bluuebunny/crossref_metadata_2025 huggingface dataset:
The association between plant-based diet and erectile dysfunction in Chinese men
Authors: Lu Yi , Kang Jiaqi , Li Zhongjia , Wang Xiao , Liu Kang , Zhou Kechong , Wang Wei , Shen Chen
Published: May 2021

Background

Diet, one of the components of lifestyle, has been believed to have associations with erectile dysfunction (ED). However, whether there is an association between plant-based diet and ED is remains to be explored. Thus, we conducted the nested case-control study to investigate the relationship between the plant-based diet and ED in China.

Results

ED group (92 subjeczts) and ED free group (92 subjects) were similar in terms of basic features (P > 0.05), except for lifestyle (P < 0.05). The plant-diet index (PDI) and healthy plant-diet index (hPDI) in the ED group were significantly lower than those in the control group (P < 0.001). Adjusted multivariate analysis indicated that the presence of ED was negatively associated with nitric oxide levels, PDI, and hPDI (all P < 0.05), and was positively related to body mass index, metabolic syndrome, and E-selectin levels. Furthermore, both the PDI and hPDI increased significantly as the International Index of Erectile Function (IIEF-5) scores increased within the ED group (P < 0.05). Multi-model multivariate analysis indicated the robustness of results.

Conclusions

More plant-based diet intake was associated with a reduced presence of ED and less severe ED in China. Committing to plant-based diet can be encouraged for many health benefits and to lower ED burden. Further well-designed studies are warranted to validate our findings.
How imputation can mitigate SNP ascertainment Bias
Authors: Geibel Johannes , Reimer Christian , Pook Torsten , Weigend Steffen , Weigend Annett , Simianer Henner
Published: May 2021

Background

Population genetic studies based on genotyped single nucleotide polymorphisms (SNPs) are influenced by a non-random selection of the SNPs included in the used genotyping arrays. The resulting bias in the estimation of allele frequency spectra and population genetics parameters like heterozygosity and genetic distances relative to whole genome sequencing (WGS) data is known as SNP ascertainment bias. Full correction for this bias requires detailed knowledge of the array design process, which is often not available in practice. This study suggests an alternative approach to mitigate ascertainment bias of a large set of genotyped individuals by using information of a small set of sequenced individuals via imputation without the need for prior knowledge on the array design.

Results

The strategy was first tested by simulating additional ascertainment bias with a set of 1566 chickens from 74 populations that were genotyped for the positions of the Affymetrix Axiom™ 580 k Genome-Wide Chicken Array. Imputation accuracy was shown to be consistently higher for populations used for SNP discovery during the simulated array design process. Reference sets of at least one individual per population in the study set led to a strong correction of ascertainment bias for estimates of expected and observed heterozygosity, Wright’s Fixation Index and Nei’s Standard Genetic Distance. In contrast, unbalanced reference sets (overrepresentation of populations compared to the study set) introduced a new bias towards the reference populations. Finally, the array genotypes were imputed to WGS by utilization of reference sets of 74 individuals (one per population) to 98 individuals (additional commercial chickens) and compared with a mixture of individually and pooled sequenced populations. The imputation reduced the slope between heterozygosity estimates of array data and WGS data from 1.94 to 1.26 when using the smaller balanced reference panel and to 1.44 when using the larger but unbalanced reference panel. This generally supported the results from simulation but was less favorable, advocating for a larger reference panel when imputing to WGS.

Conclusions

The results highlight the potential of using imputation for mitigation of SNP ascertainment bias but also underline the need for unbiased reference sets.
Association between smoking and in-hospital mortality in patients with left ventricular dysfunction undergoing coronary artery bypass surgery: a propensity-matched study
Authors: Tang Hanwei , Hou Jianfeng , Chen Kai , Huang Xiaohong , Liu Sheng , Hu Shengshou
Published: May 2021

Background

Data on the effect of smoking on In-hospital outcome in patients with left ventricular dysfunction undergoing coronary artery bypass graft (CABG) surgery are limited. We sought to determine the influence of smoking on CABG patients with left ventricular dysfunction.

Methods

A retrospective study was conducted using data from the China Heart Failure Surgery Registry database. Eligible patients with left ventricular ejection fraction less than 50% underwent isolated CABGS were included. In addition to the use of multivariate regression models, a 1–1 propensity scores matched analysis was performed. Our study (n = 6531) consisted of 3635 smokers and 2896 non-smokers. Smokers were further divided into ex-smokers (n = 2373) and current smokers (n = 1262).

Results

The overall in-hospital morality was 3.9%. Interestingly, current smokers have lower in-hospital mortality than non-smokers [2.3% vs 4.9%; adjusted odds ratio (OR) 0.612 (95% CI 0.395–0.947) ]. No difference was detected in mortality between ex-smokers and non-smokers [3.6% vs 4.9%; adjusted OR 0.974 (0.715–1.327)]. No significant differences in other clinical end points were observed. Results of propensity-matched analyses were broadly consistent.

Conclusions

It is paradoxically that current smokers had lower in-hospital mortality than non-smokers. Future studies should be performed to further understand the biological mechanisms that may explain this ‘smoker’s paradox’ phenomenon.
BEFRIENding for Depression, Anxiety and Social support in older adults living in Australian residential aged care facilities (BEFRIENDAS): randomised controlled trial protocol
Authors: Doyle Colleen , Bhar Sunil , Bryant Christina , Dow Briony , Dunt David , Mnatzaganian George , O’Connor Daniel , Ratcliffe Julie , You Emily , Bagnall Anne-Marie , Major Georgia , Harper Robin , Fearn Marcia
Published: May 2021

Background

This protocol describes an ongoing study of the impact of befriending on depression, anxiety and loneliness in older people living in residential aged care facilities in Australia. While systematic reviews of befriending have indicated positive benefits of befriending for people in a range of ages and settings, there have been no randomised controlled trials (RCTs) of befriending for older people living in residential aged care with depression and no studies of the cost effectiveness of befriending in residential aged care facilities (RACFs) in Australia.

Methods and analysis

We are conducting a single blind pragmatic RCT comparing two groups of older people living in RACFs, one receiving an intervention consisting of weekly befriending for 4 months from a trained volunteer and the other receiving treatment as usual. Participants undergo eligibility screening for depression (GDS-15 ≥ 4) and cognitive impairment (GPCog ≥ 4) and assessments at three measurement time points: baseline prior to randomisation, 2 months post-baseline and 4 months post-baseline. The primary outcome measure is depression, and secondary outcome measures are anxiety, loneliness, social isolation and quality of life. The economic evaluation will take the form of a cost-utility analysis based on the outcome of quality of life. The primary and secondary outcomes will be analysed using negative binomial and logistic regressions utilizing the Generalised Estimating Equations approach.

Discussion

To our knowledge, this is the first RCT evaluating the effectiveness of befriending on older people with depression living in residential aged care. It is expected that the befriending intervention will reduce the severity of depression symptoms experienced by older people living in residential aged care. If the intervention proves effective it may be incorporated into volunteer training programs and adopted as a way of supporting older people’s mental health.

Trial registration

Trial registered with the Australian and New Zealand Clinical Trial Registry (ANZCTR) Number: ACTRN12619000676112, registered 06/05/2019 – retrospectively registered.
“A good death but there was all this tension around”- perspectives of residential managers on the experience of delivering end of life care for people living with dementia
Authors: Borbasi Jessica A. L. , Tong Allison , Ritchie Alison , Poulos Christopher J. , Clayton Josephine M.
Published: May 2021

Background

End of life care for residents with advanced dementia in the aged care setting is complex. There is prolonged and progressive cognitive decline, uncertain disease trajectory, significant symptom burden and infrequent access to specialist palliative care. Residential aged care managers offer a unique perspective in understanding the experience of providing end of life care for residents with advanced dementia. They bring insight from the coalface to the broader policy context. The aim of this study was to describe the experience and perspectives of residential aged care managers on providing end of life care for residents living with dementia.

Methods

Focus groups and semi-structured interviews were conducted with residential or care managers from various care homes from one dementia specific aged care organisation in Australia. A comprehensive sampling strategy was used in participating care homes. Transcripts were analysed using thematic analysis.

Results

20 residential or care managers from 11 aged care homes in two states of Australia participated in two focus groups (total 16 participants) or individual interviews (4 participants). Six themes were identified: laying the ground work to establish what families understand about dementia, playing the peacemaker in the face of unrealistic family demands and expectations, chipping away at denial and cultivating a path towards acceptance of death, recruiting general practitioners as allies, supporting and strengthening the front line, and dedication to optimal care is relentless but rewarding.

Conclusion

Aged care manager participants described provision of end of life dementia care as a rewarding but sometimes fraught experience requiring persistent personalisation of care and communication to enable family acceptance of the resident’s terminal condition. The findings suggest that continuous front line aged care staff skill development, iterative family discussions, and partnership building between aged care staff and general practitioners, are all required to promote optimal end of life dementia care in residential aged care settings.
Added value of contrast-enhanced ultrasound (CEUS) in the diagnosis of primary retroperitoneal serous adenocarcinoma: a case report
Authors: Zhou Lin-Yu , Zhu Xiao-Dan , Jiang Jian , Bai Yan-Feng , Jiang Tian-An
Published: May 2021

Background

Primary retroperitoneal serous adenocarcinoma (PRSA) is a rare malignant disease. Given the rarity of the disease, the imaging features of PRSA are unclear. Contrast-enhanced ultrasound (CEUS) also plays an important role in the evaluation of the differential diagnosis of retroperitoneal lesions.

Case presentation

We report the case of a 62-year-old woman of with increased CA125 levels for 1 year who was referred to our hospital. After conducting contrast-enhanced computed tomography and magnetic resonance imaging, the mass was misdiagnosed as a chocolate cyst. After transvaginal ultrasound (TUS) combined with CEUS, cystadenocarcinoma was considered as the initial diagnosis. Pathology results confirmed PRSA as the final diagnosis.

Conclusions

CEUS features of PRSA are reported for the first time based on this case, potentially aiding in the differential diagnosis of this rare entity before surgery.
Descriptive epidemiology of nasopharyngeal carcinoma at Tikur Anbessa Hospital, Ethiopia
Authors: Beyene Elizabeth Tadesse , Ketema Siraw Girum , Alebachew Assaye Nibret , Saleh Mizan Yeshanew , Gebremariam Tsigereda Atumo
Published: May 2021

Background

Nasopharyngeal cancer is distinguished from other cancers of the head and neck in its epidemiology, histopathology, clinical characteristics, and therapeutic outcome. Its unique clinico-epidemiologic pattern of the disease is an area focus for this investigation. Accordingly, the study investigated the demographic and histologic characteristics, as well as the clinical stage at presentation of nasopharyngeal carcinoma patients at Tikur Anbessa Specialized hospital.

Methods

Hospital based retrospective descriptive study was conducted from September 2017 – October 2020. All biopsy proven incidental cases during the study period are included. SPSS version 26 is used for data entry and analysis.

Result

A total of 318 patients with histologically confirmed nasopharyngeal carcinoma cases during the study period were included. There were 218 males and 90 females, with a male: female ratio of 2.5:1. The age of patients ranges from 13 to 81 years with a mean age of 37.8 ± 15 years. The median age at diagnosis was 38 years. Age distribution has two peaks for males, first between 30 to 39 and second 50 to 59 years of age. While the peak age of occurrence for females is in the 20–39 age range. Juvenile cases constituted 34% of the study group. The study revealed, nonkeratinizing carcinoma as the most prevalent histology at 94.3% (undifferentiated type 85.9% and differentiated keratinizing squamous cell carcinoma 8.4%) and 5.7% of the cases showed keratinizing squamous cell carcinoma. Majority of the patients, 86%, presented late with stage III and IV disease.

Conclusion

Nasopharyngeal cancer is commonly found among the young and productive age group, under the age 30. Nonkeratinizing carcinoma is the predominant histopathologic variant resembling that seen in endemic areas of the world. Thus, genetic and early life environmental exposures should be well studied to identify possible risk factors in the region. Late-stage presentation at diagnosis impacts the treatment outcome of patients, thereby indicating the need for a raised index of suspicion among health professionals for early diagnosis and better prognosis of patients.
Assessing causality by means of the Naranjo scale in a paediatric patient with life threatening respiratory failure after alemtuzumab administration: a case report
Authors: Smeets Nori J. L. , Eijk Ruud J. R. , de Wildt Saskia N. , Bootsma-Robroeks Charlotte M. H. H. T.
Published: May 2021

Background

Alemtuzumab is a T cell depleting antibody agent used as induction immunosuppressant therapy in solid organ transplant recipients. In addition, it is being increasingly used to treat severe or glucocorticoid-resistant graft rejection. Despite the effectiveness of the treatment, severe adverse events have been reported related to alemtuzumab administration. We present a similar event illustrating the severity of this adverse drug reaction (ADR) and we highlight the structure causality assessment provides in approaching such a case.

Case presentation

We report a case of life-threatening respiratory failure after alemtuzumab administration in a 17 year old paediatric kidney transplant recipient. He developed near fatal severe respiratory and circulatory failure based on acute respiratory distress syndrome (ARDS) with diffuse alveolar oedema and haemoptysis hours after his second alemtuzumab administration. As it was questionable whether alemtuzumab could be regarded as the origin of his reaction and in order to assess the causality of this reaction as well as to structure clinical reasoning, we applied a widely used ADR probability scale to systematically review our case.

Discussion and conclusions

Our case shows a severe ADR after alemtuzumab administration. It illustrates the importance of proper causality assessment, the structure it provides and the benefit of a clinical pharmacology consultation when a severe reaction is suspected to be an ADR. By taking our case as an example, we demonstrate the added value of structured causality assessment to clinical reasoning and in generating differential diagnoses.
A qualitative study of experiences of NHS mental healthcare workers during the Covid-19 pandemic
Authors: Liberati Elisa , Richards Natalie , Willars Janet , Scott David , Boydell Nicola , Parker Jennie , Pinfold Vanessa , Martin Graham , Dixon-Woods Mary , Jones Peter B.
Published: May 2021

Background

The Covid-19 pandemic has imposed extraordinary strains on healthcare workers. But, in contrast with acute settings, relatively little attention has been given to those who work in mental health settings. We aimed to characterise the experiences of those working in English NHS secondary mental health services during the first wave of the pandemic.

Methods

The design was a qualitative interview-based study. We conducted semi-structured, remote (telephone or online) interviews with 35 members of staff from NHS secondary (inpatient and community) mental health services in England. Analysis was based on the constant comparative method.

Results

Participants reported wide-ranging changes in the organisation of secondary mental health care and the nature of work in response to the pandemic, including pausing of all services deemed to be “non-essential”, deployment of staff across services to new and unfamiliar roles, and moves to remote working. The quality of participants’ working life was impaired by increasing levels of daily challenge associated with trying to provide care in trying and constrained circumstances, the problems of forging new ways of working remotely, and constraints on ability to access informal support. Participants were confronted with difficult dilemmas relating to clinical decision-making, prioritisation of care, and compromises in ability to perform the therapeutic function of their roles. Other dilemmas centred on trying to balance the risks of controlling infection with the need for human contact. Many reported features of moral injury linked to their perceived failures in providing the quality or level of care that they felt service users needed. They sometimes sought to compensate for deficits in care through increased advocacy, taking on additional tasks, or making exceptions, but this led to further personal strain. Many experienced feelings of grief, helplessness, isolation, distress, and burnout. These problems were compounded by sometimes poor communication about service changes and by staff feeling that they could not take time off because of the potential impact on others. Some reported feeling poorly supported by organisations.

Conclusions

Mental health workers faced multiple adversities during the pandemic that were highly consequential for their wellbeing. These findings can help in identifying targets for support.
Somatic distress among Syrian refugees with residence permission in Germany: analysis of a cross-sectional register-based study
Authors: Borho Andrea , Morawa Eva , Schmitt Gregor Martin , Erim Yesim
Published: May 2021

Background

Previous studies have already proven high rates of common mental disorders in Syrian refugees. Nevertheless, little is known about the patterns of somatic distress among this refugee population. For this reason, we aimed to examine the prevalence, co-occurrence, and risk factors of somatic distress among Syrian refugees in Germany.

Methods

This study analyzes the second measurement point (N = 116) of a prospective register-based survey among 200 adult Syrian refugees with residence permission in Germany. The survey consisted of information on sociodemographic and migration-specific characteristics, health care utilization, traumatic life events, acculturative stress (Barcelona Immigration Stress Scale (BISS); subscales: perceived discrimination, intercultural contact stress, homesickness, and general psychosocial stress), and self-reported outcomes of somatic distress (Patient Health Questionnaire (PHQ-15)), depression (PHQ-9), generalized anxiety disorder (GAD-7), and post-traumatic symptoms (Essen Trauma Inventory (ETI)).

Results

Almost half of the respondents (49.1%) were identified as being at risk of somatic distress (PHQ-15 score ≥ 6), and even 24.1% being bothered by moderate-to-severe levels of somatic distress (PHQ-15 score ≥ 10). The most robust associations with somatic distress were found for female gender, the amount of health care utilization, multiple trauma exposures, general psychosocial stress, and self-reported depression and anxiety symptoms. High comorbidities with somatic distress were shown for all of the common mental disorders studied.

Conclusions

The presented study reveals a significant risk of somatic distress among this displaced population and highlights implications for policy and health care providers.
Correction to: A prospective study on the effect of self-reported health and leisure time physical activity on mortality among an ageing population: results from the Tromsø study
Authors: Opdal Ida Marie , Larsen Lill Sverresdatter , Hopstock Laila Arnesdatter , Schirmer Henrik , Lorem Geir Fagerjord
Published: May 2021

An amendment to this paper has been published and can be accessed via the original article.
Trends of cervical cancer at global, regional, and national level: data from the Global Burden of Disease study 2019
Authors: Zhang Xingxing , Zeng Qingle , Cai Wenwen , Ruan Weiqing
Published: May 2021

Background

Cervical cancer is an important global health problem. In this study we aimed to analyze trends in cervical cancer at the global, regional, and national levels from 1990 to 2019, to inform health service decision-making.

Methods

Data on cervical cancer was extracted from the Global Burden of Disease study, 2019. Trends in cervical cancer burden were assessed based on estimated annual percentage change (EAPC) and age-standardized rate (ASR).

Results

Globally, decreasing trends were observed in incidence, death, and disability adjusted life years (DALYs) of cervical cancer from 1990 to 2019, with respective EAPCs of − 0.38 (95% confidence interval [CI]: − 0.41 to − 0.34), − 0.93 (95%CI: − 0.98 to − 0.88), and − 0.95 (95 CI%: − 1.00 to − 0.90). Meanwhile, decreasing trends were detected in most sociodemographic index (SDI) areas and geographic regions, particularly death and DALYs in Central Latin America, with respective EAPCs of − 2.61 (95% CI: − 2.76 to − 2.46) and − 2.48 (95% CI: − 2.63 to − 2.32); hhowever, a pronounced increasing trend in incidence occurred in East Asia (EAPC = 1.33; 95% CI: 1.12 to 1.55). At the national level, decreasing trends in cervical cancer were observed in most countries/territories, particularly DALYs in the Maldives (EAPC = − 5.06; 95% CI: − 5.40 to − 4.72), Whereas increasing trends were detected in Lesotho, Zimbabwe, and Bulgaria.

Conclusions

Slowly decreasing trends in cervical cancer were detected worldwide from 1990 to 2019. Cervical cancer remains a substantial health problem for women globally, requiring more effective prevention and control strategies.
Appendicitis during the COVID-19 pandemic: lessons learnt from a district general hospital
Authors: Pringle Heather C. M. , Donigiewicz Urszula , Bennett Melissa-Rose , Walker Eleanor , Fowler George E. , Narang Sunil , Ball Susan , Bethune Robert M.
Published: May 2021

Background

The COVID-19 pandemic dramatically influenced the delivery of healthcare. In line with the UK Royal Colleges’ advice the management of acute appendicitis (AA) changed with greater consideration for non-operative management (NOM) or open appendicectomy when operative management (OM) was sought. We describe our experience of the presentation, management and outcomes for these patients to inform care for future viral pandemics.

Methods

This retrospective, cohort study compared patients diagnosed with AA between March and July 2019 with those during the pandemic period of March to July 2020. Medical records were reviewed to obtain demographics, inflammatory markers, imaging, severity, management, histology, length of stay (LOS) and 90-day outcomes.

Results

There were 149 and 125 patients in the 2019 and 2020 cohorts respectively. 14 patients (9.4%) had NOM in 2019 versus 31 (24.8%) in 2020 (p = 0.001). In the 2019 operative management (OM) group 125 patients (92.6%) had laparoscopic appendicectomy versus 65 (69.1%) in 2020. 59 patients (39.6%) had a CT in 2019 versus 70 (56%) in 2020. The median LOS was 4 days in 2019 and 3 days in 2020 (p = 0.03). Two patients in each year who received NOM had treatment failure (14.3% in 2019 and 6.5% in 2020). Three patients in 2019 who received OM had treatment failure (2.2%). Of 95 patients tested for COVID-19 all but one tested negative.

Conclusion

During the COVID-19 pandemic there was no observed increase in severity of AA, patients had a shorter LOS and were more likely to have imaging. NOM proportionally increased with no observed change in outcomes.
Microsurgical endodontic treatment of the upper molar teeth and their relationship with the maxillary sinus: a retrospective multicentric clinical study
Authors: Taschieri S. , Morandi B. , Giovarruscio M. , Francetti L. , Russillo A. , Corbella S.
Published: May 2021

Purpose

To assess the clinical and radiographic success rate of microsurgical endodontic treatment of upper molar teeth in relationship with the maxillary sinus, with 12 months follow-up.

Methods

Patients treated with microsurgical endodontic treatment of upper molar teeth in the period between 2017 and 2019 were recruited from two dental clinics according to specific selection criteria. The outcomes were determined based on clinical and radiographic results taken three, six and 12 months post-operatively, compared with those taken immediately before and after surgery. Clinical and radiographic outcomes were recorded. The distance between the most apical part of the root and of the lesion to the maxillary sinus was measured on CBCT images before the surgery. Patient-related outcomes were recorded.

Results

Out of 35 patients evaluated, 21 were selected according with the selection criteria for a total of 27 roots and 29 canals treated. After 12 months, 18 patients showed a complete healing whereas three demonstrated incomplete healing. Consequently, the success rate in this study was 85.7% after one year. In 28.5% (6 patients) there was a perforation of the Schneiderian membrane that didn’t seem to affect the outcome. All patients kept the molar one year later. The pain level decreased significantly over the time during the first week after surgery.

Conclusion

Microsurgical Endodontic treatment of the upper molar teeth should be considered a valid and predictable treatment option even in case of Schneiderian membrane perforation. Future clinical studies with a larger sample size are needed to compare the results obtained.
Something must happen before first breath
Authors: Polese Daniela , Fagioli Marcella , Virgili Fabio , Fiori Nastro Paolo
Published: May 2021

Background

Definition and concept of the ‘beginning of human life’ are weakened by co-existing contrasting hypotheses based on humanistic or religious beliefs rather than scientific foundations. This plethora of conceptually distant views have important common concerns in different fields of science and shape, in turn, several societal aspects including laws related, for instance, to inheritance eligibility or abortion, end-of-life care and euthanasia, and reproductive technology. Also, they are fundamental to evaluate opportunity for resuscitation vs. palliative care in extremely preterm infants. In this article, we address one of the most common tenets in medicine: the acceptance that human life starts with first breath, even though several events are well-documented to take place before its occurrence.

Main text

Several studies show how pivotal physiological events take place before first breath. Evidence of a number of neurological events occurring before first breath opens the way to the primacy of the Central Nervous System, given its immediate extra-uterine activation at birth. This activation eventually sets specific physiological conditions that allow the complex sequence of events determining the muscle activity associated with the influx of air in the lung and the settling of a continuous and successful extra-uterine respiration. We would like to invite the scientific community to endorse a clear-cut position against the paradigm of ‘first breath’ as the beginning of life. Herein, we also assume how, a still undefined, yet possibly specific quid in the external environment triggers further physiological response in newborns. Better understanding of the critical events that occur at the beginning of human life is likely to cause great concern and expectations in scientists, researchers and physicians working in the domain of brain, and its physiology, and mental health.

Conclusions

The comparison between beliefs and evidence-based observations generates confusion, misperceptions and false expectations in society, hence, in the scientific and medical community. Different and more solid alternatives about the carachterization of the ‘beginning of human life’ are indeed available and require to be explored and defined.
Acceptability of a complex team-based quality improvement intervention for transient ischemic attack: a mixed-methods study
Authors: Damush Teresa M. , Penney Lauren S. , Miech Edward J. , Rattray Nicholas A. , Baird Sean A. , Cheatham Ariel J. , Austin Charles , Sexson Ali , Myers Laura J. , Bravata Dawn M.
Published: May 2021

Background

The Protocol-guided Rapid Evaluation of Veterans Experiencing New Transient Neurologic Symptoms (PREVENT) program was a complex quality improvement (QI) intervention targeting transient ischemic attack (TIA) evidence-based care. The aim of this study was to evaluate program acceptability among the QI teams and factors associated with degrees of acceptability.

Methods

QI teams from six Veterans Administration facilities participated in active implementation for a one-year period. We employed a mixed methods study to evaluate program acceptability. Multiple data sources were collected over implementation phases and triangulated for this evaluation. First, we conducted 30 onsite, semi-structured interviews during active implementation with 35 participants at 6 months; 27 interviews with 28 participants at 12 months; and 19 participants during program sustainment. Second, we conducted debriefing meetings after onsite visits and monthly virtual collaborative calls. All interviews and debriefings were audiotaped, transcribed, and de-identified. De-identified files were qualitatively coded and analyzed for common themes and acceptability patterns. We conducted mixed-methods matrix analyses comparing acceptability by satisfaction ratings and by the Theoretical Framework of Acceptability (TFA).

Results

Overall, the QI teams reported the PREVENT program was acceptable. The clinical champions reported high acceptability of the PREVENT program. At pre-implementation phase, reviewing quality data, team brainstorming solutions and development of action plans were rated as most useful during the team kickoff meetings. Program acceptability perceptions varied over time across active implementation and after teams accomplished actions plans and moved into sustainment. We observed team acceptability growth over a year of active implementation in concert with the QI team’s self-efficacy to improve quality of care. Guided by the TFA, the QI teams’ acceptability was represented by the respective seven components of the multifaceted acceptability construct.

Conclusions

Program acceptability varied by time, by champion role on QI team, by team self-efficacy, and by perceived effectiveness to improve quality of care aligned with the TFA. A complex quality improvement program that fostered flexibility in local adaptation and supported users with access to data, resources, and implementation strategies was deemed acceptable and appropriate by front-line clinicians implementing practice changes in a large, national healthcare organization.

Trial registration

clinicaltrials.gov: NCT02769338.
Predicting recurrence of non-small cell lung cancer based on mean computed tomography value
Authors: Tamura Masaya , Matsumoto Isao , Tanaka Yusuke , Saito Daisuke , Yoshida Shuhei , Takata Munehisa
Published: May 2021

Background

The aim of this study was to assess the ability of using mean computed tomography (mCT) values to predict non-small cell lung cancer (NSCLC) tumor recurrence.

Methods

A retrospective study was conducted on 494 patients with stage IA NSCLC. Receiver operating characteristics analysis was used to assess the ability to use mCT value, C/T ratio, tumor size, and SUV to predict tumor recurrence. Multiple logistic regression analyses were performed to determine the independent variables for the prediction of tumor recurrence.

Results

The m-CT values were − 213.7 ± 10.2 Hounsfield Units (HU) for the recurrence group and − 594.1 ± 11.6 HU for the non-recurrence group (p < 0.0001). Recurrence occurred in 45 patients (9.1%). The tumor recurrence group was strongly associated with a high CT attenuation value, high C/T ratio, large solid tumor size, and SUV. The diagnostic value of mCT value was more accurate than the C/T ratio, excluding the pure ground-glass opacity and pure solid (0 < C/T ratio < 100) groups. The SUV and mCT are independent predictive factors of tumor recurrence.

Conclusions

The evaluation of mCT values was useful for predicting recurrence after the limited resection of small-sized NSCLC, and may potentially contribute to the selection of suitable treatment strategies.
New Therapies and Biomarkers: Are We Ready for Personalized Treatment in Small Cell Lung Cancer?
Authors: Zhang Bingnan , Birer Samuel R. , Dvorkin Mikhail , Shruti Jolly , Byers Lauren
Published: May 2021

Small cell lung cancer (SCLC) is an aggressive form of lung cancer with a 5-year survival rate of less than 7%. In contrast to non–small cell lung cancer, SCLC has long been treated as a homogeneous disease without personalized treatment options. In recent years, the incorporation of immunotherapy into the treatment paradigm has brought moderate benefit to patients with SCLC; however, more effective therapies are urgently needed. In this article, we describe the current treatment standards and emerging therapeutic approaches for the treatment of SCLC. We also discuss promising biomarkers in SCLC and the recently discovered four subtypes of SCLC, each with its unique therapeutic vulnerability. Lastly, we discuss the advances in radiation therapy for the treatment of SCLC.
Work-Care Balance over the Day and the Gender Wage Gap
Authors: Cubas German , Juhn Chinhui , Silos Pedro
Published: May 2021

We focus on the timing of labor supplied during the day and its interaction with home care responsibilities. Using the American Time Use Survey, we measure the incidence of household care activities between 8 AM and 5 PM (the prime time of the day). Women experience more work interruptions during that time. These work interruptions imply wages that are about 9 percent lower. This result is consistent with occupations offering more flexibility but also a lower wage. We offer suggestive evidence that missing work due to household demands has a larger penalty in occupations with more coordinated work schedules.
Field Specializations among Beginning Economists: Are There Gender Differences?
Authors: Sierminska Eva , Oaxaca Ronald L.
Published: May 2021

We examine the process underlying field specialization among beginning economists. Our multivariate logit framework accommodates single-and dual-field specializations with correlated choices. Including field-specific relative salaries and expected probabilities of academic employment is a novel aspect of this research. After conditioning on personal, economic, and institutional variables, we find that women graduate students are less likely to specialize in labor/health, macro/finance, industrial organization, public economics, and development/growth/international fields and are more likely to specialize in agricultural/resource/environmental fields. The Duncan dissimilarity index suggests that 14 percent of either sex would have to change specialization in order to achieve complete parity.
Grade Sensitivity and the Economics Major at a Women’s College
Authors: McEwan Patrick J. , Rogers Sheridan , Weerapana Akila
Published: May 2021

We use a regression discontinuity design to estimate the causal effect of letter grades in introductory courses on the probability of choosing an economics major at Wellesley College, a highly selective women's college. We find that women just above letter-grade cutoffs are 18 percentage points more likely to major in economics than women just below, a 50 percent increase. The effects are larger among financial aid recipients. Grade sensitivity among women is not explained by the presence of male students or instructors; it is more plausibly explained by lower precollege preferences for the major and gender-specific responses to noisy signals like grades.
Business Formation: A Tale of Two Recessions
Authors: Dinlersoz Emin , Dunne Timothy , Haltiwanger John , Penciakova Veronika
Published: May 2021

The trajectory of new business applications and transitions to employer businesses differs markedly during the Great Recession and the COVID-19 recession. Both applications and transitions to employer start-ups decreased slowly but persistently in the post-Lehman crisis period of the Great Recession. In contrast, during the COVID-19 recession, new applications initially declined but have since sharply rebounded, resulting in a surge in applications during 2020. Projected transitions to employer businesses also rise, but this is dampened by a change in the composition of applications in 2020 toward applications that are more likely to be nonemployers.
Implied Dividend Volatility and Expected Growth
Authors: Gormsen Niels J. , Koijen Ralph S.J. , Martin Ian W.R.
Published: May 2021

We study the behavior of implied dividend volatility, constructed from the prices of options on index-level dividends, during the COVID-19 pandemic. We use these data to construct a lower bound on expected excess returns on dividend claims and find that the bound moves significantly over time. However, most of the variation in dividend futures prices reflects changes in growth expectations rather than expected excess returns, making them valuable assets to uncover growth expectations. We conclude that the short-term economic outlook is uncertain and not expected to recover in the near term.
Confederate Streets and Black-White Labor Market Differentials
Authors: Williams Jhacova A.
Published: May 2021

Using a unique dataset, this paper examines the extent to which streets named after prominent Confederate generals are related to Black-White labor market differentials. Examining individual-level data shows that Blacks who reside in areas that have a relatively higher number of Confederate streets are less likely to be employed, are more likely to be employed in low-status occupations, and have lower wages compared to Whites. I find no evidence that individual characteristics, local characteristics, or geographic sorting explain these results.
Could Gentrification Stop the Poor from Benefiting from Urban Improvements?
Authors: Balboni Clare , Bryan Gharad , Morten Melanie , Siddiqi Bilal
Published: May 2021

When policymakers invest in urban infrastructure, there are concerns that poor residents living near the infrastructure will be displaced. This paper investigates mechanisms that may lead to such infrastructure-induced gentrification using a general equilibrium urban commuting model. Our goal is to elucidate the channels through which infrastructure-induced gentrification occurs and understand how policy choices mitigate or accentuate gentrification.
Confidence Men? Evidence on Confidence and Gender among Top Economists
Authors: Sarsons Heather , Xu Guo
Published: May 2021

Using data from economists working in top US universities, we find that women are less confident than men along three margins. When asked about their level of agreement on survey questions about the economy, women are less likely to provide a judgment than their male counterparts. Conditional on providing a judgment, women are less likely to give "extreme" answers in which they strongly agree or disagree. Women are also less confident in the accuracy of their answer. We show that the confidence gap is driven by women being less confident when asked questions outside their field of expertise.
How Contagious Was the Panic of 1907? New Evidence from Trust Company Stocks
Authors: Fohlin Caroline , Lu Zhikun
Published: May 2021

Using a new dataset of all NYC trust company stocks, we study the impact of the Panic of 1907 and the ensuing cash infusion by JP Morgan and the Treasury. Using synthetic controls, we find that three “troubled” trusts performed far worse than the other trusts, whose valuations rebounded within a year. Moreover, trust companies connected to “money trust” banks maintained higher valuation than independents and rebounded much faster. The desire to prevent panic from spreading from infected trusts to financial institutions in his purview could explain Morgan's rapid intervention to stem the contagion.
Pandemic Protocols, Native Nutrition: Grocery Store Access from American Indian Reservations during COVID-19
Authors: Quintero Luis , Simeonova Emilia , Akee Randall
Published: May 2021

Native Americans have 3.5 times the COVID-19 infection rate and 1.5 times the death rate of non-Hispanic Whites. We demonstrate that social distancing policies may have unanticipated effects on behaviors. We estimate the effect of nonpharmaceutical interventions (NPIs) on the types of grocery stores visited by individuals residing on and off of American Indian reservations during the pandemic. We find that there is a larger reduction in the distance traveled to grocery stores for on-reservation households than for off-reservation households. We also find an increase in the relative share of trips to convenience stores for reservation residents.
The Effects of Prize Structures on Innovative Performance
Authors: Zivin Joshua Graff , Lyons Elizabeth
Published: May 2021

Successful innovation is essential for the survival and growth of organizations, but how best to incentivize innovation is poorly understood. We compare how two common incentive schemes affect innovative performance in a field experiment run in partnership with a large life sciences company. We find that a winner-takes-all compensation scheme generates significantly more novel innovation relative to a compensation scheme that offers the same total compensation but shares it across the ten best innovations. Moreover, the winner-takes-all scheme does not reduce innovative output on average and, among teams of innovators, generates more output than the less risky prize structure.
Allergic contact versus irritant contact dermatitis in patients with hard-to-heal leg ulcer: clinical and diagnostic approach
Authors: Monari Paola , Fusano Marta , Moro Ruggero , Baiguini Ilaria , Calzavara-Pinton PierGiacomo , Vascellaro Annalisa , Gualdi Giulio
Published: May 2021

Background:

Dermatitis of surrounding skin may complicate hard-to-heal leg ulcers, delaying wound healing. The coexistence of hard-to-heal leg ulcers and irritant or allergic contact dermatitis may create difficulties for both diagnostic and therapeutic management.

Objective:

The aim of our study was to evaluate the incidence of dermatitis occurring in the surrounding skin in a population affected by hard-to-heal leg ulcers during treatment, and to differentiate between allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD) with the use of a patch test. Furthermore, we investigated which medications were most probably related to these conditions.

Method:

We conducted an observational study from 21 February to 21 July 2017, enlisting all patients affected by hard-to-heal leg ulcers who attended the Wound Care Service of the Dermatologic Department of ASST, Spedali Civili, Brescia, Italy.

Results:

We enrolled 95 patients; 81 patients did not develop dermatitis, while 14 patients developed dermatitis of the surrounding skin. These patients underwent a patch test which gave a positive result in seven patients, permitting the diagnosis of ACD.

Conclusion:

Our study confirmed the incidence of dermatitis of the surrounding skin reported in the literature but reassessed the incidence of ACD as opposed to ICD.
The use of Biomaterials as Adsorbents for Removing Colorants from Aqueous Solution Case of Straw with Respect to Methylene Blue
Authors: Kasmi L , El-begrani M. Soussi. , Ali A. Ben , Hajaji M.M.M. , Tazi S.
Published: May 2021

In the following study, we have tested Straw as a biomaterial for removing methylene blue (MB) by adsorption. The characterization of the adsorbent was carried out by scanning electron microscopy coupled with EDX (SEM), infra-red spectroscopy with Fourier transform and the point of zero charge (PZC). The studied variables are: the mass of adsorbent, the initial concentration of dye, the contact time, pH and temperature. Kinetic data were modeled by equations pseudo first order and pseudo-second order, and revealed that the adsorption of MB on the straw pseudo second order for initial dye concentration. The MB adsorption isotherms on straw were analyzed by models of Langmuir and Freundlich. The modeling of adsorption isotherms obtained good agreement with the model of Freundlich.
Phylogenetic Analysis of Indian Freshwater Pond Mussels Lamellidens corrianus and L. phenchooganjensis (Bivalvia: Unionidae) from the Upper Brahmaputra Basin of Assam, India
Authors: Sonowal Jyotish , Chetia Pankaj , Kardong Devid
Published: May 2021

To update the present knowledge of freshwater molluscs, a phylogenetic analysis of two species of Indian pond mussels was carried out using amplified sequence of 18S rRNA gene. From the phylogenetic study of 18S rRNA gene sequencing, it was found that the Lamellidenscorrianus and L. phenchooganjensis are phylogenetically closely related to 18S rRNA gene sequences of other freshwater bivalve mussels belonging to the family Unionidae of order Unionida. Like other members of the Unionidae family, the two Lamellidensspp. showed monophyletic evolutionary lineage and shared a common ancestor. The result obtained from the phylogenetic analysis of Lamellidensspp. was significant as the 18S rRNA gene sequence of L. phenchooganjensis was submitted for the first time in the global nucleotide database (Genbank, NCBI). Similarly, the 18S rRNA gene sequence of L. corrianuswas also submitted to the database for the first time from this region having unique ecological niche. Therefore, the present study on phylogenetic analysis is a contribution to the global database of 18S rRNA gene sequences of freshwater mollusc, particularly from this part of the region.