bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining the Relationship Between Weapon Type and Relationship Type in American Homicides: A Bayesian Approach
Authors: Reynolds Joshua J. , Bürkner Paul C.
Published: December 2020

The weapon type used in a homicide predicts the victim-perpetrator relationship. However, there are some limitations in this past research including the common data analytic strategies. Our purpose was to build a model of weapon type, predicting relationship type, and to address previous limitations. We examined 363,927 homicides and used Bayesian multilevel categorical regression. In addition to analyzing weapon type (final model consisted of 16 weapon categories), we examined the victims’ sex, age, and race as covariates and modeled the data across states and counties. Results indicate that weapon type is highly informative, however, the age of the victim and sex of the victim interact in important ways.
Play Effects on Hospitalized Children With Acute Respiratory Infection: An Experimental Design Study
Authors: Liu Mei-Chun , Chou Fan-Hao
Published: December 2020

Acute respiratory infection is a major health issue and a primary cause of morbidity and mortality among preschool-aged children worldwide. Disease and hospitalization are chief stressors for children during their development. Therapeutic play has been used in pediatric care processes and has been demonstrated to be effective by most studies that have targeted children undergoing surgeries or invasive medical treatments. Currently, few published studies have focused on children receiving acute inpatient care. Additionally, not all types of therapeutic play produce significant results, and few studies have elaborated on the purposes, principles, and concrete measures of therapeutic play. Therefore, this study aimed to design therapeutic play that would reduce the stress responses of preschool-aged children hospitalized with acute respiratory infection. An experimental design with a pretest/posttest was conducted with 105 preschool children recruited from a regional teaching hospital in southern Taiwan. The children in the experimental group received the therapeutic play, while those in the control group received routine nursing care. Children in the experimental group showed significantly greater reductions in their physiological, psychological, and behavioral stress responses than those in the control group. Future studies could apply therapeutic play to children from different age groups with diverse health issues before recommending it be used in pediatric health settings.
Relationship between corneal stiffness parameters and lamina cribrosa curvature in normal tension glaucoma
Authors: Sun Yunxiao , Guo Yiqin , Cao Kai , Zhang Yue , Xie Yuan , Pang Ruiqi , Shi Yan , Wang Huaizhou , Wang Ningli
Published: December 2020

Purpose:

To evaluate the relationship between corneal biomechanical parameters and lamina cribrosa (LC) curvature in normal tension glaucoma (NTG).

Methods:

95 eyes of 56 NTG patients were enrolled in this prospective, observational study. Corneal biomechanical parameters, including stiffness parameters at applanation 1 (SP-A1), deformation amplitude ratio (DA ratio), inverse concave radius and biomechanically corrected intraocular pressure estimate (bIOP), were captured using the Corneal Visualization Scheimpflug Technology instrument (Corvis-ST). LC curvature was evaluated by mean adjusted LC curvature index (maLCCI) averaged by the measurements on 12 radial B-scan images obtained using swept-source optical coherence tomography (SS-OCT). Linear mixed models were constructed to assess the relationship between corneal biomechanical parameters and LC curvature.

Results:

The mean age of participants was 51.04 ± 13.74 years (range, 24–82 years). The SP-A1 and maLCCI were 93.50 ± 13.82 mm Hg/mm and 7.57 ± 1.58, respectively. In univariate and multivariate analysis, SP-A1 ( p < 0.001 and p = 0.001) and age ( p = 0.010 and p = 0.024) were both significantly associated with maLCCI. The LC curvature increased with softer cornea demonstrated by lower SP-A1 and younger eyes. There was no statistical significance interaction between SP-A1 and age ( p = 0.194).

Conclusions:

The greater posterior LC curvature was associated with lower corneal stiffness parameters and younger eyes in NTG patients.

Clinical Trial Registration:

Chinese Clinical Trial Registry, ChiCTR1900021465.
Networked Identities: Exploring the Role of Social Networking to Optimize Event Marketing by Higher Education Institutions in the Middle East
Authors: Asim Mian Muhammad , Rasul Azmat
Published: December 2020

This article examines the growing use and influence of two popular social networking sites—Facebook and LinkedIn—in the Middle East. Under the premise of Social Identity theory, we focus on the impact of posting information about academic-related events on social networking sites. We recruited 180 participants in a laboratory-based experiment using a 2 (medium type) × 2 (message valance) × 2 (group affiliation) factorial design to assess the moderating role of medium credibility, electronic word-of-mouth valence (eWOM) and perceived in-group affiliation of the respondents. The results indicate that, under the same moderating conditions, popular and widely used social sites are more capable of generating a positive response from students than sites that are not popular or widely used. In addition, the theoretical and practical implications of the findings are addressed.
Impact of the COVID-19 pandemic on persons with multiple sclerosis: Early findings from a survey on disruptions in care and self-reported outcomes
Authors: Manacorda Tommaso , Bandiera Paolo , Terzuoli Federica , Ponzio Michela , Brichetto Giampaolo , Zaratin Paola , Bezzini Daiana , Battaglia Mario A
Published: December 2020

Objective

To describe the disruptions in care experienced by persons with Multiple Sclerosis in Italy due to the COVID-19 pandemic and the self-reported impact on their health and wellbeing.

Methods

A cross-sectional online survey was completed by 2722 persons with Multiple Sclerosis, after Italy instituted a national lockdown in response to the pandemic.

Results

Persons with Multiple Sclerosis reported that the pandemic caused broad disruptions to usual health and social care services, which impacted on their health and wellbeing. Disruptions in care were consistently associated with negative self-reported impacts on the expected progression of the disease, on out-of-pocket expenditure and on carer’s stress. Psychological consequences were associated with interruption to usual psychological support, and concerns about the safety of care delivered in person.

Conclusions

The quality of life of persons with Multiple Sclerosis depends greatly on prompt access to a broad range of health and care services. Negative psychological impacts reported by persons with Multiple Sclerosis with less severe disabilities show that accessible integrated services are crucial for maintenance of their wellbeing. Most persons with Multiple Sclerosis with more severe disability experienced negative impacts on perceived health. Their carers compensating for lack of social input resulted in care overburden. As continuity of care is crucial for persons with Multiple Sclerosis, as well as for persons with chronic conditions in general, strategies must be in place to ensure it is included in future pandemic response plans.
Stories of violence and dementia in mainstream news media: Applying a citizenship perspective
Authors: Herron Rachel V , Funk Laura M , Spencer Dale
Published: December 2020

In this article, we analyze how mainstream news media frames violence in relation to dementia and the consequences of different frames for people living with dementia and their carers. Conceptually, the goal is to bring literature on citizenship and aggression into dialog with each other. Empirically, a total of 141 regional and national English-language mainstream Canadian news media articles (2008–2019) with a focus on dementia, violence, and aggression were analyzed. Analytically, we examine how different actors are portrayed as victims or perpetrators; how their histories (identities, belonging, and exclusion) are told; how dementia is used to explain events; and what types of expert knowledge and authorities are introduced to make sense of stories of violence in relationships of care. Our analysis points to the implications of media narratives for people with dementia as well as carers and researchers seeking to address stigma and call for change.
Sound Out the Deep Colors: Photoacoustic Molecular Imaging at New Depths
Authors: Li Mucong , Nyayapathi Nikhila , Kilian Hailey I. , Xia Jun , Lovell Jonathan F. , Yao Junjie
Published: December 2020

Photoacoustic tomography (PAT) has become increasingly popular for molecular imaging due to its unique optical absorption contrast, high spatial resolution, deep imaging depth, and high imaging speed. Yet, the strong optical attenuation of biological tissues has traditionally prevented PAT from penetrating more than a few centimeters and limited its application for studying deeply seated targets. A variety of PAT technologies have been developed to extend the imaging depth, including employing deep-penetrating microwaves and X-ray photons as excitation sources, delivering the light to the inside of the organ, reshaping the light wavefront to better focus into scattering medium, as well as improving the sensitivity of ultrasonic transducers. At the same time, novel optical fluence mapping algorithms and image reconstruction methods have been developed to improve the quantitative accuracy of PAT, which is crucial to recover weak molecular signals at larger depths. The development of highly-absorbing near-infrared PA molecular probes has also flourished to provide high sensitivity and specificity in studying cellular processes. This review aims to introduce the recent developments in deep PA molecular imaging, including novel imaging systems, image processing methods and molecular probes, as well as their representative biomedical applications. Existing challenges and future directions are also discussed.
The Pushed-Out Principal
Authors: Henry Wesley , Grooms Ain A. , Locke Leslie Ann , Triplett Steven
Published: December 2020

Kathleen Pitts was hired as an elementary principal with the intent of diversifying the educator ranks in a town with growing racial, economic, and cultural diversity. Upon starting her new position, Kathleen faced resistance from the staff and community. In addition, she received little support from her administrator colleagues as she forged ahead with implementing new curriculum. This case explores the critical intersection between building capacity for entering a school community, supporting new administrators, and fostering responsive and inclusive environments for staff and students. Discussion questions and activities provide a platform for exploring the complex nature of both school and district leadership, especially in contexts experiencing change.
Leader development: A pathway for social change?
Authors: Ryan Irene , Myers Barbara , Mooney Shelagh
Published: December 2020

Critical leadership development scholars argue that leadership development programmes (LDPs) should be the setting where participant’s aspirations and struggle to be a good leader can be voiced and reflected upon. Integral to this prompt is the call for LDPs to offer alternative approaches to the conventional, individualistic, leader-centric modules through innovative programme design and delivery. In this article, we investigate the outcomes of one LDP where innovation, notions of good leadership and the power of the collective to create fundamental change for the betterment of society are sought by the facilitators. Through semi-structured interviews with alumni, we consider whether they, in the aftermath of the LDP, have taken steps to effect positive change across communities and society and secondly, whether they perceive that the LDP prepared them to meet this expectation. We argue existing societal power and leadership dynamics remain invisible and unchallenged. There was little acknowledgement of the wider role social structural forces play, both formal and informal, in reinforcing the status quo. Importantly, this research is a stark reminder of how, to varying degrees and levels of consciousness, advantaged groups prop up systemic processes that embed their privilege and further exacerbate social inequalities.
Sex disparity in long-term stroke recurrence and mortality in a rural population in the United States
Authors: Lambert Clare , Chaudhary Durgesh , Olulana Oluwaseyi , Shahjouei Shima , Avula Venkatesh , Li Jiang , Abedi Vida , Zand Ramin
Published: December 2020

Background:

Several studies suggest women may be disproportionately affected by poorer stroke outcomes than men. This study aims to investigate whether women have a higher risk of all-cause mortality and recurrence after an ischemic stroke than men in a rural population in central Pennsylvania, United States.

Methods:

We analyzed consecutive ischemic stroke patients captured in the Geisinger NeuroScience Ischemic Stroke research database from 2004 to 2019. Kaplan–Meier (KM) estimator curves stratified by gender and age were used to plot survival probabilities and Cox Proportional Hazards Ratios were used to analyze outcomes of all-cause mortality and the composite outcome of ischemic stroke recurrence or death. Fine–Gray Competing Risk models were used for the outcome of recurrent ischemic stroke, with death as the competing risk. Two models were generated; Model 1 was adjusted by data-driven associated health factors, and Model 2 was adjusted by traditional vascular risk factors.

Results:

Among 8900 adult ischemic stroke patients [median age of 71.6 (interquartile range: 61.1–81.2) years and 48% women], women had a higher crude all-cause mortality. The KM curves demonstrated a 63.3% survival in women compared with a 65.7% survival in men ( p = 0.003) at 5 years; however, the survival difference was not present after controlling for covariates, including age, atrial fibrillation or flutter, myocardial infarction, diabetes mellitus, dyslipidemia, heart failure, chronic lung diseases, rheumatic disease, chronic kidney disease, neoplasm, peripheral vascular disease, past ischemic stroke, past hemorrhagic stroke, and depression. There was no adjusted or unadjusted sex difference in terms of recurrent ischemic stroke or composite outcome.

Conclusion:

Sex was not an independent risk factor for all-cause mortality and ischemic stroke recurrence in the rural population in central Pennsylvania.
Add-on treatment with mirabegron may improve quality of life in patients with benign prostatic hyperplasia complaining of persistent storage symptoms after tamsulosin monotherapy
Authors: Kang Tae Wook , Chung Hyun Chul
Published: December 2020

Background:

The aim of this study was to evaluate the change in lower urinary tract symptoms and quality of life (QoL) after combination therapy of solifenacin and mirabegron in patients with benign prostatic hyperplasia presenting with persistent storage symptoms after treatment with tamsulosin.

Material & Methods:

We evaluated the International Prostatic Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), prostate-specific antigen, prostate volume, peak flow rate (Qmax), and post-voided residual volume (PVR) before and after treatment. Patients showing baseline OABSS ⩾3 were included and treated with tamsulosin 0.2 mg as an initial drug for 1 month. After 1 month, add-on treatment with solifenacin 5 mg or mirabegron 50 mg was provided to patients who did not show improvement in OABSS with tamsulosin 0.2 mg. After 2 months, we evaluated changes in OABSS, IPSS, Qmax, and PVR.

Results:

After combination therapy for 2 months, there were no significant differences between patients receiving add-on treatment with solifenacin and those receiving mirabegron. However, the IPSS QoL score improved in patients treated with mirabegron and tamsulosin more than in those treated with solifenacin and tamsulosin ( p < 0.05).

Conclusion:

A combination of tamsulosin and mirabegron might improve the QoL of patients presenting with persistent storage symptoms after tamsulosin monotherapy. Better QoL due to mirabegron compared with solifenacin could be associated with fewer adverse effects, such as dry mouth and constipation.
Combination of tissue and liquid biopsy molecular profiling to detect transformation to small cell lung carcinoma during osimertinib treatment
Authors: Vendrell Julie A. , Quantin Xavier , Serre Isabelle , Solassol Jérôme
Published: December 2020

Background:

Histological transformation of advanced non-small cell lung cancer (NSCLC) to small cell lung cancer (SCLC) is one of the mechanisms of resistance to third-generation tyrosine kinase inhibitors (TKIs), such as osimertinib. This acquired TKI resistance is linked to the high degree of tumor heterogeneity and adaptive cellular signaling pathways, including epidermal growth factor receptor ( EGFR)-dependent pathways, observed in NSCLC.

Methods:

Here, we investigated a series of paired pre- and post-histological transformation biopsies obtained from three patients initially having a NSCLC with an EGFRactivating mutation treated with first-generation TKI, who then received osimertinib as second-line after EGFRT790M resistance and, lastly, developed a histological transformation to SCLC. Both tissue and liquid biopsies were analyzed using large panel sequencing approaches at various time points to reconstruct the clonal evolutionary history of the tumor.

Results:

Our complementary analysis of tumor tissue and circulating tumor DNA samples allowed us to better characterize the histological and molecular alterations associated with resistance to osimertinib. SCLC transformation was linked to the presence of several concomitant gene alterations, including EGFR, TP53 and RB1, but also to specific signal bypass, such as EGFR and MET amplifications and activation of the PI3K/AKT/mTOR pathway.

Conclusion:

Our report emphasizes the mutational landscape of SCLC histological transformation and highlights the importance of combining tissue and liquid biopsy profiling before and during osimertinib treatment to predict such histological transformation.
Evaluation of efficacy of chemotherapy for mucinous carcinoma: a surveillance, epidemiology, and end results cohort study
Authors: Zhang Hanwen , Zhang Ning , Li Yaming , Liang Yiran , Yang Qifeng
Published: December 2020

Background:

In this study, we investigated the impact of chemotherapy on breast cancer-specific survival (BCSS) in patients with mucinous carcinoma using the surveillance, epidemiology, and end results ( SEER) database.

Methods:

A large-scale SEER-based retrospective analysis was conducted; 13,329 patients with mucinous carcinoma from 1994 to 2014 were identified. Clinicopathological characteristics were compared using the chi-square test. BCSS curves were generated using the Kaplan–Meier method. The prognostic significance of all demographic and clinicopathological characteristics and treatment patterns were calculated using univariate and multivariate regression analyses.

Results:

Mucinous carcinoma was demonstrated to be less aggressive than invasive ductal carcinoma and predicted a better prognosis in the Kaplan–Meier analysis (hazard ratios = 0.336, 95% confidence interval: 0.308–0.368, p < 0.001). Univariate and multivariate analyses revealed that chemotherapy did not provide any additional benefit for patients with mucinous carcinoma. Predictors for receiving chemotherapy were younger age, estrogen receptor-negative, progesterone receptor-negative, and human epidermal growth factor receptor 2-positive status, higher grade, larger tumor size, lymph node involvement, radiation reception, and mastectomy. Further subgroup analysis verified that regardless of the hormone receptor (HR) and lymph node (LN) status, patients did not benefit from chemotherapy.

Conclusion:

Our study showed that patients with HR+/LN– mucinous carcinoma did not benefit from chemotherapy and that chemotherapy could not improve the survival of all subtypes of mucinous carcinoma based on large-scale SEER data. These results support that patients with mucinous carcinoma could be exempt from chemotherapy. Additional research is needed to further evaluate the impact of adjuvant treatments, particularly in patients with favorable histology.
Exploring Perspectives on Public Land Management in Rural Montana and Idaho
Authors: Rasch Rebecca
Published: December 2020

This exploratory analysis focuses on current perspectives of rural publics on public land management and posits that demographic shifts in the rural West may be reshaping relationships between rural publics and land managers. Focusing on rural residents in Montana and Idaho (i.e., those living outside of metropolitan or micropolitan counties), this work finds that younger generations and newer residents hold more favorable views of public land managers, compared with the views of older and long-time residents. Interestingly, both support for increasing environmental protections and a history of exposure to vegetation management projects positively predict more favorable views of public land managers. Even for those who favor more preservation of designated Wilderness, exposure to timber harvesting does not negatively affect their views of public land managers, suggesting that rural individuals in the West may now embody a mosaic of values, combining elements of a spiritual preservationist ethic with a pragmatic conservationist approach. This blend of values should provide hope for more fruitful collaborative land management approaches in the future.
Enriching employee engagement using complexity theory
Authors: Lemon Laura L. , Macklin Chalise
Published: December 2020

This paper conceptually draws the connections between complexity theory and employee engagement. Instead of the tendency to adhere to a binary, dichotomous approach, complexity theory helps move employee engagement forward as a process that is rooted in multiplicity, intricacy, and variance. This approach provides a more sustainable future for employee engagement scholarship by reimagining the ways in which scholars investigate the phenomenon. In providing future research suggestions rooted in complexity, scholarship and practice can transition away from prescriptive, normalized processes and solutions for employee engagement to welcome various approaches that lead to more fluid and organic understanding. The goal is to set a standard of encouraging employee engagement scholars to challenge how they explore employee engagement and to welcome new and innovative ways of examining the phenomenon to provide a sustainable and enriching scholarly conversation.
Prevalence of Osteoporosis Treatment and Its Effect on Post-Operative Complications, Revision Surgery and Costs After Multi-Level Spinal Fusion
Authors: Jain Nikhil , Labaran Lawal , Phillips Frank M. , Khan Safdar N. , Jain Amit , Kebaish Khaled M. , Hassanzadeh Hamid
Published: December 2020

Study Design:

Retrospective cohort study.

Objective:

To study the prevalence of pre-operative osteoporosis treatment, and its effect on risk of ORC, revision surgery and costs in osteoporotic patients undergoing ≥3-level spinal fusion for degenerative pathology.

Methods:

Patients and procedures of interest were included using International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) coding. Our outcome measures were ORC at 1-year post-operatively and included instrumentation complications, pathological fracture, and revision surgery. Kaplan-Meier survival curves and Cox proportional hazards analysis was done to study the effect of osteoporosis treatment on risk of ORC.

Results:

We included a total of 849 patients with documented osteoporosis undergoing ≥3-level spinal fusion. White (85.6%), female (82.7%), and 60-79 years of age (79.9%) was the most common demographic. Of entire cohort, 121(14.3%) were on osteoporosis treatment prior to spinal fusion. Of treated patients, 52/121 (43.0%) had continued prescriptions at 1 year post-operatively. Treated patients and not-treated patients had 1-year ORC incidence of 9.1% and 15.0%, respectively. The average 1-year reimbursement/patient for managing ORC was $3,053 (treated) and $21,147 (not-treated). On adjusted cox analysis, pre-operative osteoporosis treatment was associated with a lower risk of ORC (HR: 0.53, 95% CI: 0.28-0.99, p = 0.04).

Conclusions:

Pre-operative osteoporosis treatment is associated with lower risk of ORC and revision surgery at 1-year after ≥3-level spinal fusion. There is a low incidence of osteoporosis treatment prior to spinal fusion, and subsequently a low rate of treatment continuation after surgery. These findings highlight the need for heightened awareness, patient education and management of osteoporosis before elective multi-level spinal fusion.
Arthroscopic Reduction and Fixation by Cerclage Wire Loop for Tibial Spine Avulsion in Adults: Short-term Results
Authors: Bayoumy Maysara Abdelhalim , Abdelhamid Mohamed M. , Elkady Hesham A. , Mohamed Mohamed Mosa
Published: December 2020

Background:

Several arthroscopic techniques for the treatment of avulsion tibial spine fractures have been described in the literature.

Purpose:

To evaluate the outcomes of the arthroscopically assisted stainless steel wiring technique in the treatment of avulsed tibial spine in adults.

Study Design:

Case series; Level of evidence, 4.

Methods:

This retrospective study involved 28 patients (28 knees), 16 to 42 years of age, with tibial spine avulsion fracture that was treated using arthroscopic reduction and cerclage wire fixation by a single surgeon between March 2015 and August 2018. The degrees of avulsion in these patients were type II (n = 12), type III (n = 10), and type IV fractures (n = 6). Clinical assessment included International Knee Documentation Committee (IKDC) objective score (which noted swelling), range of knee movement, Tegner activity scale, Lachman test, and pivot-shift test compared with the normal opposite knee.

Results:

The mean follow-up period was 24.1 months (range, 18-30 months). The mean IKDC score was 93.7 (range, 88.5-98.9); the IKDC score was normal in 22 patients and nearly normal in 6 patients. The Lachman test was grade 1 in 25 patients and grade 2 in 3 patients, whereas the pivot-shift test was grade 0 in 26 patients and grade 1 in 2 patients. All patients achieved their preinjury Tegner activity levels. Radiological assessment showed healing in all patients within a mean of 12 weeks after surgery.

Conclusion:

The outcomes of all patients were satisfactory; fixation by cerclage wiring permitted reduction of tibial spine fragment anatomically to its fracture bed, provided stable fixation in displaced tibial spine avulsion, and allowed for early rehabilitation and weightbearing because of stable fixation.
Return to Sport After Arthroscopic Treatment of Posterior Shoulder Instability
Authors: Pavlik Attila , Tátrai Miklós , Papp Eszter
Published: December 2020

Background:

Arthroscopic treatment of posterior shoulder instability has become more popular and effective in recent years, but few data are available concerning the rate of return to sport.

Purpose:

To present our experiences with arthroscopic posterior labral reconstruction in athletes and review our results, with a particular focus on the rate of return to sport.

Study Design:

Case series; Level of evidence, 4.

Methods:

Included in the study were 40 arthroscopic stabilizations performed because of posterior shoulder instability in 37 athletes at a single institution. During follow-up, the athletes’ rate of return to sport was calculated. Shoulder function was evaluated based on a pre- versus postoperative comparison of the Rowe instability score and the American Shoulder and Elbow Surgeons score. Additionally, the return-to-sport rate was compared among different subgroups: traumatic versus atraumatic origin of injury, competitive versus recreational athletes, high-risk versus low-risk sport, and posterior-only versus anterior and posterior stabilization. Data were statistically analyzed using paired-samples t test and nonparametric Fisher exact test.

Results:

The average follow-up period was 54.4 months (range, 24-112 months). Three shoulders (7.5%) continued to have posterior subluxations postoperatively. There were 34 excellent, 3 good, and 3 fair results based on the Rowe score (average postoperative score, 92.9), and patients achieved an average postoperative American Shoulder and Elbow Surgeons score of 92.7. The pre- to postoperative improvement was statistically significant in both scoring systems ( P < .001). Of the 37 patients, 36 (98.2%) were able to return to sport activity: 27 of them (72.9%) to their original sport and 19 (51.4%) at their preinjury level. A significantly higher rate of return to the same sport occurred in athletes who had traumatic injury compared with a subgroup of athletes without a traumatic event ( P < .02).

Conclusion:

More than half of the athletes were able to return to their preinjury level of sport after arthroscopic posterior labral reconstruction. In addition, low recurrence rates and good functional outcomes were seen in >90% of the patients, and 98% returned to sport activity. The athletes had a significantly higher rate of return to sport if their posterior shoulder instability had a clear traumatic origin.
How Elderly Residents in Nursing Homes Handle Loneliness—From the Nurses’ Perspective
Authors: Naik, MHSc Prathima , Ueland, PhD Venke Irene
Published: December 2020

Introduction

Elderly people who leave their home environment and move to a nursing home enter a phase in life with diminishing contact with family and friends. This situation often results in a feeling of loneliness with a concomitant deterioration in physical and mental health. By exploring the topic through the lens of the nurses, this study takes a novel approach to address an under-researched area in the nursing field.

Objective

The objective of the study was to identify, based on the nurses’ experience, how elderly residents handle loneliness in the nursing home.

Methods

This study used a qualitative explorative approach with data collected through two focus group interviews with nine nurses at two elderly care facilities in Norway. The resulting transcripts were examined using an approach based on inductive content analysis.

Results

Three main categories emerged as crucial to help lonely nursing home residents cope with day-to-day life: (i) maintaining ties to one’s earlier life; (ii) engaging in recreational pursuits; and (iii) building new networks.

Conclusion

Analysing the findings based on sense of coherence (SOC) and person-centred care (PCC) theories illustrates the importance of maintaining a connection with both family and friends. To that point, having access to familiar objects from their earlier life seemingly provides meaning to the residents by bridging the past and the present. Recreational activities, ideally adapted to each person’s needs and ability, have a positive impact by providing structure and meaning that help overtake feelings of loneliness. Building a new network with fellow residents and staff imparts a sense of meaningful community belonging and projects both dignity and self-worth.
The role of cytokines in modulating learning and memory and brain plasticity
Authors: Bourgognon Julie-Myrtille , Cavanagh Jonathan
Published: December 2020

Cytokines are proteins secreted in the central nervous system by neurons, microglia, astrocytes and infiltrating peripheral immune cells under physiological and pathological conditions. Over the last 20 years, a growing number of reports have investigated the effects of these molecules on brain plasticity. In this review, we describe how the key cytokines interleukin 1β, interleukin 6 and tumour necrosis factor α were found to support long-term plasticity and learning and memory processes in physiological conditions. In contrast, during inflammation where cytokines levels are elevated such as in models of brain injury or infection, depression or neurodegeneration, the effects of cytokines are mostly detrimental to memory mechanisms, associated behaviours and homeostatic plasticity.
Cities and Greenhouse Gas Emissions: Moving Forward
Authors: Hoornweg Daniel , Sugar Lorraine , Gomez Claudia Lorena Trejos
Published: December 2020

Cities are blamed for the majority of greenhouse gas (GHG) emissions. So too are more affluent, highly urbanised countries. If all production- and consumption-based emissions that result from lifestyle and purchasing habits are included, urban residents and their associated affluence likely account for more than 80 per cent of the world’s GHG emissions. Attribution of GHG emissions should be refined. Apportioning responsibility can be misguided, as recent literature demonstrates that residents of denser city centres can emit half the GHG emissions of their suburban neighbours. It also fails to capture the enormous disparities within and across cities as emissions are lowest for poor cities and particularly low for the urban poor.

This article presents a detailed analysis of per capita GHG emissions for several large cities and a review of per capita emissions for 100 cities for which peer-reviewed studies are available. This highlights how average per capita GHG emissions for cities vary from more than 15 tonnes of carbon dioxide equivalent (tCO2e) (Sydney, Calgary, Stuttgart and several major US cities) to less than half a tonne (various cities in Nepal, India and Bangladesh). The article discusses where GHG emissions arise and where mitigation efforts may be most effective. It illustrates the need to obtain comparable estimates at city level and the importance of defining the scope of the analysis. Emissions for Toronto are presented at a neighbourhood level, city core level and metropolitan area level, and these are compared with provincial and national per capita totals. This shows that GHG emissions can vary noticeably for the same resident of a city or country, depending on whether these are production- or consumption-based values. The methodologies and results presented form important inputs for policy development across urban sectors. The article highlights the benefits and drawbacks of apportioning GHG emissions (and solid waste generation) per person. A strong correlation between high rates of GHG emissions and solid waste generation is presented. Policies that address both in concert may be more effective as they are both largely by-products of lifestyles.
Recombinant porcine FVIII for bleed treatment in acquired hemophilia A: findings from a single-center, 18-patient cohort
Authors: Ellsworth Patrick , Chen Sheh-Li , Kasthuri Raj S. , Key Nigel S. , Mooberry Micah J. , Ma Alice D.
Published: December 2020

Acquired hemophilia A (AHA) is a rare bleeding disorder in which acquired autoantibodies to endogenous factor VIII (FVIII) decrease FVIII activity and lead to a bleeding phenotype. A substantial majority of individuals who develop AHA present with severe bleeding. Effective treatment requires both immunosuppressive therapy and prompt hemostatic treatment. Bleeding is commonly treated with bypassing agents (BPAs) such as recombinant activated FVII (rFVIIa) or activated prothrombin complex concentrates Disadvantages to BPAs include the inability to monitor response with standard laboratory assays, inconsistent hemostatic efficacy, and thrombosis. Recombinant porcine FVIII (rpFVIII: Obizur, Baxter, Deerfield, IL) was approved by the US Food and Drug Administration (FDA) for bleed treatment in AHA in 2014, and has the advantage of laboratory monitoring of FVIII activity levels and known hemostatic efficacy in the presence of anti-human FVIII inhibitors and after failure of BPAs. Using an algorithm-based approach, rpFVIII has been used to successfully treat 18 patients with AHA at our center with substantially lower doses than the current FDA-recommended dosing. Additionally, data from our cohort show that the preexposure anti-porcine Bethesda titer does not reliably predict the clinical response to rpFVIII treatment and is not correlated with the anti-human Bethesda titer. We also present data showing lower total rpFVIII use for initial bleed resolution when rpVIII is used upfront, as compared with use as rescue therapy. We validated our dosing algorithm, which uses much lower than FDA-recommended doses with 14 more patients than in our previously reported patient series.
Human milk triggers coagulation via tissue factor–exposing extracellular vesicles
Authors: Hu Yong , Hell Lena , Kendlbacher Ruth Anna , Hajji Najat , Hau Chi , van Dam Annemieke , Berckmans René J. , Wisgrill Lukas , Ay Cihan , Pabinger Ingrid , Brisson Alain , Repa Andreas , Nieuwland Rienk , Thaler Johannes
Published: December 2020

Almost a century ago, it was discovered that human milk activates the coagulation system, but the milk component that triggers coagulation had until now been unidentified. In the present study, we identify this component and demonstrate that extracellular vesicles (EVs) present in normal human milk expose coagulant tissue factor (TF). This coagulant activity withstands digestive conditions, mimicking those of breastfed infants, but is sensitive to pasteurization of pooled donor milk, which is routinely used in neonatal intensive care units. In contrast to human milk, bovine milk, the basis of most infant formulas, lacks coagulant activity. Currently, the physiological function of TF-exposing vesicles in human milk is unknown, but we speculate that these vesicles may be protective for infants. Another explanation could be nipple skin damage, which occurs in most breastfeeding women. Milk-derived TF-exposing EVs may seal the wound and thereby reduce bleeding and breast inflammation.
Safety and efficacy of rivaroxaban in pediatric cerebral venous thrombosis (EINSTEIN-Jr CVT)
Authors: Connor Philip , Sánchez van Kammen Mayte , Lensing Anthonie W. A. , Chalmers Elizabeth , Kállay Krisztián , Hege Kerry , Simioni Paolo , Biss Tina , Bajolle Fanny , Bonnet Damien , Grunt Sebastian , Kumar Riten , Lvova Olga , Bhat Rukhmi , Van Damme An , Palumbo Joseph , Santamaria Amparo , Saracco Paola , Payne Jeanette , Baird Susan , Godder Kamar , Labarque Veerle , Male Christoph , Martinelli Ida , Morales Soto Michelle , Motwani Jayashree , Shah Sanjay , Hooimeijer Helene L. , Prins Martin H. , Kubitza Dagmar , Smith William T. , Berkowitz Scott D. , Pap Akos F. , Majumder Madhurima , Monagle Paul , Coutinho Jonathan M.
Published: December 2020

Anticoagulant treatment of pediatric cerebral venous thrombosis has not been evaluated in randomized trials. We evaluated the safety and efficacy of rivaroxaban and standard anticoagulants in the predefined subgroup of children with cerebral venous thrombosis (CVT) who participated in the EINSTEIN-Jr trial. Children with CVT were randomized (2:1), after initial heparinization, to treatment with rivaroxaban or standard anticoagulants (continued on heparin or switched to vitamin K antagonist). The main treatment period was 3 months. The primary efficacy outcome, symptomatic recurrent venous thromboembolism (VTE), and principal safety outcome, major or clinically relevant nonmajor bleeding,were centrally evaluated by blinded investigators. Sinus recanalization on repeat brain imaging was a secondary outcome. Statistical analyses were exploratory. In total, 114 children with confirmed CVT were randomized. All children completed the follow-up. None of the 73 rivaroxaban recipients and 1 (2.4%; CVT) of the 41 standard anticoagulant recipients had symptomatic, recurrent VTE after 3 months (absolute difference, 2.4%; 95% confidence interval [CI], −2.6% to 13.5%). Clinically relevant bleeding occurred in 5 (6.8%; all nonmajor and noncerebral) rivaroxaban recipients and in 1 (2.5%; major [subdural] bleeding) standard anticoagulant recipient (absolute difference, 4.4%; 95% CI, −6.7% to 13.4%). Complete or partial sinus recanalization occurred in 18 (25%) and 39 (53%) rivaroxaban recipients and in 6 (15%) and 24 (59%) standard anticoagulant recipients, respectively. In summary, in this substudy of a randomized trial with a limited sample size, children with CVT treated with rivaroxaban or standard anticoagulation had a low risk of recurrent VTE and clinically relevant bleeding. This trial was registered at clinicaltrials.gov as #NCT02234843.
How much has allogeneic stem cell transplant–related mortality improved since the 1980s? A retrospective analysis from the EBMT
Authors: Penack Olaf , Peczynski Christophe , Mohty Mohamad , Yakoub-Agha Ibrahim , Styczynski Jan , Montoto Silvia , Duarte Rafael F. , Kröger Nicolaus , Schoemans Hélène , Koenecke Christian , Peric Zinaida , Basak Grzegorz W.
Published: December 2020

We performed a study to find out how advances in modern medicine have improved the mortality risk of allogeneic stem cell transplantation. We analyzed major transplantation outcome parameters in adult patients on the European Society for Blood and Marrow Transplantation (EBMT) registry who had hematologic malignancies and had received transplants from matched sibling donors. We performed multivariate analyses using the Cox proportional-hazards model including known risk factors for nonrelapse mortality and a matched-pairs analysis. We identified 38 800 patients who fulfilled the inclusion criteria. Considerable changes in patient characteristics have occurred in the past decades, such as older age, different underlying diseases, and a higher proportion of patients with advanced disease. Major reasons for transplantation-related death in the 1980s were infectious complications and graft-versus-host disease. Nonrelapse mortality, measured at 1 year after transplantation, has decreased over time: 29.7% from 1980 through 1989, 24.4% from 1990 through 1999, 14.8% from 2000 through 2009, and 12.2% from 2010 through 2016. On multivariate analysis, the year of transplantation was associated with reduced nonrelapse mortality (P < .0001; hazard ratio [HR] [95% confidence interval (CI)], 0.8 [0.79-0.82], for 5-year intervals) and decreased overall mortality (P < .0001; HR [95% CI], 0.87 [0.86-0.88]. In the matched-pairs analysis of 3718 patients in each group, nonrelapse mortality at 1 year was 24.4% in the 1990s and 9.5% from 2013 through 2016 (P < .0001; HR [95% CI], 0.39 [0.34-0.43]). Transplantation-related mortality has decreased significantly in the past 40 years. These favorable data facilitate evidence-based treatment decisions on transplantation indications in the context of the availability of novel immunotherapies.
Anosmic flies: what Orco silencing does to olive fruit flies
Authors: Tsoumani Konstantina T. , Belavilas-Trovas Alexandros , Gregoriou Maria-Eleni , Mathiopoulos Kostas D.
Published: December 2020

Background

The olive fruit fly (Bactrocera oleae) is the most destructive pest of the olive cultivation worldwide causing significant production losses and olive fruit impoverishment, as its larvae feed exclusively on the olive fruit. Reproductive and sexual behavior, as well as host-plant recognition of the fly, are highly dependent on its chemosensory system. Therefore, exploring the role of genes that play a critical role in olfaction, could reveal potential molecular targets that determine species-specific features on chemical communication and could be used to impair sexual behavior.

Results

In this study we identified the gene that encodes the conserved olfactory co-receptorOrco(Odorant receptor co-receptor), which interacts with all divergent insect odorant receptors, and investigated how disruption of its expression affects chemoreception. We initially searched the expression profile ofBo-Orcoin both sexes during sexual maturation, as well as pre- and post-mating communication by relative quantitative real time PCR (qRT-PCR) analysis suggesting thatBo-Orcowas abundantly expressed in sexually mature adults.

We further investigated the functional role ofBo-Orcoin mating and oviposition behavior via transient gene silencing that was performed through in vivo dsRNA hemolymph injections in sexually mature flies 7 days after eclosion.Orco-knockdown phenotypes in both sexes showed reduced copulation rates in mating competitiveness tests, possibly through impaired olfactory-mediated detection of sex pheromone. In addition, oviposition was significantly inhibited in dsRNA-Orco injected females in a post-mating behavior test.

Conclusions

Our results demonstrate thatOrcoplays a crucial role in the reproductive behavior of the olive fruit fly, since pre- and post-mating processes were affected. This is the first report in the olive fruit fly that links the chemosensory pathway with the mating behavior and the reproductive potential at a molecular basis, rendering this gene a potential target for the improvement of the olive fruit fly population control techniques.
Health research system resilience: lesson learned from the COVID-19 crisis
Authors: Yazdizadeh Bahareh , Majdzadeh Reza , Ahmadi Ayat , Mesgarpour Bita
Published: December 2020

Producing evidence in epidemics is crucial to control the current epidemic and prevent its recurrence in the future. Data must be collected and analyzed rapidly to recognize the most efficient and feasible methods with proper timelines. However, there are many challenges a research system may encounter during a crisis. This article has presented lessons learned from the COVID-19 pandemic for health research system (HRS) to deal with current and future crises. Therefore, a HRS needs to produce and use evidence in such a situation. The components Knowledge Translation Self-Assessment Tool for Research Institutes (SATORI) framework was used to review the actions required and respond to the COVID-19 pandemic in a national HRS. This framework consists of four categories of defining the research question, conducting research, translating the research results, and promoting the use of evidence. The work is proposed actions in response to the COVID-19 crisis and improving a HRS's resilience. While COVID-19 has serious harm to the health and broader socio-economic consequences, this threat should be accounted for as an opportunity to make research systems more accountable and responsible in the timely production and utilization of knowledge. It is time to seriously think about how HRS can build a better back to be resilient to potential shock and prepare for unforeseen emerging conditions.