lower dose can be used successfully with fewer number of animals per sex to prove the validity of the assay. However, based on our cumulative experience with this model, we propose to eliminate positive control dose groups in future Tg.rasH2 carcinogenicity studies.
Olanzapine Administration Reduces Chemotherapy-Induced Nausea Behavior in Rats
Authors: Jaime-Lara Rosario B. , Borner Tito , Holland Ruby A. , Shaulson Evan , Brooks Brianna , De Jonghe Bart C.
Published: April 2021

Nausea and vomiting are consistently identified among the most distressing side effects of chemotherapy. In recent years, Olanzapine (OLZ) treatment was added to anti-emetic guidelines as a treatment for chemotherapy-induced nausea and vomiting (CINV), despite little available data supporting a mechanism behind the positive benefits of the drug. Here, we examine whether OLZ reduces cisplatin chemotherapy-induced side effects on food intake and pica behavior in rats (i.e., kaolin intake, a proxy for nausea/emesis). Behavioral experiments tested whether systemic or hindbrain administration of OLZ ameliorated cisplatin-induced pica, anorexia, and body weight loss in rats. We also tested whether systemic OLZ reduces cisplatin-induced neuronal activation in the dorsal vagal complex (DVC), a hindbrain region controlling emesis. Lastly, given their role in regulating feeding and emesis, circulating ghrelin levels and central mRNA expression levels of serotonin (HT) receptor subunits, including 5-HT2C, were measured in brain regions that regulate CINV and energy balance in an exploratory analysis to investigate potential mediators of OLZ action. Our results show that both systemic and hindbrain administration of OLZ attenuated cisplatin-induced kaolin intake and body weight loss, but not anorexia. Systemic OLZ decreased cisplatin-induced c-Fos immunofluorescence in the DVC and prevented cisplatin-induced reductions in circulating ghrelin levels. IP OLZ also blocked cisplatin-induced increases in Htr2c expression in DVC and hypothalamic micropunches. These data suggest hindbrain exposure to OLZ is sufficient to induce reductions in cisplatin-induced pica and that central serotonergic signaling, via 5-HT2C, and changes in circulating ghrelin may be potential mediators of olanzapine anti-emetic action.
Bilateral ocular surface squamous neoplasia: A study of 25 patients and review of literature
Authors: Vempuluru Vijitha S , Pattnaik Monalisha , Ghose Neha , Kaliki Swathi
Published: April 2021

Purpose:

To describe the risk factors, clinical presentation, management, and outcomes of patients with bilateral ocular surface squamous neoplasia (OSSN).

Methods:

Retrospective case series.

Results:

Of the 25 patients with bilateral OSSN, the mean age at diagnosis of OSSN was 31 years (median, 24 years; range, 2–60 years). Risk factors for bilateral OSSN included xeroderma pigmentosum ( n = 15, 60%), human immunodeficiency virus infection ( n = 3, 12%), conjunctival xerosis ( n = 1, 4%), and topical steroid use ( n = 1, 4%). There were no identifiable ocular or systemic risk factors in 7 (28%) patients. Presentation was synchronous in 14 (56%) and metachronous in 11 (44%) patients. Tumor morphology was bilaterally similar in 12 (48%) patients. Histopathological examination ( n = 36) revealed conjunctival intraepithelial neoplasia (CIN) grade 1 in 4 (8%); grade 2 in 7 (14%); carcinoma in situ in 5 (10%), and invasive carcinoma in 20 (40%). Primary management of OSSN ( n = 49) included excisional biopsy ( n = 31, 62%), topical immunotherapy (IFN α2B) ( n = 11; 22%), topical Mitomycin C (MMC) ( n = 3, 6%), enucleation ( n = 1, 2%), orbital exenteration ( n = 2, 4%), and plaque brachytherapy (PBT) ( n = 1, 2%). One patient was lost to follow-up after detection of tumor in the second eye. Recurrent tumors were noted in 16 (32%) eyes and binocular globe salvage was achieved in 16 (64%) patients at a mean follow up of 41 months (median 30 months; range, 1–164 months).

Conclusion:

OSSN occurrence can be synchronous or metachronous. Meticulous examination of the fellow eye is important for an early diagnosis of OSSN.
Recent advances in the mechanical durability of superamphiphobic surfaces: A review
Authors: Singh Sartaj , Kango Saurabh , Sharma Nitin , Verma Rajeev
Published: April 2021

Superamphiphobic (water and oil repellent) surfaces have distinct application areas such as anti-corrosion, anti-friction, anti-icing, self-cleaning, etc. To fabricate these types of surfaces, the base material must have low surface energy and dual-scale roughness (micro and nano levels). The durability of such surfaces is indicated by the duration up to which they remain stable and effective. When mechanical forces interact with these surfaces, it deteriorates the surface integrity and ultimately degrades its superamphiphobic property. Hence, these surfaces have very limited mechanical wear sturdiness and long-term durability. Therefore, in this article, efforts have been made to review the different types of mechanical durability tests performed on superamphiphobic metallic and non-metallic surfaces. Moreover, various kinds of surface texturing techniques in context with durability of such surfaces have been discussed. Finally, from the reported literature, critical conclusions, challenges, and scopes for future work have also been presented.
Pulmonary Embolism Response Team utilization during the COVID-19 pandemic
Authors: Finn Matthew T , Gogia Shawn , Ingrassia Joseph J , Cohen Matthew , Madhavan Mahesh V , Nabavi Nouri Shayan , Brailovsky Yevgeniy , Masoumi Amir , Fried Justin A , Uriel Nir , Agerstrand Cara I , Eisenberger Andrew , Einstein Andrew J , Brodie Daniel , B Rosenzweig Erika , Leon Martin B , Takeda Koji , Pucillo Anthony , Green Philip , Kirtane Ajay J , Parikh Sahil A , Sethi Sanjum S
Published: April 2021

Coronavirus disease 2019 (COVID-19) may predispose patients to venous thromboembolism (VTE). Limited data are available on the utilization of the Pulmonary Embolism Response Team (PERT) in the setting of the COVID-19 global pandemic. We performed a single-center study to evaluate treatment, mortality, and bleeding outcomes in patients who received PERT consultations in March and April 2020, compared to historical controls from the same period in 2019. Clinical data were abstracted from the electronic medical record. The primary study endpoints were inpatient mortality and GUSTO moderate-to-severe bleeding. The frequency of PERT utilization was nearly threefold higher during March and April 2020 ( n = 74) compared to the same period in 2019 ( n = 26). During the COVID-19 pandemic, there was significantly less PERT-guided invasive treatment (5.5% vs 23.1%, p = 0.02) with a numerical but not statistically significant trend toward an increase in the use of systemic fibrinolytic therapy (13.5% vs 3.9%, p = 0.3). There were nonsignificant trends toward higher in-hospital mortality or moderate-to-severe bleeding in patients receiving PERT consultations during the COVID-19 period compared to historical controls (mortality 14.9% vs 3.9%, p = 0.18 and moderate-to-severe bleeding 35.1% vs 19.2%, p = 0.13). In conclusion, PERT utilization was nearly threefold higher during the COVID-19 pandemic than during the historical control period. Among patients evaluated by PERT, in-hospital mortality or moderate-to-severe bleeding were not significantly different, despite being numerically higher, while invasive therapy was utilized less frequently during the COVID-19 pandemic.
Patient experience surveys for children’s community health services: A scoping review
Authors: Nelson Helen J , Pienaar Catherine , Williams Anne M , Munns Ailsa , McKenzie Katie , Mörelius Evalotte
Published: April 2021

Patient experience surveys have a user focus and measure the quality of person-centered health care for hospital inpatients and consumers of community health services, providing a governance process to evaluate the quality of care and to action improvement. Experience of care has been described as effective communication, respect and dignity, and emotional support. Measurement criteria for these domains are not standardized, leading to inconsistent reporting of patient experience. The objective of this scoping review was to synthesize evidence for measuring experience of care in children’s community health services using the Joanna Briggs Institute framework for scoping review method. Three parent-reported surveys met the inclusion criteria, and 50 survey items were assessed by expert reviewers for fit to domains of healthcare experience. Conceptual domains of parent experience in children’s community health services included respect and dignity, effective communication, and emotional support. A gap was identified, in that few items in identified surveys measured emotional support. This contribution will promote consistent reporting of healthcare experience, informing policy and practice for person-centered health care.
Who Likes to Vote by Mail?
Authors: Plescia Carolina , Sevi Semra , Blais André
Published: April 2021

Interest in voting by mail has increased during the coronavirus as a way to avoid in person contact. In this study, we conducted a survey in February 2020 in the United States to examine citizen preferences to cast their ballot at a polling station, over the internet, or by mail. By including simultaneously internet and mail as alternative voting options to the polling station we aim to disentangle convenience (both alternative options are presumably more convenient) from novelty (internet is more novel than mail and polling station voting). We find that the person who likes voting by mail the most is an older White-American with little interest in politics; and the person who likes voting by mail the least is a younger African-American or Latino with high interest in politics. All in all, the biggest cleavage in citizens’ preferences about how to vote is generational, not ideological.
Variable number tandem repeats – Their emerging role in sickness and health
Authors: Marshall Jack NG , Lopez Ana Illera , Pfaff Abigail L , Koks Sulev , Quinn John P , Bubb Vivien J
Published: April 2021

Understanding the mechanisms regulating tissue specific and stimulus inducible regulation is at the heart of understanding human biology and how this translates to wellbeing, the ageing process, and disease progression. Polymorphic DNA variation is superimposed as an extra layer of complexity in such processes which underpin our individuality and are the focus of personalized medicine. This review focuses on the role and action of repetitive DNA, specifically variable number tandem repeats and SINE-VNTR- Alu domains, highlighting their role in modification of gene structure and gene expression in addition to their polymorphic nature being a genetic modifier of disease risk and progression. Although the literature focuses on their role in disease, it illustrates their potential to be major contributors to normal physiological function. To date, these elements have been under-reported in genomic analysis due to the difficulties in their characterization with short read DNA sequencing methods. However, recent advances in long read sequencing methods should resolve these problems allowing for a greater understanding of their contribution to a host of genomic and functional mechanisms underlying physiology and disease.
Asthma, atopy, and exercise: Sex differences in exercise-induced bronchoconstriction
Authors: Rodriguez Bauza Daniel Enrique , Silveyra Patricia
Published: April 2021

Asthma is a chronic inflammatory lung disease affecting approximately 7.7% of the US population. Sex differences in the prevalence, incidence, and severity of asthma have been widely described throughout the lifespan, showing higher rates in boys than girls before puberty, but a reversed pattern in adults. Asthma is often associated with atopy, i.e. the tendency to develop allergic diseases, and can be worsened by environmental stimuli and/or exercise. While not exclusive to patients with asthma, exercise-induced bronchoconstriction (EIB) is a common complication of athletes and individuals who exercise regularly. Currently, there is limited research on sex differences in EIB and its relationship with atopy and asthma in men and women. In this minireview, we summarize the available literature on this topic. Overall, the collective knowledge supports the notion that physiological changes triggered during exercise affect males and females differently, suggesting an interaction among sex, exercise, sex hormones, and atopic status in the course of EIB pathophysiology. Understanding these differences is important to provide personalized management plans to men and women who exercise regularly and suffer from underlying asthma and/or atopy.
Short Communication: Combining Ethics With Efficiency—Israel Defense Forces' Experience in Clinical Trials During the Coronavirus Disease 2019 Pandemic
Authors: Muginshtein-Simkovitch Evgenia , Kayouf Raeed , Twig Gilad , Ketko Itay , Bader Tarif , Fink Noam
Published: April 2021

The coronavirus disease 2019 (COVID-19) pandemic, first reported in China, soon spread worldwide, has evolved into one of the most complex global public health crises the world has encountered in the last several decades. Conducting military medical research is vital to study the unique influences of military service conditions on soldiers' health and to improve the medical response in various emergency periods. The Israel Defense Forces (IDF) Medical Corps maintains an Institutional Review Board (IRB) which reviews clinical studies conducted within the IDF. During the COVID-19 pandemic, the IRB of the IDF had to rapidly implement procedural modifications in order to comply with expanding urgent demands for research without compromising ethical standards. The ethical dilemmas and the IDF policy and perspective are outlined in this article.
Functional Outcomes for Basilar Joint Arthroplasty with Meniscus Allograft Compared with Trapeziectomy Alone
Authors: McCullough Meghan C. , Minasian Raquel , Tanabe Kylie , Rodriguez Sandra , Kulber David
Published: April 2021

Background

Advanced thumb carpometacarpal (CMC) joint arthritis is widely treated with trapeziectomy. To obviate the need for autologous tissue, maintain thumb length, and reduce the risk of scaphoid impingement, the senior author developed an interposition arthroplasty technique using meniscal allograft. We hypothesize that the use of meniscus improves outcomes and subsequent functionality compared with trapeziectomy alone.

Methods

Twenty-three patients with Eaton stage III-IV CMC osteoarthritis underwent arthroplasty with meniscal allograft, and 7 patients underwent trapeziectomy alone. Preoperative Disabilities of the Arm, Shoulder, and Hand (DASH), pain, grip and pinch strength, and range of motion scores were compared with postoperative scores at 6 weeks, 6 months, and 1 year.

Results

The study group consisted of 17 women and 6 men, and the control group consisted of 5 women and 2 men. The mean age was similar at 61.4 (48-72) years and 65.7 (56-78) years for the study and control groups, respectively. The DASH scores dropped by 61.8% in the study group compared with 38.8% in the control group (<0.01), whereas pain decreased 86.0% and 69.8%, respectively ( P < .01). Strength and range of motion improvement was similar between the groups. Subsidence of the joint space was 1% in the study group compared with 18.4% in the control group. There were no surgical complications in either group.

Conclusions

Joint resurfacing with meniscal allograft represents a viable joint salvage option in severe cases of CMC arthritis. Early results suggest that, compared with trapeziectomy alone, the approach results in greater reduction in subjective pain and disability scores, similar improvement in strength measures and range of motion, and less subsidence.
Retrospective Comparison of Capitolunate Arthrodesis Using Headless Compression Screws Versus Nitinol Memory Staples for SLAC and SNAC Wrist: Radiographic, Functional, and Patient-Reported Outcomes
Authors: McKnight R. Randall , Tait Mark A. , Bracey John W. , Odum Susan M. , Lewis Daniel R. , Gaston R. Glenn
Published: April 2021

Background

Nitinol memory compression staples have been proposed as an effective alternative to compression screws for capitolunate arthrodesis (CLA) for scaphoid nonunion advanced collapse (SNAC) and scapholunate advanced collapse (SLAC) wrist. The purpose of this study was to compare the clinical outcomes of CLA for SNAC or SLAC wrist treatment using either compression screws or nitinol staples.

Methods

In all, 47 patients with CLA for SLAC or SNAC wrist with screws or nitinol staples were retrospectively identified. Primary outcome was fusion on radiographs and/or computed tomography. Secondary outcomes were hardware-related complications (HWCs) and other complications, range of motion, grip strength, and patient-reported outcome measures (PROMs), including Visual Analogue Pain scale; Disabilities of the Arm, Shoulder, and Hand score; and patient-rated wrist evaluation.

Results

Of the 47 eligible patients, 40 (85%) were included: 31 patients in the staple group and 9 patients in the screw group. The average age was 49 (17-80) years. There was an 89% union rate for the screw group and a 97% union rate for the staple group. Two patients had screw backout: one who went onto union after screw removal and the other who went onto nonunion after hardware removal. There were 2 (6.5%) HWCs in the staple group. One patient had staple loosening requiring revision and the other dorsal impingement requiring staple removal after radiographic union. In all subsequent cases, the staples were countersunk with no impingement. No significant differences existed between any additional outcomes.

Conclusions

We found no differences between nitinol staples and screws for CLA regarding HWCs or PROMs. Nitinol staples may offer additional benefits as a safe and effective alternative to compression screws for wrist fusions.
Clinical outcomes and overview of dedicated venous stents for management of chronic iliocaval and femoral deep venous disease
Authors: Taha Mohamed AH , Busuttil Andrew , Bootun Roshan , Thabet Bahgat AH , Badawy Ayman EH , Hassan Haitham A , Shalhoub Joseph , Davies Alun H
Published: April 2021

Objectives

Venous stenting of the lower extremities has grown in popularity and is now considered a key component of the primary treatment strategy for the management of pathologically obstructive or stenotic lesions of the deep venous system. This review aims to provide an overview of the role of venous stenting in the management of chronic conditions affecting the deep venous system of the lower limbs.

Methods

An overview of venous stents design and current role of stenting procedure in individuals presenting with Chronic Venous Insufficiency (CVI) and presenting the current trials of dedicated venous stenting in management of chronic deep venous lesions. This review provides a focused insight on venous stent design, physical properties and the available dedicated venous stents selected studies with their related patency outcome based on selective literature search of the PubMed database and Cochrane library.

Conclusions

Dedicated venous stent technology is advancing at a rapid pace alongside the increased undertaking of endovascular deep venous stent reconstruction in the management of iliocaval vein pathologies. The ideal design(s) for venous stents remain unknown, although it is hoped that the presence of new dedicated venous stents in clinical practice will allow the generation of experience and data to advance our understanding in this area.
Disease-modifying therapy prescription patterns in people with multiple sclerosis by age
Authors: Zhang Yinan , Salter Amber , Jin Shan , Culpepper William J. , Cutter Gary R. , Wallin Mitchell , Stuve Olaf
Published: April 2021

Background:

Disease-modifying therapies (DMTs) for multiple sclerosis (MS) are approved for their ability to reduce disease activity, namely clinical relapses and signal changes on magnetic resonance imaging (MRI). Disease activity appears age dependent. Thus, the greatest benefit would be expected in younger people with MS (PwMS) whereas benefits in the elderly are uncertain.

Methods:

Real-world data were obtained from PwMS from the North American Research Committee on Multiple Sclerosis (NARCOMS) registry and the US Department of Veterans Affairs Multiple Sclerosis Surveillance Registry (MSSR).

Results:

6948 PwMS were surveyed from NARCOMS, and the MSSR had 1719 participants. In younger adult PwMS 40-years old or less, 183 (61.4%) in NARCOMS and 179 (70.5%) in the MSSR were prescribed DMTs. Among PwMS over age 60, 1575 (40.1%) in NARCOMS and 239 (36.3%) in the MSSR were prescribed DMTs. More PwMS in the age group of 31–40 ( p = 0.035) and 41–50 ( p = 0.001) in the MSSR were using DMTs compared with PwMS of the same age groups in NARCOMS.

Conclusion:

These findings suggest that DMTs are under-utilized in the younger population and continue to be commonly prescribed in the elderly. Broader access may explain the higher prescription rate of DMTs in US veterans.