bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient partnership in cardiovascular clinical trials
Authors: Zannad Faiez , Chauhan Cynthia , Gee Patrick O , Hartshorne-Evans Nick , Hernandez Adrian F , Mann Marilyn K , Martinez Robin , Mehran Roxana
Published: November 2021

Patients are ultimately the end-users of medical therapies and need to be actively integrated as contributors and decision-makers in the process of product development throughout product lifecycles. This is increasingly being recognized by patients, investigators, regulators, payers, sponsors, and medical journals. However, cardiovascular research remains behind other fields in terms of the extent of patient involvement and awareness of clinical trials in cardiovascular research. True patient partnerships in cardiovascular therapeutic development may permit more rapid recognition of unmet needs, ensure alignment of product development priorities with patient priorities, improve efficiency of trials (e.g. recruitment), and ensure outcomes of value to patients are being measured in trials (e.g. quality of life). This paper reviews ongoing initiatives and remaining opportunities to accomplish contributive patient involvement in cardiovascular clinical research.
Genome-wide association study of mitochondrial copy number
Authors: Gentiluomo Manuel , Giaccherini Matteo , Gào Xīn , Guo Feng , Stocker Hannah , Schöttker Ben , Brenner Hermann , Canzian Federico , Campa Daniele
Published: November 2021

Mitochondrial DNA copy number (mtDNAcn) variation has been associated with increased risk of several human diseases in epidemiological studies. The quantification of mtDNAcn performed with real-time PCR is currently considered the de facto standard among several techniques. However, the heterogeneity of the laboratory methods (DNA extraction, storage, processing) used could give rise to results that are difficult to compare and reproduce across different studies. Several lines of evidence suggest that mtDNAcn is influenced by nuclear and mitochondrial genetic variability, however this relation is largely unexplored. The aim of this work was to elucidate the genetic basis of mtDNAcn variation. We performed a genome-wide association study (GWAS) of mtDNAcn in 6836 subjects from the ESTHER prospective cohort, and included, as replication set, the summary statistics of a GWAS that used 295 150 participants from the UK Biobank. We observed two novel associations with mtDNAcn variation on chromosome 19 (rs117176661), and 12 (rs7136238) that reached statistical significance at the genome-wide level. A polygenic score that we called mitoscore including all known single nucleotide polymorphisms explained 1.11% of the variation of mtDNAcn (p = 5.93 × 10−7). In conclusion, we performed a GWAS on mtDNAcn, adding to the evidence of the genetic background of this trait.
A Systematic Literature Review of Relational Autonomy in Dialysis Decision Making
Authors: Sledge Renata , Meyer Dixie , Zubatsky Max , Heiden-Rootes Katie , Philipneri Marie , Browne Teri
Published: November 2021

Nephrology interdisciplinary guidelines, professional codes of ethics, principle-based ethical standards, and literature promote patient autonomy and self-determination through shared decision making as ethical practice. Healthcare professionals are accountable for practice that is mindful of the impact of cultural diversity and community on the values and beliefs of the patient, an important part of shared decision making (SDM). Despite previous research regarding dialysis decision making, relational autonomy in chronic kidney disease (CKD) and end-stage kidney disease SDM conversations is not well understood. This systematic literature review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework for identifying peer-reviewed literature on SDM for CKD. The findings were summarized into four broad themes: (1) promoting autonomy is a foundation of medical caring; (2) providers have a responsibility to respond to their asymmetrical social power; (3) autonomy is situated within the context of the patient; and (4) dialogue is a tool that negotiates clinical recommendations and patient goals. The caring practices of promoting autonomy with a dialogical resolution of a conflict acknowledging the interdependence of the parties and the patient’s social–relational situatedness support a perspective of relational autonomy in dialysis decision-making practice and research.
Barriers and facilitators for the inclusion of fertility care in reproductive health policies in Africa: a qualitative evidence synthesis
Authors: Afferri Anna , Allen Haddijatou , Booth Andrew , Dierickx Susan , Pacey Allan , Balen Julie
Published: November 2021

BACKGROUND

Infertility affects over 50 million couples worldwide and impacts people’s social and emotional wellbeing. In low- and middle-income countries, particularly across Africa, the inclusion of fertility care into reproductive health (RH) policies remains fragmented or non-existent.

OBJECTIVE AND RATIONALE

This review aims to provide a framework for understanding the inclusion (or lack thereof) of fertility care in RH policies in African settings. It synthesizes the barriers and facilitators to such inclusion, with a view to uncovering the positioning of fertility care in broader health systems and on the agendas of key stakeholders such as health policymakers and practitioners.

SEARCH METHODS

A qualitative evidence synthesis was performed, systematically searching papers and grey literature. Searches were conducted in MEDLINE, EMBASE, CINAHL, Web of Science and Scopus between February and April 2020. No date restrictions were applied. Language was limited to publications written in English and French. Two reviewers independently screened titles and abstracts, and extracted data, applying thematic coding. The quality of the included papers was evaluated using The Joanna Briggs Institute Checklist for Text and Opinion Papers.

OUTCOMES

The search identified 744 papers, of which 20 were included. Findings were organized under four cross-cutting categories, namely: perceived importance of infertility; influence of policy context; resource availability and access; and perceived quality of care. Across these categories, key barriers to the inclusion of fertility care in RH policies were limited political commitment, under-recognition of the burden of infertility and high costs associated with ART. Conversely, facilitators comprised specialized training on infertility for healthcare providers, standard procedures for ART safety and guidelines and North–South/South–South collaborations.

WIDER IMPLICATIONS

The inclusion of fertility care in African RH policies depends upon factors that include the recognition of infertility as a disease, strong political engagement and proactivity and affordability of ART through opportunities for partnership with the private sector, which ease costs on the public health system. Further qualitative and quantitative research, including context-specific analysis and in-depth comparative approaches across diverse African countries, will help to delineate differential impacts of local and global factors on fertility care to address this neglected RH issue.
Ascending aortic extension to increase aortopulmonary space after comprehensive stage II palliation
Authors: Brancaccio Gianluca , Trezzi Matteo , Secinaro Aurelio , Iacobelli Roberta , Perri Gianluigi , Filippelli Sergio , Bordonaro Veronica , Galletti Lorenzo
Published: November 2021

Aortic reconstruction at the time of the comprehensive stage II (CSII) procedure can be complicated by compression within the aortopulmonary space resulting in airway or pulmonary artery narrowing. We describe our experience with 2 patients with hypoplastic left heart syndrome and pulmonary artery stenosis after the CSII procedure. Both patients underwent an aortic extension with a Hemashield interposition graft to open up the aortopulmonary space. The patients were discharged from the hospital. In all cases the aortopulmonary space was enlarged, and the pulmonary arteries and airway were free from compression. Aortic extension is an option to be considered in children with pulmonary artery compression who previously had a CSII procedure.
Candida auris susceptibility on surfaces coated with the antifungal drug caspofungin
Authors: Lamont-Friedrich Stephanie J , Kidd Sarah E , Giles Carla , Griesser Hans J , Coad Bryan R
Published: November 2021

Candida auris is known to survive for weeks on solid material surfaces. Its longevity contributes to medical device contamination and spread through healthcare facilities. We fabricated antifungal surface coatings by coating plastic and glass surfaces with a thin polymer layer to which the antifungal drug caspofungin was covalently conjugated. Caspofungin-susceptible and -resistant C. auris strains were inhibited on these surfaces by 98.7 and 81.1%, respectively. Cell viability studies showed that this inhibition was fungicidal. Our findings indicate that C. auris strains can be killed on contact when exposed to caspofungin that is reformulated as a covalently-bound surface layer.

Lay summary

Candida auris is pathogenic, multidrug resistant yeast with the ability to survive on surfaces and remain transmissible for long periods of time in healthcare settings. In this study, we have prepared an antifungal surface coating and demonstrated its ability to kill adhering C. auris cells on contact.
The GALAH Survey: dependence of elemental abundances on age and metallicity for stars in the Galactic disc
Authors: Sharma Sanjib , Hayden Michael R , Bland-Hawthorn Joss , Stello Dennis , Buder Sven , Zinn Joel C , Spina Lorenzo , Kallinger Thomas , Asplund Martin , De Silva Gayandhi M , D’Orazi Valentina , Freeman Ken C , Kos Janez , Lewis Geraint F , Lin Jane , Lind Karin , Martell Sarah L , Schlesinger Katharine J , Simpson Jeffrey D , Zucker Daniel B , Zwitter Tomaž , Chen Boquan , Cotar Klemen , Kafle Prajwal R , Khanna Shourya , Tepper-Garcia Thor , Wang Purmortal , Wittenmyer Rob A
Published: November 2021

Using data from the GALAH survey, we explore the dependence of elemental abundances on stellar age and metallicity among Galactic disc stars. We find that the abundance of most elements can be predicted from age and [Fe/H] with an intrinsic scatter of about 0.03 dex. We discuss the possible causes for the existence of the abundance–age–metallicity relations. Using a stochastic chemical enrichment scheme that takes the volume of supernovae remnants into account, we show the intrinsic scatter is expected to be small, about 0.05 dex or even smaller if there is additional mixing in the ISM. Elemental abundances show trends with both age and metallicity and the relationship is well described by a simple model in which the dependence of abundance ([X/Fe]) on age and [Fe/H] are additively separable. Elements can be grouped based on the direction of their abundance gradient in the (age,[Fe/H]) plane and different groups can be roughly associated with three distinct nucleosynthetic production sites, the exploding massive stars, the exploding white dwarfs, and the AGB stars. However, the abundances of some elements, like Co, La, and Li, show large scatter for a given age and metallicity, suggesting processes other than simple Galactic chemical evolution are at play. We also compare the abundance trends of main-sequence turn-off (MSTO) stars against that of giants, whose ages were estimated using asteroseismic information from the K2 mission. For most elements, the trends of MSTO stars are similar to that of giants. The existence of abundance relations implies that we can estimate the age and birth radius of disc stars, which is important for studying the dynamic and chemical evolution of the Galaxy.
MASCOT: an ESO–ARO legacy survey of molecular gas in nearby SDSS-MaNGA galaxies – I. First data release, and global and resolved relations between H2 and stellar content
Authors: Wylezalek D , Cicone C , Belfiore F , Bertemes C , Cazzoli S , Wagg J , Wang (王无忌) W , Aravena M , Maiolino R , Martin S , Bothwell M S , Brownstein J R , Bundy K , De Breuck C
Published: November 2021

We present the first data release of the Mapping Nearby Galaxies at Apache Point Observatory (MaNGA)–Arizona Radio Observatory (ARO) Survey of CO Targets (MASCOT), a European Southern Observatory public spectroscopic survey conducted at the ARO. We measure the CO(1–0) line emission in a sample of 187 nearby galaxies selected from the MaNGA survey that has obtained integral field unit (IFU) spectroscopy for a sample of ∼10 000 galaxies at low redshift. The main goal of MASCOT is to probe the molecular gas content of star-forming galaxies with stellar masses >109.5 M⊙ and with associated MaNGA IFU observations and well-constrained quantities like stellar masses, star formation rates, and metallicities. In this paper, we present the first results of the MASCOT survey, providing integrated CO(1–0) measurements that cover several effective radii of the galaxy and present CO luminosities, CO kinematics, and estimated H2 gas masses. We observe that the decline of the galaxy star formation rate with respect to the star formation main sequence increases with the decrease of molecular gas and with a reduced star formation efficiency, in agreement with results of other integrated studies. Relating the molecular gas mass fractions with the slope of the stellar age gradients inferred from the MaNGA observations, we find that galaxies with lower molecular gas mass fractions tend to show older stellar populations close to the galactic centre, while the opposite is true for galaxies with higher molecular gas mass fractions, providing tentative evidence for inside-out quenching.
Cosmological constraints from gas mass fractions of massive, relaxed galaxy clusters
Authors: Mantz Adam B , Morris R Glenn , Allen Steven W , Canning Rebecca E A , Baumont Lucie , Benson Bradford , Bleem Lindsey E , Ehlert Steven R , Floyd Benjamin , Herbonnet Ricardo , Kelly Patrick L , Liang Shuang , von der Linden Anja , McDonald Michael , Rapetti David A , Schmidt Robert W , Werner Norbert , Wright Adam
Published: November 2021

We present updated cosmological constraints from measurements of the gas mass fractions (fgas) of massive, dynamically relaxed galaxy clusters. Our new data set has greater leverage on models of dark energy, thanks to the addition of the Perseus cluster at low redshifts, two new clusters at redshifts z ≳ 1, and significantly longer observations of four clusters at 0.6 < z < 0.9. Our low-redshift (z < 0.16) fgas data, combined with the cosmic baryon fraction measured from the cosmic microwave background (CMB), imply a Hubble constant of h = 0.722 ± 0.067. Combining the full fgas data set with priors on the cosmic baryon density and the Hubble constant, we constrain the dark energy density to be ΩΛ = 0.865 ± 0.119 in non-flat Lambda cold dark matter (cosmological constant) models, and its equation of state to be $w=-1.13_{-0.20}^{+0.17}$ in flat, constant-w models, respectively 41 per cent and 29 per cent tighter than our previous work, and comparable to the best constraints available from other probes. Combining fgas, CMB, supernova, and baryon acoustic oscillation data, we also constrain models with global curvature and evolving dark energy. For the massive, relaxed clusters employed here, we find the scaling of fgas with mass to be consistent with a constant, with an intrinsic scatter that corresponds to just ∼3 per cent in distance.
The emergence of dark matter-deficient ultra-diffuse galaxies driven by scatter in the stellar mass–halo mass relation and feedback from globular clusters
Authors: Trujillo-Gomez Sebastian , Kruijssen J M Diederik , Reina-Campos Marta
Published: November 2021

In addition to their low stellar densities, ultra-diffuse galaxies (UDGs) have a broad variety of dynamical mass-to-light ratios, ranging from dark matter (DM) dominated systems to objects nearly devoid of DM. To investigate the origin of this diversity, we develop a simple, semi-empirical model that predicts the structural evolution of galaxies, driven by feedback from massive star clusters, as a function of their departure from the mean SMHM relation. The model predicts that a galaxy located ≳ 0.5 dex above the mean relation at Mhalo = 1010 M⊙ will host a factor of ∼10–100 larger globular cluster (GC) populations, and that feedback from these GCs drives a significant expansion of the stellar component and loss of DM compared to galaxies on the SMHM relation. This effect is stronger in haloes that collapse earlier and have enhanced star formation rates at $z\gtrsim 2$, which leads to increased gas pressures, stellar clustering, and mean cluster masses, and significantly enhances the energy loading of galactic winds and its impact on the DM and stellar orbits. The impact on galaxy size and DM content can be large enough to explain observed galaxies that contain nearly the universal baryon fraction, as well as NGC 1052-DF2 and DF4 and other isolated UDGs that contain almost no DM. The trend of increasing galaxy size with GC specific frequency observed in galaxy clusters also emerges naturally in the model. Our predictions can be tested with large and deep surveys of the stellar and GC populations in dwarfs and UDGs. Because stellar clustering drives the efficiency of galactic winds, it may be a dominant factor in the structural evolution of galaxies and should be included as an essential ingredient in galaxy formation models.
Radiomic signatures of posterior fossa ependymoma: Molecular subgroups and risk profiles
Authors: Zhang Michael , Wang Edward , Yecies Derek , Tam Lydia T , Han Michelle , Toescu Sebastian , Wright Jason N , Altinmakas Emre , Chen Eric , Radmanesh Alireza , Nemelka Jordan , Oztekin Ozgur , Wagner Matthias W , Lober Robert M , Ertl-Wagner Birgit , Ho Chang Y , Mankad Kshitij , Vitanza Nicholas A , Cheshier Samuel H , Jacques Tom S , Fisher Paul G , Aquilina Kristian , Said Mourad , Jaju Alok , Pfister Stefan , Taylor Michael D , Grant Gerald A , Mattonen Sarah , Ramaswamy Vijay , Yeom Kristen W
Published: November 2021

Background

The risk profile for posterior fossa ependymoma (EP) depends on surgical and molecular status [Group A (PFA) versus Group B (PFB)]. While subtotal tumor resection is known to confer worse prognosis, MRI-based EP risk-profiling is unexplored. We aimed to apply machine learning strategies to link MRI-based biomarkers of high-risk EP and also to distinguish PFA from PFB.

Methods

We extracted 1800 quantitative features from presurgical T2-weighted (T2-MRI) and gadolinium-enhanced T1-weighted (T1-MRI) imaging of 157 EP patients. We implemented nested cross-validation to identify features for risk score calculations and apply a Cox model for survival analysis. We conducted additional feature selection for PFA versus PFB and examined performance across three candidate classifiers.

Results

For all EP patients with GTR, we identified four T2-MRI-based features and stratified patients into high- and low-risk groups, with 5-year overall survival rates of 62% and 100%, respectively (P < .0001). Among presumed PFA patients with GTR, four T1-MRI and five T2-MRI features predicted divergence of high- and low-risk groups, with 5-year overall survival rates of 62.7% and 96.7%, respectively (P = .002). T1-MRI-based features showed the best performance distinguishing PFA from PFB with an AUC of 0.86.

Conclusions

We present machine learning strategies to identify MRI phenotypes that distinguish PFA from PFB, as well as high- and low-risk PFA. We also describe quantitative image predictors of aggressive EP tumors that might assist risk-profiling after surgery. Future studies could examine translating radiomics as an adjunct to EP risk assessment when considering therapy strategies or trial candidacy.
Diffusion MRI is an early biomarker of overall survival benefit in IDH wild-type recurrent glioblastoma treated with immune checkpoint inhibitors
Authors: Hagiwara Akifumi , Oughourlian Talia C , Cho Nicholas S , Schlossman Jacob , Wang Chencai , Yao Jingwen , Raymond Catalina , Everson Richard , Patel Kunal , Mareninov Sergey , Rodriguez Fausto J , Salamon Noriko , Pope Whitney B , Nghiemphu Phioanh L , Liau Linda M , Prins Robert M , Cloughesy Timothy F , Ellingson Benjamin M
Published: November 2021

Background

Diffusion MRI estimates of the apparent diffusion coefficient (ADC) have been shown to be useful in predicting treatment response in patients with glioblastoma (GBM), with ADC elevations indicating tumor cell death. We aimed to investigate whether the ADC values measured before and after treatment with immune checkpoint inhibitors (ICIs) and the changes in these ADC values could predict overall survival (OS) in patients with recurrent IDH wild-type GBM.

Methods

Forty-four patients who met the following inclusion criteria were included in this retrospective study: (i) diagnosed with recurrent IDH wild-type GBM and treated with either pembrolizumab or nivolumab and (ii) availability of diffusion data on pre- and post-ICI MRI. Tumor volume and the median relative ADC (rADC) with respect to the normal-appearing white matter within the enhancing tumor were calculated.

Results

Median OS among all patients was 8.1 months (range, 1.0–22.5 months). Log-rank test revealed that higher post-treatment rADC was associated with a significantly longer OS (median, 10.3 months for rADC ≥ 1.63 versus 6.1 months for rADC < 1.63; P = .02), whereas tumor volume, pretreatment rADC, and changes in rADC after treatment were not significantly associated with OS. Cox regression analysis revealed that post-treatment rADC significantly influenced OS (P = .02, univariate analysis), even after controlling for age and sex (P =.01, multivariate analysis), and additionally controlling for surgery after ICI treatment (P = .045, multivariate analysis).

Conclusions

Elevated post-treatment rADC may be an early imaging biomarker for OS benefits in GBM patients receiving ICI treatment.
Discharge of treated Fukushima nuclear accident contaminated water: macroscopic and microscopic simulations
Authors: Liu Yi , Guo Xue-Qing , Li Sun-Wei , Zhang Jian-Min , Hu Zhen-Zhong
Published: November 2021

The diffusion process of the treated Fukushima nuclear accident contaminated water to be discharged into the Pacific Ocean from 2023 is analyzed by two analysis models from macroscopic and microscopic perspectives. Results show that the tritium will spread to the whole North Pacific in 1200 days, which is important to formulate global coping strategies.
Singlet Oxygen Leads to Structural Changes to Chloroplasts during their Degradation in the Arabidopsis thaliana plastid ferrochelatase two Mutant
Authors: Fisher Karen E , Krishnamoorthy Praveen , Joens Matthew S , Chory Joanne , Fitzpatrick James A J , Woodson Jesse D
Published: November 2021

During stress, chloroplasts produce large amounts of reactive oxygen species (ROS). Chloroplasts also contain many nutrients, including 80% of a leaf’s nitrogen supply. Therefore, to protect cells from photo-oxidative damage and to redistribute nutrients to sink tissues, chloroplasts are prime targets for degradation. Multiple chloroplast degradation pathways are induced by photo-oxidative stress or nutrient starvation, but the mechanisms by which damaged or senescing chloroplasts are identified, transported to the central vacuole and degraded are poorly defined. Here, we investigated the structures involved with degrading chloroplasts induced by the ROS singlet oxygen (1O2) in the Arabidopsis thaliana plastid ferrochelatase two (fc2) mutant. Under mild 1O2 stress, most fc2 chloroplasts appeared normal, but had reduced starch content. A subset of chloroplasts was degrading, and some protruded into the central vacuole via ‘blebbing’ structures. A 3D electron microscopy analysis demonstrated that up to 35% of degrading chloroplasts contained such structures. While the location of a chloroplast within a cell did not affect the likelihood of its degradation, chloroplasts in spongy mesophyll cells were degraded at a higher rate than those in palisade mesophyll cells. To determine if degrading chloroplasts have unique structural characteristics, allowing them to be distinguished from healthy chloroplasts, we analyzed fc2 seedlings grown under different levels of photo-oxidative stress. A correlation was observed among chloroplast swelling, 1O2 signaling and the state of degradation. Finally, plastoglobule (PG) enzymes involved in chloroplast disassembly were upregulated while PGs increased their association with the thylakoid grana, implicating an interaction between 1O2-induced chloroplast degradation and senescence pathways.
‘Passing’, but Far from Perfect: Assessing Public Confidence in Police and Desire for Reform in Pennsylvania
Authors: Kruis Nathan E , Donohue Richard H , Perry Payton , Rowland Nicholas J
Published: November 2021

With data collected from a representative sample of 522 Pennsylvania residents, this study measures public confidence in police and analyses public support for policing practices. Adopting a mixed-method approach, this study also analyses public desire for police reform and correlates of support for police reform. Findings reveal that participants expressed moderate levels of confidence in their local police, although confidence varied across racial groups. Despite this avowed confidence, participants also expressed desire for police reforms. The most supported reforms were those intended to increase officers’ training on mental illness, substance use dependency, and de-escalation techniques; enhance officers’ capabilities of handling critical incidents involving vulnerable populations; implement policing models that incorporate community input and oversight; and increase officer transparency and accountability. A key finding on police reform suggests that the racial divide in support for police reform is usefully informed by including, and not ignoring, significant generational, regional, and political divides. Policy implications based on these findings are discussed within.
Substitution of distal and active site residues reduces product inhibition of E1 from Acidothermus Cellulolyticus
Authors: Summers Samantha R , Alamdari Sarah , Kraft Casey J , Brunecky Roman , Pfaendtner Jim , Kaar Joel L
Published: November 2021

Cellulases are largely afflicted by inhibition from their reaction products, especially at high-substrate loading, which represents a major challenge for biomass processing. This challenge was overcome for endoglucanase 1 (E1) from Acidothermus cellulolyticus by identifying a large conformational change involving distal residues upon binding cellobiose. Having introduced alanine substitutions at each of these residues, we identified several mutations that reduced cellobiose inhibition of E1, including W212A, W213A, Q247A, W249A and F250A. One of the mutations (W212A) resulted in a 47-fold decrease in binding affinity of cellobiose as well as a 5-fold increase in the kcat. The mutation further increased E1 activity on Avicel and dilute-acid treated corn stover and enhanced its productivity at high-substrate loadings. These findings were corroborated by funnel metadynamics, which showed that the W212A substitution led to reduced affinity for cellobiose in the +1 and +2 binding sites due to rearrangement of key cellobiose-binding residues.
Analysis of Factors Influencing Anxiety and Depression among Hospitalized Patients with Chronic Wounds
Authors: Yan Ruihong , Strandlund Kara , Ci Hai , Huang Yinyan , Zhang Yixuan , Zhang Yujuan
Published: November 2021

OBJECTIVE

To investigate the prevalence of anxiety and depression among hospitalized patients with a chronic wound and explore the influence of demographic factors, disease characteristics, social support, and coping styles on their mental status.

METHODS

Investigators recruited 216 patients with a chronic wound. The Self-rating Anxiety Scale and Self-rating Depression Scale were used to measure anxiety and depression. Patients’ coping style and their social support were assessed through face-to-face interviews.

RESULTS

Overall, 36.6% of participants presented with symptoms of anxiety, and 37% showed depressive symptoms. Participants who typically had less than 5 hours of sleep; experienced more severe pain; or had an odorous wound, negative coping style, or lower level of social support had a higher prevalence of anxiety and depression (P < .05). Men with higher monthly incomes who lived in the city were more likely to develop anxiety than women with lower monthly incomes who lived outside the city (P < .05). Participants with fewer years of education and without spouses were more likely to experience depression than married participants with more education (P < .05).

CONCLUSIONS

The prevalence of anxiety and depression among hospitalized patients with a chronic wound is high. Support from loved ones including a spouse and a positive coping style are key protective factors for mental health and well-being.
Moral distress amid COVID-19
Authors: Virani Salima Bano
Published: November 2021

ED nurses are at high risk for developing moral distress during the COVID-19 pandemic. Predisposing factors include limited resources, inadequate staffing, PPE shortages, and caring for vulnerable populations. This article explores personal and organizational strategies to help nurses cope with moral distress.
Early pregnancy loss
Authors: Chichester Melanie , Harding Kimberly M.
Published: November 2021

One of every five pregnancies ends in miscarriage, disputing the common misconception that miscarriage is rare. Early pregnancy loss has a complex impact on women's mental health, requiring compassionate, trauma-informed care. This article explores the emotional and psychological impacts of miscarriage, and strategies for nurses to support the needs of patients after a miscarriage.
Sarcoidosis
Authors: Crawford Anna , Ruth-Sahd Lisa
Published: November 2021

Pulmonary sarcoidosis is a multisystem disease characterized by sarcoid granulomas, vasculitis, and degrees of necrosis with unknown etiology. This article discusses the pathophysiology of sarcoidosis and its medical and nursing management. A case presentation highlights some long-term concerns with this chronic disease.
Addressing internet gaming disorder in children and adolescents
Authors: Gallegos Cara , Connor Kelley , Zuba Lauren
Published: November 2021

Internet gaming disorder (IGD) has been recognized as a potential behavioral addiction that warrants further research. This article discusses the signs, symptoms, and risk factors of this behavioral addiction as well as nursing interventions to support children and adolescents with IGD and their families.
The voice of adolescents
Authors: Lapp Valerie , Fowler Susan B. , Miller Harriet D.
Published: November 2021

There is a lack of understanding of the pediatric patient experience in isolation. This qualitative, descriptive study interviewed adolescent patients during their hospital stay about their perception of isolation. This article analyzes the themes gleaned from the interviews as well as nursing practice implications and strategies in caring for young patients in isolation.
Current and Upcoming Treatment Modalities in Myasthenia Gravis
Authors: Beladakere Ramaswamy Swathi , Singh Shivangi , Hooshmand Sara , Junsang Cho , Sweeney Megan , Govindarajan Raghav
Published: November 2021

Myasthenia gravis (MG) is one of the extensively studied autoimmune disorder. There has been a dramatic increase in research to further understand molecular pathogenesis of MG and clinical trials for new drugs in MG treatment in the past decade. This review article is to consolidate the available information in simple terms with students, residents, and fellows as target audience for easy learning and help application of this knowledge to clinical practice.
Anti-TIF-1α/γ Antibody-Positive Dermatomyositis Associated With Metastatic Prostatic Adenocarcinoma
Authors: Psomadakis Corinna E. , Maron Samuel Z. , Ng Melissa J. , Kessler Alaina J. , Bryce Clare H. , Shanker Vicki L. , Scelsa Stephen N.
Published: November 2021

Dermatomyositis (DM) is an autoimmune myopathy characterized by proximal muscle weakness and distinct skin findings. DM is associated with an increased risk of malignancy in adults. We describe a case of dermatomyositis with unusually severe oropharyngeal dysphagia and respiratory muscle weakness on presentation, who was found to have underlying metastatic prostate cancer. Prostate cancer is uncommonly associated with DM. The patient tested positive for antitranscription intermediate family-1 (anti-TIF-1, also known as anti-p155/410) antibodies, which are linked to malignancy-associated DM in adults and are associated with dysphagia and more severe cutaneous findings.
What Is in the Myopathy Literature?
Authors: Lacomis David
Published: November 2021

This edition concentrates on inflammatory myopathies with reports of reclassification of polymyositis, cancer associations, evaluation of subclinical cardiac involvement, myositis-specific and -associated antibodies, and immune checkpoint inhibitor myositis. A number of reports address sporadic late-onset nemaline myopathy and point out its diagnostic difficulty and the importance of identifying an associated monoclonal gammopathy that is likely of clinical significance and may warrant aggressive immunotherapy. Finally, treatment of nondystrophic channelopathies is addressed.
An Advanced Surgical Dressing for High-risk Patients Undergoing Breast Cancer Surgery: A Case-control Study
Authors: Nicotera A. , Ferrando P.M. , Ala A. , Brunetti M. , D’Anna M.R. , Passera R. , Malan F.
Published: November 2021

Background:

Oncological breast surgeries, classified as breast conserving surgery, oncoplastic surgery, and mastectomies (standard or with tissue sparing and reconstruction), are burdened with an overall complication rate up to 33%. Aquacel Ag Surgical is a combined hydrofiber-hydrocolloids dressing. The aim of this study is to evaluate the incidence of surgical site complications in patients presenting with three or more risk factors (or two, of which at least one classified as “high risk”), undergoing breast cancer surgery with/without reconstruction, comparing advanced (Aquacel Ag Surgical) with traditional dressing.

Methods:

This is a retrospective, monocentric, case-control study based at the breast unit of the Città della Salute e della Scienza Hospital of Turin, Italy. Forty-two patients who underwent breast surgeries and met the inclusion criteria were enrolled, from February 1 to July 31, 2018. The primary endpoint was comparing the incidence of surgical site complications (skin alterations, infection, and wound dehiscence) in the two groups. The secondary endpoints were evaluating patient’s quality of life, aesthetic outcomes, and compliance to the dressings.

Results:

The distribution of risk factors at the baseline between the two groups was balanced, without statistically significant differences. Wound complications’ incidence at 1 week was lower in the advanced dressing group (P = 0.015). On the bivariate descriptive analysis, advanced dressing proved to be easier to remove for the operator (P = 0.026). The aesthetic outcomes vouched for better scores in the advanced dressing group.

Conclusion:

In the presented study Aquacel Ag Surgical dressing reduces surgical site complications in the first week after surgery in patients affected by three or more risk factors (or two with at least one classified as “high risk”).
NEW BIOMARKER QUANTIFYING THE EFFECT OF ANTI-VEGF THERAPY IN EYES WITH PROLIFERATIVE DIABETIC RETINOPATHY ON ULTRAWIDE FIELD FLUORESCEIN ANGIOGRAPHY
Authors: Fan Wenying , Nittala Muneeswar Gupta , Wykoff Charles C. , Brown David M. , Uji Akihito , Hemert Jano Van , Fleming Alan , Robertson Gavin , Sadda Srinivas R. , IP Michael
Published: November 2021

Purpose:

To quantify changes of the retinal vascular bed area (RVBA) in mm2 on stereographically projected ultrawide field fluorescein angiography images in eyes with proliferative diabetic retinopathy after antivascular endothelial growth factor injection.

Methods:

This is a prospective, observational study. The early-phase ultrawide field fluorescein angiography images (Optos 200Tx) of 40 eyes with proliferative diabetic retinopathy and significant nonperfusion obtained at baseline and after six months (NCT02863354) were stereographically projected by correcting peripheral distortion. The global retinal vasculature on ultrawide field fluorescein angiography was extracted for calculating RVBA by summing the real size (mm2) of all the pixels automatically.

Results:

For the entire cohort, the global RVBA for the entire retina decreased from 67.1 ± 15.5 to 43.6 ± 18.8 mm2 after anti-VEGF treatment at six months (P < 0.001). In the subgroup receiving monthly anti-VEGF injections, the global RVBA decreased from 68.7 ± 16.2 to 33.9 ± 13.3 mm2 (P < 0.001). In the subgroup receiving anti-VEGF every three months, the global RVBA decreased from 65.6 ± 15.1 to 50.8 ± 19.3 mm2 (P = 0.004).

Conclusion:

RVBA seems to be a new biomarker to indicate efficiency of retinal vascular changes after anti-VEGF injection. Eyes with proliferative diabetic retinopathy and significant nonperfusion demonstrate reduced RVBA after anti-VEGF treatment.
Preparing Faculty to Incorporate Health Systems Science into the Clinical Learning Environment: Factors Associated with Sustained Outcomes
Authors: Lazorick Suzanne , Teherani Arianne , Lawson Luan , Dekhtyar Michael , Higginson Jason , Garris Jenna , Baxley Elizabeth G.
Published: November 2021

This study assesses participants’ perceptions of long-term impacts of the Teachers of Quality Academy, a medical school faculty development program designed to prepare faculty to both practice and teach health system science. A previously published 1-year evaluation of the first cohort of 27 participants showed improved perceived skills, with positive career and health system impacts. In this 5-year evaluation, a mixed-methods design included a questionnaire followed by semistructured interviews to assess perceived long-term impacts on participants. Quantitative and qualitative analyses were completed. Questionnaire response rate was 88% (N = 22), and 14 interviews were analyzed. Results demonstrated that participants had incorporated quality improvement concepts into their clinical work and teaching, better understood interprofessionalism, and observed continued improvements in care delivery. They felt the longitudinal training, delivered in a shared setting, created a learning community with lasting positive effects in institutional culture, supported long-term professional development, and had broader institutional impact. Advancements in clinical care, medical education, and professional and academic advancements were noted.
Mobile Extracorporeal Membrane Oxygenation for Covid-19 Does Not Pose Extra Risk to Transport Team
Authors: Javidfar Jeffrey , Labib Ahmed , Ragazzo Gabrielle , Kurtzman Ethan , Callahan Maria , Heinsar Silver , Gudzenko Vadim , Barrett Peter , Binongo José , Wei Jane Wenjing , Fraser John , Suen Jacky Y. , Li Bassi Gianluigi , Peek Giles ,   for the Covid-19 Critical Care Consortium
Published: November 2021

Previous experience has shown that transporting patients on extracorporeal membrane oxygenation (ECMO) is a safe and effective mode of transferring critically ill patients requiring maximum mechanical ventilator support to a quaternary care center. The coronavirus disease 2019 (COVID-19) pandemic posed new challenges. This is a multicenter, retrospective study of 113 patients with confirmed severe acute respiratory syndrome coronavirus 2, cannulated at an outside hospital and transported on ECMO to an ECMO center. This was performed by a multidisciplinary mobile ECMO team consisting of physicians for cannulation, critical care nurses, and an ECMO specialist or perfusionist, along with a driver or pilot. Teams practised strict airborne contact precautions with eyewear while caring for the patient and were in standard Personal Protective Equipment. The primary mode of transportation was ground. Ten patients were transported by air. The average distance traveled was 40 miles (SD ±56). The average duration of transport was 133 minutes (SD ±92). When stratified by mode of transport, the average distance traveled for ground transports was 36 miles (SD ±52) and duration was 136 minutes (SD ±93). For air, the average distance traveled was 66 miles (SD ±82) and duration was 104 minutes (SD ±70). There were no instances of transport-related adverse events including pump failures, cannulation complications at outside hospital, or accidental decannulations or dislodgements in transit. There were no instances of the transport team members contracting COVID-19 infection within 21 days after transport. By adhering to best practices and ACE precautions, patients with COVID-19 can be safely cannulated at an outside hospital and transported to a quaternary care center without increased risk to the transport team.
MELD-Na Accurately Predicts 6-Month Mortality in Patients With Decompensated Cirrhosis
Authors: Brown Cristal , Aksan Nazan , Muir Andrew J.
Published: November 2021

Goal:

The goal of this study was to determine the accuracy of Model of End-stage Liver Disease—Sodium (MELD-Na) in predicting 6-month mortality for patients listed for liver transplantation on the United Network of Organ Sharing (UNOS) waitlist.

Background:

End-stage liver disease patients underutilize hospice services despite significant morbidity and mortality associated with advanced liver disease. A well-known barrier to hospice referral is clinician uncertainty in identifying patients with an expected survival of <6 months, a requirement for a referral.

Methods:

Retrospective cross-sectional analysis was performed from UNOS data spanning February 27, 2002, to September 30, 2019. Inclusion criteria of patients aged 18 years and above, diagnosis of cirrhosis, liver transplant eligible, and listed in the UNOS database. Exclusion criteria included fulminant hepatic failure, prior history of liver transplantation, diagnosis of hepatocellular carcinoma, receipt of liver transplant in <180 days, or removal from waiting list <180 days for a reason other than death.

Measurement:

Mortality by 180 days.

Results:

Of the 93,157 patients that met inclusion criteria, MELD-Na was calculated for all patients with sodium, total bilirubin, international normalized ratio, and creatinine available (N=79,611). The c-statistic with 95% confidence interval for MELD-Na for the predicted 6-month mortality was 0.83 (0.827-0.835). Mean MELD-Na of 28.2 was associated with ≤50% 6-month survival.

Conclusion:

MELD-Na is an objective, quick measure that can aid providers in identifying patients with increased 6-month mortality in time-constrained settings, and a score of 28 can trigger the discussion for hospice as a means of improving value-based health care.
Understanding components of mobility during the COVID-19 pandemic
Authors: Edsberg Møllgaard Peter , Lehmann Sune , Alessandretti Laura
Published: November 2021

Travel restrictions have proven to be an effective strategy to control the spread of the COVID-19 epidemics, in part because they help delay disease propagation across territories. The question, however, as to how different types of travel behaviour, from commuting to holiday-related travel, contribute to the spread of infectious diseases remains open. Here, we address this issue by using factorization techniques to decompose the temporal network describing mobility flows throughout 2020 into interpretable components. Our results are based on two mobility datasets: the first is gathered from Danish mobile network operators; the second originates from the Facebook Data-For-Good project. We find that mobility patterns can be described as the aggregation of three mobility network components roughly corresponding to travel during workdays, weekends and holidays, respectively. We show that, across datasets, in periods of strict travel restrictions the component corresponding to workday travel decreases dramatically. Instead, the weekend component, increases. Finally, we study how each type of mobility (workday, weekend and holiday) contributes to epidemics spreading, by measuring how the effective distance, which quantifies how quickly a disease can travel between any two municipalities, changes across network components.

This article is part of the theme issue ‘Data science approaches to infectious disease surveillance’.
pISA-tree - a data management framework for life science research projects using a standardised directory tree
Authors: Petek Marko , Zagorščak Maja , Blejec Andrej , Ramšak Živa , Coll Anna , Baebler Špela , Gruden Kristina
Published: November 2021

We developed pISA-tree, a straightforward and flexible data management solution for organisation of life science project-associated research data and metadata. pISA-tree was initiated by end-user requirements thus its strong points are practicality and low maintenance cost. It enables on-the-fly creation of enriched directory tree structure (project/Investigation/Study/Assay) based on the ISA model, in a standardised manner via consecutive batch files. Templates-based metadata is generated in parallel at each level enabling guided submission of experiment metadata. pISA-tree is complemented by two R packages, pisar and seekr. pisar facilitates integration of pISA-tree datasets into bioinformatic pipelines and generation of ISA-Tab exports. seekr enables synchronisation with the FAIRDOMHub repository. Applicability of pISA-tree was demonstrated in several national and international multi-partner projects. The system thus supports findable, accessible, interoperable and reusable (FAIR) research and is in accordance with the Open Science initiative. Source code and documentation of pISA-tree are available at https://github.com/NIB-SI/pISA-tree.
Modern microbial mats from the Chihuahuan Desert provide insights into ecological stability throughout Earth’s history
Authors: Madrigal-Trejo David , Sánchez-Pérez Jazmín , Espinosa-Asuar Laura , Souza Valeria
Published: November 2021

Microbial mats are complex ecological assemblages that are found in the Precambrian fossil record and in extant extreme environments. Hence, these structures are regarded as highly stable ecosystems. In this work, we assess the ecological stability in a modern, fluctuating, hypersaline pond from the Cuatro Ciénegas Basin. From the 2016 to 2019 metagenomic sampling of this site, we found that this microbial site is sensitive to disturbances, which leads to high taxonomic replacement. Additionally, the mats have shown to be functionally stable throughout time, and could be differentiated between dry and rainy seasonal states. We speculate that this microbial system could represent modern analogs of ancient microbial mats where functions were preserved over time, whereas composition was subject to diversification in the face of local and planetary perturbations.
Dissociating experience-dependent and maturational changes in fine motor function during adolescence
Authors: Berencsi Andrea , Gombos Ferenc , Gerván Patrícia , Tróznai Zsófia , Utczás Katinka , Oláh Gyöngyi , Kovács Ilona
Published: November 2021

Adolescence is a sensitive period in motor development but little is known about how long-term learning dependent processes shape hand function in tasks of different complexity. We mapped two fundamental aspects of hand function: simple repetitive and complex sequential finger movements, as a function of the length of musical instrumental training. We controlled maturational factors such as chronological and biological age of adolescent female participants (11 to 15 years of age, n=114). We demonstrated that experience improves performance as a function of task complexity, the more complex task being more susceptible for experience driven performance changes. Overall, these results suggest that fine motor skills involving cognitive control and relying on long-range functional brain networks are substantially shaped by experience. On the other hand, performance in a simple repetitive task that explains fine motor speed is primarily shaped by white matter development driven by maturational factors.