bluuebunny/crossref_metadata_2025 huggingface dataset:
Provider perspectives and experiences following the integration of the prescription drug monitoring program into the electronic health record
Authors: Witry Matthew , Marie Barbara St , Reist Jeffrey
Published: July 2022

Prescription drug monitoring programs (PDMPs) are a public health tool for prescribers and pharmacists to monitor controlled substance use at the patient level. The objectives of this study were to (1) assess attitudes about the PDMP and perceived changes in experience and decision-making following integration into the electronic health record (EHR), and (2) identify barriers to optimal PDMP use and user recommendations for improvement. This descriptive study used an electronic survey to obtain feedback from prescribers and pharmacists at a single academic medical center. Descriptive statistics were calculated, and textual data were analyzed. Of 1480 PDMP users 208 responded (14.1%). Responses demonstrated the integration of the PDMP into the EHR simplified log-in and access to PDMP information resulting in more frequent access and perceived improvement of care quality. Barriers included technical issues accessing the PDMP within the EHR and the lack of integration of other state PDMPs. Overall, the benefit of integrating the PDMP into the EHR was positive but largely limited to streamlining log-in and patient selection. Recommendations for improvement include addressing technological issues and education on PDMP interpretation and integrating new features that may modify prescribing, referral, and co-prescribing behaviors.
How older adult information and communication technology users are impacted by aging stereotypes: A multigenerational perspective
Authors: Birkland Johanna LH
Published: July 2022

Older adults (those aged 65 years and above) are stereotyped as warm but incompetent, particularly in their use of modern information and communication technologies (ICTs). Interpretative interactionist data from 17 cases of older adult ICT use suggests that older adults are aware of these stereotypes. Each of these cases included an older adult (the primary participant of each case) and, if possible, two to three individuals the person used ICTs within their relationship (family members, friends, and/or coworkers). Those surrounding the older adults often spoke about older adult ICT use in stereotypical terms, seeing skilled older adult ICT users as exceptional. The most highly skilled advanced ICT users were most likely to have internalized these ageist technology stereotypes.
The effects of alloying composition on plasticity and strength of notched metallic glasses
Authors: Abdalkareem Jasim Saade , Ismailov Botir , Jade Catalan Opulencia Maria , Shafik Shafik S. , Kadhim Mustafa M. , Lafta Holya A. , Abed Azher M. , Sivaraman R. , Sharma Himanshu , Thaeer Hammid Ali , Fakri Mustafa Yasser
Published: July 2022

Using notch geometry in the metallic glass (MG) samples, it is possible to improve the homogeneous plasticity and mechanical properties. In this work, the molecular dynamics (MD) simulation was performed to indicate how the alloying composition of MGs can tune the mechanical properties of notched samples. For this purpose, CuZr MGs were constructed through atomic-scale simulation with alloying compositions of Cu64Zr36, Cu60Zr40, Cu54Zr46, and Cu50Zr50, while a symmetrical surface notch was produced at the waistline of samples by removing certain atoms and relaxing the new free surfaces. The tensile loading was also carried out to characterize the plastic deformation and strength in the CuZr MGs. According to the results, Cu64Zr36 and Cu60Zr40 alloys exhibited a localized plastic deformation in the notch region, while the decrease in Cu content, i.e. Cu54Zr46, led to the generation of nanoscale shear events outside the notch region and extended the deformation area in the body of the sample. The results also indicated that the change in the mechanism of plastic deformation in the notched samples strongly depended on the type and population of polyhedrons rearranged in the backbone structure. Moreover, it was found that the Voronoi volume in the Cu54Zr46 alloy exhibited a gentle increment under the tensile loading in both the notched and un-notched regions, while the Cu-rich MGs, i.e. Cu64Zr36 and Cu60Zr40, showed a sudden increment of Voronoi volume at the center of the notch region, which was indicative of strain localization in the atomic system.
Japanese parents’ experiences supporting their school-aged children’s acculturation to the U.S.
Authors: Kayama Misa , Haight Wendy
Published: July 2022

The 19th century roots of social work in social justice movements within immigrant communities continue to thrive in contemporary social work. Yet relatively little attention has focused on the challenges faced by Asian immigrants, currently the second largest immigrant group in the U.S. Indeed, Asians in the U.S. have long been stereotyped as a “model minority,” perpetuating the myth that Asian children do not need special attention when acculturating to U.S. schools. Yet parents report obstacles to their children’s acculturation, including racism. As part of a larger ethnography, this study examines how Japanese immigrant and temporary resident parents understand their children’s acculturation to the U.S. We conducted in-depth, individual interviews with 14 Japanese immigrant and temporary resident parents of school-aged children. They discussed acculturation challenges centered on differences in the Japanese and U.S. cultural self, and how they modified their socialization practices to support their children’s acculturation. Rather than employing Japanese child rearing practices that implicitly guide children by shaping their environment, parents shifted to explicit efforts to ensure their children’s development of Japanese cultural selves in the U.S. Such practices, however, may result in children losing a sense of independence and autonomy important to both U.S. and Japanese cultural selves. These experiences of Japanese parents challenge the stereotype of Asians as a model minority. We discuss social work implications for culturally appropriate support for acculturation.
Optimal cut-off value of serum procalcitonin in predicting bacterial infection induced acute exacerbation in chronic obstructive pulmonary disease: A prospective observational study
Authors: Ye Yan-Ping , Zhao Hang , Kang Tao , Zhao Li-Hua , Li Ning , Chen Jing , Peng Xiao-Xia
Published: July 2022

Objective

To explore the optimal cut-off value of serum procalcitonin (PCT) level in predicting bacterial infection in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

Methods

204 hospitalized patients with AECOPD were enrolled in this study. Their diagnoses and treatments followed routine protocols in Fu-Xing Hospital affiliated to Capital Medical University, Beijing, China. Extra blood samples were taken for serum PCT level testing and the results were blinded to the treating physicians. On discharge, clinical data were collected and the treating physicians made comprehensive analyses to determine whether the AECOPD were triggered by respiratory tract bacterial infection or non-bacterial causes according to the “new diagnostic criteria” defined in this study. In the AECOPD patients with bacterial infection, treating physicians decided whether they had bacterial pneumonia based on imaging studies. Receiver operating characteristic curve (ROC) was used to analyze the accuracy of serum PCT level in predicting bacterial infection.

Results

In the 173 AECOPD patients who did not have pneumonia, 115 had evidences of bacterial infection while 58 did not. The median PCT levels were 0.1(0.08, 0.18) ng/ml and 0.07 (0.05, 0.08) ng/ml for each group, which were statistically different. The proposed optimal cut-off value of serum PCT level in predicting bacterial infection was 0.08 ng/mL according to this study, with a sensitivity of 81%, specificity of 67% and area under the ROC curve (AUC) of 0.794. There were 31 AECOPD patients diagnosed with pneumonia, their median PCT level was 0.23 ng/mL.

Conclusions

The serum PCT levels slightly increased in the majority of hospitalized patients with AECOPD compared with reference range. When PCT level was ≥0.08 ng/mL, AECOPD was more likely to be caused by bacterial infection. A significantly elevated PCT levels may indicate combination of AECOPD and bacterial pneumonia.
Triggers or Prompts? When Methods Resurface Unsafe Memories and the Value of Trauma-Informed Photovoice Research Practices
Authors: Pichon Latrice C. , Teti Michelle , Brown L. Lauren
Published: July 2022

In this article, we describe a case study in which the method and approach to understanding internalizations of stigma may have both triggered and prompted suppressed memories and past trauma to reemerge. Drawing from trauma informed care approaches, we outline strategies to bear in mind for future studies.
Patient-led integrated cognitive behavioural therapy for management of long COVID with comorbid depression and anxiety in primary care - A case study
Authors: Skilbeck Lilian
Published: July 2022

Objective

Long COVID affects approximately ten-percent of people following post-acute Coronavirus infection. Long COVID is a complex, multisystemic recent illness. Therefore, there are currently no unitary guidelines on its management. The UK national guidelines currently recommended that interventions are guided by objective research evidence and subjective experiences of patients. They also emphasise multidisciplinary/interdisciplinary professional care and patient self-management.

Methods

The current case study applied patient-led integrated cognitive behavioural therapy in a 36-year-old male presenting with long COVID symptoms with comorbid depression and anxiety. It applied integrated interdisciplinary CBT with emphasis on enhancing patient self-management. The patient attended twelve, individual, 60 min video sessions, via Microsoft Teams over a period of five months. The treatment was conducted in collaboration with the patient’s general practitioner, physiotherapists and cardiopulmonary specialists. In line with the National Institute for Health and Care Excellence guidelines, it applied symptom monitoring, graded pacing and behavioural experiments.

Results

At the end of therapy, the patient showed reliable change in his somatic symptoms, depression and anxiety symptoms. He also showed improved quality of life.

Discussion

This case illustrates the effective use of patient-led CBT for managing symptoms of long COVID with comorbid depression and anxiety in primary care.
Control Yourself: Broad Implications of Narrowed Attention
Authors: Ward Andrew , Mann Traci
Published: July 2022

Attention represents a key element of self-control, and multiple theoretical accounts have highlighted the role played by abundant attentional capacity in effecting successful self-regulation. What, then, are the consequences of living in today’s world, in which attention can become so easily divided by a multitude of stimuli? In this article, we consider the implications of divided attention for self-control and show that although the end result is typically disinhibited behavior, under specified conditions, attentional limitation, or what we term attentional myopia, can be associated with enhanced restraint.
The Kraft of Labour, Labour as Craft: Hayao Miyazaki’s Images of Work
Authors: Law Jo
Published: July 2022

The animated films of Hayao Miyazaki are populated by women, children and men at work. This article argues that the rendering of physical labour has the capacity to (re)connect the body to its broader social collective experience. The late philosopher, Bernard Stiegler, identifies the loss of savoir-faire (know-how) and savoir-vivre (life skills) as a critical deficit to how we live and work today. Miyazaki’s animated films provide a platform for potentially regaining savoir-faire and savoir-vivre in their reflexive portrayals of human labour. Every story told by Miyazaki involves scenes where bodies work with tools, with each other, and with machines to perform tasks. The rhythms of the working body speak to the ideals of labour as craft – not as exceptionally skilled expertise, but as an everyday practice – that presents ‘an opportunity to “think otherwise”’ as proposed by Glenn Adamson in The Crafter Reader (2010: 136). This article examines the performance of manual tasks in three contexts: the physical act of labour, labouring with machines and the animator’s labour. The author concludes by making the case that the animator’s labour extends to the craft of storytelling and, specifically, that Miyazaki’s animations are what Walter Benjamin called Kraftwerk – a ‘power work’ that re-models the ‘folkloric relations of space’ (see Esther Leslie’s, ‘Walter Benjamin, Traces of Craft’, 1998: 47) that keeps the human spirit alive.
Towards a Conceptual Framework for Abstracted Animation Derived from Motion Captured Movements
Authors: Van Opdenbosch Paul M
Published: July 2022

Outside the realm of feature films, smaller creative collectives and individual animators are exploring the creative applications of motion capture data to develop compelling and unique abstract animated short films. However, despite an increasing number of examples, there has been little detailed documentation of this practice and the processes involved in this format of animation production. More specifically, there has been little analysis of the key considerations and issues that might confront practitioners when integrating motion capture movement data into their abstract animation practice. As such, a more developed understanding of approaches to incorporating motion capture technologies into the field of abstract animation is called for. This study emerges at the intersection of two key areas of knowledge: abstract animation and computational generative art. The outcomes of this study contribute to building a better understanding of abstract animation practice by exploring and documenting possible strategies and approaches for generating elements that compose abstract animated short films from captured dance movements. This article reveals a possible framework for this type of practice and outlines five key considerations: capture of human movement, retention of human form and movement, influence of the simulation, influence of the virtual environment and visual connection to practice, which should be taken into account by practitioners who use motion capture in the production of abstract animated short films.
Plasmatic and Metamorphic Movement: The Materiality of the Moving Idea
Authors: Ray Kaustubh
Published: July 2022

In this article, the author proposes that both substance and process philosophy inadequately address the ‘plasmatic’ and metamorphic movement (PMM) of early animation since it subverts the logic of the ‘cinematographic illusion’. Cognition, which is apparently dependent on identity formation, is predicated on substance, which conforms to representational thought. PMM, which is predicated on the ‘fluid’ linkage of images, destabilizes substance, consequently problematizing representation by introducing conflict between speculative substance predicated on form and perceived materiality from movement. A different problem appears with process philosophy privileging continuing flux that cannot logically be based on identity formation as it resists predication. Yet, cognition is possible as process is speculative and substance is manifest. PMM, as a manifest process that dematerializes substance, ungrounds the basis of both philosophies, simultaneously highlighting their complementarity. By problematizing both, PMM is able to highlight the relational and dependently originated nature of thought.
Synthesis of new 5-benzylidene-hydantoin esters
Authors: Tshiluka Ndivhuwo R , Bvumbi Mpelegeng V , Tshishonga Unarine , Mnyakeni-Moleele Simon S
Published: July 2022

Compounds containing a hydantoin moiety are found in several medicines in clinical use. In this research, ethyl- and methyl-[2-(5-benzylidene)-2,4-dioxoimidazolidin-3-yl]acetyl esters are successfully synthesized over four reaction steps using conventional methods. The synthesis begins by subjecting hydantoin to a Knoevenagel condensation reaction with three different benzaldehydes to afford the penultimate products, which are further reacted with ethyl or methyl (bromoacetyl)alaninates, butanoates, valinates, and norvalinates to give the desired products as esters in low to moderate yields.
The powerful, the powerless, and the empowered: Visualizations of power in high school and university through social network analysis
Authors: Litsa Maria , Bekiari Alexandra
Published: July 2022

The investigation uses Popitz’s power theory (1992) to examine relationships among social power position, attractiveness, and verbal aggressiveness comparing social networks of high school and university students. 117 high school PE students and 195 university PE students participated in the research completing both a network and a joint non-network questionnaire. Visone 1.1 software was used for the processing of the network data and SPSS 26 was implemented for the non-network data. The results revealed in both settings that students demonstrating scientific/task attractiveness develop authoritative power/power of internalized control in their network and are protected from verbal aggressiveness and enforcement of instrumental power/power of externalized control. Social attractiveness enhances the development of authoritative power/power of internalized control in high school only. In this research, a type of powerful student is suggested who does not tend to concentrate power but rather to share power for empowering the powerless ones.
Fostering creativity, equity, and inclusion through social justice praxis
Authors: Ramlackhan Karen , Catania Nicholas
Published: July 2022

The increasing population of culturally and linguistically diverse students in the United States necessitates the use of culturally responsive practices for equitable and inclusive educational systems. This duoethnographic study explores how social justice, equity, and inclusion principles are embedded within our research and teaching in higher education programs for leadership and teacher education. Findings focus on addressing inequities through social justice praxis and the implications emphasise leading, teaching, and learning through creativity, justice, and inclusion.
“‘We Wear the Mask’: Three Movements on Survival, Resistance, and Activist Affect with deference to Paul Laurence Dunbar”
Authors: Alexander Bryant Keith
Published: July 2022

In this short performative piece, the performer engages a critical juxtaposition of Paul Laurence Dunbar’s classic poem, “We Wear the Mask” in relation to shifting currents of COVID-19, Racism, and Black Lives Matter; using the act of masking not just as a safety precaution against COVID-19 but as strategies of passing through oppression, and surviving under threat, with de-masking as a performative act of resistance against that which most threatens our humanity.
The Mind’s Mask: Concealing, Filling In, and Filling Out
Authors: Lockford Lesa
Published: July 2022

Among the many challenges occasioned by the pandemic has been the health and social requirement of wearing a facial covering or mask. In this paper, I explore a few ways masks influence our reception and perception of others. While perhaps we all understand that masks may alter our perceptions through concealment, I suggest that masks additionally potentially facilitate a shift in how we perceive through a process of filling in what the mask conceals. Finally, I also explore how masks potentially empower an agentic process of filling out into the social world in order to effect social change.
A “Curriculum of Hope”: Designing and Evaluating a Remote Mentoring Program for Pupils in a Pandemic
Authors: Pountney Richard
Published: July 2022

Purpose

This paper reports the evaluation of an ongoing intervention, the GROW Programme, aimed at meeting the needs of 15–18-year-old pupils who were unable to attend school in England for periods during 2020–2021. The aim of the paper is to theorize the underlying basis of practice in such a lockdown context to inform future responses.

Design/Approach/Methods

Thematic analysis of a mixed-method evaluation, using surveys and interviews of teachers and mentors, and pupil focus groups, of the remote mentoring of pupils and their learning during lockdown, is further analyzed by means of Bernstein's knowledge codes and concept of open schools, to identify the form of knowledge inherent in online mentoring.

Findings

The analysis offers a framework for open schooling valuable to schools in uncertain times and identifies the shift to metacognition and self-regulated learning as holding particular benefits for learning under disruption.

Originality/Value

The paper takes a novel view of the disruption brought about by the partial closure of schools and offers a methodology for evaluating its effects by means of a unique intervention. It makes visible the characteristics and the potential benefits of alternative approaches in order that schools can make informed choices.
Buprenorphine Waiver Attitudes Among Primary Care Providers
Authors: Lai Benjamin , Croghan Ivana , Ebbert Jon O.
Published: July 2022

Background:

Despite efforts to improve access to Medications for Opioid Use Disorder (MOUD), such as buprenorphine, the number of opioid overdoses in the United States continues to rise. In April 2021, the Department of Health and Human Services removed the mandatory training requirement to obtain a buprenorphine waiver; the goal was to encourage more providers to prescribe buprenorphine, thus improving access. Little is known about the attitudes on buprenorphine prescribing after this policy change.

Objective:

The primary objective was to assess attitudes among primary care providers toward the removal of the buprenorphine waiver training requirement. A secondary objective was to identify other barriers to prescribing buprenorphine.

Methods:

We conducted a survey between September 15 and October 13, 2021 to assess the overall beliefs on the effectiveness of MOUD and attitudes toward the removal of the waiver training, current knowledge of buprenorphine, current practice styles related to screening for and treating OUD, and attitudes toward prescribing buprenorphine in the future. This survey was sent to 890 Mayo Clinic primary care providers in 5 US states.

Results:

One hundred twenty-three respondents (13.8%) completed the survey; 35.8% respondents agreed that the removal of the waiver training was a positive step. These respondents expressed a greater familiarity with the different formulations, pharmacology, and titration of buprenorphine. This group was also more likely to prescribe (or continue to prescribe) buprenorphine in the future. Approximately one-third (34.4%) of respondents reported perceived institutional support in prescribing buprenorphine. This group expressed greater confidence in diagnosing OUD, had greater familiarity with the different formulations, pharmacology, and titration of buprenorphine, and was more likely to prescribe (or continue to prescribe) buprenorphine in the future. Respondents who have been in practice for 11 to 20 years since completion of training were most likely to refer all OUD patients to specialists.

Conclusions:

Results of our survey suggests that simply removing the mandatory waiver training requirement is insufficient in positively changing attitudes toward buprenorphine prescribing. A key barrier is the perceived lack of institutional support. Future studies investigating effective ways to provide such support may help improve providers’ willingness to prescribe buprenorphine.
Surgical Repair of a Sinus of Valsalva Aneurysm
Authors: Regeer Madelien V. , van der Zwaan Heleen B. , Schoof Paul H. , van Aarnhem Egidius E. H. L.
Published: July 2022

A surgically challenging case of an unruptured Sinus of Valsalva aneurysm (SoVA) with severe aortic regurgitation (AR) due to cusp prolapse is presented. Sinus reconstruction with a patch cut out from the sinus portion of a Gelweave Valsalva graft (Terumo Vascutek) was performed. Intraoperative measurements showed insufficient effective height of the right coronary cusp; therefore, cusp plication and pericardial patch augmentation of the right coronary cusp were performed with satisfying result.
Characteristics of Emergency Department Patient Visits Referred for Follow-Up Medical Care After Discharge, National Hospital Ambulatory Medicare Care Survey—United States, 2018
Authors: Adekoya Nelson , Roberts Henry , Truman Benedict I.
Published: July 2022

Objective

To describe characteristics of a nationally representative sample of patient visits that ended with a referral for follow-up medical care after discharge from hospital emergency department (ED) visits.

Methods

We used 2018 National Hospital Ambulatory Medical Care Survey data to identify patient characteristics associated with higher rates of visits with referrals for follow-up medical care after ED discharge from nonfederal short-stay and general hospitals throughout the United States. Referral included categories of all disposition variables that indicated referral to a source of care consistent with the patient’s clinical condition at ED discharge.

Results

Approximately 97 million of 130 million visits (29 700/100 000 US resident population) were referred for follow-up medical care during 2018. Visit referral rates were higher among females (33 100) than among males (26 300/100 000 population); higher among Black patients (61 700) than among White patients (25 600/100 000 population); highest in the South (33 200/100 000 population); and similar rates in Nonmetropolitan (29 900/100 000 population) and Metropolitan Statistical Areas (30 200/100 000 population). Visit referral rates were higher for patients with Medicaid/Children's Health Insurance Program (CHIP) (66 900) than those with Medicare (31 500) or private insurance (14 000/100 000 population). Abnormal clinical findings and injuries were the discharge diagnoses most often referred for follow-up medical care.

Conclusion

Higher visit referral rates were observed among female sex, non-Hispanic Black race, Medicaid/CHIP, abnormal clinical findings, and injuries. Future studies might reveal reasons that prompted higher referral rates among various patients’ characteristics.
Building clustering for regional seismic response and damage analysis
Authors: Ghasemi Amin , Stephens Max T
Published: July 2022

This article presents a framework to cluster buildings into typologically similar groups and select indicator buildings for regional seismic response and damage analysis. The framework requires a robust database of buildings to provide high-level structural and site information of buildings. Here, a database of 234 reinforced concrete buildings with five or more above-ground stories in the central business district of Wellington, New Zealand, has been selected as the case study of this research. First, key structural and site parameters that contribute to the seismic demand, response, and damage of each building are extracted from the database. Extracted parameters comprise three numerical and five categorical attributes of each building, including the year of construction, height, period, lateral load resisting system, floor system, site subsoil class, importance level, and strong motion station. Next, two prominent unsupervised machine learning clustering approaches are utilized to cluster the mixed categorical and numerical building database: k-prototype on the mixed numerical and categorical database and k-means on principal components numerical subspace adopted from factor analysis of mixed data (FAMD). A novel autoencoder deep learning neural network is also designed and trained to convert the mixed data into a low-dimensional subspace called latent space and feed this into k-means for clustering. The proposed autoencoder method is demonstrated to be more effective at clustering buildings into useful typological clusters for seismic response and damage analysis based on multiple criteria from both data-science and engineering perspectives. The details of selected indicator buildings for each similar seismic vulnerability cluster are also represented.
Rheological impact of Sutterby fluid in isothermal forward roll coating process: a theoretical study
Authors: Hanif Alia , Abbas Zaheer , Khaliq Sabeeh
Published: July 2022

In this paper, the incompressible and isothermal flow of Sutterby fluid is investigated during the forward roll coating process. The mass and momentum equations are non-dimensionalized and simplified using lubrication approximation theory (LAT). Perturbative results are obtained for the velocity, pressure gradient, flow rate, and shear stress, while coating thickness, maximum pressure, separating point, roll separating force and roll-transmitted power are found by Simpson’s 3/8 rule. Outcomes exhibit that velocity, pressure gradient and coating thickness are substantially influenced by the non-Newtonian fluid parameter, which may increase the coating efficiency. Also, power input and roll separating force is directly proportional to the non-Newtonian parameter.
Understanding the pathogenesis of occupational coal and silica dust-associated lung disease
Authors: Vanka Kanth Swaroop , Shukla Shakti , Gomez Henry M. , James Carole , Palanisami Thava , Williams Kenneth , Chambers Daniel C. , Britton Warwick J. , Ilic Dusan , Hansbro Philip Michael , Horvat Jay Christopher
Published: July 2022

Workers in the mining and construction industries are at increased risk of respiratory and other diseases as a result of being exposed to harmful levels of airborne particulate matter (PM) for extended periods of time. While clear links have been established between PM exposure and the development of occupational lung disease, the mechanisms are still poorly understood. A greater understanding of how exposures to different levels and types of PM encountered in mining and construction workplaces affect pathophysiological processes in the airways and lungs and result in different forms of occupational lung disease is urgently required. Such information is needed to inform safe exposure limits and monitoring guidelines for different types of PM and development of biomarkers for earlier disease diagnosis. Suspended particles with a 50% cut-off aerodynamic diameter of 10 µm and 2.5 µm are considered biologically active owing to their ability to bypass the upper respiratory tract's defences and penetrate deep into the lung parenchyma, where they induce potentially irreversible damage, impair lung function and reduce the quality of life. Here we review the current understanding of occupational respiratory diseases, including coal worker pneumoconiosis and silicosis, and how PM exposure may affect pathophysiological responses in the airways and lungs. We also highlight the use of experimental models for better understanding these mechanisms of pathogenesis. We outline the urgency for revised dust control strategies, and the need for evidence-based identification of safe level exposures using clinical and experimental studies to better protect workers’ health.
DriverRWH: discovering cancer driver genes by random walk on a gene mutation hypergraph
Authors: Wang Chenye , Shi Junhan , Cai Jiansheng , Zhang Yusen , Zheng Xiaoqi , Zhang Naiqian
Published: July 2022

Background

Recent advances in next-generation sequencing technologies have helped investigators generate massive amounts of cancer genomic data. A critical challenge in cancer genomics is identification of a few cancer driver genes whose mutations cause tumor growth. However, the majority of existing computational approaches underuse the co-occurrence mutation information of the individuals, which are deemed to be important in tumorigenesis and tumor progression, resulting in high rate of false positive.

Results

To make full use of co-mutation information, we present a random walk algorithm referred to as DriverRWH on a weighted gene mutation hypergraph model, using somatic mutation data and molecular interaction network data to prioritize candidate driver genes. Applied to tumor samples of different cancer types from The Cancer Genome Atlas, DriverRWH shows significantly better performance than state-of-art prioritization methods in terms of the area under the curve scores and the cumulative number of known driver genes recovered in top-ranked candidate genes. Besides, DriverRWH discovers several potential drivers, which are enriched in cancer-related pathways. DriverRWH recovers approximately 50% known driver genes in the top 30 ranked candidate genes for more than half of the cancer types. In addition, DriverRWH is also highly robust to perturbations in the mutation data and gene functional network data.

Conclusion

DriverRWH is effective among various cancer types in prioritizes cancer driver genes and provides considerable improvement over other tools with a better balance of precision and sensitivity. It can be a useful tool for detecting potential driver genes and facilitate targeted cancer therapies.
Adverse event using Medtronic NIM™ EMG endotracheal tube on a patient receiving anesthesia for hemithyroidectomy: a case report
Authors: Carpenter Emilee , Norris Lorraine , Beniamin Myriam
Published: July 2022

Background

The neural integrity monitor (NIM) electromyogram (EMG) endotracheal (ET) tube is a widely used device to monitor neural response through muscle activity. It is helpful in surgical procedures with high risk of damaging delicate structures in the head and neck. This case provides a thorough analysis of an adverse event that was encountered in the operating room, which others can hopefully learn from.

Case presentation

We are reporting a case in which a patient undergoing hemithyroidectomy had experienced an adverse event using the Medtronic NIM™ EMG endotracheal tube. After successful induction and intubation, confirming the proper positioning of the electrode wires was necessary before the incision could be made. Upon reexamination, the patient suddenly became difficult to ventilate with increased peak airway pressure, decreased tidal volume, and end tidal CO2. This episode lasted approximately 15 min and the patient’s condition remained stable despite low tidal volumes. The problem was unexpectedly resolved upon deflation of the cuff of the ET tube.

Conclusions

There are several similar reports of these endotracheal tubes causing obstruction, especially those in which overinflation of the cuff caused cuff herniation and blockage of the Murphy eye and the bevel. It is currently believed that the design of this tube allowed for the obstruction to occur. The patient’s short body habitus may have also been a small contributing factor. The distance that the electrodes must sit within the vocal cords to the tip of the bevel is longer in this type of ET tube compared with a standard ET tube. The distance from the true vocal cords to where the cuff sits in the trachea is also greater in this model NIM EMG tube. There was no confirmation of the exact obstructive process that took place, however, confirming the tube and cuff positioning would have been optimal.
The association of change in peak oxygen uptake with use of psychotropics in community-dwelling older adults - The Generation 100 study
Authors: Carlsen Trude , Stensvold Dorthe , Wisløff Ulrik , Ernstsen Linda , Halvorsen Thomas
Published: July 2022

Background

The use of psychotropics is high among the older population and may have detrimental effects on their physical and mental health. Cardiorespiratory fitness (CRF) is a strong and modifiable measure of health and declines with age. We aimed to study the association of change in CRF with use of psychotropics in community-dwelling older adults.

Methods

We analyzed longitudinal data from 1531 older adults from the Generation 100 study, aged 70–77 years at inclusion, and with a permanent address in Trondheim, Norway. Data on objectively measured peak oxygen uptake (VO2peak) were linked with register data from the Norwegian Prescription Database on prescribed psychotropics. The included psychotropics were antidepressants (N06A), antipsychotics (N05A), anxiolytics (N05B), hypnotics and sedatives (N05C), and N03AE (benzodiazepine derivatives). Analyses were done on any psychotropics as one group, and on the following separate groups: antidepressants (N06A), benzodiazepines (N05BA, N05CD, and N03AE), and z-hypnotics (N05CF). Peak oxygen uptake was measured four times over a five-year period and corresponding medication use was measured as defined daily doses (DDD). A random effects estimator was applied to investigate the association of change in VO2peak with the use of psychotropics.

Results

We found a statistically significant curvilinear association of change in VO2peak with use of any psychotropics and antidepressants. For VO2peak up to ~ 40 ml/kg/min, each 1 ml/kg/min increase was associated by a 3.3 DDD and 2.5 DDD decrease in use of any psychotropics and antidepressants, respectively. A bottoming-out effect was found and increases in VO2peak above ~ 40 ml/kg/min showed increased use of any psychotropics and antidepressants. However, the association of change in VO2peak with use was stronger for changes in the lower continuum of VO2peak levels and decreased with increasing VO2peak. No statistically significant association of change in VO2peak with use of benzodiazepines and z-hypnotics were found. However, because of a non-randomized design, we cannot rule out the possibility of confounding by indication.

Conclusions

The results of this study show a curvilinear association of change in VO2peak with use of any psychotropics and antidepressants in older adults. This relationship adds a new viewpoint on the adverse effects of psychotropic use and should be considered in interventions and policies aimed at reducing psychotropic medication use among the older population.
Prediction model of renal function recovery for primary membranous nephropathy with acute kidney injury
Authors: Chen Tianxin , Zhou Ying , Zhu Jianfen , Chen Xinxin , Pan Jingye
Published: July 2022

Background and objectives

The clinical and pathological impact factors for renal function recovery in acute kidney injury (AKI) on the progression of renal function in primary membranous nephropathy (PMN) with AKI patients have not yet been reported, we sought to investigate the factors that may influence renal function recovery and develop a nomogram model for predicting renal function recovery in PMN with AKI patients.

Methods

Two PMN with AKI cohorts from the Nephrology Department, the First Affiliated Hospital of Wenzhou Medical University during 2012–2018 and 2019–2020 were included, i.e., a derivation cohort during 2012–2018 and a validation cohort during 2019–2020. Clinical characteristics and renal pathological features were obtained. The outcome measurement was the recovery of renal function within 12 months. Lasso regression was used for clinical and pathological features selection. Prediction model was built and nomogram was plotted. Model evaluations including calibration curves were performed.

Result

Renal function recovery was found in 72 of 124 (58.1%) patients and 41 of 72 (56.9%) patients in the derivation and validation cohorts, respectively. The prognostic nomogram model included determinants of sex, age, the comorbidity of hypertensive nephropathy, the stage of glomerular basement membrane and diuretic treatment with a reasonable concordance index of 0.773 (95%CI,0.716–0.830) in the derivation cohort and 0.773 (95%CI, 0.693–0.853) in the validation cohort. Diuretic use was a significant impact factor with decrease of renal function recovery in PMN with AKI patients.

Conclusion

The predictive nomogram model provides useful prognostic tool for renal function recovery in PMN patients with AKI.
Real-world data analysis of immune checkpoint inhibitors in stage III-IV adenocarcinoma and squamous cell carcinoma
Authors: Sun Meiling , Ji Huaijun , Xu Ning , Jiang Peng , Qu Tao , Li Yu
Published: July 2022

Background

This study was designed to investigate the clinical application, efficacy, and safety of immune checkpoint inhibitors (ICIs) in the treatment of lung cancer in the real world.

Methods

A retrospective, observational analysis was conducted on patients treated with ICIs in four tertiary hospitals in the region from January 2015 to March 2021, to evaluate the clinical efficacy of ICIs single-agent or combined chemotherapy and anti-vascular drugs in the first-line or second-line treatment of patients with lung cancer.

Results

Three hundred and fifteen patients were enrolled in this study. In patients with stage III-IV adenocarcinoma and Squamous cell carcinoma, the objective response rate (ORR) and disease control rate (DCR) were 35.5% (87/245) and 93.5% (229/245), respectively, the median progression-free survival (PFS) was 10.8 months, and the median overall survival (OS) was not reached. A total of 132 patients received ICIs as the first-line treatment, the median treatment cycle was 8 cycles (2–20 cycles), the short-term efficacy ORR was 38.6%, DCR was 93.9%, and the median PFS was 11.4 months. One hundred thirteen patients received ICIs treatment as second-line treatment, the median treatment cycle was five cycles (2–10 cycles), the short-term efficacy ORR was 31.9%, DCR was 92.9%, and the median PFS was 10.0 months. There were no statistically significant differences in ORR, DCR, or median PFS with ICIs as the first-line treatment compared with the second-line treatment(P > 0.05). The results of subgroup analysis showed that Eastern Cooperative Oncology Group performance status (ECOG PS), epidermal growth factor receptor (EGFR) mutation status, pathological type and number of treatment lines were not correlated with median PFS(P > 0.05). However, there were statistically significant differences in programmed death-ligand 1(PD-L1) expression, corticosteroid interference, and antibiotic (Abx) treatment among all groups (P < 0.05). In terms of safety, the overall incidence of adverse reactions in 315 patients was 62.5%, and the incidence of immune-related adverse events (irAEs) was 13.7%. Grade 1–2 and 3–4 incidence of adverse events were 34.9 and 27.65%, respectively. There were four patients who experienced fatal irAEs, two cases were liver damage leading to liver failure, one case was immune related pneumonia, and one case was immune related myocarditis.

Conclusion

In the real world, ICIs has a good effect on patients with lung cancer and significantly improves ORR and PFS.
A potential decision-making algorithm based on endoscopic ultrasound for staging early gastric cancer: a retrospective study
Authors: Yan Yan , Ma Zhonghua , Ji Xin , Liu Jiawei , Ji Ke , Li Shijie , Wu Qi
Published: July 2022

Background

Clinical staging of gastric cancer (GC) before treatment is essential. Endoscopic ultrasound (EUS) is a recommended staging tool, but its efficacy remains controversial. Our previous prospective study evaluated the potential value of EUS for T staging and presented discrepancies. In this study, we aimed to evaluate the efficacy of EUS in T staging by comparing it with pathological staging. We analyze the factors that can potentially affect accuracy to identify suitable subgroups for EUS staging.

Methods

Data from a total of 1763 consecutive patients with GC from January 2015 to December 2017 were analyzed. Results from EUS and pathological T staging were compared. The factors that might affect EUS’s accuracy were analyzed.

Results

The sensitivity, specificity, positive predictive value, and negative predictive value of EUS in patients with early GC were 62.08%, 96.13%, 90.94%, and 80.21%, respectively. The accuracy rates of uT1, uT2–uT4, and uT3–uT4 were 90.94%, 79.02%, and 78.39%, respectively. In multivariate analysis, underestimation was more likely to be observed in patients with tumors located in the middle or upper third of the stomach. Overestimation was more likely to be observed in patients with tumors located in the lower third or those without ulcer. Other factors affecting accuracy included ulcer, differentiation, larger size and undergoing surgery.

Conclusion

Our findings highlight the role of EUS in determining the T staging of GC. Overestimation and underestimation in T-staging were significantly associated with the tumor location in early GC, and a decision-making algorithm was proposed for clinical practice in early cancers based on these findings.
Symptomatic care of late-onset Alexander disease presenting with area postrema-like syndrome with prednisolone; a case report
Authors: Zardadi Safoura , Razmara Ehsan , Rasoulinezhad Maryam , Babaei Meisam , Ashrafi Mohammad Reza , Pak Neda , Garshasbi Masoud , Tavasoli Ali Reza
Published: July 2022

Background

Alexander disease (AxD) is classified into AxD type I (infantile) and AxD type II (juvenile and adult form). We aimed to determine the potential genetic cause(s) contributing to the AxD type II manifestations in a 9-year-old male who presented area postrema-like syndrome and his vomiting and weight loss improved after taking prednisolone.

Case presentation

A normal cognitive 9-year-old boy with persistent nausea, vomiting, and a significant weight loss at the age of 6 years was noticed. He also experienced an episode of status epilepticus with generalized atonic seizures. He showed non-febrile infrequent multifocal motor seizures at the age of 40 days which were treated with phenobarbital. He exhibited normal physical growth and neurologic developmental milestones by the age of six. Occasionally vomiting unrelated to feeding was reported. Upon examination at 9 years, a weak gag reflex, prominent drooling, exaggerated knee-deep tendon reflexes (3+), and nasal tone speech was detected. All gastroenterological, biochemical, and metabolic assessments were normal. Brain magnetic resonance imaging (MRI) revealed bifrontal confluent deep and periventricular white matter signal changes, fine symmetric frontal white matter and bilateral caudate nucleus involvements with garland changes, and a hyperintense tumefactive-like lesion in the brain stem around the floor of the fourth ventricle and area postrema with contrast uptake in post-contrast T1-W images. Latter MRI at the age of 8 years showed enlarged area postrema lesion and bilateral middle cerebellar peduncles and dentate nuclei involvements. Due to clinical and genetic heterogeneities, whole-exome sequencing was performed and the candidate variant was confirmed by Sanger sequencing. A de novo heterozygous mutation, NM_001242376.1:c.262 C > T;R88C in exon 1 of the GFAP (OMIM: 137,780) was verified. Because of persistent vomiting and weight loss of 6.0 kg, prednisolone was prescribed which brought about ceasing vomiting and led to weight gaining of 3.0 kg over the next 3 months after treatment. Occasional attempts to discontinue prednisolone had been resulting in the reappearance of vomiting.

Conclusions

This study broadens the spectrum of symptomatic treatment in leukodystrophies and also shows that R88C mutation may lead to a broad range of phenotypes in AxD type II patients.