bluuebunny/crossref_metadata_2025 huggingface dataset:
Non-calcific aortic tissue quantified from computed tomography angiography improves diagnosis and prognostication of patients referred for transcatheter aortic valve implantation
Authors: Grodecki Kajetan , Tamarappoo Balaji K , Huczek Zenon , Jedrzejczyk Szymon , Cadet Sebastien , Kwiecinski Jacek , Rymuza Bartosz , Parma Radoslaw , Olasinska-Wisniewska Anna , Fijalkowska Jadwiga , Protasiewicz Marcin , Walczak Andrzej , Nowak Adrianna , Gocol Radoslaw , Slomka Piotr J , Reczuch Krzysztof , Jagielak Dariusz , Grygier Marek , Wojakowski Wojciech , Filipiak Krzysztof J , Dey Damini
Published: October 2020

Aims

We aimed to investigate the role of aortic valve tissue composition from quantitative cardiac computed tomography angiography (CTA) in patients with severe aortic stenosis (AS) for the differentiation of disease subtypes and prognostication after transcatheter aortic valve implantation (TAVI).

Methods and results

Our study included 447 consecutive AS patients from six high-volume centres reporting to a prospective nationwide registry of TAVI procedures (POL-TAVI), who underwent cardiac CTA before TAVI, and 224 matched controls with normal aortic valves. Components of aortic valve tissue were identified using semi-automated software as calcific and non-calcific. Volumes of each tissue component and composition [(tissue component volume/total tissue volume) × 100%] were quantified. Relationship of aortic valve composition with clinical outcomes post-TAVI was evaluated using Valve Academic Research Consortium (VARC)-2 definitions.

High-gradient (HG) AS patients had significantly higher aortic tissue volume compared to low-flow low-gradient (LFLG)-AS (1672.7 vs. 1395.3 mm3, P < 0.001) as well as controls (509.9 mm3, P < 0.001), but increased non-calcific tissue was observed in LFLG compared to HG patients (1063.6 vs. 860.2 mm3, P < 0.001). Predictive value of aortic valve calcium score [area under the curve (AUC) 0.989, 95% confidence interval (CI): 0.981–0.996] for severe AS was improved after addition of non-calcific tissue volume (AUC 0.995, 95% CI: 0.991–0.999, P = 0.011). In the multivariable analysis of clinical and quantitative computed tomography parameters of aortic valve tissue, non-calcific tissue volume [odds ratio (OR) 5.2, 95% CI 1.8–15.4, P = 0.003] and history of stroke (OR 2.6, 95% CI 1.1–6.5, P = 0.037) were independent predictors of 30-day major adverse cardiovascular event (MACE).

Conclusion

Quantitative CTA assessment of aortic valve tissue volume and composition can improve detection of severe AS, differentiation between HG and LFLG-AS in patients referred for TAVI as well as prediction of 30-day MACEs post-TAVI, over the current clinical standard.
Methodological quality and risk of bias in orthodontic systematic reviews using AMSTAR and ROBIS
Authors: Hooper Emily J , Pandis Nikolaos , Cobourne Martyn T , Seehra Jadbinder
Published: October 2020

Background

This study aimed to compare the methodological quality and risk bias of orthodontic systematic reviews (SRs) using the AMSTAR (Assessing the Methodological Quality of Systematic Reviews) and ROBIS (Risk of Bias in Systematic Review) tools.

Materials and Methods

A search of electronic databases (OVID and Medline) was undertaken to identify orthodontic SRs published in five primary orthodontic journals (January 2015 to December 2018) and the Cochrane Library of Systematic Reviews (January 2000 to January 2018). Full articles were reviewed by two assessors against the eligibility criteria. Methodological quality of each SR was gauged using the AMSTAR tool with a score of 0 or 1 given for each of the 11 items. Cumulative totals were calculated and scores between 4 and 8 represented poor to fair methodological quality and 9 or greater deemed to be good. As per the ROBIS tool, the risk of bias (ROB) for each domain was assessed and the overall ROB was classified as low, high, or unclear.

Results

A total of 91 SRs were included. The median AMSTAR score was 8 (IQR = 3). The methodological quality of 47.3% SRs was rated good. SRs without protocol registration (Coef: −3.00, 95% CI: −3.72, −2.28, P < 0.001) and American continent SRs (Coef: −1.00, 95% CI: −1.72, −0.21, P = 0.007) were associated with lower AMSTAR scores. A total of 56.0% SRs were rated a low ROB, with a lower ROB apparent in multicentre SRs (OR: 0.27, 95% CI: 0.11, 0.64, P = 0.003) and a higher ROB evident in SRs without a registered protocol (OR: 111.81, 95% CI: 22.34, 559.62, P < 0.001). When adjusted for the effect of AMSTAR score on ROB, a higher ROB was associated with SRs without protocol registration (OR: 32.24, 95% CI: 6.03, 172.44, P ≤ 0.001). As the AMSTAR score (per unit) increased, the odds of having a high ROB rating decreased (OR: 0.31, 95% CI: 0.21, 0.45, P ≤ 0.001).

Conclusions

As the methodological quality rating of orthodontic SRs increases, a reduction in the ROB is evident.
Improved Equations for the Density Management Diagram Isolines of Ponderosa Pine Stands
Authors: Jang Woongsoon , Ritchie Martin W , Zhang Jianwei
Published: October 2020

This study was conducted to improve estimation of concomitant variables for implementation of a stand density management diagram (SDMD) for ponderosa pine (Pinus ponderosa Laws.) in northern California and Oregon. In traditional SDMD, isolines for variables such as stand volume are presented in such a way that uncertainty with estimation is not available. We developed the new top height and stand volume equations, as well as aboveground biomass and percent canopy cover, for building isolines in the SDMD using high-quality data collected from well-managed even-aged stands. The data were selected from the USDA Forest Service’s Pacific Southwest Research Station database. A total of 829 observations (from 113 plots across 15 sites in Oregon and California) were used for model construction. In addition, covariance-variance structures of all of the estimated parameters were provided so that users can evaluate the uncertainty associated with predictions. The model validation results indicated that the predictions made from fixed-effects model forms performed better than the current volume equation of SDMD, as well as those from mixed-effects model forms using the population average effect. The proposed equations provide enhanced predictions and additional useful information about managed ponderosa pine stands, including their uncertainty.
Functions of Presynaptic Voltage-gated Calcium Channels
Authors: Dolphin Annette C
Published: October 2020

Voltage-gated calcium channels are the principal conduits for depolarization-mediated Ca2+ entry into excitable cells. In this review, the biophysical properties of the relevant members of this family of channels, those that are present in presynaptic terminals, will be discussed in relation to their function in mediating neurotransmitter release. Voltage-gated calcium channels have properties that ensure they are specialized for particular roles, for example, differences in their activation voltage threshold, their various kinetic properties, and their voltage-dependence of inactivation. All these attributes play into the ability of the various voltage-gated calcium channels to participate in different patterns of presynaptic vesicular release. These include synaptic transmission resulting from single action potentials, and longer-term changes mediated by bursts or trains of action potentials, as well as release resulting from graded changes in membrane potential in specialized sensory synapses.
“Goodness and Kindness”: Long-Distance Caregiving Through Volunteers During the COVID-19 Lockdown in India
Authors: Roy Senjooti , Ayalon Liat
Published: October 2020

Objectives

The first Covid-19 lockdown in India was announced on March 24, 2020, with less than 4 hours’ notice, leaving older adults without access to domestic help and paid caregivers. As traditional caregiving models ceased to function in the new setup, relatives of older adults turned to strangers and volunteers in an effort to provide urgent care to their older family members. This study explores the role of volunteers in meeting the immediate needs of older adults during the lockdown.

Methods

A pan-India group of volunteers was formed during the lockdown on a popular social media website to connect people of all ages in need of help with those able to offer assistance. A sample of 242 messages pertaining to older adults was extracted for quantitative content analysis.

Results

All but 2 requests were placed by adult relatives of older adults. Requests covered a number of needs, some of which were directly tied to the pandemic and lockdown, while others were general in nature but were greatly exacerbated by recent events.

Discussion

The use of social media to encourage acts of kindness at a time of crisis was an innovative attempt to meet the immediate needs of older adults. The lockdown, however, exposed the lack of dedicated supports and services for older adults in India.
Deeply Discrediting: A Systematic Review Examining the Conceptualizations and Consequences of the Stigma of Working in Aged Care
Authors: Manchha Asmita V , Walker Nicole , Way Kïrsten A , Dawson Danielle , Tann Ken , Thai Michael
Published: October 2020

Background and Objectives

The stigma of working in aged care can discredit and devalue those working in gerontology. This overlooked workforce issue may underpin complex staffing challenges like chronic worker shortages and inadequate care delivery. Our review synthesizes the existing literature and introduces a conceptual framework based on linguistics to reconcile disparate conceptualizations and negative consequences of this stigma.

Research Design and Methods

We conducted a systematic review and assessed peer-reviewed articles published from 1973 to 2019 across 5 databases. Fifty-nine articles were selected based on criteria grounded in stigma theory.

Results

Only 10 articles explicitly used the term “stigma” when conceptualizing the stigma of working in aged care. An additional 49 articles conceptualized this stigma in terms of stigma processes (e.g., status loss). Findings from a deeper examination using a linguistic analysis revealed societal groups predominantly conceptualized stigma in 3 distinct ways based on (a) unfavorable character judgment of aged care workers, (b) lower value placed on aged care work, and (c) negative emotional reactions towards working in aged care. Last, stigma was associated with adverse psychological and job-related consequences.

Discussion and Implications

Reconceptualizing this workforce issue and recognizing it as a societal challenge will enable policymakers to design evidence-based interventions at industry and societal levels. We propose workforce challenges in the aged care sector such as attraction, retention, and well-being may lessen with interventions aimed at mitigating the stigma of working in aged care.
Machine-learning model to predict the cause of death using a stacking ensemble method for observational data
Authors: Kim Chungsoo , You Seng Chan , Reps Jenna M. , Cheong Jae Youn , Park Rae Woong
Published: October 2020

Objective

Cause of death is used as an important outcome of clinical research; however, access to cause-of-death data is limited. This study aimed to develop and validate a machine-learning model that predicts the cause of death from the patient’s last medical checkup.

Materials and Methods

To classify the mortality status and each individual cause of death, we used a stacking ensemble method. The prediction outcomes were all-cause mortality, 8 leading causes of death in South Korea, and other causes. The clinical data of study populations were extracted from the national claims (n = 174 747) and electronic health records (n = 729 065) and were used for model development and external validation. Moreover, we imputed the cause of death from the data of 3 US claims databases (n = 994 518, 995 372, and 407 604, respectively). All databases were formatted to the Observational Medical Outcomes Partnership Common Data Model.

Results

The generalized area under the receiver operating characteristic curve (AUROC) of the model predicting the cause of death within 60 days was 0.9511. Moreover, the AUROC of the external validation was 0.8887. Among the causes of death imputed in the Medicare Supplemental database, 11.32% of deaths were due to malignant neoplastic disease.

Discussion

This study showed the potential of machine-learning models as a new alternative to address the lack of access to cause-of-death data. All processes were disclosed to maintain transparency, and the model was easily applicable to other institutions.

Conclusion

A machine-learning model with competent performance was developed to predict cause of death.
Referral Patterns of Burn Injury in Rural Kenya
Authors: Hunter Mary A , Sylvester Kimutai , White Russell E , Harrington David T , Vivier Patrick M , Parker Robert K
Published: October 2020

Burn injury represents a substantial burden of disease in resource-limited settings. Kenya has no formal trauma system and referral practices for burn injuries are not well understood. The purpose of this study was to determine the factors associated with burn injury referrals in rural Kenya. A retrospective chart review was conducted for patients with burn injury from January 1, 2014 to December 31, 2017 at a 300-bed faith-based, teaching hospital in southwest Kenya. Bivariate analysis compared referred and non-referred patients. Multivariable logistic regression was used to assess the association between burn severity and odds of referral adjusting for age, sex, insurance, time from injury to arrival, and estimated travel time from home to hospital. The study included 171 patients with burn injury; 11 patients were excluded due to missing referral data. Of the 160 patients, 31.9% (n = 51) were referred. Referral patients had higher average total body surface area burn (23.1 ± 2.4% vs 11.1 ± 1.2%, P < .001), were more likely to have full-thickness burns (41.3% vs 25.5%, P = .05), and less likely to present to the referral hospital within 24 hours after injury (47.8% vs 73.0%, P = .005). Referral patients had longer travel time to hospital (90+ min: 52.9% vs 22.0%, P < .001). Odds of referral increased 1.62 times (95% confidence interval: 1.19–2.22) for every 10% increase in total body surface area burn. Without a coordinated trauma system, referrals represent a substantial portion of burn injury patients at a hospital in rural Kenya. Referred patients present with more severe burns and experience delays to presentation.
Raising Boys for the Navy: Health, Welfare, and the British Sea Services, 1870-1905
Authors: Juzda Smith Elise
Published: October 2020

Efforts to improve the quality and quantity of seafarers in the Royal Navy and merchant service became a particular concern amidst the degeneration debates of late-Victorian Britain. Maritime reformers not only promoted fitness in adult sailors, but also particularly sought to improve health and physique of boy recruits in order to rear a new generation of healthy sailors. This article shows how both services experimented with tighter admission criteria and dietary and exercise reforms, and became early advocates of using metrical standards to exclude all but the fittest, healthiest boys from training opportunities. While the physical monitoring of boy recruits undoubtedly showed the value of early lifestyle interventions in fostering healthy development, the rising physical standards of British seafarers in this period was just as much the result of restrictive medical examinations as a commitment to welfare initiatives.
Low-Dose Radiation Therapy for COVID-19: Promises and Pitfalls
Authors: Venkatesulu Bhanu P , Lester Scott , Hsieh Cheng-En , Verma Vivek , Sharon Elad , Ahmed Mansoor , Krishnan Sunil
Published: October 2020

The coronavirus disease-2019 (COVID-19) pandemic caused by SARS-CoV-2 has exacted an enormous toll on healthcare systems worldwide. The cytokine storm that follows pulmonary infection is causally linked to respiratory compromise and mortality in the majority of patients. The sparsity of viable treatment options for this viral infection and the sequelae of pulmonary complications have fueled the quest for new therapeutic considerations. One such option, the long-forgotten idea of using low-dose radiation therapy, has recently found renewed interest in many academic centers. We outline the scientific and logistical rationale for consideration of this option and the mechanistic underpinnings of any potential therapeutic value, particularly as viewed from an immunological perspective. We also discuss the preliminary and/or published results of prospective trials examining low-dose radiation therapy for COVID-19.
Topical Review: Examining Multidomain Pain Resilience in Late Adolescents and Young Adults
Authors: Palit Shreela , Palermo Tonya M , Fillingim Roger B , Bartley Emily J
Published: October 2020

Objective

Upwards of 14% of late adolescents and young adults (AYAs) experience chronic pain; however, limited research has focused on factors specifically influencing late AYAs as they transition to adulthood. In this topical review, we propose a conceptual model of multidomain pain resilience (MDPR) in late AYAs with chronic pain that extends existing pain resilience literature, including the Ecological Resilience-Risk Model for Pediatric Chronic Pain.

Method

A conceptual framework for MDPR in late AYAs was developed from the existing literature on resilience in young people with chronic pain. Gaps in knowledge specific to late AYAs are identified, and relevant research examining MDPR in adults with pain are summarized to inform applications of this concept to youth as they transition to adulthood.

Results

Few studies have explored resilience factors in pediatric pain. Of note, these endeavors have largely neglected late adolescence and young adulthood, despite unique considerations germane to this crucial developmental period. Existing research has also focused exclusively on assessing resilience as a unitary, rather than a multidimensional construct. Although limited, MDPR has been examined in midlife and older adults with chronic pain, highlighting the need to expand prior models of pain resilience and extend these principles to emerging adulthood.

Conclusions

Understanding MDPR in late AYAs with chronic pain may provide insights regarding measurable and modifiable resilience factors (e.g., adaptive and personal resources) that promote healthy pain-related outcomes (e.g., reduced pain and enhanced physical functioning) and optimize prevention and/or treatment strategies for this group.
Designing Versailles: landscapes and the perspectival peace
Authors: O’Donnell Thérèse
Published: October 2020

This article analyses the 1919 peace treaty’s signing at Versailles, and what the magnificent staging signalled about the peace terms, notably regarding power and emerging notions of self-determination. In 1919, international society appeared to be on the threshold of a new era. However, a dissonance emerged between the peacemakers’ proclamations and the operationalisation of new principles of openness and emancipation. Certain royal houses and empires may have vanished but the remaining power-holders were not about to relinquish their dominance. While the familiar, blunt-edged tools of brazen colonialism were no longer available, some finer instruments and skilled professional expertise would finesse the details of an unequal hegemonic future. In all senses, this was a design project and in acknowledgement of Versailles’s backdrop and the peacemakers’ cartographic approach, landscape architecture’s specialist principles offer a lens for comprehending and critiquing the legal-political practices of Versailles 1919.
“What Race Problem?”: The Satirical Gaze of (White) History in The Underground Railroad
Authors: Heneks Grace
Published: October 2020

This essay brings critical discourse on whiteness into conversation with African American satire to demonstrate how Colson Whitehead's The Underground Railroad (2016) engages in both traditional and postmodern forms of satire to trouble our assumptions about the function of historical fiction in a post-truth era. Whitehead satirizes various moments in American history to show how white power is maintained through a dialectic of fear. Whitehead's novel claims control over the white gaze by asserting a satirical black gaze, rendering established (white) history the subject of scrutiny. Through an engagement with W. E. B. Du Bois's “The Souls of White Folk” (1920) and bell hooks's “The Oppositional Gaze” (1992), I demonstrate how Whitehead utilizes satire to subvert this white gaze of history. When, in our contemporary post-truth moment, facts are ignored or repudiated—when reality looks disturbingly similar to “fake news”—and when the US president is a former reality television star with a nostalgic desire to “make America great again,” satire emerges as a way to throw the ridiculous into sharp, biting relief. The Underground Railroad exposes how an underlying (white) fear of black liberty and power contributes to the violence committed against black people throughout history, thereby demanding we take an oppositional look at American history in the ongoing project of emancipation.
EVLncRNAs 2.0: an updated database of manually curated functional long non-coding RNAs validated by low-throughput experiments
Authors: Zhou Bailing , Ji Baohua , Liu Kui , Hu Guodong , Wang Fei , Chen Qingshuai , Yu Ru , Huang Pingping , Ren Jing , Guo Chengang , Zhao Huiying , Zhang Hongmei , Zhao Dongbo , Li Zhiwei , Zeng Qiangcheng , Yu Jiafeng , Bian Yunqiang , Cao Zanxia , Xu Shicai , Yang Yuedong , Zhou Yaoqi , Wang Jihua
Published: October 2020

Long non-coding RNAs (lncRNAs) play important functional roles in many diverse biological processes. However, not all expressed lncRNAs are functional. Thus, it is necessary to manually collect all experimentally validated functional lncRNAs (EVlncRNA) with their sequences, structures, and functions annotated in a central database. The first release of such a database (EVLncRNAs) was made using the literature prior to 1 May 2016. Since then (till 15 May 2020), 19 245 articles related to lncRNAs have been published. In EVLncRNAs 2.0, these articles were manually examined for a major expansion of the data collected. Specifically, the number of annotated EVlncRNAs, associated diseases, lncRNA-disease associations, and interaction records were increased by 260%, 320%, 484% and 537%, respectively. Moreover, the database has added several new categories: 8 lncRNA structures, 33 exosomal lncRNAs, 188 circular RNAs, and 1079 drug-resistant, chemoresistant, and stress-resistant lncRNAs. All records have checked against known retraction and fake articles. This release also comes with a highly interactive visual interaction network that facilitates users to track the underlying relations among lncRNAs, miRNAs, proteins, genes and other functional elements. Furthermore, it provides links to four new bioinformatics tools with improved data browsing and searching functionality. EVLncRNAs 2.0 is freely available at https://www.sdklab-biophysics-dzu.net/EVLncRNAs2/.
Aging Patient Population With Ruptured Aneurysms: Trend Over 28 Years
Authors: Feghali James , Gami Abhishek , Rapaport Sarah , Bender Matthew T , Jackson Christopher M , Caplan Justin M , McDougall Cameron G , Huang Judy , Tamargo Rafael J
Published: October 2020

BACKGROUND

Given increasing life expectancy in the United States and worldwide, the proportion of elderly patients affected by aneurysmal subarachnoid hemorrhage (aSAH) would be expected to increase.

OBJECTIVE

To determine whether an aging trend exists in the population of aSAH patients presenting to our institution over a 28-yr period.

METHODS

A prospectively maintained database of consecutive patients presenting to our institution with subarachnoid hemorrhage between January 1991 and December 2018 was utilized. The 28-yr period was categorized into 4 successive 7-yr quarter intervals. The age of patients was compared among these intervals, and yearly trends were derived using linear regression.

RESULTS

The cohort consisted of 1671 ruptured aneurysm patients with a mean age of 52.8 yr (standard deviation = 15.0 yr). Over the progressive 7-yr time intervals during the 28-yr period, there was an approximately 4-fold increase in the proportion of patients aged 80 yr or above (P < .001) and an increase in mean patient age from 51.2 to 54.6 yr (P = .002). Independent of this trend but along the same lines, there was a 29% decrease in the proportion of younger patients (<50 yr) from 49% to 35%. On linear regression, there was 1-yr increase in mean patient age per 5 calendar years (P < .001).

CONCLUSION

Analyses of aSAH patients demonstrate an increase in patient age over time with a considerable rise in the proportion of octogenarian patients and a decrease in patients younger than 50 yr. This aging phenomenon presents a challenge to the continued improvement in outcomes of aSAH patients.
Hepatitis C Seroprevalence Among Consecutive Labor and Delivery Admissions in Two New York City Hospitals
Authors: Kushner Tatyana , Park Claire , Masand Dana , Wagner Brian , Grace Marie , Rosenbluth Emma , Rodriguez-Rivas Clara , de la Cruz Hernis , Overbey Jessica , Sperling Rhoda
Published: October 2020

Background

Rates of hepatitis C virus (HCV) among women of childbearing age have increased as a result of the opioid epidemic, especially in the nonurban white population. Recently updated US Preventative Services Task Force and Centers for Disease Control and Prevention guidance have recommended universal HCV screening during pregnancy, but obstetrics societies have not yet endorsed this recommendation. We evaluated the seroprevalence of HCV among pregnant women in an inner-city population, compared rates with other sexually transmitted infections (STIs) screened for during pregnancy, and evaluated factors associated with HCV positivity.

Methods

We performed a prospective seroprevalence study of consecutive labor and delivery admissions (both antepartum complications and delivery admissions) by testing serum samples for HCV antibody over 9 months at 2 major hospital settings in New York City.

Results

Fifty-six of 7373 (0.75%; 95% confidence interval [CI], 0.57–0.98) patients screened positive for HCV, with 28 of 4013 (0.70%; 95% CI, 0.46%–1.01%) and 28 of 3413 (0.82%; 95% CI, 0.55%–1.18%) at each hospital. Forty-one percent of HCV-positive patients had any reported HCV risk factors. Hepatitis C virus-positive patients were less likely to have private insurance and more likely to have a history of cannabis, cocaine, and injection drug use (P < .001). The HCV rates were higher among antepartum admissions compared with delivery admissions and higher than that of hepatitis B virus (0.65%; 95% CI, 0.48–0.86), human immunodeficiency virus (0.27%; 95% CI, 0.16–0.42), and syphilis (0.16%; 95% CI, 0.08–0.28).

Conclusions

We found a higher than expected HCV seroprevalence among pregnant women and higher than most other STIs routinely screened for in pregnancy. Most patients had no risk factors. These findings support universal screening for hepatitis C during pregnancy.
Rapid identification of Nocardia cyriacigeorgica from a brain abscess patient using MALDI-TOF-MS
Authors: AlMogbel Mohammed , AlBolbol Mohammed , Elkhizzi Noura , AlAjlan Hisham , Hays John Philip , Khan Mushtaq Ahmad
Published: October 2020

Nocardia cyriacigeorgica (N. cyriacigeorgica) is most frequently associated with human infections, including chronic bronchitis, pulmonary disease and brain abscesses. In general, N. cyriacigeorgica causes infections in immunocompromised individuals and has been reported in clinical samples worldwide. However, the isolation and speciation of N. cyriacigeorgica in the routine diagnostic microbiology laboratory are complicated and time consuming. Recent mass spectrometry techniques such as matrix-assisted laser desorption/ionization time-of-flight-mass spectrometry (MALDI-TOF-MS) have been successfully integrated into many routine diagnostic microbiology laboratories, allowing for the rapid, accurate and simple identification and speciation of many different microorganisms, including difficult-to-identify bacterial species. Here, we present a case report of a 65-year-old female patient from the neurology ward of Prince Sultan Military Medical City in Riyadh, Saudi Arabia, who was infected with N. cyriacigeorgica. The bacterium was successfully identified by MALDI-TOF-MS, with species identification subsequently confirmed by sequence analysis of the 16S ribosomal RNA.
Lupus myocarditis in an octogenarian patient—a case report
Authors: Shemesh Elad , Abu Akel Mahmood , Feld Joy , Zisman Devy , Hijaze Nizar , Hamdan Ashraf , Zissman Keren
Published: October 2020

Lupus myocarditis is a relatively rare manifestation of systemic lupus erythematosus. The majority of patients who experience myocardial involvement are females of young age. Here, we report a case of an 87-year-old male who was hospitalized because of perimyocarditis 2 weeks after undergoing percutaneous coronary intervention. Despite standard therapy his condition worsened, biomarkers and inflammation indices remained elevated, and pericardial effusion accumulated. The use of cardiac magnetic resonance (CMR) imaging, along with thorough history taking and testing for relevant antibodies allowed to establish the unusual diagnosis of lupus myocaridits. We demonstrate that lupus myocarditis may occur even in elderly males, as supported by characteristic CMR features.
Macrophage activation syndrome in children with Kawasaki disease: an experience from a tertiary care hospital in northwest India
Authors: Pilania Rakesh Kumar , Jindal Ankur Kumar , Johnson Nameirakpam , Prithvi Ashwini , Vignesh Pandiarajan , Suri Deepti , Rawat Amit , Gupta Anju , Singh Surjit
Published: October 2020

Objectives

To carry out a review of clinical characteristics, laboratory profiles, management and outcomes of patients with Kawasaki disease (KD) and macrophage activation syndrome (MAS).

Methods

Medical records of patients treated for KD and MAS between January 1994 and December 2019 were reviewed. Patient demographics, clinical signs, laboratory values, coronary artery abnormalities, treatments and outcomes of patients with KD and MAS were recorded. We also performed a review published studies on the subject.

Results

Of the 950 cases with KD, 12 (1.3%; 10 boys, 2 girls) were diagnosed with MAS. The median age at diagnosis was 4 years (range 9 months–7.5 years). The median interval between onset of fever and diagnosis of KD was 11 days (range 6–30). Thrombocytopenia was seen in 11 patients. The median pro-brain natriuretic peptide value was 2101 pg/ml (range 164–75 911). Coronary artery abnormalities were seen in 5 (41.7%) patients; 2 had dilatation of the left main coronary artery (LMCA), 1 had dilatation of both the LMCA and right coronary artery (RCA), 1 had dilatation of the RCA and 1 had bright coronary arteries. All patients received IVIG as first-line therapy for KD. MAS was treated with i.v. methylprednisolone pulses followed by tapering doses of oral prednisolone. Additional therapy included i.v. infliximab (n = 4), second-dose IVIG (n = 1) and oral ciclosporin (n = 1).

Conclusion

MAS is an unusual and underrecognized complication of KD. In our cohort of 950 patients with KD, 1.3% had developed MAS. KD with MAS is associated with an increased propensity towards development of coronary artery abnormalities.
The Politics of Labels: Imperial Categorisations and the Marginalisation of Ethnomedicine in Nigeria during the Twentieth Century
Authors: Williams Ogechukwu E
Published: October 2020

The names imposed on traditional medical institutions in colonial Nigeria criminalised and designated ethnomedical practitioners as quacks, charlatans and ‘witch doctors’ whose practices lacked merit. These labels shifted throughout the colonial and post-colonial era based on imperial politics and biomedical interests. Drawing from medical reports, anthropological essays and archival documents, this article explores twentieth-century colonial and post-colonial labels assigned to ethnomedicine in Nigeria as a strategy for delegitimisation and reflects on the post-colonial implications of such labels. Various scholars have explored the role of medicine in creating classification systems that were essential to the operation of colonial power. The article extends this body of literature by exploring the impacts of specific labels and naming patterns on representations of ethnomedicine throughout the twentieth century. It examines the various ways, including Nigeria’s extensive Nollywood film industry, through which stereotypes from pre-1960s labels continued to be propagated well beyond the colonial era.
Trajectories of sleep problems in childhood: associations with mental health in adolescence
Authors: Shimizu Mina , Zeringue Megan M , Erath Stephen A , Hinnant J Benjamin , El-Sheikh Mona
Published: October 2020

Study Objectives

We examined initial levels (intercepts) of sleep–wake problems in childhood and changes in sleep–wake problems across late childhood (slopes) as predictors of externalizing behavior problems, depressive symptoms, and anxiety in adolescence. To ascertain the unique effects of childhood sleep problems on adolescent mental health, we controlled for both childhood mental health and adolescent sleep problems.

Methods

Participants were 199 youth (52% boys; 65% White/European American, 35% Black/African American). Sleep–wake problems (e.g. difficulty sleeping and waking up in the morning) were assessed during three time points in late childhood (ages 9, 10, and 11) with self-reports on the well-established School Sleep Habits Survey. At age 18, multiple domains of mental health (externalizing behavior problems, depressive symptoms, and anxiety) and sleep–wake problems were assessed.

Results

Latent growth curve modeling revealed that children with higher levels of sleep–wake problems at age 9 had consistently higher levels of such problems between ages 9 and 11. The initial level of sleep–wake problems at age 9 predicted externalizing behaviors, depressive symptoms, and anxiety at age 18, controlling for mental health in childhood and concurrent sleep–wake problems in adolescence. The slope of sleep–wake problems from ages 9 to 11 did not predict age 18 mental health.

Conclusions

Youth who had higher sleep–wake problems during late childhood had higher levels of mental health problems in adolescence even after controlling for childhood mental health and concurrent sleep–wake problems. Findings illustrate that childhood sleep problems may persist and predict adolescent mental health even when potentially confounding variables are rigorously controlled.
Cross-sectional and prospective associations between sleep regularity and metabolic health in the Hispanic Community Health Study/Study of Latinos
Authors: Fritz Josef , Phillips Andrew J K , Hunt Larissa C , Imam Akram , Reid Kathryn J , Perreira Krista M , Mossavar-Rahmani Yasmin , Daviglus Martha L , Sotres-Alvarez Daniela , Zee Phyllis C , Patel Sanjay R , Vetter Céline
Published: October 2020

Study Objectives

Sleep is an emergent, multi-dimensional risk factor for diabetes. Sleep duration, timing, quality, and insomnia have been associated with diabetes risk and glycemic biomarkers, but the role of sleep regularity in the development of metabolic disorders is less clear.

Methods

We analyzed data from 2107 adults, aged 19–64 years, from the Sueño ancillary study of the Hispanic Community Health Study/Study of Latinos, followed over a mean of 5.7 years. Multivariable-adjusted complex survey regression methods were used to model cross-sectional and prospective associations between the sleep regularity index (SRI) in quartiles (Q1-least regular, Q4-most regular) and diabetes (either laboratory-confirmed or self-reported antidiabetic medication use), baseline levels of insulin resistance (HOMA-IR), beta-cell function (HOMA-β), hemoglobin A1c (HbA1c), and their changes over time.

Results

Cross-sectionally, lower SRI was associated with higher odds of diabetes (odds ratio [OR]Q1 vs. Q4 = 1.64, 95% CI: 0.98–2.74, ORQ2 vs. Q4 = 1.12, 95% CI: 0.70–1.81, ORQ3 vs. Q4 = 1.00, 95% CI: 0.62–1.62, ptrend = 0.023). The SRI effect was more pronounced in older (aged ≥ 45 years) adults (ORQ1 vs. Q4 = 1.88, 95% CI: 1.14–3.12, pinteraction = 0.060) compared to younger ones. No statistically significant associations were found between SRI and diabetes incidence, as well as baseline HOMA-IR, HOMA-β, and HbA1c values, or their changes over time among adults not taking antidiabetic medication.

Conclusions

Our results suggest that sleep regularity represents another sleep dimension relevant for diabetes risk. Further research is needed to elucidate the relative contribution of sleep regularity to metabolic dysregulation and pathophysiology.
Trusts and the Chinese Civil Code: toward a new era of codification
Authors: Qu Jian
Published: October 2020

Starting from 28 May 2020, China, which has long been considered a civil law jurisdiction, finally has its own Civil Code. However, among 1260 articles of the Code, trust is mentioned only once. From a perspective of comparative law, the trust’s appearance in the civil code has always been informative for observing its transplantation process. Thus, by investigating the five rounds of civil law codification in China over decades, as well as the considerable controversy regarding trusts and codification, this article attempts to discuss the reasons, implications, and influences of the legislative result of trusts in the Code.
Intersubject Spatial Pattern Correlations During Movie Viewing Are Stimulus-Driven and Nonuniform Across the Cortex
Authors: Zhang Angela , Farivar Reza
Published: October 2020

A fundamental step to predicting brain activity in healthy and diseased populations is characterizing the common spatio-temporal response to a shared experience. Multivoxel pattern analysis allows us to investigate information encoding through these patterns; however, we have yet to explore local, stimulus-driven, patterns of cortical activity during naturalistic stimulation. We sought to examine these patterns with minimum interpolation—excluding functional alignment—to characterize the most basic degree of shared response between subjects. We used an unbiased analytic approach, combined with rich, naturalistic, and nonsemantic stimulation to estimate shared spatial patterns in functional magnetic resonance imaging responses across a large group. We found that meso-scale spatial patterns were shared nonuniformly across the visual cortex and represent information distinct from the shared temporal response. Shared spatial patterns were stimulus-driven, modulated by pattern size, and more sensitive to the contrast of 3D versus 2D stimulus differences than the temporal signals. Although the grand functional structure of the brain is understood to be common, these results suggest that even at a meso-scale, we share common spatial structures with anatomical alignment alone. The strength of this similarity varies across the cortex, suggesting some spatial structures are innately organized, whereas others are shaped by factors such as learning and plasticity.
Stability of the Initial Diagnosis of Autism Spectrum Disorder by DSM-5 in Children: A Short-Term Follow-Up Study
Authors: Kadam Archana , Patni Bindu , Pandit Anand , Patole Sanjay
Published: October 2020

Background

Assessing the stability of the diagnosis of autism spectrum disorder (ASD) in children is important. Only few such studies have been reported from India. We aimed to assess the stability after 18–30 months, of an initial diagnosis of ASD based on DSM-5, in children ≤ 5 years of age using Autism Diagnostic Observation Schedule, 2nd Edition (ADOS-2).

Methods

A total of 125 children with ASD diagnosed by DSM-5 at ≤ 5 years of age were followed up at 18–30 months using ADOS-2, which is considered as the ‘gold-standard’ observational assessment for diagnosing ASD and hence suitable for confirming the stability of the diagnosis.

Results

Similar to previous studies from developed countries, the stability of ASD diagnosis was 80%. There was no significant correlation between gender, socioeconomic status and the stability of the final diagnosis. All the children continued to have some developmental difficulties mainly in the domain of language, attention or social communication.

Conclusion

Our results suggest that DSM-5 can be used for the initial diagnosis ASD to initiate early intervention for children with this condition in resource-limited set-ups. Adequately powered prospective studies with long-term follow-up are needed to confirm our findings.
Home Oxygen Therapy
Authors: Fields Bronwyn E. , Whitney Robin L. , Bell Janice F.
Published: October 2020

This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home. Nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet—Information for Family Caregivers—and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses.
Considering an Advanced Degree?
Authors: Pilcher Jobeth
Published: October 2020

An advanced degree can expand knowledge and skills, enhance work performance, improve earning potential, increase contributions to the field, and promote a sense of accomplishment. This article provides nurses with a list of factors to consider prior to pursuing an advanced degree, and offers information on available master's and doctoral programs.
Obesity in children and adolescents
Authors: Bradwisch Sarah A. , Smith Erin Murphy , Mooney Catherine , Scaccia Debra
Published: October 2020

Childhood obesity is an epidemic in the US. This article discusses the evolution, prevention, and associated physical and psychosocial consequences of and interventions for obesity in the pediatric population.
The Effects of Hearing Loss on Balance: A Critical Review
Authors: Carpenter Mark G. , Campos Jennifer L.
Published: October 2020

Recent epidemiological findings of associations between hearing loss (HL) and poorer mobility and higher falls risk have increased the demand for ecologically valid experimental research to determine the potential mechanisms underlying human hearing-balance relationships. This review provides an overview of the laboratory-based approaches to studying human balance, identifies crucial factors that should be considered to improve the ecological validity of hearing-balance research, and provides a critical review of the scientific literature to date on the effects of HL on balance. Most present studies can be subdivided into those that examine balance changes due to the effects of (1) auditory suppression in individuals with normal hearing, (2) HL with and without hearing aids, and (3) cochlear implants in children and adults. To allow for meaningful comparisons, we based our in-depth critical review on studies that met minimum criteria of having at least one objective kinetic or kinematic measure of standing balance during a two-legged stance with feet side-by-side, for at stance duration of at least 30 sec. With this minimum criterion in place, we found mixed evidence that hearing suppression, HL, or hearing devices affects postural stability, especially when other sensory information is available and/or reliable, and task demands are relatively low. However, hearing may become more important when multiple sensory systems become unreliable, task demands, or cognitive impairments are greater, or when sounds provide important auditory cues to assist with orientation or provide early detection of an impending balance disturbance. However, more research is clearly needed, because there is a wide range of technical and experimental differences and limitations observed across the present literature. To address these gaps, we have provided a number of recommendations and suggested priorities for future research to provide the ecologically valid, reliable, and reproducible evidence needed to uncover any potential relationships between HL, balance, and falls.
Three New Outcome Measures That Tap Into Cognitive Processes Required for Real-Life Communication
Authors: Lunner Thomas , Alickovic Emina , Graversen Carina , Ng Elaine Hoi Ning , Wendt Dorothea , Keidser Gitte
Published: October 2020

To increase the ecological validity of outcomes from laboratory evaluations of hearing and hearing devices, it is desirable to introduce more realistic outcome measures in the laboratory. This article presents and discusses three outcome measures that have been designed to go beyond traditional speech-in-noise measures to better reflect realistic everyday challenges. The outcome measures reviewed are: the Sentence-final Word Identification and Recall (SWIR) test that measures working memory performance while listening to speech in noise at ceiling performance; a neural tracking method that produces a quantitative measure of selective speech attention in noise; and pupillometry that measures changes in pupil dilation to assess listening effort while listening to speech in noise. According to evaluation data, the SWIR test provides a sensitive measure in situations where speech perception performance might be unaffected. Similarly, pupil dilation has also shown sensitivity in situations where traditional speech-in-noise measures are insensitive. Changes in working memory capacity and effort mobilization were found at positive signal-to-noise ratios (SNR), that is, at SNRs that might reflect everyday situations. Using stimulus reconstruction, it has been demonstrated that neural tracking is a robust method at determining to what degree a listener is attending to a specific talker in a typical cocktail party situation. Using both established and commercially available noise reduction schemes, data have further shown that all three measures are sensitive to variation in SNR. In summary, the new outcome measures seem suitable for testing hearing and hearing devices under more realistic and demanding everyday conditions than traditional speech-in-noise tests.