bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiogenic Shock Complicating Acute Myocardial Infarction Treated With Percutaneous Coronary Intervention Supported by Impella: Implications of Advanced Age and Refractory Shock on Outcomes
Authors: Boshara Andrew , Patel Ami , Alasaad Mohammad , Dutcheshen Karey J. , LaLonde Thomas A. , Schreiber Theodore L. , Mehta Rajendra H. , Kaki Amir , Rosman Howard S.
Published: June 2021

OBJECTIVES:

With percutaneous left ventricular mechanical circulatory support devices becoming increasingly available for patients with cardiogenic shock due to acute myocardial infarction and the lack of a clear mortality benefit to date, identifying optimal candidates for this technology is crucial. We studied the effectiveness of Impella Cardiac Pow (Abiomed, Danvers, MA) in various stages of cardiogenic shock and elderly cohorts.

DESIGN:

Retrospective review.

SETTING:

Data were collected for patients at a single community hospital between January 1, 2018, and December 31, 2019.

SUBJECTS:

Thirty-one consecutive adult patients with cardiogenic shock due to acute myocardial infarction who received Impella Cardiac Pow support. Shock stages were defined by the Society for Cardiovascular Angiography and Intervention (Stages A–E).

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

The primary outcome was in-hospital death across Society for Cardiovascular Angiography and Intervention cardiogenic shock stages and in patients greater than or equal to 80 and less than 80 years old. Secondary outcomes were Valve Academic Research Consortium-2 vascular and bleeding complications, stroke, and renal failure requiring dialysis. The median age of the study population was 64 years, with seven patients (23%) being greater than or equal to 80 years old. No patients were in Society for Cardiovascular Angiography and Intervention Stage A, whereas there were seven in B, eight in C, six in D, and 10 (32%) in E. Overall in-hospital mortality occurred in 61% of patients. All 10 patients in Stage E died before hospital discharge. Mortality occurred in 54% of patients (13/24) age less than 80 years compared with 86% of those 80 years or older (6/7). A total of 38.7% of patients (12/31) and 32.3% of patients (10/31) experienced Valve Academic Research Consortium-2 bleeding and vascular events, which were evenly distributed across Society for Cardiovascular Angiography and Intervention cardiogenic shock Stages.

CONCLUSIONS:

In conclusion, patients with shock in extremis and those 80 years old and older may have a prohibitively high mortality despite Impella use. These findings merit further prospective investigation in a larger number of patients to evaluate the effectiveness of Impella (and other left ventricular mechanical circulatory devices) and the inherent resource utilization in advanced cardiogenic shock and the elderly.
Impact of Different Approaches to Preparing Notes for Analysis With Natural Language Processing on the Performance of Prediction Models in Intensive Care
Authors: Mahendra Malini , Luo Yanting , Mills Hunter , Schenk Gundolf , Butte Atul J. , Dudley R. Adams
Published: June 2021

OBJECTIVES:

To evaluate whether different approaches in note text preparation (known as preprocessing) can impact machine learning model performance in the case of mortality prediction ICU.

DESIGN:

Clinical note text was used to build machine learning models for adults admitted to the ICU. Preprocessing strategies studied were none (raw text), cleaning text, stemming, term frequency-inverse document frequency vectorization, and creation of n-grams. Model performance was assessed by the area under the receiver operating characteristic curve. Models were trained and internally validated on University of California San Francisco data using 10-fold cross validation. These models were then externally validated on Beth Israel Deaconess Medical Center data.

SETTING:

ICUs at University of California San Francisco and Beth Israel Deaconess Medical Center.

SUBJECTS:

Ten thousand patients in the University of California San Francisco training and internal testing dataset and 27,058 patients in the external validation dataset, Beth Israel Deaconess Medical Center.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Mortality rate at Beth Israel Deaconess Medical Center and University of California San Francisco was 10.9% and 7.4%, respectively. Data are presented as area under the receiver operating characteristic curve (95% CI) for models validated at University of California San Francisco and area under the receiver operating characteristic curve for models validated at Beth Israel Deaconess Medical Center. Models built and trained on University of California San Francisco data for the prediction of inhospital mortality improved from the raw note text model (AUROC, 0.84; CI, 0.80–0.89) to the term frequency-inverse document frequency model (AUROC, 0.89; CI, 0.85–0.94). When applying the models developed at University of California San Francisco to Beth Israel Deaconess Medical Center data, there was a similar increase in model performance from raw note text (area under the receiver operating characteristic curve at Beth Israel Deaconess Medical Center: 0.72) to the term frequency-inverse document frequency model (area under the receiver operating characteristic curve at Beth Israel Deaconess Medical Center: 0.83).

CONCLUSIONS:

Differences in preprocessing strategies for note text impacted model discrimination. Completing a preprocessing pathway including cleaning, stemming, and term frequency-inverse document frequency vectorization resulted in the preprocessing strategy with the greatest improvement in model performance. Further study is needed, with particular emphasis on how to manage author implicit bias present in note text, before natural language processing algorithms are implemented in the clinical setting.
Randomized, Placebo-Controlled Phase 1/2 Study to Determine the Appropriate ATX-101 Concentration for Reduction of Submental Fat
Authors: Goodman Greg J. , Spelman Lynda J. , Lowe Nicholas , Bowen Beta
Published: June 2021

BACKGROUND

ATX-101 is indicated for submental fat treatment.

OBJECTIVE

Evaluate ATX-101 versus placebo for reducing submental fat.

MATERIALS AND METHODS

Adults with unwanted submental fat across 6 global sites were randomized to ATX-101 (0.5%, 1.0%, or 2.0%) or placebo for ≤4 treatments every 28 days. Outcomes included safety (adverse events and pain visual analog scale) throughout the study and efficacy (submental fat rating, patient satisfaction, and submental fat improvements) at Week 16.

RESULTS

Eighty-four of 85 enrolled patients received ≥1 ATX-101 treatment (0.5% [n = 20], 1.0% [n = 20], 2.0% [n = 22] or placebo [n = 22]). Most patients (n = 82) experienced adverse events, which were mostly mild/moderate, seemed to be dose-related, and led to no study discontinuations. The mean pain scores were highest in the ATX-101 1.0% and 2.0% groups. Week-16 change from baseline in the submental fat rating scale was significantly greater for ATX-101 0.5% and 1.0% versus placebo (p ≤ .05). At Week 16, 71%, 74%, 53%, and 40% of patients in the ATX-101 0.5%, 1.0%, 2.0%, and placebo groups, respectively, achieved a ≥1-grade reduction in submental fat from baseline. Satisfaction with appearance and patient-assessed global improvement ratings increased in all ATX-101 treatment groups versus placebo.

CONCLUSION

All ATX-101 concentrations were safe and efficacious for moderate/severe submental fat reduction.
Harmful Use of Alcohol as Predictor of Presex Drinking in Mexican Young College Women
Authors: Villegas-Pantoja Miguel A. , Mendez-Ruiz Martha D. , Sánchez-López Lucrecia , Herrera-Paredes José Manuel , Álvarez-Aguirre Alicia
Published: June 2021

Alcohol use presents a serious risk to women's health. Of particular interest is the association of harmful alcohol consumption and risky behaviors, such as drinking before sexual intercourse, an understudied phenomenon in the Mexican population.

Aim

The aim of this study was to identify whether the harmful use of alcohol is associated with an increased probability of presex drinking in Mexican young women.

Method

This was a study with a predictive design. Multiple logistic regressions were performed in a random sample of 304 young college women (between the ages of 18 and 24 years) from Guanajuato and Tamaulipas, Mexico. Participants completed a sociodemographic data survey and the Alcohol Use Disorders Identification Test questionnaire.

Results

Women with a pattern of harmful use of alcohol were more likely to report drinking before sex (adjusted odds ratio = 4.679, 95% confidence interval [1.619, 13.520], McFadden's pseudo R
2 = 25.5%). Further analyses revealed that presex drinking by partners was an even stronger predictor of alcohol use before sexual intercourse in women (adjusted odds ratio = 12.749, 95% confidence interval [4.714, 34.483], McFadden's pseudo R
2 = 34.7%).

Conclusions

The findings demand additional nursing studies to corroborate—and to better understand—the relationship between harmful use of alcohol in Mexican women, their partners' drinking behavior, and unhealthy behaviors like drinking before sexual intercourse.
Older Adult Patients Use More Aminosalicylate Monotherapy Compared With Younger Patients With Inflammatory Bowel Disease
Authors: Barnes Edward L. , Hanson John S. , Regueiro Miguel D. , Saha Sumona , Sands Bruce E. , Rubin David T. , Dubinsky Marla C. , Siegel Corey A. , Gazis Derek R. , Crawford Julie M. , Long Millie D.
Published: June 2021

Goal:

The goal of this study was to describe medication utilization patterns in older inflammatory bowel disease (IBD) patients.

Background:

Despite a growing population of older patients with Crohn’s disease (CD) and ulcerative colitis (UC), questions remain regarding medication utilization patterns in comparison to younger populations.

Materials and Methods:

We collected data from the 34 sites in TARGET-IBD, a multicenter, observational cohort. The primary outcome in this study was the IBD-specific therapy utilized among older patients with IBD compared with younger age groups. Therapy use was analyzed using pairwise comparisons and then the odds of IBD-specific therapy use among patients older than age 65 were evaluated using multivariable logistic regression models.

Results:

We identified 2980 patients with IBD (61% CD). In multivariable analysis, younger patients with UC were significantly less likely to utilize aminosalicylate monotherapy when compared with patients above 65 years [age 18 to 29: adjusted odds ratio (aOR)=0.51, 95% confidence interval (CI): 0.33-0.78]. In patients with CD, younger patients were significantly less likely to use aminosalicylate monotherapy when compared with patients above 65 (greatest difference age 18 to 29: aOR=0.31, 95% CI: 0.18-0.52). Younger patients with CD and UC were significantly more likely to use anti–tumor necrosis factor monotherapy than patients above 65 years (age 18 to 29: aOR=3.87, 95% CI: 2.47-6.06 and aOR=2.68, 95% CI: 1.29-5.58, respectively).

Conclusions:

Older patients with IBD demonstrate significant differences in medication utilization, including more aminosalicylate monotherapy and less anti–tumor necrosis factor monotherapy compared with younger age groups. Given the aging population in the United States, these utilization patterns may have long-term implications for disease control.
A Pilot Randomized Trial of Polypectomy Techniques for 4 to 6 mm Colonic Polyps
Authors: Fatima Hala , Rex Douglas K. , Imperiale Thomas
Published: June 2021

Background and Goals:

There is variation in polypectomy techniques for resection of small polyps. Aim was to compare techniques for 4 to 6 mm polyps for recurrent adenoma, efficiency, and adverse events and to establish methodological factors for definitive trial.

Materials and Methods:

The study was a randomized controlled trial. Outpatients with ≥1, 4 to 6 mm polyps were randomized to cold forceps (CF), cold snare (CS), and hot snare (HS). Polypectomy site was marked with SPOT to assess for recurrence at the original polypectomy site during surveillance colonoscopy. To assess feasibility of a definitive trial we measured (1) rates of patient refusal, participation, ineligibility; (2) retention; (3) recurrent neoplasia; and (4) sample size for a definitive trial.

Results:

Three hundred fifty-three patients were randomized to 1 of the 3 polypectomy techniques, of whom 260 (73.6%) completed the initial colonoscopy (mean age 57 y, 50.4% women), with 91, 87, and 82 patients randomized to CF, CS, and HS polypectomy, respectively. Mean time for polyp resection for CF, CS, and HS were 198.8, 58.5, and 96.8 seconds, respectively, with CS and HS requiring less time than CF (P<0.001). One hundred sixty-four (63.1%) completed surveillance colonoscopy. Polyp recurrences were 9 (14.5%) with CF, 5 (9.6%) with CS, and 0 (0%) with HS. Although the recurrence relative risks with CF and CS polypectomy were 1.84 and 1.65 as compared with HS, respectively, neither was statistically significant.

Conclusions:

CS and HS polypectomy require less time than CF. HS polypectomy may have a lower risk for recurrent neoplasia. High attrition rate is a challenge in conducting randomized controlled trial with polyp recurrence as endpoint.
RNA-sequencing of peripheral blood circular RNAs in Parkinson disease
Authors: Kong Fancong , Lv Zhanyun , Wang Lifang , Zhang Kui , Cai Ying , Ding Qingqing , Sun Zuzhen , Zhen Hefu , Jiao Fengjuan , Ma Qianqian , Nie Chao , Yang Yan
Published: June 2021

Background:

Circular RNAs (circRNAs) play an important role in many neurological diseases and can serve as biomarkers for these diseases. However, the information about circRNAs in Parkinson disease (PD) remained limited. In this study, we aimed to determine the circRNAs expression profile in PD patients and discuss the significance of circRNAs in the diagnosis of PD.

Methods and Results:

Using RNA-sequencing in peripheral blood RNAs, we showed that a significant number of mRNAs or circRNAs were differentially expressed between PD patients and normal controls (NCs), which included 273 up-regulated and 493 down-regulated mRNAs, and 129 up-regulated and 282 down-regulated circRNAs, respectively. Functional analysis was performed using the Kyoto Encyclopedia of Gene and Genomes (KEGG) pathway analysis, and the results showed that the second most enriched KEGG pathway was PD. These data suggest that the levels of mRNAs and circRNAs in peripheral blood could be potentially used as biomarkers for PD. In addition, we correlated mRNAs and circRNAs by constructing a competing endogenous RNA (ceRNA) network in PD. The resulted-in ceRNA network included 10 differentially expressed mRNAs from PD pathway, 13 predicted miRNAs, and 10 differentially expressed circRNAs.

Conclusion:

Collectively, we first characterized the expression profiles of circRNAs and mRNAs in peripheral blood from PD patients and proposed their possible characters in the pathogenesis of PD. These results provided valuable insights into the clues underlying the pathogenesis of PD.
Prognostic factors of chondroblastic osteosarcoma and nomogram development for prediction
Authors: Peng Cheng , Hao Yingjie , Ren Zhinan , Zhu Guangduo , Yu Lei
Published: June 2021

The present study aimed to develop nomograms to predict survival in patients with chondroblastic osteosarcoma (COS).

An analysis was conducted of 320 cases of COS collected from the surveillance, epidemiology, and end results (SEER) database between 2004 and 2015. Independent prognostic factors were screened using univariate and multivariate Cox analyses. Subsequently, nomograms were established to predict the patients’ cancer-specific survival (CSS) and overall survival (OS) rates. The prediction accuracy and discriminative ability of the nomograms were examined using calibration curves and the concordance index (C-index).

As revealed in the univariate and multivariate Cox regression analysis, age, tumor size, the primary site, the presence of metastasis, a history of having undergone surgery, and a history of having received radiotherapy were found to be independent prognostic factors associated with survival in patients with COS (all P < .05). Furthermore, age >39 years, the presence of distant metastasis, no history of having undergone any surgery, and tumor size >103 mm were found to be associated with poor prognosis in patients, while the primary site of the mandible and no history of having undergone radiotherapy showed associations with a more favorable prognosis in patients. Next, nomograms were constructed to predict the OS and CSS in patients with COS.

We constructed nomograms that can provide accurate survival predictions in patients with chondroblastic osteosarcoma. These nomograms can help surgeons customize the treatment strategies for patients with chondroblastic osteosarcoma.
CNKSR2 gene mutation leads to Houge type of X-linked syndromic mental retardation
Authors: Kang Qingyun , Yang Liming , Liao Hongmei , Wu Liwen , Chen Bo , Yang Sai , Kuang Xiaojun , Yang Haiyang , Liao Caishi
Published: June 2021

Rationale:

Mutations of connector enhancer of kinase suppressor of Ras-2 (CNKSR2) gene were identified as the cause of Houge type of X-linked syndromic mental retardation. The mutations of CNKSR2 gene are rare, we reporta patient carrying a novel nonsense mutation of CNKSR2,c.625C > T(p.Gln209∗) and review the clinical features and mutations of CNKSR2 gene for this rare condition considering previous literature.

Patient concerns:

We report a case of a 7-year and 5-month-old Chinese patient with clinical symptoms of intellectual disability, language defect, epilepsy and hyperactivity. Genetic study revealed a novel nonsense variant of CNKSR2, which has not been reported yet.

Diagnosis:

According to clinical manifestations, genetic pattern and ACMG classification of mutation site as Class 1-cause disease, the patient was diagnosed as Houge type of X-linked syndromic mental retardation caused by CNKSR2 gene mutation.

Interventions:

The patient was administrated with a gradual titration of valproic acid (VPA).

Outcomes:

On administration of valproic acid, he had no further seizures.

Lessons:

This is the first time to report a nonsense variant in CNKSR2, c.625C > T(p.Gln209∗), this finding could expand the spectrum of CNKSR2 mutations and might also support the further study of Houge type of X-linked syndromic mental retardation.
Efficacy and safety of chemotherapy combined with different doses of IL-2 maintenance therapies for acute myeloid leukemia
Authors: Yin Xuewei , Ding Yi , Yu Liming , Guo Chenchen , Cui Yanyan , Zhai Xixi , Wang Yan , Ding Shumin , Shen Mingyue , Li Zonghong , Xu Ruirong
Published: June 2021

Background:

Acute myeloid leukemia (AML) is the most common malignant tumor of the hematopoietic system, which seriously threatens the lives of patients. Most AML patients have acute onset, severe condition, and poor prognosis. The present study aimed to comprehensively evaluate the effectiveness and safety of chemotherapy combined with different doses of interleukin-2 (IL-2) maintenance treatments in AML by Bayesian network meta-analysis (NMA).

Methods:

From its inception until October 2021, we will search PubMed, Cochrane Library, CNKI, Embase, and other databases to comprehensively collect randomized controlled trials (RCTs) of chemotherapy combined with different doses of IL-2 maintenance therapies for AML. Two independent researchers will complete the literature screening and data extraction according to the inclusion and exclusion criteria, and then independently conduct a bias risk assessment of all the evidence. Bayesian NMA was used to evaluate all the evidence comprehensively. Use STATA16.0 and WinBUGS1.4.3 software to process and analyze all data, and classify the quality of evidence in NMA according to grading of recommendations assessment, development, and evaluation .

Results:

The study will evaluate the efficacy and safety of chemotherapy combined with different doses of IL-2 maintenance therapies for AML.

Conclusion:

The study will provide a basis for the efficacy and safety of chemotherapy combined with different doses of IL-2 maintenance therapies for AML. We hope that this study can provide meaningful support for clinicians and patients.

Protocol registration number:

INPLASY202140106

Ethical approval:

Since the study is based on published or registered RCTs, ethical approval and patient informed consent are abandoned.
Effects of respiratory training on pulmonary function, bad mood, and quality of life in patients with COVID-19
Authors: Zhu Jianfei , Long Qing , Mao Huihui , Ran Weirong
Published: June 2021

Background:

At present, whether respiratory training can improve the lung function, quality of life, and mental health of patients with Coronavirus Disease 2019 (COVID-19) is still controversial. Therefore, in order to provide new evidence-based medicine for clinical treatment, we conducted a systematic review and meta-analysis to evaluate the effects of respiratory training in improving lung function, quality of life, and mental health of patients with COVID-19.

Methods:

Relevant publications were searched from clinical trials. Computer was used to retrieve Cochrane Central Register of Controlled Trials Repositories, PubMed, Embase, and Web of Science databases. The retrieval time limit was from the establishment of the database to April 2021. Two researchers independently carried out data extraction and literature quality evaluation on the quality and meta-analysis of the included literature was performed with Revman 5.3 software.

Results:

The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.

Conclusion:

This study will provide reliable evidence-based evidence on the effects of breathing training on lung function, bad mood, and quality of life in patients with COVID-19.

Ethics and dissemination:

Ethical approval was not required for this study. The systematic review will be published in a peer-reviewed journal, presented at conferences, and shared on social media platforms.

OSF Registration number:

DOI 10.17605/OSF.IO/ZQTGY.
A rare case of diabetic ketoacidosis presenting with severe hypertriglyceridemia requiring plasmapheresis in an adult with type-2 diabetes mellitus
Authors: Roy Pooja , Koetter Paige , Cunningham Jessica , Komanduri Saketram , Cinicola John
Published: June 2021

Introduction:

Severe hypertriglyceridemia (HTG) is a rare complication of insulin resistance. Its presentation with diabetic ketoacidosis (DKA) has been reported in a few cases, where most patients have type-1 diabetes mellitus (DM). Our case represents a unique presentation of DKA associated with severe HTG above 10,000 mg/dL in an adult with type-2 DM.

Patient concerns and diagnosis:

Case Report: A 51-year-old man with no prior illnesses presented to the emergency department with abdominal pain and nausea. He was found to have DKA with a blood glucose level of 337 mg/dL, pH of 7.17, beta-hydroxybutyrate of 7.93 mmol/L, and anion gap of 20 mmol/L. His triglyceride levels were >10,000 mg/dL. His serum was found to be lipemic. Computerized tomography scan of the abdomen demonstrated mild acute pancreatitis. Negative GAD65 antibodies supported the diagnosis of type-2 DM.

Interventions and outcomes:

Endocrinology was consulted and one cycle of albumin-bound plasmapheresis was administered. This therapy significantly improved his HTG. DKA gradually resolved with insulin therapy as well. He was discharged home with endocrinology follow-up.

Conclusion:

This unique case highlights an uncommon but critical consequence of uncontrolled DM. It brings forth the possibility of severe HTG presenting as a complication of uncontrolled type-2 DM. Severe HTG commonly presents with acute pancreatitis, which can be debilitating if not managed promptly. Most patients with this presentation are managed with insulin infusion. The use of plasmapheresis for management of severe HTG has not been well studied. Our case supports the use of plasmapheresis as an effective and rapid treatment for severe HTG.
Distribution of complete blood count constituents in gestational diabetes mellitus
Authors: Zhang Yonggang , Zhang Yipeng , Zhao Limin , Shang Yanyan , He Dabao , Chen Jiying
Published: June 2021

Background (Trial Design):

The incidence rate of gestational diabetes is high. In the long run, it harms the health of both the mother and child. In order to understand the distribution of hematological cells with gestational diabetes mellitus (GDM), a longitudinal cohort study was conducted from 2012 to 2018.

Methods:

A longitudinal case control study of 1860 pregnant women was conducted between 2012 and 2018. Data of hematological parameters at 11 time points of gestational stage were obtained from a laboratory database. Repeated measures analysis and independent t-test were used to analyze the effect of the hematological parameters on GDM.

Results:

The trend of blood cells fluctuated with gestational age in normal controls but was more remarkable in GDM. Compared with the controls, blood neutrophils, lymphocytes, and monocytes augmented in the second trimester but decreased in the third trimester; platelet (PLT) and thrombocytocrit increased throughout the three trimesters, and red blood cell (RBC) was abundant in the last 2 trimesters in GDM.

Conclusions:

Peripheral blood leukocytes, platelets, and erythrocytes were significantly different during gestation between GDM and normal controls. Inflammation may also be involved in GMD.
Universal approach for full endoscopic decompression and percutaneous transpedicular fixation of the lumbar spine
Authors: Malo-Camacho Víctor Hugo , Bañuelos-Díaz Gerardo Enrique , Martínez-Velázquez Víctor Hugo , López-Ortega Luis , Malo-Macías Oscar , Villarreal-Ríos Enrique , Sosa-Gallegos Alejandro , Alva-Nájera Mauricio , Mejía-Valencia Mario Iván
Published: June 2021

Cohort study.

This study aimed to determine the effectiveness of the universal approach of full endoscopy and percutaneous transpedicular fixation via a medial central approach (ACM) performed to surgically treat patients with lumbar degenerative surgical pathologies.

Alternatives to interventionist treatments available to patients with lumbar degenerative surgical pathologies are related to recovery from minimally invasive surgery. Considering this, full endoscopic spinal decompression (full endoscopy) and percutaneous transpedicular fixation via an ACM represent advances in neurosurgical procedures, in particular, spinal surgery. Thus, the introduction of endoscopic and minimally invasive surgeries for the lumbar region has become 1 of the most important advances in modern surgery.

A cohort of 79 patients undergoing full endoscopy and percutaneous transpedicular fixation was evaluated 6 times in 1 year. Pain intensity was measured using the visual analog scale (VAS), and lumbar functionality was measured using the Oswestry Disability Index (ODI). Six evaluations were performed: before surgery and on discharge after surgery as well as at 1, 3, 6, and 12 months after surgery.

Before the ACM was applied, the VAS pain score was 8.52. At 11 hours post-surgery, the pain score reduced to 2.59 points (a difference of 5.73 points; P = 0.001). Of the 10 ODI domains evaluated, a difference was found between the period prior to surgery and 1 month later (P < 0.01).

The universal approach to full endoscopy and lumbar percutaneous transpedicular fixation via an ACM is highly effective for patients with lumbar surgical degenerative pathologies.
Organ failure, aetiology and 7-day all-cause mortality among acute adult patients on arrival to an emergency department: a hospital-based cohort study
Authors: Pedersen Peter Bank , Henriksen Daniel Pilsgaard , Brabrand Mikkel , Lassen Annmarie Touborg
Published: June 2021

Background

Organ failure is both a frequent and dangerous condition among adult patients on arrival to an emergency department (ED). The risk of an unfavourable outcome could depend on the underlying aetiology. Knowledge of the relation between aetiology and prognosis could improve the risk stratification at arrival.

Objectives

To describe the relation between organ failure, aetiology and prognosis through 7-day all-cause mortality.

Methods

An observational three-year cohort study at the ED at Odense University Hospital, Denmark, including all acute adult patients.

First-measured vital signs and laboratory values were included to evaluate the presence of the following organ failures: respiratory, coagulation, hepatic, circulatory, cerebral or renal.

The primary outcome was 7-day all-cause mortality. Aetiological disease categories were based on primary discharge diagnoses. We described the association between 7-day mortality, aetiology category, site of organ failures and number of patients at risk.

Results

Of 40 423 patients with a first-time visit at the ED, 5883(14.6%) had an organ failure on arrival. The median age was 69 (IQR 54–80), and 50% were men. The most frequent aetiology was infection (1495, 25.4%). Seven-day all-cause mortality ranged between aetiologies from 0.0% (95% confidence interval [CI], 0.0–14.2) allergy) to 45.6% (95% CI, 41.3–50.0) (cardiac). Combining aetiology and site of organ failure, 7-day all-cause mortality was the highest in the cardiac category, from 14.8% (95% CI, 4.2–3.7) with hepatic failure to 79.2% (95% CI, 73.6–84.1) with cerebral failure. The combination of infection and respiratory failure characterised most patients (n = 949).

Conclusion

Infection was the most prevalent aetiology, and 7-day all-cause mortality was highly associated with the site of organ failure and aetiology.
Impact of COVID-19 Mitigation Efforts on Adults With Serious Mental Illness
Authors: Benjenk Ivy , Saliba Zeina , Duggal Neel , Albaroudi Asmaa , Posada Jacqueline , Chen Jie
Published: June 2021

In response to COVID-19 mitigation policies, mental health and social service agencies have had to rapidly change their operations, creating challenges for patients with serious mental illness (SMI). This study aimed to explore the experiences of adults with SMI navigating these altered systems during the pandemic. In-depth interviews were conducted with 20 hospitalized adults with SMI in the fall of 2020; they were coded using thematic analysis. Most participants found the new systems effective at meeting their essential needs. However, several reported significant unmet needs, including inability to access mental health care and public benefits. These participants lacked identification documents, housing, and/or a personal device. Although none of the participants used telemedicine before COVID-19, most reported no or minimal problems with telemental health. Those reporting difficulties did not have personal devices, were receiving audio-only services, or viewed telemedicine as less personal or too distracting.
Automated generation of context-specific gene regulatory networks with a weighted approach in
Drosophila melanogaster
Authors: Murgas Leandro , Contreras-Riquelme Sebastian , Martínez-Hernandez J. Eduardo , Villaman Camilo , Santibáñez Rodrigo , Martin Alberto J. M.
Published: June 2021

The regulation of gene expression is a key factor in the development and maintenance of life in all organisms. Even so, little is known at whole genome scale for most genes and contexts. We propose a method, Tool for Weighted Epigenomic Networks in
Drosophila melanogaster
(Fly T-WEoN), to generate context-specific gene regulatory networks starting from a reference network that contains all known gene regulations in the fly. Unlikely regulations are removed by applying a series of knowledge-based filters. Each of these filters is implemented as an independent module that considers a type of experimental evidence, including DNA methylation, chromatin accessibility, histone modifications and gene expression. Fly T-WEoN is based on heuristic rules that reflect current knowledge on gene regulation in
D. melanogaster
obtained from the literature. Experimental data files can be generated with several standard procedures and used solely when and if available. Fly T-WEoN is available as a Cytoscape application that permits integration with other tools and facilitates downstream network analysis. In this work, we first demonstrate the reliability of our method to then provide a relevant application case of our tool: early development of
D. melanogaster
. Fly T-WEoN together with its step-by-step guide is available at
https://weon.readthedocs.io
.
Safety and Potency of COVIran Barekat Inactivated Vaccine Candidate for SARS-CoV-2: A Preclinical Study
Authors: Abdoli Asghar , Aalizadeh Reza , Aminianfar Hossein , Kianmehr Zahra , Azimi Ebrahim , Emamipour Nabbi , Jamshidi Hamidreza , Hosseinpour Mohammadreza , Taqavian Mohammad , Jalili Hasan
Published: June 2021

There is an urgent demand to manufacture an effective and safe vaccine to prevent SARS-CoV2 infection, which resulted in a global pandemic. In this study, we developed an inactivated whole-virus SARS-CoV-2 candidate vaccine named COVIran Barekat. Immunization at two different doses (3 µg or 5 µg per dose) elicited a high level of SARS-CoV-2 specific neutralizing antibodies in mice, rabbits, and non-human primates. The results show the safety profile in studied animals (include guinea pig, rabbit, mice, and monkeys). Rhesus macaques were immunized with the two-dose of 5 µg and 3 µg of the COVIran Barekat vaccine and showed highly efficient protection against 104 TCID50 of SARS-CoV-2 intratracheal challenge compared with the control group. These results highlight the COVIran Barekat vaccine as a potential candidate to induce a strong and potent immune response which may be a promising and feasible vaccine to protect against SARS-CoV2 infection.
Unraveling the functions of uncharacterized transcription factors inEscherichia coliusing ChIP-exo
Authors: Gao Ye , Lim Hyun Gyu , Verkler Hans , Szubin Richard , Quach Daniel , Rodionova Irina , Chen Ke , Yurkovich James T. , Cho Byung-Kwan , Palsson Bernhard O.
Published: June 2021

Bacteria regulate gene expression to adapt to changing environments through transcriptional regulatory networks (TRNs). Although extensively studied, no TRN is fully characterized since the identity and activity of all the transcriptional regulators that comprise a TRN are not known. Here, we experimentally evaluate 40 uncharacterized proteins inEscherichia coliK-12 MG1655, which were computationally predicted to be transcription factors (TFs). First, we used a multiplexed ChIP-exo assay to characterize genome-wide binding sites for these candidate TFs; 34 of them were found to be DNA-binding protein. We then compared the relative location between binding sites and RNA polymerase (RNAP). We found 48% (283/588) overlap between the TFs and RNAP. Finally, we used these data to infer potential functions for 10 of the 34 TFs with validated DNA binding sites and consensus binding motifs. These TFs were found to have various roles in regulating primary cellular processes inE. coli. Taken together, this study: (1) significantly expands the number of confirmed TFs, close to the estimated total of about 280 TFs; (2) predicts the putative functions of the newly discovered TFs, and (3) confirms the functions of representative TFs through mutant phenotypes.
Major upgrade of the synchrotron radiation calculation code SPECTRA
Authors: Tanaka Takashi
Published: June 2021

Since the first release in 2001, the synchrotron radiation calculation code SPECTRA has been used by many users and continuously upgraded to answer the requests and feedbacks from the users. Although such an incremental upgrade made in nearly two decades has significantly enhanced the capability of SPECTRA, the source code has become much more complicated, and thus the maintenance and further improvement are rather troublesome. To solve this issue, and to take advantage of the recent progress in the programming language, a major upgrade has been made as presented in this paper, in which a number of new features and advanced functions are implemented as well.
The 3D structure of fibrous material is fully restorable from its X-ray diffraction pattern
Authors: Iwamoto Hiroyuki
Published: June 2021

X-ray fiber diffraction is potentially a powerful technique to study the structure of fibrous materials, such as DNA and synthetic polymers. However, only rotationally averaged diffraction patterns can be recorded and it is difficult to correctly interpret them without the knowledge of esoteric diffraction theories. Here we demonstrate that, in principle, the non-rotationally averaged 3D structure of a fibrous material can be restored from its fiber diffraction pattern. The method is a simple puzzle-solving process and in ideal cases it does not require any prior knowledge about the structure, such as helical symmetry. We believe that the proposed method has a potential to transform the fiber diffraction to a 3D imaging technique, and will be useful for a wide field of life and materials sciences.
Training transfer model as a possibility for the mandatory internship at sport science undergraduate courses
Authors: Silva Piovani Verónica Gabriela , Parra Barbosa Rinaldi Ieda , Both Jorge
Published: June 2021

Purpose

This article aims to explain the transfer of training model used in the training of human resources within organizations and its possibilities for the mandatory internship (MI) in sport science (SS) higher education.

Design/methodology/approach

A review that argues the concept of transfer of learning, the model of factors that affect the transfer of training and its evolution was undertaken.

Findings

The possibilities and implications of thinking about the MI in the SS undergraduate courses are listed based on the transfer of learning and of training model. It is concluded that different factors such as the students' characteristics, the characteristics of the different spaces of SS professional's intervention, the evaluation, the academic and technical supervisors, the host organization and peers, as well as other elements of the transfer of training model, are important to develop the MI at the SS undergraduate courses.

Originality/value

The consideration of this model of factors could be relevant to improve the teaching and learning processes within the MI at the SS undergraduate courses.
Development of a behavioral taxonomy of agility in the workplace
Authors: Petermann Moritz Karl Herbert , Zacher Hannes
Published: June 2021

Purpose

The concept of workforce agility has become increasingly popular in recent years. However, defining it has sparked much discussion and ambiguity. Recognizing this ambiguity, this paper aims to inductively develop a behavioral taxonomy of workforce agility.

Design/methodology/approach

The authors interviewed 36 experts in the field of agility and used concept mapping and the critical incident technique to create a behavioral taxonomy.

Findings

The authors identified a behavioral taxonomy consisting of ten dimensions: (1) accepting changes, (2) decision making, (3) creating transparency, (4) collaboration, (5) reflection, (6) user centricity, (7) iteration, (8) testing, (9) self-organization, and (10) learning.

Research limitations/implications

The authors’ research contributes to the literature in that it offers an inductively developed behavioral taxonomy of workforce agility with ten dimensions. It further adds to the literature by tying the notion of workforce agility to the performance literature.

Practical implications

The authors’ results suggest that it might be beneficial for companies to take all workforce agility dimensions into account when creating an agile culture, starting agile projects, integrating agility into hiring decisions or evaluating employee performance.

Originality/value

This paper uses an inductive approach to define workforce agility as a set of behavioral dimensions, integrating the scientific as well as the practitioner literature on agility.
Determinants of e-commerce satisfaction: a comparative study between Romania and Moldova
Authors: Dospinescu Octavian , Dospinescu Nicoleta , Bostan Ionel
Published: June 2021

Purpose

The purpose of this article is to highlight the relevance of the factors that influence the satisfaction of e-commerce consumers in Romania and Moldova. The study aims to clearly define the main influence factors, so that the marketing managers of the online stores can adopt scientific well-founded decisions.

Design/methodology/approach

The paper opted for a study including a large sample of 399 respondents from two countries. For the analysis of the factors influencing the e-commerce satisfaction, multiple linear regression analysis was implemented, and their differentiation within the two countries was highlighted by multivariate analysis of variance.

Findings

The research conducted and the results obtained show that there is a differentiation of the factors that influence the level of satisfaction of e-commerce users in Romania and Moldova.

Research limitations/implications

The research is still limited in terms of population studied to only two countries: Romania and Moldova. Although the study is intended to be exhaustive by analyzing no less than 11 factors influencing the satisfaction generated by e-commerce, it is still limited to this group of representative factors. Another limitation has to do with the limited number of demographic variables the authors have included.

Practical implications

Based on the results, the managerial implications for e-commerce companies that want to uniquely address consumers in Romania and Moldova are related to the decisions of marketing and sales managers who must allocate budgets and resources to improve the eight aspects highlighted in the paper. Also, the e-commerce companies should not allocate resources for the implementation of functionalities such as in-app after sales services, the possibility to cancel an order or the live consultant support feature, because these aspects do not influence the satisfaction of e-commerce consumers in Romania and Moldova.

Originality/value

This paper is the first in the scientific literature that implements a comparative study on the influence factors regarding the e-commerce satisfaction in Romania and Moldova. Also, it is important to mention that the present study is an exhaustive one because it includes many influence factors that were analyzed separately in the previous research papers from literature review.
Financial Hedging, Corporate Cash Policy, and the Value of Cash
Authors: Sun Wenyi , Yin Chao , Zeng Yeqin
Published: June 2021

We study the implications of financial hedging for corporate cash policy and the value of cash holdings. Using a web crawler program to collect data on the use of financial derivatives between 1993 and 2016, we find that US public firms with financial hedging programs have smaller cash reserves but a higher value of cash than firms without hedging contracts in place. Our empirical results are robust when controlling for potential endogeneity issues, corporate governance, cash regimes and alternative measures of cash holdings. Further, we find that financial hedging not only increases the investment sensitivity to internal cash, but also has a positive effect on investment efficiency. The positive effect of financial hedging on the value of cash is more pronounced for firms with more financial constraints, higher information asymmetry and weaker corporate governance. Collectively, our paper highlights the importance of corporate cash policy as a channel through which financial risk management increases firm value.
Effects of preserving the bronchial artery on cough after thoracoscopic lobectomy
Authors: Pan Liuying , Zhou Xiaofei , Xu Chun , Ding Cheng , Chen Jun , Zhu Xinyu , Zhao Jun , Li Chang
Published: June 2021

Background

The purpose of this prospective study was to explore the influence of both preoperative three‐dimensional (3D) reconstruction and intraoperative preservation of the bronchial artery (BA) on postoperative cough after thoracoscopic lobectomy.

Methods

A total of 60 patients who had received a combination of thoracoscopic lobectomy and systematic lymph node dissection were included in this study. They were divided into two groups, namely the BA preservation group (Group A), and conventional surgical treatment group (Group B). In group A, we used Exoview software for 3D reconstruction of the BA before the operation and the BA was preserved during the operation. 3D reconstruction of the BA was not performed before surgery in group B. The incidence of postoperative cough, the Mandarin Chinese version of the Leicester cough questionnaire (LCQ‐MC), physiological, psychological and social dimensions and total score of the two groups were compared and analyzed.

Results

The scores and total scores of LCQ‐MC in group B were lower than those in group A one and two months after surgery. There were significant differences between the two groups in physiological and psychological dimensions and total scores (p < 0.05), but there was no significant difference in social dimension between the two groups (p > 0.05). The incidence of postoperative cough in group A (16.7%) was lower than that in group B (30%), while the difference was not statistically significant (p = 0.222).

Conclusions

Preoperative 3D reconstruction and intraoperative preservation of the BA can reduce the severity of postoperative cough.
Disturbance‐specific behavioral responses of giant otters exposed to ecotourism and extractive activities
Authors: Barocas A. , Farfan J. , Groenendijk J. , Mendoza J. , Silva J. , Mujica O. , Ochoa J. A. , Macdonald D. W. , Swaisgood R. R.
Published: June 2021

Human activities increasingly result in disturbance of wild animal populations. Behavioral responses vary according to the type, duration, frequency and intensity of disturbance. Exposure to disturbance, for example, arising from ecotourism, may promote tolerance of humans and drive a decrease in vigilance and avoidance behaviors, whereas disturbance resulting from extractive activities is typically more intense and is likely to be perceived as a threat. To understand how animals cope with land transformation and human presence, it is imperative to study their responses under different disturbance regimes. We performed behavioral sampling of groups of the giant otter, a charismatic top carnivore, exposed to ecotourism, extractive activities (mining and fishing) and control sites without disturbance to compare their responses. Foraging efficiency was impacted by fish abundance and thus was reduced in mined and fished areas. Giant otters in lakes with managed ecotourism did not show avoidance of research vessels and demonstrated reduced rates of defensive behavior compared to control lakes. Groups from lakes with fishing and gold mining showed increased avoidance, suggesting that these types of disturbance may involve more direct conflict. Our findings suggest that noninvasive disturbance such as ecotourism may promote giant otter tolerance to the presence of humans, whereas extractive activities may be perceived as riskier. Current protected area conservation strategies of strict ecotourism regulation and the maintenance of no‐access oxbow lakes may ensure the maintenance of behavioral flexibility in giant otter populations. However, resource depletion and more intense human‐giant otter interactions in disturbed areas may not be sustainable. Further studies are necessary to determine whether distinct disturbance regimes drive longer‐term demographic effects.