bluuebunny/crossref_metadata_2025 huggingface dataset:
Fault Line Selection Method Based on Transfer Learning Depthwise Separable Convolutional Neural Network
Authors: Zhang Haixia , Cheng Wenao
Published: November 2021

With the continuous development of artificial intelligence technology, the value of massive power data has been widely considered. Aiming at the problem of single-phase-to-ground fault line selection in resonant grounding system, a fault line selection method based on transfer learning depthwise separable convolutional neural network (DSCNN) is proposed. The proposed method uses two pixel-level image fusions to transform the three-phase current of each feeder into the RGB color image, which is used as the input of DSCNN. After DSCNN self-feature extraction, the fault line selection is completed. With the consideration that not all of power distribution systems can obtain a large amount of data in practical applications, the transfer learning strategy is adopted to transplant the trained line selection model. The smaller number of DSCNN parameters increases the portability of the model. The test results show that not only does the proposed method extracts obvious features, but also the line selection accuracy can reach 99.76%. It also has good adaptability under different sampling frequencies, different noise environments, and different distribution network topologies; the line selection accuracy can reach more than 97.43%.
Longitudinal SARS-CoV-2 mRNA Vaccine-Induced Humoral Immune Responses in Patients with Cancer
Authors: Figueiredo Jane C. , Merin Noah M. , Hamid Omid , Choi So Yung , Lemos Tucker , Cozen Wendy , Nguyen Nathalie , Finster Laurel J. , Foley Joslyn , Darrah Justin , Gong Jun , Paquette Ronald , Mita Alain C. , Vescio Robert , Mehmi Inderjit , Basho Reva , Tourtellotte Warren G. , Huynh Carissa A. , Melmed Gil Y. , Braun Jonathan , McGovern Dermot P.B. , Mengesha Emebet , Botwin Greg , Prostko John C. , Frias Edwin C. , Stewart James L. , Joung Sandy , Van Eyk Jennifer , Ebinger Joseph E. , Cheng Susan , Sobhani Kimia , Reckamp Karen L. , Merchant Akil
Published: November 2021

Longitudinal studies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine-induced immune responses in patients with cancer are needed to optimize clinical care. In a prospective cohort study of 366 (291 vaccinated) patients, we measured antibody levels [anti-spike (IgG-(S-RBD) and anti-nucleocapsid immunoglobulin] at three time points. Antibody level trajectories and frequency of breakthrough infections were evaluated by tumor type and timing of treatment relative to vaccination. IgG-(S-RBD) at peak response (median = 42 days after dose 2) was higher (P = 0.002) and remained higher after 4 to 6 months (P = 0.003) in patients receiving mRNA-1273 compared with BNT162b2. Patients with solid tumors attained higher peak levels (P = 0.001) and sustained levels after 4 to 6 months (P < 0.001) compared with those with hematologic malignancies. B-cell targeted treatment reduced peak (P = 0.001) and sustained antibody responses (P = 0.003). Solid tumor patients receiving immune checkpoint inhibitors before vaccination had lower sustained antibody levels than those who received treatment after vaccination (P = 0.043). Two (0.69%) vaccinated and one (1.9%) unvaccinated patient had severe COVID-19 illness during follow-up. Our study shows variation in sustained antibody responses across cancer populations receiving various therapeutic modalities, with important implications for vaccine booster timing and patient selection.

Significance:

Long-term studies of immunogenicity of SARS-CoV-2 vaccines in patients with cancer are needed to inform evidence-based guidelines for booster vaccinations and to tailor sequence and timing of vaccinations to elicit improved humoral responses.
Factors Leading to Institutionalization among the Oldest Old: Longitudinal Findings from the AgeCoDe-AgeQualiDe Study
Authors: Hajek André , Buczak-Stec Elżbieta , van den Bussche Hendrik , Eisele Marion , Oey Anke , Wiese Birgitt , Weyerer Siegfried , Werle Jochen , Fuchs Angela , Pentzek Michael , Luppa Melanie , Pabst Alexander , Weeg Dagmar , Bickel Horst , Kleineidam Luca , Wagner Michael , Scherer Martin , Maier Wolfgang , Riedel-Heller Steffi G. , König Hans-Helmut
Published: November 2021

Introduction: Due to the strong association between old age and the need for long-term care, the number of individuals in need for care is projected to increase noticeably. The aim of this study was to examine the determinants of institutionalization among the oldest old longitudinally. Methods: Longitudinal data (follow-up [FU] wave 7–9) were gathered from a multicenter prospective cohort study (“Study on needs, health service use, costs and health-related quality of life in a large sample of oldest old primary care patients [85+],” AgeQualiDe). At FU wave 7, in 2014, complete measures were available for 763 individuals. The average age was 88.9 (standard deviation 2.9) years (range 85–100), and 68% were female. Sociodemographic and health-related independent variables (e.g., depressive symptoms or functioning) were included in the regression model. Institutionalization (admission to assisted living home or nursing home) was used as an outcome measure. Logistic random-effects models were used. Results: Regressions revealed that among oldest old, the odds of being institutionalized were lower for men (odds ratio [OR] = 0.03; 95% confidence interval [CI] 0.00–0.16). Institutionalization was associated with an increased age (OR = 1.27; 95% CI 1.04–1.55). Additionally, widowed individuals (ref. non-widowed) had higher odds of being institutionalized (OR = 8.95; 95% CI 1.61–49.81). Institutionalization was also associated with functional decline (OR = 0.16; 95% CI 0.11–0.23), whereas it was not significantly associated with cognitive decline, depressive symptoms, and social support. Conclusion: Our findings stress the importance of gender, age, widowhood, and functional decline for institutionalization among the oldest old. Preventing or at least postponing functional decline might help to delay institutionalization as far as possible.
High Encephalization in a Fossil Rorqual Illuminates Baleen Whale Brain Evolution
Authors: Bisconti Michelangelo , Daniello Riccardo , Damarco Piero , Tartarelli Giandonato , Pavia Marco , Carnevale Giorgio
Published: November 2021

Baleen whales are considered underencephalized mammals due to their reduced brain size with respect to their body size (encephalization quotient [EQ] << 1). Despite their low EQ, mysticetes exhibit complex behavioral patterns in terms of motor abilities, vocal repertoire, and cultural learning. Very scarce information is available about the morphological evolution of the brain in this group; this makes it difficult to investigate the historical changes in brain shape and size in order to relate the origin of the complex mysticete behavioral repertoire to the evolution of specific neural substrates. Here, the first description of the virtual endocast of a fossil balaenopterid species, Marzanoptera tersillae from the Italian Pliocene, reveals an EQ of around 3, which is exceptional for baleen whales. The endocast showed a morphologically different organization of the brain in this fossil whale as the cerebral hemispheres are anteroposteriorly shortened, the cerebellum lacks the posteromedial expansion of the cerebellar hemispheres, and the cerebellar vermis is unusually reduced. The comparative reductions of the cerebral and cerebellar hemispheres suggest that the motor behavior of M. tersillae probably was less sophisticated than that exhibited by the extant rorqual and humpback species. The presence of an EQ value in this fossil species that is around 10 times higher than that of extant mysticetes opens new questions about brain evolution and provides new, invaluable information about the evolutionary path of morphological and size change in the brain of baleen whales.
Bariatric Surgery in Adolescents with Obesity: Long-Term Perspectives and Potential Alternatives
Authors: Halloun Rana , Weiss Ram
Published: November 2021

Background: Severe obesity among adolescent shows a worrisome trend in regard to its increasing prevalence and poses a great challenge for treatment. Conservative measures have modest effects on weight loss, usually fail in achieving a sustainable weight loss and resolution of comorbidities. This has led to greater utilization of bariatric surgery (BS) that offers a fast reduction in body mass index with little perioperative complications. Despite the increasing utilization of BS, data are still insufficient, regarding their long-term outcome in adolescents. We review short- and long-term effects of BS and their implications on bone health and nutritional deficiencies in adolescents. In addition, we discuss possible pharmaceutical alternatives. Summary: BS results in a substantial weight loss of roughly 37% in the first-year post-operation and is superior to conservative measures in resolution of metabolic comorbidities. BS significantly improves health-related quality of life. Longer follow-up (F/U) shows weight regain in 50% of patients. Furthermore, reduced bone mass and nutritional deficiencies were reported in up to 90% of patients. Most recently, alternative to BS became more relevant with approval of GLP-1 analogues use in adolescents. GLP-1 analogues are potent enough to induce moderate clinically meaningful weight loss and improvement of metabolic component. Key Messages: We conclude that obese adolescents without major obesity-related complications may benefit from pharmacological interventions with lifestyle modification. We advise considering BS as treatment approach in adolescents with severe obesity and major obesity-related complications with proper preoperative preparation and postoperative F/U in excellence centers.
Evolution and Future of Growth Plate Therapeutics
Authors: Allen David B. , Merchant Nadia , Miller Bradley S. , Backeljauw Philippe F.
Published: November 2021

Background: Longitudinal bone growth is regulated by multiple endocrine signals (e.g., growth hormone, insulin-like growth factor I, estrogen, and androgen) and local factors (e.g., fibroblast growth factors and their receptors and the C-natriuretic peptide/natriuretic peptide receptor-B pathway). Summary: Abnormalities in both endocrine and local regulation of growth plate physiology cause many disorders of human skeletal growth. Knowledge of these pathways creates therapeutic potential for sustaining or even augmenting linear growth. Key Message: During the past 4 decades, advances in understanding growth plate physiology have been accompanied by development and implementation of growth-promoting treatments that have progressed in both efficacy and specificity of action. This paper reviews the history and continuing evolution of growth plate therapeutics.
Genetic Predictors of Salt Sensitivity of Blood Pressure: The Additive Impact of 2 Hits in the Same Biological Pathway
Authors: Haas Andrea V. , En Yee Li , Yuan Yan E. , Wong Yin H. , Hopkins Paul N. , Jeunemaitre Xavier , Lasky-Su Jessica , Williams Jonathan S. , Adler Gail K. , Williams Gordon H.
Published: November 2021

Salt sensitivity of blood pressure is associated with increased cardiovascular morbidity and mortality. A diplotype in the
β2AR
gene (rs1042713, rs1042714) and single nucleotide polymorphisms in
ESR2
(rs10144225),
SGK1
(rs2758151), and
AGT
(rs2493134) genes are all independently associated with salt sensitivity of blood pressure and all but AGT are associated with increased aldosterone levels and/or activity. We sought to determine whether individuals who carried a double hit risk phenotype—a risk allele associated with increased aldosterone secretion (either
β2AR
or
ESR2
) and a risk allele associated with amplification of aldosterone’s effects (
SGK1
) would result in more significant SSBP compared with individuals homozygous for a single risk allele. Data were obtained from the Hypertension Pathotypes cohort where individuals completed 7 days of restricted sodium and liberal sodium diets. We defined 3 genetic combinations:
β2AR/SGK, ESR2/SGK
, and
AGT/SGK.
Multivariate regression analyses found a significantly higher salt sensitivity of blood pressure as the number of risk allele pairs increased in both the
β2AR/SGK
(β=5.46;
P
<0.001) and
ESR2/SGK
(
β
=4.87;
P
0.01). In addition, the number of risk allele pairs was associated with serum aldosterone levels for
β2AR/SGK
and
ESR2/SGK
. On the other hand, there was no association between the number of risk allele pairs with salt sensitivity of blood pressure nor aldosterone levels in the
AGT/SGK
combination. In conclusion, genetic combinations of
β2AR/SGK1
and
ESR2
/
SGK1
are associated with greater salt sensitivity of blood pressure and plasma aldosterone concentrations. Hypertensive combination risk homozygotes may be candidates for mineralocorticoid receptor antagonist therapy—gene-driven, personalized medicine.
Common Carotid Artery Flow Parameters Predict the Incidence of Hypertension
Authors: Sasaki Nobuo , Maeda Ryo , Ozono Ryoji , Nakano Yukiko , Higashi Yukihito
Published: November 2021

The resistance index (RI) and pulsatility index (PI) in the common carotid artery (CCA) reflect vascular resistance and aortic stiffness. We investigated the association of these CCA flow parameters with the prevalence and incidence of hypertension, with comparison to the intima-media thickness (IMT). The cross-sectional analysis included 2660 participants who underwent carotid artery ultrasonography. Of those, 1249 normotensive participants at baseline were enrolled in the retrospective cohort analysis. A high RI, high PI, and increased IMT were indicated based on the optimal cutoff values in a receiver operating characteristic curve analysis. RI (β=0.158,
P
<0.001) and PI (β=0.130,
P
<0.001) were significantly associated with systolic blood pressure in the cross-sectional analysis. Over a mean 5.1-year follow-up period, 524 participants developed hypertension. A high RI (odds ratio [OR], 1.65;
P
<0.001), high PI (OR, 1.63;
P
<0.001), and increased IMT (OR, 1.40;
P
=0.017) were significant predicators for incident hypertension. Combining IMT and the PI, a high PI alone (OR, 1.52;
P
=0.008) was a significant predicator for incident hypertension, whereas increased IMT alone was not significantly associated with the risk of hypertension. The group with both increased IMT and a high PI had the highest risk of hypertension (OR, 2.24;
P
<0.001). Similar results were obtained from the analysis of IMT and RI, suggesting that CCA parameters evaluated by ultrasonography may help identify individuals at high risk of hypertension. In particular, CCA flow parameters are better predictors.
Benefit–Risk of Rivaroxaban for Extended Thromboprophylaxis After Hospitalization for Medical Illness: Pooled Analysis From MAGELLAN and MARINER
Authors: Raskob Gary E. , Spyropoulos Alex C. , Spiro Theodore E. , Lu Wentao , Yuan Zhong , Levitan Bennett , Suh Eunyoung , Barnathan Elliot S.
Published: November 2021

Background

Thromboprophylaxis extended after hospital discharge in medically ill patients currently is not recommended by practice guidelines because of uncertainty about the benefit for preventing major or fatal thromboembolic events, and the risk of bleeding.

Methods and Results

We assessed the benefit and risk of thromboprophylaxis with rivaroxaban 10 mg once daily extended for 25 to 45 days after hospitalization for preventing major thromboembolism in medically ill patients using the pooled data in 16 496 patients from 2 randomized trials, MARINER (Medically Ill Patient Assessment of Rivaroxaban Versus Placebo in Reducing Post‐Discharge Venous Thrombo‐Embolism Risk) and MAGELLAN (Multicenter, randomized, parallel‐group efficacy and safety study for the prevention of venous thromboembolism in hospitalized medically ill patients comparing rivaroxaban with enoxaparin). The data from the MARINER trial were pooled with the data from the MAGELLAN trial in patients who were free of thrombotic or bleeding events up to the last dose of enoxaparin/placebo and who continued in the outpatient phase of thromboprophylaxis. The composite outcome of major thromboembolic events (symptomatic deep vein thrombosis, nonfatal pulmonary embolism, myocardial infarction, and nonhemorrhagic stroke) and all‐cause mortality was used to assess benefit and was compared with the risk of the composite of fatal and critical site bleeding. The incidence of the composite efficacy outcome was 1.80% (148 of 8222 patients) in the rivaroxaban group, compared with 2.31% (191 of 8274 patients in the placebo group) (HR, 0.78 [95% CI, 0.63–0.97],
P
=0.024). Fatal or critical site bleeding events were infrequent and occurred in <0.1% of patients in both groups (rivaroxaban 0.09%; placebo 0.04%; HR, 2.36;
P
=0.214).

Conclusions

The results suggest a benefit for reducing major thromboembolic outcomes (number needed to treat: 197), with a favorable trade‐off to fatal or critical site bleeding (number needed to harm: 2045).

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifiers: NCT00571649 and NCT02111564.
Carotid Artery Plaque Calcifications: Lessons From Histopathology to Diagnostic Imaging
Authors: Saba Luca , Nardi Valentina , Cau Riccardo , Gupta Ajay , Kamel Hooman , Suri Jasjit S. , Balestrieri Antonella , Congiu Terenzio , Butler Anthony P.H. , Gieseg Steven , Fanni Daniela , Cerrone Giulia , Sanfilippo Roberto , Puig Josep , Yang Qi , Mannelli Lorenzo , Faa Gavino , Lanzino Giuseppe
Published: November 2021

The role of calcium in atherosclerosis is controversial and the relationship between vascular calcification and plaque vulnerability is not fully understood. Although calcifications are present in ≈50% to 60% of carotid plaques, their association with cerebrovascular ischemic events remains unclear. In this review, we summarize current understanding of carotid plaque calcification. We outline the role of calcium in atherosclerotic carotid disease by analyzing laboratory studies and histopathologic studies, as well as imaging findings to understand clinical implications of carotid artery calcifications. Differences in mechanism of calcium deposition express themselves into a wide range of calcification phenotypes in carotid plaques. Some patterns, such as rim calcification, are suggestive of plaques with inflammatory activity with leakage of the vasa vasourm and intraplaque hemorrhage. Other patterns such as dense, nodular calcifications may confer greater mechanical stability to the plaque and reduce the risk of embolization for a given degree of plaque size and luminal stenosis. Various distributions and patterns of carotid plaque calcification, often influenced by the underlying systemic pathological condition, have a different role in affecting plaque stability. Modern imaging techniques afford multiple approaches to assess geometry, pattern of distribution, size, and composition of carotid artery calcifications. Future investigations with these novel technologies will further improve our understanding of carotid artery calcification and will play an important role in understanding and minimizing stroke risk in patients with carotid plaques.
The Effects of Steering Locomotion on User Preference and Accuracy in
Virtual Environments
Authors: Rebenitsch Lisa , Engle Delaina
Published: November 2021

Locomotion in virtual environments presents challenges due to the discrepancy between the virtual and the real-world space. Teleportation has been suggested for rapid transit and low cybersickness. However, users often find the method disorienting and difficult over short distances. This is problematic in many gaming scenarios where moderate distances are common. We examined three methods of self-directed, steering locomotion for short to mid-range distances. The methods were pointing, head, and semi-decoupled head and controller. The decoupled method was to explore if game console navigation would be preferred due to familiarity. The experiment focused on user preference and accuracy and had 19 participants. We anticipated that more intuitive methods would be preferred. The pointing method had the greatest impact on accuracy. History of motion sickness susceptibility and prior use of video games did not affect preference with participants favoring the pointing method twice as often over the head method and with none preferring the semi-decoupled method. The pointing method also had lower average illness scores, although not statistically significant. The results suggest that pointing provides an accurate method of locomotion while also being a lower cybersickness option for steering navigation.
Impact of Internal Climate Variability on the Relationship between Spring Northern Tropical Atlantic SST Anomalies and Succedent Winter ENSO: The Role of the North Pacific Oscillation
Authors: Chen Shangfeng , Chen Wen , Yu Bin , Li Zhibo
Published: November 2021

Previous studies suggested that spring sea surface temperature anomalies (SSTAs) in the northern tropical Atlantic (NTA) have a marked influence on the succedent winter El Niño–Southern Oscillation (ENSO). In this study, we examine the spring NTA SSTA–winter ENSO connection in a 50-member large-ensemble simulation conducted with the Canadian Centre for Climate Modelling and Analysis second-generation Canadian Earth System Model (CanESM2) and a 100-member ensemble simulation conducted with the Max Planck Institute Earth System Model (MPI-ESM). The observed out-of-phase relation of spring NTA SSTA with winter ENSO can be captured by the multimember ensemble means of the large-ensemble simulations from both models. However, the relation shows a large diversity among different ensemble members attributing to the internal climate variability. The preceding winter North Pacific Oscillation (NPO) is suggested to be an important source of the internal climate variability that modulates the spring NTA SSTA–ENSO connection. The modulation of the winter NPO on the subsequent spring NTA SSTA–winter ENSO relation is seen in both climate modeling and observational datasets. When winter NPO and spring NTA SSTA indices have the same (opposite) sign, the linkage between the spring NTA SSTA and the following winter ENSO tends to be weak (strong). The NPO modulates the spring NTA SSTA–winter ENSO relation mainly via changing the zonal wind anomalies over the tropical western-to-central Pacific induced by the spring NTA SSTA. In addition, our analysis indicates that winter NPO may have a marked effect on the predictability of winter ENSO based on the condition of spring NTA SSTA.
Retrospective Observational Single-Center Study of Complications of Arterial Indwelling Catheters for Invasive Blood Pressure in Intensive Care Unit Patients
Authors: Baptistella Conrado Dias Pacheco Annicchino , Mendes Cynthia de Almeida , Silva Marcela Juliano , Wolosker Nelson
Published: November 2021

This study aimed to analyze the incidence of complications resulting from the use of an indwelling arterial catheter (IAC). We compared the characteristics of the patients with an IAC who developed complications with those who did not present any complications. The study included 1,869 patients with an IAC hospitalized in intensive care units (ICUs) between 2017 and 2018. Most patients were male (58.7%), in the seventh decade of life, and had systemic arterial hypertension. The most common site of IAC implantation was the radial artery. Fifty-four (2.88%) cases of complications related to an IAC were identified including bleeding, hematomas, and thrombosis. Female patients had a higher risk of complications ( P = .030). Comorbidities such as arrhythmias ( P < .001) and peripheral arterial disease ( P = .041) also increased that risk. The use of vasoactive drugs ( P = .001), hemodialysis ( P = .001), and orotracheal intubation (OTI) ( P = .001) was significantly associated with the occurrence of complications as well as length of stay in ICUs ( P < .001) and IAC duration ( P = .001). IACs are safe devices commonly used in ICUs, with an incidence of complications of 2.88%.
Dismantling the Safety-Net Hospital: The Construction of “Underutilization” and Scarce Public Hospital Care
Authors: Aumoithe George
Published: November 2021

Safety-net hospitals are vulnerable to government financing. After the Nixon administration encouraged states to conduct utilization review to identify medical cost savings, federal campaigns against hospital subsidies placed public hospital systems in perilous states and paralleled efforts in cities to eliminate “underutilized” facilities. New York City mayor John Lindsay sought a political balance between community participation and the technocratic search for underused beds. Subsequent mayors Abe Beame and Ed Koch proved less sympathetic. With community participation limited to symbolic input on hospital administrator hiring, south Brooklyn, the Bronx, and Harlem all suffered closures. This article contributes to literature on urban governance and health care administration by showing how macroeconomic fiscal decision-making overrode local demands and eventually became microeconomic motivators between and within hospitals. Municipal hospitals and Community Accountability Boards debated austerity budgeting’s negative effects on chronic and epidemic disease readiness, while the Health and Hospitals Corporation framed deprivation as patient choice.
Acupuncture combined with opioids for cancer pain: a pilot pragmatic randomized controlled trial
Authors: He Yihan , Zhang Haibo , Li Yifang , Long Shunqin , Xiao Shujing , May Brian H , Lin Zhang Anthony , Guo Xinfeng , Xue Charlie Changli , Lu Chuanjian
Published: November 2021

Objective:

Given the existing evidence for the analgesic effect of acupuncture, the current study aimed to assess whether acupuncture could be feasible and manageable as an adjunctive therapy for cancer pain in a real-world hospital setting.

Methods:

Thirty patients in an Oncology department with moderate or severe pain were recruited and randomized to an adjunctive acupuncture group or control group, who received pharmacotherapy for pain management without acupuncture. The duration of the treatment course was 1 week with a 2-week follow-up. In total, four acupuncture sessions were administered, on days 1/2/4/6 of the trial. Pain intensity was measured using a numerical rating scale (NRS) and the daily opioid dose was recorded.

Results:

The overall trends favored acupuncture for both pain intensity and daily opioid consumption. The proportion of participants experiencing at least a 2-point reduction in the NRS at the end of the treatment was 93% (n = 14/15) for the acupuncture group and 57% (n = 8/14) for the control group (risk difference (RD) 36.1%, 95% confidence interval (CI) [7.4%–65.0%]; relative risk (RR) 1.63, 95% CI [1.02–2.62]; p = 0.04). There were no serious adverse events and no dropouts during the treatment.

Conclusion:

This pilot study showed that adding acupuncture to routine analgesia for patients with cancer pain was feasible and acceptable to patients. The clinical effects of adding acupuncture as an adjunctive therapy need to be further evaluated.

Clinical trial registration number:

ChiCTR1800017023 (Chinese Clinical Trial Registry)
Trends in East Asian nurses recognizing ethical behavioral practices
Authors: Nishimura Akiko , Yamada Mitsuko
Published: November 2021

Background:

Nurses are expected to make and implement autonomous decisions to provide patients with excellent quality nursing while practicing complex, high-level care. However, studies have shown that nursing practice based on autonomous decision-making is difficult, and a gap exists between decision-making and implementation.

Research question/aim/objectives:

This study aims to clarify trends among nursing professionals who recognize they are practicing ethical behavior in their nursing practice.

Research design/Participants and research context:

We surveyed the basic attributes of and used the Ode’s Ethical Behavior Scale for Nurses with 3467 nursing professionals working at 34 hospitals in suburban cities of Japan and investigated the relationships among these factors.

Ethical considerations:

This study was approved by the appropriate research ethics committee. The Ethical Behavior Scale for Nurses was used with the authors’ permission.

Findings/results:

Significant differences were found in the mean “ethical behavior” scores between nurses and licensed practical nurses and midwives and licensed practical nurses. Mean scores for the “justice” subscale differed significantly between the low experience group and mid-level experience group and between the high experience group and mid-level experience group. Significant differences were also found in the mean scores between those with ethics education experience and those without, those with ethics training experience and those without, and those with ethics conference experience and those without.

Discussion:

Midwives and nurses had higher ethical behaviors than licensed practical nurses. Nursing professionals with low and high experience had higher justice scores than those with mid-level experience. Finally, nursing professionals with ethics education, training, or conference experience had higher ethical behavior than those without such experience.

Conclusion:

Nursing professionals who recognize they are practicing ethical behavior tend to be midwives or nurses with low or high levels of experience who attended ethics education, training, or conferences.
Economic Scar Tissue of COVID-19 Puzzle: An Analysis, Evidence and Suggestion on Global Perspective
Authors: Hossain Mohammed Sawkat
Published: November 2021

The COVID-19 pandemic has instigated tremendous human and economic hardship around the world. Using meta-literature and time series analysis, we conduct both synthesis and empirical analysis to investigate particularly the economic perspectives of COVID-19 across several financial systems: (a) Asian market, (b) European market, (c) American market and (d) Gulf Cooperation Council (GCC) and Middle East and North Africa’s (MENA) market. The critical review of the leading business and finance journals of ISI-WOS summarizes that the outburst of COVID-19 mercilessly affects global economies; however, the end phase of the systematic cascading effect has not clearly folded yet. The probable reasons of economic downturn are productivity reduction, labour immobility, undue job loss, scarcity of employment opportunities, discontinuation of supply chain, declining foreign exports, investment uncertainty, adverse clientele effect, etc. However, after analysing the pre- and during COVID effect on foreign reserve and remittance, we identify an inconclusive finding: (a) bullish trend, (e.g., the USA, Canada, Mexico, Japan, India, Bangladesh and Singapore); (b) bearish trend, (e.g., the UK, Sri-Lanka, Saudi Arabia, Malaysia, Nigeria, Italy and Brazil). Our time series analysis between pre- and during COVID-19 also documents the economic mystery that although the overall economic growth has gone down, foreign reserve and remittance have increased gradually across several economies. Overall, the current global situation demands systematic, well-targeted and aggressive fiscal-monetary stimulus initiatives. Therefore, this study offers theoretical, empirical and policy-oriented academic novelty with the possible suggestions and dynamic strategies to circumvent COVID-19 adverse effects.
Harmless flirtations or co-creation? Exploring flirtatious encounters in hospitable experiences
Authors: Gibbs Darryl , Haven-Tang Clare , Ritchie Caroline
Published: November 2021

Exploring the relationship between sexual harassment and service work in hospitality has long been considered a complex issue, due to the blurred and sometimes invisible line between flirting, harassment and the very nature of close contact hospitality service work. Little research has examined how mutual flirtations (when they are conducted in an appropriate manner and within safe boundaries) between customer and staff can play a positive role in the co-creation of hospitable experiences. This paper presents the findings of one theme from a wider PhD study which sought to explore the role of staff, customers and managers in the co-creation and performance of natural hospitable experiences. The focus of this paper is an exploration of the relationship between flirtatious encounters and the co-creation of hospitable experiences. In the wider study, three research phases were conducted. Semi-structured interviews were undertaken with service staff and managers from a range of hospitality servicescapes and data was gathered from customers through a number of focus groups, and the findings suggest that harmless and appropriate flirtatious encounters between customers and staff which are initiated in a natural and safe manner can have a positive influence on the co-creation of hospitable experiences.
“The American Outlaws Are Our People”: Fox Sports and the Branded Ambivalence of an American Soccer Fan at the 2019 FIFA Women’s World Cup
Authors: Howell Charlotte E.
Published: November 2021

Drawing on fan studies, sports media studies, media industries studies, and participant observation of the American Outlaws, this essay analyzes specific aspects of the 2019 FIFA Women’s World Cup as televised by Fox Sports in the wider context of soccer’s evolving place within the American sports media marketplace. American media companies have increasingly positioned soccer as an upscale sport in the U.S. In addition to representing an affluent and cosmopolitan taste culture, the representation of the American Outlaws as part of Fox Sports’ programming and branding flattened the frictions of class, national identity, politics, and race that shaped American soccer discourse in the summer of 2019. This essay explores this flattening and the underlying tensions between televising a tournament based in American national identity that allows for a more mass audience appeal and the more niche-based framing of soccer—including the progressive politics of women’s soccer—in U.S. sports media.
Efficacy of Generalized Face Masking Mandates
Authors: Boretti Alberto
Published: November 2021

This commentary discusses if targeted uses of face masks may provide better results than generalized face masks mandates to limit the spread of Covid-19. The study is based on a literature review, as well as the analysis of cases and fatalities of different countries adopting different mask mandates. Before the Covid-19 emergency, the literature was consistently against generalized masking for cold and flu viruses. The latest literature for Covid-19 infection is opposite mostly supportive for generalized masking, even if contrarian works exist. The Covid-19 recommendations are not based on randomized controlled trials of healthy individuals wearing or not masks, differentiating in between closed or open spaces. Countries that did not mandate face masks have not performed worse for the number of cases and fatalities than countries that adopted generalized face masking policies during the Covid-19 emergency. Face masks help against Covid-19 infection but also have downfalls. Their benefits are overestimated, while their risks are underestimated. Masks can block the larger droplets exhaled by an infected wearer, protecting the healthy from viral exposure, but their ability to filter out viruses is variable and generally poor especially in reused cloth masks worn by the public. New surgical masks should be used in crowded spaces especially indoors, preferring distancing without masks outdoor. There are serious unintended consequences from wearing face masks improperly and for too long that must be accounted for. There could be more advantages from targeted rather than generalized uses of only surgical face masks.
Outcomes of nephron sparing surgery and cortical sparing adrenalectomy in the management of Von Hippel–Lindau syndrome
Authors: Jayanth Selvin Theodore , Mukherjee Partho , George Arun Jacob Philip , Chandrasingh J. , Nirmal T. J. , Mukha Rajiv Paul , Kumar Santosh , Devasia Antony
Published: November 2021

Background

The management of Von Hippel–Lindau syndrome (VHLS) is multidisciplinary. The urologist is involved in treating the renal, epididymal tumors and often adrenal pheochromocytoma. Preservation of renal and adrenal function is a challenge. We present 17 cases of VHLS in a tertiary care center in South India.

Methods

A retrospective review of the patients who underwent surgical treatment under urology for VHLS from January 2009 to November 2018 was conducted. The demographic data, the spectrum of manifestation, treatment, change in glomerular filtration rate, adrenal insufficiency, and recurrence-free survival were analyzed.

Results

There were 17 patients diagnosed with VHLS. The median age of diagnosis was 39 years (range 23–41). The spectrum of clinical manifestation was: multifocal RCC (88%), pancreatic cysts/tumors (70%), cerebellar hemangioblastoma (59%), retinal angiomas (47%), epididymal cysts/tumors (47%), pheochromocytomas (41%), and spinal hemangiomas (30%). There were seven patients with ten pheochromocytoma lesions. Three underwent cortical sparing and seven total adrenalectomies; 13 patients underwent nephron sparing surgery (NSS), of which seven patients had bilateral tumors. The median duration of follow-up was 6.5 years (range 2–12 years). Following NSS, seven patients had a local recurrence, and one developed pancreatic metastasis. Two patients (11%) were lost to follow-up. Renal function was preserved in all patients at the last follow-up, and there was no postoperative adrenal crisis or mortality.

Conclusion

Nephron sparing surgery and cortical sparing adrenalectomy are the treatment of choice for multifocal RCC and pheochromocytomas in patients with VHLS providing good oncological outcomes and preservation of renal and adrenal function.
Mechanical power normalized to predicted body weight is associated with mortality in critically ill patients: a cohort study
Authors: Zhu Yanhong , Peng Wenyong , Zhen Shuai , Jiang Xiaofeng
Published: November 2021

Background

Mechanical power (MP), defined as the amount of energy produced by mechanical ventilation and released into the respiratory system, was reportedly a determining factor in the pathogenesis of ventilator-induced lung injury. However, previous studies suggest that the effects of MP were proportional to their involvement in the total lung function size. Therefore, MP normalized to the predicted body weight (norMP) should outperform the absolute MP value. The objective of this research is to determine the connection between norMP and mortality in critically ill patients who have been on invasive ventilation for at least 48 h.

Methods

This is a study of data stored in the databases of the MIMIC–III, which contains data of critically ill patients for over 50,000. The study involved critically ill patients who had been on invasive ventilation for at least 48 h. norMP was the relevant exposure. The major endpoint was ICU mortality, the secondary endpoints were 30-day, 90-day mortality; ICU length of stay, the number of ventilator-free days at day 28.

Result

The study involved a total of 1301 critically ill patients. This study revealed that norMP was correlated with ICU mortality [OR per quartile increase 1.33 (95% CI 1.16–1.52), p <  0.001]. Similarly, norMP was correlated with ventilator-free days at day 28, ICU length of stay. In the subgroup analysis, high norMP was associated with ICU mortality whether low or high Vt (OR 1.31, 95% CI 1.09–1.57, p = 0.004; OR 1.32, 95% CI 1.08–1.62, p = 0.008, respectively). But high norMP was associated with ICU mortality only in low PIP (OR 1.18, 95% CI 1.01–1.38, p = 0.034).

Conclusion

Our findings indicate that higher norMP is independently linked with elevated ICU mortality and various other clinical findings in critically ill patients with a minimum of 48 h of invasive ventilation.
Experience with a triplex arbovirus nucleic acid test (NAT) at a Canadian Public Health Laboratory
Authors: Choudhury Saugata , Tellier Raymond , Fonseca Kevin , Berenger Byron M.
Published: November 2021

Background

Dengue, chikungunya and zika infections occur in tropical and subtropical regions of the world. We describe the utilization of an in-house nucleic acid test (NAT) targeting all three viruses for febrile returning travelers in Alberta, Canada.

Methods

NAT was performed until 40 days from symptom onset or exposure due to the prolonged duration of zika virus RNA detection. From Sept 1, 2017 to August 31, 2019, 2552 specimens from 1932 patients were tested.

Results

Approximately 2% of patients tested were NAT positive for dengue virus (n = 42), chikungunya virus (n = 4), and zika virus (n = 1). The majority presented with fever, myalgia and rash. Regions with the most frequent travel included SouthEast Asia (68.5%), South America (25%) and the Caribbean (6.5%). Ct values were stronger (~ 1.5 logs) for patients within 1–3 days following onset of clinical symptoms than those presenting later. Nineteen patients had urine and plasma submitted; 5 were positive for both specimens and 2 were positive only for dengue virus in the urine. Also, Ct values were lower for plasma when compared to the corresponding urine. RNA was detected until 10 days and 5 days post-exposure in plasma and urine respectively for dengue virus.

Conclusions

Owing to dengue viremia detected beyond the conventional 7 days and low levels of circulating zika virus globally, a cutoff of 14 days from symptom onset to NAT is sufficient to diagnose acute cases. Inclusion of a zoonotic history form that collects appropriate clinical history results in improved test utilization.
Perceptions of physical activity and technology enabled exercise interventions among people with advanced chronic kidney disease: a qualitative study
Authors: Weber Mary Beth , Ziolkowski Susan , Bootwala Ahad , Bienvenida Alan , Anand Shuchi , Lobelo Felipe
Published: November 2021

Background

Exercise improves health outcomes and quality of life in persons with chronic kidney disease (CKD). The numbers of persons with advanced CKD meeting physical activity guidelines however is low. We undertook a qualitative study of men and women aged 36–74 from various race/ethnic populations with advanced CKD not requiring dialysis to describe their experiences and opinions around prior physical activity, motivating factors for and barriers to exercise, and perceptions of exercise-promoting technology and group-based programming designed to improve physical activity levels.

Methods

Nineteen persons with advanced CKD not requiring dialysis were interviewed at two high volume nephrology clinics enriched with racial/ethnic minority patients (Emory University and Santa Clara Valley Medical Center). We used thematic analysis to identify dominant themes (n = 4) and subthemes (n = 19) around exercise experience, barriers, motivators, views, and preferences.

Results

Four dominant themes and 19 subthemes were identified. The most common motivators to exercise included physical and mental health benefits, appearance, improvement in energy levels, and potential social interaction in group-based programs. Common barriers included health concerns, particularly complications related to other co-morbidities, as well as time and transportation constraints. Participants were skeptical of exercise programs solely reliant on technology.

Conclusions

The use of group-based exercise programs may motivate persons with CKD to increase exercise levels, while programs entirely based on technology may be less effective.
Study on the application of King’s combined uterine suture for hemostasis during cesarean section
Authors: Xia Li , Lin Jinxiao , Dai Yan , Wang Xinrui
Published: November 2021

Introduction

Postpartum hemorrhage is a serious complication of childbirth and is still the leading cause of maternal death worldwide. Lower uterine segment hemorrhage during cesarean section is an important cause of postpartum hemorrhage. Our objective is to expore the efficacy and safety of King’s combined uterine suture for hemostasis during cesarean section.

Methods

We examined 48 cases: 16 cases of pernicious placenta previa (including one case of twins), 11 cases of central placenta previa (including one case of twins), 18 cases of uterine scarring (including two cases of twins), as well as one case of twin pregnancy, two cases of breech presentation, and one case of pulmonary hypertension. The “King’s combined uterine suture” method for hemostasis was used in patients with lower uterine segment hemorrhage during cesarean section.

Results

The results showed that all patients had successful hemostasis during surgery, and there were no cases of hysterectomy.

Conclusion

We have concluded that King’s combined uterine suture is a fast and safe hemostasis method for cesarean section that can effectively reduce blood loss and restore the normal shape of the lower uterine segment. Furthermore, this suture method can reduce postpartum hemorrhage and hysterectomy rate, as well as improve maternal prognosis.
Protein deubiquitylase USP3 stabilizes Aurora A to promote proliferation and metastasis of esophageal squamous cell carcinoma
Authors: Shi Ke , Zhang Jin Zhong , Yang Liang , Li Ning-Ning , Yue Ying , Du Xiu-Hong , Zhang Xiu-Zhi , Lu Yu Cheng , Guo Dan
Published: November 2021

Aurora A kinase is a cell cycle regulator that is dysregulated in several different malignancies. Nevertheless, its regulatory mechanisms are still not fully understood. Here, we report that ubiquitin specific peptidase 3 (USP3) promotes proliferation and metastasis of esophageal squamous cell carcinoma (ESCC) cells by mediating deubiquitination of Aurora A. Analysis of human clinical samples indicated that USP3 and Aurora A are highly expressed in ESCC. Cellular experiments confirmed that high expression of USP3 and Aurora A in ESCC cells promoted malignant cell proliferation and invasion. In this mechanism, USP3 leads to suppression of Aurora A ubiquitination, resulting less proteasome degradation. We constructed the deubiquitinated mimetic K143R of Aurora A and found that K143R significantly promoted the proliferation and invasion of ESCC cells and was not regulated by the deubiquitination of USP3. Moreover, Aurora A K143R potentiated the kinase activity of Aurora A in ESCC cells. Thus, our findings demonstrate that the tumorigenic feature of ESCC is in part mediated by USP3-facilitated deubiquitination of Aurora A.