bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of the COVID-19 Pandemic on Breast Cancer Mortality in the US: Estimates From Collaborative Simulation Modeling
Authors: Alagoz Oguzhan , Lowry Kathryn P , Kurian Allison W , Mandelblatt Jeanne S , Ergun Mehmet A , Huang Hui , Lee Sandra J , Schechter Clyde B , Tosteson Anna N A , Miglioretti Diana L , Trentham-Dietz Amy , Nyante Sarah J , Kerlikowske Karla , Sprague Brian L , Stout Natasha K ,   from the CISNET Breast Working Group
Published: May 2021

Background

The coronavirus disease 2019 (COVID-19) pandemic has disrupted breast cancer control through short-term declines in screening and delays in diagnosis and treatments. We projected the impact of COVID-19 on future breast cancer mortality between 2020 and 2030.

Methods

Three established Cancer Intervention and Surveillance Modeling Network breast cancer models modeled reductions in mammography screening use, delays in symptomatic cancer diagnosis, and reduced use of chemotherapy for women with early-stage disease for the first 6 months of the pandemic with return to prepandemic patterns after that time. Sensitivity analyses were performed to determine the effect of key model parameters, including the duration of the pandemic impact.

Results

By 2030, the models project 950 (model range = 860-1297) cumulative excess breast cancer deaths related to reduced screening, 1314 (model range = 266-1325) associated with delayed diagnosis of symptomatic cases, and 151 (model range = 146-207) associated with reduced chemotherapy use in women with hormone positive, early-stage cancer. Jointly, 2487 (model range = 1713-2575) excess breast cancer deaths were estimated, representing a 0.52% (model range = 0.36%-0.56%) cumulative increase over breast cancer deaths expected by 2030 in the absence of the pandemic’s disruptions. Sensitivity analyses indicated that the breast cancer mortality impact would be approximately double if the modeled pandemic effects on screening, symptomatic diagnosis, and chemotherapy extended for 12 months.

Conclusions

Initial pandemic-related disruptions in breast cancer care will have a small long-term cumulative impact on breast cancer mortality. Continued efforts to ensure prompt return to screening and minimize delays in evaluation of symptomatic women can largely mitigate the effects of the initial pandemic-associated disruptions.
Valproic acid triggers radiation-induced abscopal effect by modulating the unirradiated tumor immune microenvironment in a rat model of breast cancer
Authors: Jin Liya , Duan Wenhua , Cai Zuchao , Lim David , Feng Zhihui
Published: May 2021

An abscopal effect occurs when localized radiotherapy causes the regression of tumors distant from the irradiated site. However, such a clinically detectable abscopal effect from radiotherapy alone is rare. This study investigated whether valproic acid ([VPA], a histone deacetylase inhibitor [HDACi]) treatment can stimulate radiation-induced abscopal effect. We used 7,12-dimethylbenz[a]anthracene, a typical environmental carcinogen, to establish a rat model with multiple breast tumors. Only one tumor received 8 Gy fractionated doses of X-rays (2 Gy daily fractions over four days) and 200 mg/kg VPA was administered intraperitoneally. We monitored the growth of both irradiated and unirradiated tumors after treatments. The unirradiated tumor was collected for hematoxylin and eosin (HE) staining, immunohistochemistry (IHC) (CD8, Granzyme B, Cleaved Caspase-3, BrdU, Ki67, F4/80 and CD68), double immunofluorescence (F4/80 and CD86), Western blot (Cleaved Caspase-3) and qRT-PCR (CD86, CD163, IL-1β, IL-6, IL-12, IL-23, IL-10, TGF-β) analysis. We found ionizing radiation (IR) + VPA treatment inhibited both irradiated and unirradiated tumor growth as compared to IR alone. Such observe abscopal effect was mediated by the recruitment of activated CD8+ T cells into the unirradiated tumor sites, which released Granzyme B to cause tumor cell apoptosis. Furthermore, IR + VPA treatment led to macrophages infiltration into the unirradiated tumor sites and polarization to M1 phenotype, resulted in increased levels of pro-inflammatory cytokines such as IL-1β and IL-12, and decreased levels of anti-inflammatory cytokines such as IL-10 and TGF-β. Our data supports the proposition that VPA may be a potential therapeutic candidate to trigger radiation-induced abscopal effect by modulating the unirradiated tumor immune microenvironment.
A new method to visualize CEP hormone–CEP receptor interactions in vascular tissue in vivo
Authors: Lee Han-Chung , Binos Steve , Chapman Kelly , Pulsford Sacha B , Ivanovici Ariel , Rathjen John P , Djordjevic Michael A
Published: May 2021

C-TERMINALLY ENCODED PEPTIDEs (CEPs) control diverse responses in plants including root development, root system architecture, nitrogen demand signalling, and nutrient allocation that influences yield, and there is evidence that different ligands impart different phenotypic responses. Thus, there is a need for a simple method that identifies bona fide CEP hormone–receptor pairings in vivo and examines whether different CEP family peptides bind the same receptor. We used formaldehyde or photoactivation to cross-link fluorescently tagged group 1 or group 2 CEPs to receptors in semi-purified Medicago truncatula or Arabidopsis thaliana leaf vascular tissues to verify that COMPACT ROOT ARCHITECTURE 2 (CRA2) is the Medicago CEP receptor, and to investigate whether sequence diversity within the CEP family influences receptor binding. Formaldehyde cross-linked the fluorescein isothiocyanate (FITC)-tagged Medicago group 1 CEP (MtCEP1) to wild-type Medicago or Arabidopsis vascular tissue cells, but not to the CEP receptor mutants, cra2 or cepr1. Binding competition showed that unlabelled MtCEP1 displaces FITC–MtCEP1 from CRA2. In contrast, the group 2 CEP, FITC–AtCEP14, bound to vascular tissue independently of CEPR1 or CRA2, and AtCEP14 did not complete with FITC–MtCEP1 to bind CEP receptors. The binding of a photoactivatable FITC–MtCEP1 to the periphery of Medicago vascular cells suggested that CRA2 localizes to the plasma membrane. We separated and visualized a fluorescent 105 kDa protein corresponding to the photo-cross-linked FITC–MtCEP1–CRA2 complex using SDS–PAGE. Mass spectrometry identified CRA2-specific peptides in this protein band. The results indicate that FITC–MtCEP1 binds to CRA2, MtCRA2 and AtCEPR1 are functionally equivalent, and the binding specificities of group 1 and group 2 CEPs are distinct. Using formaldehyde or photoactivated cross-linking of biologically active, fluorescently tagged ligands may find wider utility by identifying CEP–CEP receptor pairings in diverse plants.
Session 6: Bringing Mindfulness to Our Relationships
Authors: Smart Colette M.
Published: May 2021

The participants’ experience of “falling down the hole” is discussed, and this is connected to further cultivation of awareness as a way to track our experience without reacting to it. The discussion of reacting versus responding is broadened to incorporate our experiences with others, and how we communicate with others. The participants are provided with psychoeducation on different communication styles and are encouraged to track these as well as the tendency to respond versus react. Participants continue with Open Monitoring and are invited to track their mindfulness in daily life and to find ways of adding to their mental bank account.
Session 9: Booster Session
Authors: Smart Colette M.
Published: May 2021

The standard for mindfulness training programs, including MBSR, is an 8-week, weekly format. This chapter provides the structure for an optional follow-up or booster session that can occur outside of the standard 8-week structure of the program. The booster can be scheduled for a one-month follow-up after the group ends. At the facilitator’s discretion, you may wish to schedule additional boosters, such as at 3 months or even 1 year (such as was done in the original Wisdom Mind study). A booster session can be used to enhance ongoing engagement by promoting continued connection between participants and to troubleshoot difficulties with the practices.
Common Cognitive Slip-Ups
Authors: Smart Colette M.
Published: May 2021

At the core of Wisdom Mind is the premise that normal cognitive aging can be a source of distress for certain older adults, and that mindfulness practice can help to alleviate that distress. To that end, this chapter provides an overview of the major cognitive domains and how our abilities within those domains can change with age. This material will be particularly informative for those who have not worked with older adults or do not have a background in clinical neuropsychology. It will allow the reader to connect with some of the common cognitive slip-ups that group participants may spontaneously report, so that these slip-ups can be situated within the context of mindfulness as presented in this program.
Wisdom Mind
Authors: Smart Colette M.
Published: May 2021

Wisdom Mind is an empirically supported intervention program for older adults—those who are cognitively healthy, as well as those who may be experiencing some concerns about their thinking abilities, what we refer to as subjective cognitive decline. While mindfulness is already known to benefit a wide variety of individuals, the unique strengths of this program are the ways in which it is tailored specifically to older adults. Session content is grounded in and contextualized with the developmental concerns of older adults (e.g., cognitive slip-ups, loss and grief). Content is further grounded in a clinical-neuropsychological perspective, which incorporates both restitution (i.e., scaffolding mindfulness practices in a sequence of increasing difficulty) and compensation (e.g., strategies to promote learning and integration). The session-by-session Facilitator Guide provides detailed information on how to deliver the program as well as the reasoning behind why certain practices and strategies are provided at different times and in different ways. In this way, even seasoned mindfulness instructors can benefit from the Facilitator Guide, which provides integrative guidance on how to deliver mindfulness effectively to older adults. The companion Participant Workbook contains all of the information needed to participate in the program, including written prompts for homework and space for notetaking. A companion website provides downloadable meditation audios that facilitators and participants can access throughout the program. For facilitators who wish to record their own audios, scripts are also provided in the Guide.
Session 4: Paying Attention to the Commentator
Authors: Smart Colette M.
Published: May 2021

The main principle that we will talk about in this session is the idea of a “commentator,” the thoughts, opinions, and beliefs that go on in the background of our awareness, but can have a big impact on how we feel. Specifically, the emotional reactions we have to cognitive slip-ups. Through the homework you previously did related to tracking “slips and falls,” you will be invited to reflect on the aspect of your mind that is constantly commenting on your experience (i.e., the “commentator”). This, in turn, is connected to the concept of mind-wandering; this is a core concept in most discussions of mindfulness practices, and may become even more of an issue as we age. For homework, you will be introduced to the second of two Mindful Yoga series, and we will once again revisit the attention hierarchy in terms of the practices you are learning. Tracking unpleasant events is also assigned for homework.
Introduction to Wisdom Mind
Authors: Smart Colette M.
Published: May 2021

This chapter provides the background to the Wisdom Mind program—why it was developed, the conceptual foundations on which it is based, and the results from the original empirical evaluation of the program. While the program is broadly influenced by Jon Kabat-Zinn’s mindfulness-based stress reduction, Wisdom Mind stands on its own as a unique program that is grounded in principles of clinical neuropsychology (specifically, cognitive rehabilitation) as well as lifespan developmental psychology. This chapter will introduce you to the concept of mindfulness, tell you more about some of the background work that has already been done on mindfulness, and how it may be helpful to you in particular as an older adult. This chapter will also prepare you for the program, with some information on what to expect and what kind of mindset to bring to your experience.
CBT Applications in Schools
Authors: Joyce-Beaulieu Diana , Zaboski Brian A. , Dixon Alexa R.
Published: May 2021

Anxiety, depression, substance use, conduct disorders, attention-deficit/hyperactivity disorder, and learning disorder are but a subset of problems that youth experience throughout their lives. Chapter 1 presents the school-based practitioner as a first-line interventionist for these difficulties. Framing school-based care within a multi-tiered system of support, Chapter 1 introduces cognitive behavioral therapy (CBT), an evidence-based intervention with flexible applications for children and adolescents. It acknowledges the complex intersection between CBT, 504 plans, and Individualized Education Programs; discusses the many ways students may receive services under the law (and otherwise); and highlights the details of school-based practice integral to evaluating these plans. Chapter 1 ends with a thorough case presentation complete with background information, interviews, behavior and symptom assessment, CBT session planning, and outcome data.
Psychoeducation, Relaxation Training, and Mindfulness
Authors: Schrack Anna , Romaker Emma , Joyce-Beaulieu Diana , Zaboski Brian A.
Published: May 2021

Chapter 5 presents fundamental counseling skills that are easily implemented within a cognitive behavioral therapy framework: psychoeducation, motivational interviewing, relaxation training, and mindfulness. The chapter offers a brief historical note on each technique, an evaluation of its research support, and authentic client–therapist dialog that emphasizes its utility and key elements. Each technique is discussed within the context of cognitive behavioral theory, including its overall effect on intervention outcomes and applicability for different referral problems. This chapter’s appendix material includes practical school-based resources for practitioners seeking to apply these techniques in session (detailed breathing, muscle relaxation, and guided imagery scripts) along with multimedia resources for children and families.
Terminating Therapy and Referrals
Authors: Gallant Jason , Joyce-Beaulieu Diana , Zaboski Brian A.
Published: May 2021

Cognitive behavioral therapy (CBT) is an efficacious and efficient intervention; as such, closure encompasses an essential part of intervention planning. Chapter 9 discusses closure: how to graduate clients from CBT, arrange booster sessions, ethically terminate CBT, and, if needed, progress clients to a higher level of care. It describes reasons for why clients may become demotivated for treatment and demystifies insurance coverage and co-pays. For clients with more severe issues, Chapter 9 explains the many referral options available, like in-home family services, outpatient clinics, intensive outpatient services, partial hospitalization, acute inpatient hospitalization, and residential treatment facilities. The chapter concludes with a discussion of psychopharmacology and incorporates a multidisciplinary, consultative approach throughout.
Global Health Engagement: Leveraging New Technology and Multilateral Partnerships During the COVID-19 Pandemic
Authors: Payne Chelsea B
Published: May 2021

United States government global health engagements range from delivering aid, to medical skill certification, and building multilateral partnerships with key leaders. This article discusses three critical questions to consider when planning engagements during pandemics. By expanding virtual programming, and including SARS-CoV-2 mitigation measures with in-person events, we can enhance support to partner nations through medical engagements.
A new MWA limit on the 21 cm power spectrum at redshifts ∼13–17
Authors: Yoshiura S , Pindor B , Line J L B , Barry N , Trott C M , Beardsley A , Bowman J , Byrne R , Chokshi A , Hazelton B J , Hasegawa K , Howard E , Greig B , Jacobs D , Jordan C H , Joseph R , Kolopanis M , Lynch C , McKinley B , Mitchell D A , Morales M F , Murray S G , Pober J C , Rahimi M , Takahashi K , Tingay S J , Wayth R B , Webster R L , Wilensky M , Wyithe J S B , Zhang Z , Zheng Q
Published: May 2021

Observations in the lowest Murchison Widefield Array (MWA) band between 75 and 100 MHz have the potential to constrain the distribution of neutral hydrogen in the intergalactic medium at redshift ∼13–17. Using 15 h of MWA data, we analyse systematics in this band such as radio-frequency interference (RFI), ionospheric and wide field effects. By updating the position of point sources, we mitigate the direction-independent calibration error due to ionospheric offsets. Our calibration strategy is optimized for the lowest frequency bands by reducing the number of direction-dependent calibrators and taking into account radio sources within a wider field of view. We remove data polluted by systematics based on the RFI occupancy and ionospheric conditions, finally selecting 5.5 h of the cleanest data. Using these data, we obtain 2σ upper limits on the 21 cm power spectrum in the range of $0.1~ h~{\mathrm{ Mpc}}^{-1}\lessapprox k \lessapprox 1 ~ ~h~{\mathrm{ Mpc}}^{-1}$ and at z = 14.2, 15.2, and 16.5, with the lowest limit being $6.3\times 10^6 ~\rm mK^2$ at $k=0.14 ~h~{\mathrm{ Mpc}}^{-1}$ and at z = 15.2 with a possibility of a few  per cent of signal loss due to direction-independent calibration.
Internal rotation of Milky Way dwarf spheroidal satellites with Gaia Early Data Release 3
Authors: Martínez-García Alberto Manuel , del Pino Andrés , Aparicio Antonio , van der Marel Roeland P , Watkins Laura L
Published: May 2021

We present an analysis of the kinematics of 14 satellites of the Milky Way (MW). We use proper motions (PMs) from the Gaia Early Data Release 3 (EDR3) and line-of-sight velocities (vlos) available in the literature to derive the systemic 3D motion of these systems. For six of them, namely the Carina, Draco, Fornax, Sculptor, Sextans, and Ursa Minor dwarf spheroidal galaxies (dSph), we study the internal kinematics projecting the stellar PMs into radial, VR (expansion/contraction), and tangential, VT (rotation), velocity components with respect to the centre of mass. We find significant rotation in the Carina (|VT| = 9.6 ± 4.5 km s−1 ), Fornax (|VT| = 2.8 ± 1.3 km s−1 ), and Sculptor (|VT| = 3.0 ± 1.0 km s−1 ) dSphs. Besides the Sagittarius dSph, these are the first measurements of internal rotation in the plane of the sky in the MW’s classical dSphs. All galaxies except Carina show |VT|/σv < 1. We find that slower rotators tend to show, on average, larger sky-projected ellipticity (as expected for a sample with random viewing angles) and are located at smaller Galactocentric distances (as expected for tidal stirring scenarios in which rotation is transformed into random motions as satellites sink into the parent halo). However, these trends are small and not statistically significant, indicating that rotation has not played a dominant role in shaping the 3D structure of these galaxies. Either tidal stirring had a weak impact on the evolution of these systems or it perturbed them with similar efficiency regardless of their current Galactocentric distance.
Density profile of a self-gravitating polytropic turbulent fluid in the context of ensembles of molecular clouds
Authors: Donkov S , Stefanov I Zh , Veltchev T V , Klessen R S
Published: May 2021

We obtain an equation for the density profile in a self-gravitating polytropic spherically symmetric turbulent fluid with an equation of state $p_{\rm gas}\propto \rho ^\Gamma$. This is done in the framework of ensembles of molecular clouds represented by single abstract objects as introduced by Donkov et al. The adopted physical picture is appropriate to describe the conditions near to the cloud core where the equation of state changes from isothermal (in the outer cloud layers) with Γ = 1 to one of ‘hard polytrope’ with exponent Γ > 1. On the assumption of steady state, as the accreting matter passes through all spatial scales, we show that the total energy per unit mass is an invariant with respect to the fluid flow. The obtained equation reproduces the Bernoulli equation for the proposed model and describes the balance of the kinetic, thermal, and gravitational energy of a fluid element. We propose as well a method to obtain approximate solutions in a power-law form which results in four solutions corresponding to different density profiles, polytropic exponents, and energy balance equations for a fluid element. One of them, a density profile with slope −3 and polytropic exponent Γ = 4/3, matches with observations and numerical works and, in particular, leads to a second power-law tail of the density distribution function in dense, self-gravitating cloud regions.
Long-term and multiwavelength evolution of a changing-look AGN Mrk 1018
Authors: Lyu Bing , Yan Zhen , Yu Wenfei , Wu Qingwen
Published: May 2021

The physical mechanism for triggering the changing-look phenomenon in active galactic nuclei (AGNs) is still unclear. We explore this issue based on the multiwavelength spectral and flux variations for a changing-look AGN Mrk 1018 with long-term observations in the X-ray, optical/ultraviolet (UV), and radio bands. Both the optical and the X-ray emission experience a rapid decay in changing-look phase during 2010–2015, where a re-flare appears in the optical/UV and X-ray bands. We find a time lag of ∼20 d of optical/UV behind X-ray variations in type 1.9 phase. The 5 GHz radio flux decreases by ∼20 per cent in type 1.9 phase during 2016–2017. We find that both the X-ray photon index (Γ) and the optical-to-X-ray spectral index (αox ) are anticorrelated with the Eddington scaled 2–10 keV X-ray luminosity (LX/LEdd) in the type 1.9 phase. However, the type 1 phase deviates from these two anticorrelations, which suggests that the change of broad emission lines might be regulated by the evolution of accretion disc (e.g. disappearing of the inner cold disc in the type 1.9 phase).
Cancer predisposition in pediatric neuro-oncology—practical approaches and ethical considerations
Authors: Hirsch Steffen , Dikow Nicola , Pfister Stefan M , Pajtler Kristian W
Published: May 2021

A genetic predisposition to tumor development can be identified in up to 10% of pediatric patients with central nervous system (CNS) tumors. For some entities, the rate of an underlying predisposition is even considerably higher. In recent years, population-based approaches have helped to further delineate the role of cancer predisposition in pediatric oncology. Investigations for cancer predisposition syndrome (CPS) can be guided by clinical signs and family history leading to directed testing of specific genes. The increasingly adopted molecular analysis of tumor and often parallel blood samples with multi-gene panel, whole-exome, or whole-genome sequencing identifies additional patients with or without clinical signs. Diagnosis of a genetic predisposition may put an additional burden on affected families. However, information on a given cancer predisposition may be critical for the patient as potentially influences treatment decisions and may offer the patient and healthy carriers the chance to take part in intensified surveillance programs aiming at early tumor detection. In this review, we discuss some of the practical and ethical challenges resulting from the widespread use of new diagnostic techniques and the most important CPS that may manifest with brain tumors in childhood.
Engaging People Who Inject Drugs Living With HIV in Antiretroviral Treatment and Medication for Opioid Use Disorder: Extended Follow-up of HIV Prevention Trials Network (HPTN) 074
Authors: Lancaster Kathryn E , Mollan Katie R , Hanscom Brett S , Shook-Sa Bonnie E , Ha Tran V , Dumchev Kostyantyn , Djoerban Zubairi , Rose Scott M , Latkin Carl A , Metzger David S , Go Vivian F , Dvoriak Sergii , Reifeis Sarah A , Piwowar-Manning Estelle M , Richardson Paul , Hudgens Michael G , Hamilton Erica L , Eshleman Susan H , Susami Hepa , Chu Viet Anh , Djauzi Samsuridjal , Kiriazova Tetiana , Nhan Do Thi , Burns David N , Miller William C , Hoffman Irving F
Published: May 2021

Background

People who inject drugs (PWID) living with HIV experience inadequate access to antiretroviral treatment (ART) and medication for opioid use disorders (MOUD). HPTN 074 showed that an integrated intervention increased ART use and viral suppression over 52 weeks. To examine durability of ART, MOUD, and HIV viral suppression, participants could re-enroll for an extended follow-up period, during which standard-of-care (SOC) participants in need of support were offered the intervention.

Methods

Participants were recruited from Ukraine, Indonesia and Vietnam and randomly allocated 3:1 to SOC or intervention. Eligibility criteria included: HIV-positive; active injection drug use; 18-60 years of age; ≥1 HIV-uninfected injection partner; and viral load ≥1,000 copies/mL. Re-enrollment was offered to all available intervention and SOC arm participants, and SOC participants in need of support (off-ART or off-MOUD) were offered the intervention.

Results

The intervention continuation group re-enrolled 89 participants, and from week 52 to 104, viral suppression (<40 copies/mL) declined from 41% to 29% (estimated 9.4% decrease per year, 95% CI -17.0%; -1.8%). The in need of support group re-enrolled 94 participants and had increased ART (re-enrollment: 55%, week 26: 69%) and MOUD (re-enrollment: 16%, week 26: 25%) use, and viral suppression (re-enrollment: 40%, week 26: 49%).

Conclusions

Viral suppression declined in year 2 for those who initially received the HPTN 074 intervention and improved maintenance support is warranted. Viral suppression and MOUD increased among in need participants who received intervention during the study extension. Continued efforts are needed for widespread implementation of this scalable, integrated intervention.
Pneumonia Caused by Severe Acute Respiratory Syndrome Coronavirus 2 and Influenza Virus: A Multicenter Comparative Study
Authors: Oi Issei , Ito Isao , Hirabayashi Masataka , Endo Kazuo , Emura Masahito , Kojima Toru , Tsukao Hitokazu , Tomii Keisuke , Nakagawa Atsushi , Otsuka Kojiro , Akai Masaya , Oi Masahiro , Sugita Takakazu , Fukui Motonari , Inoue Daiki , Hasegawa Yoshinori , Takahashi Kenichi , Yasui Hiroaki , Fujita Kohei , Ishida Tadashi , Ito Akihiro , Kita Hideo , Kaji Yusuke , Tsuchiya Michiko , Tomioka Hiromi , Yamada Takashi , Terada Satoru , Nakaji Hitoshi , Hamao Nobuyoshi , Shirata Masahiro , Nishioka Kensuke , Yamazoe Masatoshi , Shiraishi Yusuke , Ogimoto Tatsuya , Hosoya Kazutaka , Ajimizu Hitomi , Shima Hiroshi , Matsumoto Hisako , Tanabe Naoya , Hirai Toyohiro
Published: May 2021

Background

Detailed differences in clinical information between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia (CP), which is the main phenotype of SARS-CoV-2 disease, and influenza pneumonia (IP) are still unclear.

Methods

A prospective, multicenter cohort study was conducted by including patients with CP who were hospitalized between January and June 2020 and a retrospective cohort of patients with IP hospitalized from 2009 to 2020. We compared the clinical presentations and studied the prognostic factors of CP and IP.

Results

Compared with the IP group (n = 66), in the multivariate analysis, the CP group (n = 362) had a lower percentage of patients with underlying asthma or chronic obstructive pulmonary disease (P < .01), lower neutrophil-to-lymphocyte ratio (P < .01), lower systolic blood pressure (P < .01), higher diastolic blood pressure (P < .01), lower aspartate aminotransferase level (P < .05), higher serum sodium level (P < .05), and more frequent multilobar infiltrates (P < .05). The diagnostic scoring system based on these findings showed excellent differentiation between CP and IP (area under the receiver operating characteristic curve, 0.889). Moreover, the prognostic predictors were different between CP and IP.

Conclusions

Comprehensive differences between CP and IP were revealed, highlighting the need for early differentiation between these 2 pneumonias in clinical settings.
Future Directions in Robotic Neurosurgery
Authors: Wagner Christopher R , Phillips Timothy , Roux Serge , Corrigan Joseph P
Published: May 2021

In this paper, we highlight promising technologies in each phase of a robotic neurosurgery operation, and identify key factors affecting how quickly these technologies will mature into products in the operating room. We focus on specific technology trends in image-guided cranial and spinal procedures, including advances in imaging, machine learning, robotics, and novel interfaces. For each technology, we discuss the required effort to overcome safety or implementation challenges, as well as identifying example regulatory approved products in related fields for comparison. The goal is to provide a roadmap for clinicians as to which robotic and automation technologies are in the developmental pipeline, and which ones are likely to impact their practice sooner, rather than later.
Mesenchymal stem cells loaded on 3D-printed gradient poly(ε-caprolactone)/methacrylated alginate composite scaffolds for cartilage tissue engineering
Authors: Cao Yanyan , Cheng Peng , Sang Shengbo , Xiang Chuan , An Yang , Wei Xiaochun , Shen Zhizhong , Zhang Yixia , Li Pengcui
Published: May 2021

Cartilage has limited self-repair ability due to its avascular, alymphatic and aneural features. The combination of three-dimensional (3D) printing and tissue engineering provides an up-and-coming approach to address this issue. Here, we designed and fabricated a tri-layered (superficial layer (SL), middle layer (ML) and deep layer (DL)) stratified scaffold, inspired by the architecture of collagen fibers in native cartilage tissue. The scaffold was composed of 3D printed depth-dependent gradient poly(ε-caprolactone) (PCL) impregnated with methacrylated alginate (ALMA), and its morphological analysis and mechanical properties were tested. To prove the feasibility of the composite scaffolds for cartilage regeneration, the viability, proliferation, collagen deposition and chondrogenic differentiation of embedded rat bone marrow mesenchymal stem cells (BMSCs) in the scaffolds were assessed by Live/dead assay, CCK-8, DNA content, cell morphology, immunofluorescence and real-time reverse transcription polymerase chain reaction. BMSCs-loaded gradient PCL/ALMA scaffolds showed excellent cell survival, cell proliferation, cell morphology, collagen II deposition and hopeful chondrogenic differentiation compared with three individual-layer scaffolds. Hence, our study demonstrates the potential use of the gradient PCL/ALMA construct for enhanced cartilage tissue engineering.
Golden Handcuffs and Corporate Innovation: Evidence from Defined Benefit Pension Plans
Authors: Duong Huu Nhan , Qiu Bin , Rhee S Ghon
Published: May 2021

This study examines the relation between employee incentives and corporate innovation. We find that firms with a higher defined benefit (DB) pension value secure more patents and patent citations. We further show that pension freezes, which stop the accumulation of pension obligations, negatively affect innovation outcomes. The value of a DB plan enhances innovation by motivating employees to produce higher output and through loyalty. However, pension deficits impede innovation because of the nature of inside debt. Overall, our findings call for a fresh look at pensions by policy makers and practitioners, given the historic shift away from DB plans. (JEL G31, G32, O31, O32).
Liquidity Restrictions, Runs, and Central Bank Interventions: Evidence from Money Market Funds
Authors: Li Lei , Li Yi , Macchiavelli Marco , Zhou Xing (Alex)
Published: May 2021

Liquidity restrictions on investors, like the redemption gates and liquidity fees introduced in the 2016 money market fund (MMF) reform, are meant to improve financial stability. However, we find evidence that such liquidity restrictions exacerbated the run on prime MMFs during the COVID-19 crisis. Our results indicate that gates and fees could generate strategic complementarities among investors in crisis times. Severe outflows from prime MMFs led the Federal Reserve to intervene with the Money Market Mutual Fund Liquidity Facility (MMLF). Using MMLF microdata, we show how the provision of “liquidity of last resort” stabilized prime funds.
Physiological correlates of the Epworth Sleepiness Scale reveal different dimensions of daytime sleepiness
Authors: Lok Renske , Zeitzer Jamie M
Published: May 2021

The Epworth Sleepiness Scale is commonly used to examine self-reported daytime sleepiness in clinical populations; the physiologic correlates of this scale, however, are not well understood. Furthermore, how well this scale correlates with parallel objective and self-reported concepts of daytime sleepiness is not well described. As such, we used machine learning algorithms to examine the association between Epworth Sleepiness Scale scores and 55 sleep and medical variables in the Sleep Heart Health Study (N = 2105). Secondary analyses examined data stratified by age and gender and the relationship between the Epworth and other measures of daytime sleepiness. Analyses of the main data set resulted in low explained variance (7.15%–10.0%), with self-reported frequency of not getting enough sleep as most important predictor (10.3%–13.9% of the model variance). Stratification by neither age nor gender significantly improved explained variance. Cross-correlational analysis revealed low correlation of other daytime sleepiness measures to Epworth scores. We find that Epworth scores are not well explained by habitual or polysomnographic sleep values, or other biomedical characteristics. These analyses indicate that there are different, potentially orthogonal dimensions of the concept of “daytime sleepiness” that may be driven by different aspects of sleep physiology. As the physiologic correlates of the Epworth Sleepiness Scale remain to be elucidated, interpretation of the clinical meaning of these scores should be done with caution.
Endothelial Dysfunction as a Component of Severe Acute Respiratory Syndrome Coronavirus 2–Related Multisystem Inflammatory Syndrome in Children With Shock
Authors: Borgel Delphine , Chocron Richard , Grimaud Marion , Philippe Aurélien , Chareyre Judith , Brakta Charlyne , Lasne Dominique , Bonnet Damien , Toubiana Julie , Angoulvant François , Desvages Maximilien , Renolleau Sylvain , Smadja David M. , Oualha Mehdi
Published: May 2021

TRIAL REGISTRATION:

NCT04420468.

OBJECTIVES:

Severe acute respiratory syndrome coronavirus 2–related multisystem inflammatory syndrome in children is frequently associated with shock; endothelial involvement may be one of the underlying mechanisms. We sought to describe endothelial dysfunction during multisystem inflammatory syndrome in children with shock and then assess the relationship between the degree of endothelial involvement and the severity of shock.

DESIGN:

Observational study.

SETTING:

A PICU in a tertiary hospital.

PATIENTS:

Patients aged under 18 (n = 28) with severe acute respiratory syndrome coronavirus 2–related multisystem inflammatory syndrome in children and shock, according to the Centers for Disease Control and Prevention criteria.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Correlations between endothelial marker levels and shock severity were assessed using Spearman coefficient. The median (interquartile range) age was 9 years (7.5–11.2 yr). Sixteen children presented with cardiogenic and distributive shock, 10 presented with cardiogenic shock only, and two presented with distributive shock only. The median left ventricular ejection fraction, troponin level, and lactate level were, respectively, 40% (35–45%), 261 ng/mL (131–390 ng/mL), and 3.2 mmol/L (2–4.2 mmol/L). Twenty-five children received inotropes and/or vasopressors; the median Vasoactive and Inotropic Score was 8 (5–28). Plasma levels of angiopoietin-2 (6,426 pg/mL [2,814–11,836 pg/mL]), sE-selectin (130,405 pg/mL [92,987–192,499 pg/mL]), von Willebrand factor antigen (344% [288–378%]), and the angiopoietin-2/angiopoietin-1 ratio (1.111 [0.472–1.524]) were elevated and significantly correlated with the Vasoactive and Inotropic Score (r = 0.45, p = 0.016; r = 0.53, p = 0.04; r = 0.46, p = 0.013; and r = 0.46, p = 0.012, respectively).

CONCLUSIONS:

Endothelial dysfunction is associated with severe acute respiratory syndrome coronavirus 2–related multisystem inflammatory syndrome in children with shock and may constitute one of the underlying mechanisms.
Conjunctival Infiltration in a Child as a Rare Manifestation of IgG4-Related Disease
Authors: Qi Susan Ruyu , Hébert Mélanie , You Eunice , Proulx-Gauthier Jean-Philippe , Légaré Marie Eve
Published: May 2021

Purpose:

Ocular manifestations of immunoglobulin G4 (IgG4)-related disease are common in children although remain ill-defined because of the disease's rarity. We describe a pediatric case of IgG4-related orbital disease (IgG4-ROD) who presented with persistent conjunctival infiltration before developing lacrimal gland enlargement 3 years later.

Methods:

This was a case report.

Results:

An 8-year-old girl developed forniceal salmon-patch-like conjunctival lesions in her left eye that were refractory to topical corticosteroids. Investigations, including an orbital MRI and 2 conjunctival biopsies, were negative for lymphoma. She was treated with topical corticosteroids and then nonsteroidal antiinflammatory drops. The lesions decreased mildly, and no new lesion emerged. After 3 years, the patient developed a ptosis, new salmon-patch conjunctival lesions, and papillae. Vision deteriorated to 20/80 because of severe punctate epithelial erosions in the left eye, and the Schirmer test was significantly reduced. A repeat MRI revealed an enlarged left lacrimal gland. A biopsy was performed and was compatible with IgG4-ROD. An elevated IgG4 level of 4.61 g/L was also found. The patient was successfully treated with oral prednisone but flared on tapering the dosage. Rituximab was therefore initiated with excellent clinical response, and prednisone was discontinued. Vision returned to 20/20 after aggressive lubrification, punctal plugs, and autologous serum eye drops. Tear function came back to normal, and local treatments were stopped.

Conclusions:

This case describes a pediatric case of IgG4-ROD presenting initially with conjunctival follicular reaction, later developing lacrimal gland involvement. Therefore, it is important to consider IgG4-ROD in chronic atypical follicular conjunctival lesions in children, even in the absence of orbital disease.
Long-term Outcomes of Cataract Surgery in Patients With Chronic Ocular Graft-Versus-Host Disease
Authors: Bae Steven S. , Iovieno Alfonso , Yeung Sonia N.
Published: May 2021

Purpose:

The aim of this study was to evaluate the outcomes of cataract surgery in patients with chronic ocular graft-versus-host disease (GVHD).

Methods:

A retrospective review was performed on 77 eyes of 42 patients with chronic ocular GVHD that underwent cataract surgery between January 2014 and February 2020 in a tertiary institution.

Results:

Posterior subcapsular cataract was seen in 53 (68.8%) of 77 eyes, with a mean preoperative corrected distance visual acuity (CDVA) of 0.61 ± 0.49 logarithm of the minimum angle of resolution (logMAR). Postoperatively, with a mean follow-up of 21 months, CDVA improved to 0.17 ± 0.22 logMAR at the latest visit (P < 0.0001). With latest available refraction, 42 (57.5%) of 73 eyes were within 0.5 diopters of target refraction, and 59 eyes (80.8%) were within 1.0 diopter. Postoperative complications included superficial punctate keratopathy within 1 month postoperatively (19 eyes, 24.7%), posterior capsular opacification requiring yttrium-aluminum-garnet (YAG) laser capsulotomy (36 eyes, 46.8%), corneal epithelial defect (7 eyes, 9.1%), filamentary keratopathy (5 eyes, 6.5%), cystoid macular edema (3 eyes, 3.9%), and infectious crystalline keratopathy (1 eye, 1.3%). Lower preoperative National Institutes of Health ocular GVHD severity scores were associated with a better postoperative CDVA (grade 1, 0.13 ± 0.16 logMAR; grade 2, 0.16 ± 0.23 logMAR; and grade 3, 0.36 ± 0.21 logMAR; P = 0.004).

Conclusions:

Cataract surgery improves visual acuity long term in most patients with chronic ocular GVHD. Close postoperative monitoring is important to detect ocular surface inflammation secondary to chronic ocular GVHD, particularly in severe ocular GVHD.
Comparison of the Incidence of Urinary Tract Infection by Replacement Time of the Urinary Drainage System
Authors: CHEN Yin-Yin , CHEN Chii-Shya , CHEN Ian-Horng , LIN Chu-Chun
Published: May 2021

Background

Urinary catheters (UCs) with a closed urinary drainage system have been widely used in patients for many years. However, the frequency of replacing and operating these devices may be associated with catheter-associated urinary tract infection (CAUTI).

Purpose

This study was designed to compare the incidence of CAUTI by replacement time (every 14 or ≥ 15 days) of the urinary drainage system.

Methods

This 1-year prospective, nonrandomized controlled study was conducted in a major teaching hospital. The Transparent Reporting of Evaluations with Nonrandomized Designs Statement checklist was used. All of the patients with UCs were divided into two groups based on each patient's preference with regard to replacement time of the urinary drainage system.

Results

Five hundred sixty-two patients were evaluated, and 341 patients with UCs were enrolled as participants in the study. In the per-protocol analysis, 16 patients (22.2%; 9.3 episodes/1,000 catheter-days) in the 14-day group and 15 patients (17.9%; relative risk = 1.24, 95% confidence interval [0.66, 2.34]) in the ≥ 15-day group (7.7 episodes/1,000 catheter-days; incidence density ratio 1.20, 95% confidence interval [0.60, 2.43]) had CAUTIs. A comparison of cleanliness within urinary bags showed no significant intergroup difference (p > .05). In the intention-to-treat analysis, the incidence of CAUTI between the two groups was also not significantly different (p > .05).

Conclusions

No statistically significant difference in the incidence of CAUTI was identified between patients who used the 14-day replacement interval and those who used the ≥ 15-day replacement interval for their urinary drainage system.
Transmastoid Superior Semicircular Canal Plugging: A Prospective Analysis of Surgical Outcomes
Authors: Kontorinis Georgios , Gaggini Margaret
Published: May 2021

Objectives:

To assess the outcomes of the transmastoid superior semicircular canal plugging in patients with superior semicircular canal dehiscence (SSCD).

Study design:

Prospective cohort study.

Setting:

Tertiary, university center.

Patients:

Patients with SSCD undergoing transmastoid superior semicircular canal plugging within a 30-month period.

Interventions:

Transmastoid superior semicircular canal occlusion.

Main outcome measures:

We documented the surgical technique, pre- and postoperative (3-month review) dizziness handicap inventory scores, average hearing thresholds, low-frequency air-bone gap, six-canal video head-impulse-test responses, improvement of the auditory symptoms and complications.

Results:

Out of 30 patients with SSCD, 11 patients (12 ears) were enrolled with an average age 41.17 years (range 32–65 years). Oscillopsia resolved in all patients; DHI score improved from 56.7 (range 22–84) preoperatively to 25.83 (10–46) postoperatively (p = 0.001), while out of the nine patients with troublesome auditory symptoms, five patients noticed an improvement. The average pre- and postoperative hearing thresholds were 15.2 dB (range 3–32.5 dB) and 14.17 dB (range 5–30 dB) (p = 0.73), respectively. The average pre- and postoperative low-frequency air bone gap was 12.3 dB (range 5–20 dB) and 9.4 dB (range 0–20 dB), respectively (p = 0.24) (Table 1). There were no major complications; two patients developed postoperative benign paroxysmal positional vertigo.

Conclusion:

Transmastoid plugging of the superior semicircular canal can safely and significantly improve the vestibular symptoms of the patients with SCDS, as well as the auditory symptoms in a substantial number of patients in a hearing-preservation way.
Effects of Moringa Extract on Aminoglycoside-Induced Hair Cell Death and Organ of Corti Damage
Authors: Broderick Michael T. , Prince Andrew D. P. , Dhukhwa Asmita , Mukherjea Debashree , Jiang Peng , Campbell Kathleen C. M. , Rybak Leonard P. , Brenner Michael J.
Published: May 2021

Hypothesis:

Moringa extract, a naturally occurring anti-oxidant, protects against aminoglycoside-induced hair cell death and hearing loss within the organ of Corti.

Background:

Reactive oxygen species (ROS) arise primarily in the mitochondria and have been implicated in aminoglycoside-induced ototoxicity. Mitochondrial dysfunction results in loss of membrane potential, release of caspases, and cell apoptosis. Moringa extract has not previously been examined as a protective agent for aminoglycoside-induced ototoxicity.

Methods:

Putative otoprotective effects of moringa extract were investigated in an organotypic model using murine organ of Corti explants subjected to gentamicin-induced ototoxicity. Assays evaluated hair cell loss, cytochrome oxidase expression, mitochondrial membrane potential integrity, and caspase activity.

Results:

In vitro application of moringa conferred significant protection from gentamicin-induced hair cell loss at dosages from 25 to 300 μg/mL, with dosages above 100 μg/mL conferring near complete protection. Assays demonstrated moringa extract suppression of ROS, preservation of cytochrome oxidase activity, and reduction in caspase production.

Conclusion:

Moringa extract demonstrated potent antioxidant properties with significant protection against gentamicin ototoxicity in cochlear explants.
Cochlear Implantation in the Setting of Menière's Disease After Labyrinthectomy: A Meta-Analysis
Authors: Selleck Anne Morgan , Dillon Margaret , Perkins Elizabeth , Brown Kevin D.
Published: May 2021

Objective:

Characterize the speech recognition and sound source localization of patients with unilateral Menière's disease who undergo labyrinthectomy for vertigo control with simultaneous or sequential cochlear implantation.

Databases Reviewed:

PubMed, Embase, and Cochrane databases.

Methods:

The search was performed on May 6, 2020. The keywords utilized included: “Menière's disease AND cochlear implant;” “cochlear implant AND single sided deafness;” “cochlear implant AND vestibular;” and “labyrinthectomy AND cochlear implant.” Manuscripts published in English with a publication date after 1995 that assessed adult subjects (≥18 years of age) were included for review. Subjects must have been diagnosed with Menière's disease unilaterally and underwent labyrinthectomy with simultaneous or sequential cochlear implantation. Reported outcomes with cochlear implant (CI) use included speech recognition as measured with the consonant-nucleus-consonant (CNC) word test and/or sound source localization reported in root-mean squared (RMS) error. The method of data collection and study type were recorded to assess level of evidence. Statistical analysis was performed with Wilcoxon signed ranks test.

Results:

Data from 14 CI recipients met the criteria for inclusion. Word recognition comparisons between the preoperative interval and a postactivation interval demonstrated a significant improvement with the CI (p = 0.014), with an average improvement of 23% (range −16 to 50%). Sound source localization postoperatively with the CI demonstrated an average RMS error of 26° (SD 6.8, range 18.7–43.1°) compared to the 42° (SD 19.1, range 18–85°) in the preoperative or CI off condition, these two conditions were not statistically different (p = 0.148).

Conclusion:

Cochlear implantation and labyrinthectomy in adult patients with Menière's disease can support improvements in speech recognition and sound source localization for some CI users, though observed performance may be poorer than traditional CI candidates.