bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnosis of Gulf War Illness Using Laser-Induced Spectra Acquired from Blood Samples
Authors: Gaudiuso Rosalba , Chen Sirui , Kokkotou Efi , Conboy Lisa , Jacobson Eric , Hanlon Eugene B. , Melikechi Noureddine
Published: October 2021

Gulf War illness (GWI) is a chronic illness with no known validated biomarkers that affects the lives of hundreds of thousands of people. As a result, there is an urgent need for the development of an untargeted and unbiased method to distinguish GWI patients from non-GWI patients. We report on the application of laser-induced breakdown spectroscopy (LIBS) to distinguish blood plasma samples from a group of subjects with GWI and from subjects with chronic low back pain as controls. We initially obtained LIBS data from blood plasma samples of four GWI patients and four non-GWI patients. We used an analytical method based on taking the difference between a mean LIBS spectrum obtained with those of GWI patients from the mean LIBS spectrum of those of the control group, to generate a “difference” spectrum for our classification model. This model was cross-validated using different numbers of differential LIBS emission peaks. A subset of 17 of the 82 atomic and ionic transitions that provided 70% of correct diagnosis was selected test in a blinded fashion using 10 additional samples and was found to yield 90% classification accuracy, 100% sensitivity, and 83.3% specificity. Of the 17 atomic and ionic transitions, eight could be assigned unambiguously to species of Na, K, and Fe.
Ethical tensions in occupational therapy practice: Conflicts and competing allegiances
Authors: Durocher Evelyne , Kinsella Elizabeth Anne
Published: October 2021

Background.

Ethical tensions inevitably arise in practice in light of diverse agendas embedded in practice contexts. Such tensions can contribute to moral distress and lead to professional burnout and attrition. Despite potentially serious implications, little work has been done to examine how various allegiances in occupational therapy practice can set up ethical tensions.

Purpose.

In this article, we present findings of an exploratory study examining conflicting allegiances in occupational therapy.

Method.

Using collective case study methodology, we examined ethical tensions reported by seven occupational therapists practicing in different settings in Southwestern Ontario.

Findings.

Ethical tensions were seen to arise in ways that highlighted competing allegiances to participants’ own values, clients, others in the context, colleagues, employers, and regulatory colleges.

Implications.

The findings open a discussion informing how practice settings can better facilitate practice directed at responding to client needs while also meeting the various demands imposed on occupational therapists.
Alternate Cultural Paradigms in Psychology: Long Overdue Recognition and Further Articulations
Authors: Consoli Andrés J. , Myers Linda James
Published: October 2021

Many ethnic-acknowledging psychology researchers, practitioners, and their allies have expressed dissatisfaction with Eurowestern, mainstream psychology in the United States as it shows serious shortcomings when used to understand and serve minoritized communities. Eurowestern psychology has been criticized for its imperialistic, one-size-fits-all view of humanity. Accordingly, we challenge the neglect of the history and value of ethnic acknowledgment in psychology perpetrated and maintained by Eurowestern psychology, including mainstream psychology in the United States. We operationalize such challenge by articulating the construct of alternate cultural paradigms, by following it with a series of contributions authored by leading figures from each of the Ethnic Acknowledging Psychological Associations (EAPAs) in the United States, and by closing with a commentary by a renowned scholar in the field. The current article, followed by five separate and distinct articles from authors identified with each of the EAPAs (i.e., the Association of Black Psychologists [ABPsi], the National Latinx Psychological Association [NLPA], the Society of Indian Psychologists [SIP], the Asian American Psychological Association [AAPA], the Arab, Middle Eastern, and North African Psychological Association [AMENA-Psy]), together with a concluding commentary conforms the Special Issue on alternate cultural paradigms in psychology in the United States.
Trends in Deaths Fully Attributable to Alcohol in Minnesota, 2000-2018
Authors: Braun Nicholas J. , Gloppen Kari M. , Roesler Jon
Published: October 2021

Objective

Overall trends in rates of fully alcohol-attributable mortality may mask disparities among demographic groups. We investigated overall, demographic, and geographic trends in fully alcohol-attributable mortality rates in Minnesota.

Methods

We obtained mortality data from Minnesota death certificates and defined fully alcohol-attributable deaths as deaths that would not occur in the absence of alcohol. We calculated age-adjusted death rates during 2000-2018 using 5-year moving averages stratified by decedents’ characteristics and geographic location.

Results

Chronic conditions accounted for most of the alcohol-attributable deaths in Minnesota (89% during 2014-2018). Alcohol-attributable mortality rates per 100 000 population increased from an average rate of 8.0 during 2000-2004 to 12.6 during 2014-2018. During 2000-2018, alcohol-attributable mortality rates were highest among males (vs females), adults aged 55-64 (vs other ages), and American Indian/Alaska Native people (vs other racial and ethnic groups) and lowest among people aged ≤24 years and Asian or Pacific Islander people. During 2014-2018, the alcohol-attributable mortality rate among American Indian/Alaska Native people was more than 5 times higher than the overall mortality rate in Minnesota.

Conclusions

Results from this study may increase awareness of racial and ethnic disparities and continuing health inequities and inform public health prevention efforts, such as those recommended by the Community Preventive Services Task Force, including regulating alcohol outlet density and increasing alcohol taxes.
A novel multivariable nonlinear robust control design for turbofan engines
Authors: Cheng Dingding , Liu Lijun , Yu Zhen
Published: October 2021

Traditional steady-state control methods are applied to turbofan engines operating in the small region near certain operating conditions, which need to switch controllers for operating in the large region and then may lead to instability and performance degradation of the closed-loop system. In this paper, a novel multivariable nonlinear robust control method for turbofan engines is proposed to improve the control performance within the large region. To enlarge the controllable region, a polynomial state-space model describes the nonlinear characteristics of turbofan engines. Based on the analysis of the closed-loop control system, by using the Lyapunov function theorems, a polynomial robust controller is designed to ensure the stability and desired nonlinear control performance of turbofan engines. Compared with the classical PI, mixed sensitivity, and H∞ control, simulation results show that the proposed method has better transient responses, disturbance rejection, and other control performance for the turbofan engine within the large region.
A novel adaptive-gain disturbance estimator-based asymptotic adaptive tracking control for uncertain nonlinear systems
Authors: Yang Xiaowei , Deng Wenxiang , Liu Long , Yao Jianyong
Published: October 2021

This article focuses on the asymptotic tracking control problem for uncertain nonlinear systems subject to both multiple disturbances and parametric uncertainties. To address this issue, a parameter adaptation law is synthesized to deal with the parametric uncertainties, and an adaptive-gain disturbance estimator (ADE) is constructed to estimate the mismatched and matched disturbances, and compensate them in feedforward channels, which eliminates the impact of disturbances on tracking performance. Meanwhile, an updated law for estimator gain driven by the estimation errors is utilized in the ADE when facing unknown upper bounds of disturbances, which reduces the conservatism of estimator gain selection and is beneficial to practical implementation. Based on the parameter adaption technique and the presented ADE approach, a composite controller is proposed to ensure an excellent asymptotic output tracking performance. The stability analysis shows the proposed controller can attain asymptotic tracking performance in the presence of both time-variant disturbances and parametric uncertainties. Comparative simulation results of the application to a robot manipulator reveal the validity of the developed approach.
Numerical solution for a class of fractional optimal control problems using the fractional-order Bernoulli functions
Authors: Valian Forugh , Ordokhani Yadollah , Vali Mohammad Ali
Published: October 2021

The main purpose of this paper is to provide an efficient method for solving some types of fractional optimal control problems governed by integro-differential and differential equations, and because finding the analytical solutions to these problems is usually difficult, a numerical method is proposed. In this study, the fractional-order Bernoulli functions (F-BFs) are applied as basis functions and a new operational matrix of fractional integration is constructed for these functions. In the first step, the problem is transformed into an equivalent variational problem. Then the F-BFs, the constructed operational matrix, the Gauss quadrature formula, and necessary conditions for optimization are used to convert the problem into a system of algebraic equations. Finally, with the aid of Newton’s iterative method, the system of algebraic equations is solved and the approximate solution of the problem is obtained. Several numerical examples have been analysed for illustrating the efficiency and accuracy of the proposed method, and the results have been compared with the exact solutions and the results of other methods. The results show that the method provides accurate solutions.
Internet blackouts in Meghalaya: A case of emerging complexities in the digital age
Authors: Passah Alexander Lewis
Published: October 2021

The paper is rooted in the observations from the two internet blackouts witnessed in Meghalaya in 2018 and 2019. The state is located in the North Eastern region of India and this study focuses on the Khasi population residing in the East Khasi Hills District. The study explores the complex role social media has played in information dissemination in the digital age. India currently leads the world in terms of internet blackouts and it has been imposed 538 times in the country. This phenomenon has become a reoccurring trend over the last few years with the rise in digital communications and technological affordances. The paper addresses the dualistic nature of social media and how it can be empowering on the one hand, and can also be a key contributor to mis(dis)information on the other. The study offers a non-digital centric approach by adopting digital ethnographic methods and offers insights into the social media practices and experiences of the Khasi participants as well as delving into the problematic nature of internet blackouts with respect to Meghalaya. Evidently, social media has become a space in which most individuals carry their identity, aspirations, views, history, and opinions.
Time for a change: women, work, and gender equality in TV production
Authors: Milner Susan , Gregory Abigail
Published: October 2021

This article uses Acker’s concept of inequality regimes to analyze qualitative research findings on work-life balance and gender equality for women in British television production. Female survey respondents, focus group participants, and interviewees spoke of their subjective experience of gendered work practices which disadvantage women as women. These findings build on existing research showing gender disadvantage in the industry, leading to loss of human capital and a narrowing of the range of creative experience. They also show that growing numbers of women are seeking alternative modes of production, at a time of increased awareness of inequality. Such alternatives suggest that change is possible, although it is strongly constrained by organizational logics and subject to continued resistance, in line with Acker’s framework of analysis. Visibility of inequalities is the key to supporting change.
Narcissism Today: What We Know and What We Need to Learn
Authors: Miller Joshua D. , Back Mitja D. , Lynam Donald R. , Wright Aidan G. C.
Published: October 2021

Narcissism is of great interest to behavioral scientists and the lay public. Research across the past 20 years has led to substantial progress in the conceptualization, measurement, and study of narcissism. This article reviews the current state of the field, identifying recent advances and outlining future directions. Advances include hierarchical conceptualizations of narcissism across one-factor (narcissism), two-factor (grandiose vs. vulnerable narcissism), and three-factor (agentic extraversion, antagonism, narcissistic neuroticism) levels; the development of measures to assess the components of narcissism; clarification of the relations between narcissism and self-esteem; an understanding of the behavioral and motivational dynamics underlying narcissistic actions and social outcomes; and insight regarding potential fluctuations between narcissistic states. Future directions point in general to increased research using the lower levels of the narcissism hierarchy, especially the three-factor level. At this level, more research on the etiology, heritability, stability, and centrality of the three components is required.
Non-naïve organizational positivity through a generative paradox pedagogy
Authors: Cunha Miguel Pina e , Simpson Ace Volkmann , Rego Arménio , Clegg Stewart
Published: October 2021

Positive Organizational Scholarship (POS), with positivity as a core conceptual component, is a major innovation in recent decades in management and organizational studies. Just as organization is an inherently paradox laden process, so too, we argue, is positivity. Yet in classrooms and in practice, POS is mostly taught in a manner that accepts only one side of the paradox, that which, at first glance, appears positive. Against such linear approaches we propose another possibility: teaching positivity through a pedagogy of generative paradoxes emergent from creatively harmonizing the energy of competing and interdependent positive and negative tensions. In the process we extend the notion of generative paradox as discussed in paradox literature by embracing the notion of generativity as discussed in POS theorizing where it is associated with organizational processes that facilitate outcomes of collective flourishing, abundance, wellbeing, and virtue. Our proposed three-part generative paradox pedagogy contributes to the literature on POS, organizational paradox, and management learning.
Identity concerns drive belief: The impact of partisan identity on the belief and dissemination of true and false news
Authors: Pereira Andrea , Harris Elizabeth , Van Bavel Jay J.
Published: October 2021

We test three competing theoretical accounts invoked to explain the rise and spread of political (mis)information. We compare the ideological values hypothesis (people prefer news that bolster their values and worldviews); the confirmation bias hypothesis (people prefer news that fit their preexisting stereotypical knowledge); and the political identity hypothesis (people prefer news that allow them to believe positive things about political ingroup members and negative things about political outgroup members). In three experiments ( N = 1,420), participants from the United States read news describing actions perpetrated by their political ingroup or outgroup. Consistent with the political identity hypothesis, Democrats and Republicans were both more likely to believe news about the value-upholding behavior of their ingroup or the value-undermining behavior of their outgroup. Belief was positively correlated with willingness to share on social media in all conditions, but Republicans were more likely to believe and want to share apolitical fake news.
Factors related to instrumental activities of daily living in persons with chronic thromboembolic pulmonary hypertension
Authors: Iwasawa Tatsuya , Fukui Shogo , Kawakami Michiyuki , Kawakami Takashi , Kataoka Masaharu , Yuasa Shinsuke , Fukuda Keiichi , Fujiwara Toshiyuki , Tsuji Tetsuya
Published: October 2021

Instrumental activities of daily living (IADL) are significantly related to quality of life and mortality among individuals with heart disease. However, few reports have examined IADL in persons with chronic thromboembolic pulmonary hypertension (CTEPH). The aim of this study was to clarify factors related to IADL in persons with CTEPH. This retrospective, observational study enrolled 163 persons with CTEPH (mean ± standard deviation age = 65 ± 13 years; 68% female) admitted to the Department of Cardiology at Keio University Hospital between January 2015 and July 2019. The Frenchay Activities Index (FAI) was used to assess IADL. Age, sex, body mass index, World Health Organization functional class (WHO-FC), cardiac function (mean pulmonary arterial pressure, mean right atrial pressure, pulmonary capillary wedge pressure, and cardiac index), pulmonary function (percentage vital capacity, percentage forced expiratory volume in 1 s, diffusion capacity of carbon monoxide (DLCO)/alveolar volume (VA)), physical function (knee extension strength and walking speed), and 6-min walking distance (6MWD) were assessed. Multiple regression analysis was performed to identify factors significantly associated with FAI. Mean FAI was 25 ± 8. Univariate analysis showed that sex, WHO-FC, DLCO/VA, walking speed, and 6MWD were correlated with FAI. Multiple regression analysis showed that 6MWD (sβ = 0.338, 95% CI 0.014–0.034, p < .001), sex (sβ = 0.268, 95% CI 2.238–7.165, p < .001), and DLCO/VA (sβ = 0.257, 95% CI 1.011–3.528, p < .001) were significantly correlated with FAI ( R2 = 0.261). IADL were associated with exercise tolerance, sex, and DLCO/VA in persons with CTEPH. In the future, more details of IADL are expected to be clarified by analyzing individual components of IADL and investigating social background characteristics, including living environment.
Ethnographic Biography: Tracing Paths Across Multiple Times and Spaces
Authors: Tabib-Calif Yosepha , Lomsky-Feder Edna
Published: October 2021

In this article, we propose “ethnographic biography” as a research strategy designed to address the basic difficulty of qualitative studies in capturing the temporal dimension of human action and experience. This difficulty is particularly salient when the subjects are dispersed in space and their contacts with the researcher are repeatedly interrupted. To overcome these discontinuities in space and time, the “ethnographic biography” combines complementary research tactics: Alongside biographical follow-up interviews — the commonly acceptable approach to resolving the temporal challenge — we propose two additional ethnographic methods: focused observations of social events and ongoing interactions with the subjects in virtual spaces. The advantage of that set of methods lies in that each method which locates the encounter between the researcher and the subjects in a different space and captures a different temporal dimension.
TMPRSS4 overexpression promotes the metastasis of colorectal cancer and predicts poor prognosis of stage III–IV colorectal cancer
Authors: Zhao Xue-Feng , Yang Yu-Shen , Gao Da-Zhi , Park Young Kyu
Published: October 2021

Purpose

To study in detail the expression pattern and prognostic significance of TMPRSS4 in colorectal cancer.

Methods

The expression of TMPRSS4 protein was determined using Western blot in the colorectal cancer tissues and normal tissues. Immunohistochemistry was used to detect the TMPRSS4 expression in colorectal cancer tissues, and the clinicopathologic characteristics and prognostic significance were analyzed.

Results

TMPRSS4 overexpression was associated with tumor budding, lymphovascular invasion, perineural invasion, cancerous emboli, infiltration depth, lymph node metastasis, distant metastasis, and tumor node metastasis stage ( P < 0.05 for all). Interestingly, TMPRSS4 expression in the tumor budding, tumor emboli, lymph node, and liver metastatic tumor samples was higher than in the paired primary tumors. In contrast, TMPRSS4 overexpression is inversely correlated with both the overall survival and the disease-free survival of the patients with colorectal cancer ( P < 0.05 for both). Also, we found that TMPRSS4 is only of significance in predicting the prognosis of stage III and IV colorectal cancer, not stage I and II.

Conclusions

TMPRSS4 was shown to be involved in the whole process of metastasis from tumor budding to lymph node and/or distant metastasis in colorectal cancer and predicted the unfavorable prognosis of stage III–IV, indicating that it is a novel target for the precise treatment of colorectal cancer with lymph node or distant organ metastasis.
Management and complications of complete heart block in pregnancy
Authors: Christensen AP , Singh V , England AJ , Khiani R , Herrey AS
Published: October 2021

Although rare, increasing numbers of women with pacemakers are becoming pregnant. We describe the complications of a woman with arrhythmia and a pacemaker for complete heart block experienced before, during, between and after her pregnancies. We illustrate the benefits of multidisciplinary care, good communication and regular assessment in a stable, but complex woman.
Health‐related quality of life and hospitalizations in chronic thromboembolic pulmonary hypertension versus idiopathic pulmonary arterial hypertension: an analysis from the Pulmonary Hypertension Association Registry (PHAR)
Authors: Minhas Jasleen , Narasimmal Sai Prasanna , M. Bull Todd , De Marco Teresa , McConnell John Wesley , Lammi Matthew R. , Thenappan Thenappan , P. Feldman Jeremy , S. Sager Jeffrey , B. Badesch David , Ryan John J. , C. Grinnan Daniel , Zwicke Dianne , M. Horn Evelyn , Elwing Jean M. , Moss John E. , Eggert Michael , Shlobin Oksana A. , P. Frantz Robert , D. Bartolome Sonja , Mathai Stephen C. , Mazimba Sula , C. Pugliese Steven , Al‐Naamani Nadine ,   PHAR investigators
Published: October 2021

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare, morbid, potentially curable subtype of pulmonary hypertension that negatively impacts health‐related quality of life (HRQoL). Little is known about differences in HRQoL and hospitalization between CTEPH patients and idiopathic pulmonary arterial hypertension (IPAH) patients. Using multivariable linear regression and mixed effects models, we examined differences in HRQoL assessed by emPHasis‐10 (E10) and SF‐12 between CTEPH and IPAH patients in the Pulmonary Hypertension Association Registry, a prospective multicenter cohort of patients newly evaluated at a Pulmonary Hypertension Care Center. Multivariable negative binomial regression models were used to estimate incidence rate ratios (IRR) for hospitalization amongst the two groups. We included 461 IPAH patients and 169 CTEPH patients. Twenty‐one percent of CTEPH patients underwent pulmonary thromboendarterectomy (PTE) before the end of follow‐up. At baseline, patients with CTEPH had significantly worse HRQoL (higher E10 scores) (ß 2.83, SE 1.11, p = 0.01); however, differences did not persist over time. CTEPH patients had higher rates of hospitalization (excluding the hospitalization for PTE) compared to IPAH patients after adjusting for age, sex, body mass index, WHO functional class and six‐minute walk distance (IRR 1.66, 95%CI 1.04–2.65, p = 0.03). CTEPH patients who underwent PTE had improved HRQoL as compared to those who were medically managed, but patients who underwent PTE were younger, had higher cardiac outputs and greater six‐minute walk distances. In this large, prospective, multicenter cohort, CTEPH patients had significantly worse baseline HRQoL and higher rates of hospitalizations than those with IPAH. CTEPH patients who underwent PTE had significant improvements in HRQoL.
Early Versus Late Sternal Closure in Infants—Perioperative Associations and Outcomes
Authors: Asfari Ahmed , Clark Matthew G. , Hock Kristal M. , Huskey Jordan L. , Rahman A. K. M. F. , Dabal Robert J. , Borasino Santiago
Published: October 2021

Background:

Delayed sternal closure (DSC) has been used for patients who develop bleeding, chest wall edema, and malignant arrhythmia following cardiopulmonary bypass. Multiple factors can influence the timing of when to perform DSC. We aimed to describe our DSC experience in neonates and infants by comparing outcomes between patients undergoing early (<48 hours) versus late DSC (> 48 hours). We explored the associations between specific clinical and laboratory variables and the timing of DSC.

Methods:

Retrospective chart review of neonates and infants (<one-year-old) with DSC after heart surgery from December 2012 to December 2018. Patients requiring extracorporeal membrane oxygenation were excluded.

Results:

A total of 121 patients were included in the analysis, 34% (n = 41) met late DSC criteria. The overall cohort had a 75% survival rate and a median time for open sternum of 42.5 hours (Q1:23-Q3:65). The median time for open sternum in the early and late DSC groups was 24 hours (Q1:21-Q3:43) and 93 hours (Q1:65-Q3:141), respectively ( P < .01). There was no statistical difference in mortality rate between groups. Patients with late DSC endured longer intensive care unit stays (median 24.3 days [Q1:13-Q3:35.3] vs 36.8 [Q1:23.9, 73.6]; P< .01) and a two-fold longer hospital stay compared to the early DSC group (multivariable analysis: relative risk = 2, 95% CI: 1.5-2.7; P < .01). Univariate analysis revealed patients with late DSC had higher median lactates both intraoperatively (7.6 [Q1:5.9-Q3:10.7] vs 9.3 [Q1:7.5-Q3:12.1]; P < .01) and 24 hours postoperatively (6.5 [Q1:4.3-Q3:10.3] vs 8.7 [Q1:5.7-Q3:14.70]; P = .03). A higher vasoactive inotrope score at 36 hours was associated with late DSC (odds ratio = 1.1, 95% CI: 1.01-1.2; P = .02).

Conclusions:

Future research that explores additional clinical and laboratory variables that can help guide DSC decision-making and timing is needed.
Repeat Extracorporeal Membrane Oxygenation Support Is Appropriate in Selected Children With Cardiac Disease: An Extracorporeal Life Support Organization Study
Authors: Alsoufi Bahaaldin , Trivedi Jaimin , Rycus Peter , Sinha Pranava , Deshpande Shriprassad
Published: October 2021

Objective:

Children requiring multiple consecutive extracorporeal membrane oxygenation (ECMO) runs likely have ongoing cardiac pathology (eg, residual lesions, myocardial dysfunction) and are exposed to increased complications and end-organ failure. Often, repeat back-to-back ECMO is suggested to be futile due to poor reported survival.

Methods:

Using Extracorporeal Life Support Organization (ELSO) data (2011-2019), we evaluated children (n = 669) who received multiple cardiac ECMO runs (≥2) within 30 days interval. Factors associated with hospital mortality were evaluated using multivariable regression analysis.

Results:

Median ECMO runs was 2 (range: 2-5) including 294 (44%) patients who received extracorporeal cardiopulmonary resuscitation (ECPR). There were 250 (37%) hospital survivors. Survivors were more likely older, Caucasian, and less likely to have hypoplastic left heart syndrome, require >2 runs, receive longer support duration, require inotropes or have acidosis while on ECMO, or develop renal and neurological complications. On multivariable analysis, factors associated with death included neonates (odds ratio [OR] = 3.6, 95% CI = 1.8-7.5, P = .0002), African Americans (OR = 2.7, 95% CI = 1.4-4.9, P = .0307), longer ECMO duration (OR = 1.1, 95% CI = 1.05-1.11, P < .0001, per 10 hours), central cannulation at initial run (OR = 1.7, 95% CI = 1.1-2.8, P = .0285), renal failure (OR = 3.0, 95% CI = 1.9-4.6, P < .0001), and neurological complications (OR = 3.8, 95% CI = 2.2-6.8, P < .0001).

Conclusions:

In selected children with cardiac pathology, multiple back-to-back ECMO and/or ECPR runs are associated with 37% hospital survival. Although registry data limit the ability to clearly determine selection criteria for repeat ECMO, our findings suggest that in properly selected patients, repeat ECMO support is not futile. Ongoing assessment of support adequacy, end-organ function, and cardiopulmonary recovery is necessary as longer support and emerging complications are associated with poor survival.
Applicability and Durability of Valve-Sparing Tetralogy of Fallot Repair
Authors: Stephens Elizabeth H. , Wolfe Brian L. , Talwar Abhinav A. , Patel Angira , Camarda Joseph A. , Eltayeb Osama , Monge Michael C. , Forbess Joseph M.
Published: October 2021

Background:

Although valve-sparing repair remains ideal for patients with tetralogy of Fallot, the durability of valve-sparing repair and which patients may have been better served with a transannular patch remain unclear.

Methods:

Retrospective review was performed of tetralogy of Fallot operations at our institution from January 2008 to December 2018. Standard demographic data were collected, including echocardiographic parameters, operative details, and clinical outcomes. Statistical analysis was performed comparing the transannular patch and valve-sparing repair groups.

Results:

Sixty-seven patients underwent tetralogy of Fallot repair with a median age of 4.5 (3.2-6.0) months and weight of 5.8 (5.2, 6.7) kg. Seventeen (25%) patients underwent transannular patch repair and 50 (75%) patients underwent valve-sparing repair. There was no difference in age or weight between patients who underwent a transannular patch repair and those who underwent a valve-sparing repair. At last follow-up (median 42 months), there was a trend of a higher peak pulmonary valve/right ventricular outflow tract gradient ( P = .06) in the valve-sparing group, but no difference in the pulmonary valve annulus z-scores. Additionally, the pulmonary valve z-scores in the valve-sparing group decreased from −2.3 ± 1.0 on predischarge echocardiogram of to −1.2 ± 1.6 on last follow-up, with the peak gradient on predischarge 23 (0-37) mm Hg remaining stable on last follow-up at 18 (0-29) mm Hg. There was one reoperation: pulmonary valve replacement six years after a transannular patch.

Conclusions:

Obtaining a postrepair pulmonary valve z-score of −2 yields satisfactory, stable valve-sparing repair with pulmonary valve growth, acceptable gradients, minimal regurgitation, and high freedom from reintervention during follow-up.
Congenital Solitary Left Atrial Mass
Authors: Cheang Stefanie , Samples Stefani
Published: October 2021

Rhabdomyoma in the absence of tuberous sclerosis presenting as a large solitary atrial mass is an atypical finding. We hereby present images from an infant with a fetally diagnosed large left atrial mass with no evidence of mitral valve dysfunction who subsequently developed persistent arrhythmias requiring surgical resection of the mass in the neonatal period.
Communicating Bad News: Using Role-Play to Teach Nursing Students
Authors: Laranjeira Carlos , Afonso Catarina , Querido Ana Isabel
Published: October 2021

Receiving bad news can have a profound impact on a patient's physical, psychological and social well-being. Therefore, communication of bad news is an essential skill required for health professionals. A good interpersonal relationship based on trust, empathy, and respect can help the psychological adjustment to end-of-life losses. This study presents a simulation-based learning experience designed to teach communication skills to nursing students who care for palliative patients and their family members. The authors suggest adopting Gibbs’ reflective cycle during structured debriefing that enables the students to move logically through the reflective process. A student-centered learning approach can promote responsibility and success in achieving the expected learning outcomes.
Highly individual- and tissue-specific expression of glycoprotein group A and B blood antigens in the human kidney and liver
Authors: Wang Xianding , Zhang Fan , Jiang Yamei , Xu Zilin , Feng Xiaobing , Li Linde , Fan Yu , Song Turun , Shi Yunying , Huang Zhongli , Lin Tao
Published: October 2021

Background

Currently, research on the quantitative distribution of ABO antigens in different organs and tissues remains limited. We aimed to examine the individual characteristics of blood group glycoprotein A and B antigen expression in human kidneys and livers.

Methods

We obtained human samples, including the renal artery, renal vein, renal tissue, hepatic artery, hepatic vein, portal vein, and hepatic tissue, from 24 deceased organ transplant donors. The expression of the blood group antigens glycoprotein A and B was analysed and compared by Western blotting.

Results

There was no significant difference in the expression between blood group glycoprotein A and B antigens at any of the seven sites (p > 0.05). The expression of both A and B antigens was highest in renal tissue and the portal vein and was lowest in the renal artery. A large difference in glycoprotein antigen expression was observed among various donors or different regions of the same individual. Univariate analysis revealed that glycoprotein A/B antigens were affected by the age and sex of donors and were significantly higher in males and in young people.

Conclusions

Our study found that blood group glycoprotein antigen expression showed certain trends and distinct distribution in the kidney, liver, and vessels among individuals and in different regions of the same individual, which may explain the different clinical outcomes of patients who received ABO-incompatible transplantation.
Factors influencing women’s perceptions of choice and control during pregnancy and birth: a cross-sectional study
Authors: Leahy-Warren Patricia , Mulcahy Helen , Corcoran Paul , Bradley Róisín , O’Connor Mary , O’Connell Rhona
Published: October 2021

Background

Women across the world value choice and control throughout their maternity care experiences. In response to this health policy and frameworks are adapting and developing. The concepts of choice and control are extrinsically complex and open to interpretation by healthcare professionals and service users, with the two not necessarily aligning. Depending on a number of factors, women’s experiences of choice and control within the same maternity care system may be very different. This study aimed to investigate the factors influencing women’s perceptions of choice and control during pregnancy and birth in Ireland.

Methods

We conducted a cross-sectional study using an adapted version of the UK national maternity experience survey (National Perinatal Epidemiology Unit). During March – July 2017, a sample of 1277 women were recruited from the postnatal wards of three maternity units and a tertiary maternity hospital. Poisson regression was used to assess the association between twelve factors and a series of measures of the women’s perception of choice and control.

Results

Most women reported not having choice in the model or location of their maternity care but most reported being involved enough in decision-making, especially during birth. Women who availed of private maternity care reported higher levels of choice and control than those who availed of public maternity care. This factor was the most influential factor on almost all choice and control measures.

Conclusion

Most women experiencing maternity care in Ireland report not having choice in the model and location of care. These are core elements of the Irish maternity strategy and significant investment will be required if improved choice is to be provided. Availing of private maternity care has the strongest influence on a woman’s perceived choice and control but many women cannot afford this type of care, nor may they want this model of care.
Service providers endorse integrated services model for youth with mental health and substance use challenges: findings from a discrete choice experiment
Authors: Hawke Lisa D. , Thabane Lehana , Iyer Srividya N. , Jaouich Alexia , Reaume-Zimmer Paula , Henderson Joanna
Published: October 2021

Background

Given high rates of mental health and substance challenges among youth and substantial system access barriers, system innovation is required. Integrated youth services (IYS) models aim to transform youth mental health and substance use services by creating integrative, collaborative models of care in youth-friendly settings. This study examines service provider perspectives on the key service components to include in IYS models.

Method

A discrete choice experiment modeled service provider preferences for the service components of IYSs. The sample includes 388 service provider/agency leader participants (age 18+) from youth-serving organizations in Ontario. Importance scores and utility values were calculated for 12 attributes represented by four levels each. Latent class analysis identified subgroups of participants with different preferences.

Results

The majority of participants were direct service providers working in larger organizations in the mental health and/or substance use sectors in large urban centers. Participants strongly endorsed service models that provide rapid access to the widest variety of culturally sensitive service options, with supplementary e-health services, in youth-focused community settings with evening and weekend hours. They prefer caregiver involvement in youth services and treatment decisions and support youth and family engagement. Latent class analyses reveal three segments of service providers: a Youth-Focused Service Accessibility segment representing 62.1% (241/388) of participants, a Service Options segment representing 27.6% (107/388) of participants, and a Caregiver Integration segment representing 10.3% (40/388) of participants. Within these segments, the degree of prioritization of the various service components differ; however, the overall endorsement of the service components remains largely consistent across classes for most attributes. The segments did not differ based on demographic or agency characteristics.

Conclusions

The core characteristics of IYS settings for youth with mental health and substance use challenges, i.e., rapid access to a wide range of youth-oriented services, are strong priorities of service providers and youth-serving agency leaders. These findings confirm that youth-oriented service providers endorse the importance and relevance of IYS models as a whole; strong service provider buy-in to the model is expected to facilitate development, implementation and scaling of IYS models. Hearing stakeholder perspectives, including those of service providers, youth, and caregivers, is essential to developing, effectively implementing, and scaling effective youth services.
Transmission event of SARS-CoV-2 delta variant reveals multiple vaccine breakthrough infections
Authors: Farinholt Timothy , Doddapaneni Harsha , Qin Xiang , Menon Vipin , Meng Qingchang , Metcalf Ginger , Chao Hsu , Gingras Marie-Claude , Avadhanula Vasanthi , Farinholt Paige , Agrawal Charu , Muzny Donna M. , Piedra Pedro A. , Gibbs Richard A. , Petrosino Joseph
Published: October 2021

Background

This study aims to identify the causative strain of SARS-CoV-2 in a cluster of vaccine breakthroughs. Vaccine breakthrough by a highly transmissible SARS-CoV-2 strain is a risk to global public health.

Methods

Nasopharyngeal swabs from suspected vaccine breakthrough cases were tested for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) by qPCR (quantitative polymerase chain reaction) for Wuhan-Hu1 and alpha variant. Positive samples were then sequenced by Swift Normalase Amplicon Panels to determine the causal variant. GATK (genome analysis toolkit) variants were filtered with allele fraction ≥80 and min read depth 30x.

Results

Viral sequencing revealed an infection cluster of 6 vaccinated patients infected with the delta (B.1.617.2) SARS-CoV-2 variant. With no history of vaccine breakthrough, this suggests the delta variant may possess immune evasion in patients that received the Pfizer BNT162b2, Moderna mRNA-1273, and Covaxin BBV152.

Conclusions

Delta variant may pose the highest risk out of any currently circulating SARS-CoV-2 variants, with previously described increased transmissibility over alpha variant and now, possible vaccine breakthrough.

Funding

Parts of this work was supported by the National Institute of Allergy and Infectious Diseases (1U19AI144297) and Baylor College of Medicine internal funding.
Environmental health research needed to inform strategies, policies, and measures to manage the risks of anthropogenic climate change
Authors: Ebi Kristie L.
Published: October 2021

Anthropogenic climate change is affecting population health and wellbeing worldwide. The two main policy options to prepare for and manage these risks are adaptation and mitigation; significantly increased investments in each are urgently needed. However, medical research councils worldwide have provided minuscule amounts of funding for environmental health research to provide timely and useful insights on effectively protecting vulnerable populations and regions, for building climate-resilient health systems, and for promoting health system-related greenhouse gas emission reductions in a changing climate.
Application of the CRISPR/Cas9-based gene editing technique in basic research, diagnosis, and therapy of cancer
Authors: Zhang Huimin , Qin Chunhong , An Changming , Zheng Xiwang , Wen Shuxin , Chen Wenjie , Liu Xianfang , Lv Zhenghua , Yang Pingchang , Xu Wei , Gao Wei , Wu Yongyan
Published: October 2021

The 2020 Nobel Prize in Chemistry was awarded to Emmanuelle Charpentier and Jennifer Doudna for the development of the Clustered regularly interspaced short palindromic repeats/CRISPR-associated nuclease9 (CRISPR/Cas9) gene editing technology that provided new tools for precise gene editing. It is possible to target any genomic locus virtually using only a complex nuclease protein with short RNA as a site-specific endonuclease. Since cancer is caused by genomic changes in tumor cells, CRISPR/Cas9 can be used in the field of cancer research to edit genomes for exploration of the mechanisms of tumorigenesis and development. In recent years, the CRISPR/Cas9 system has been increasingly used in cancer research and treatment and remarkable results have been achieved. In this review, we introduced the mechanism and development of the CRISPR/Cas9-based gene editing system. Furthermore, we summarized current applications of this technique for basic research, diagnosis and therapy of cancer. Moreover, the potential applications of CRISPR/Cas9 in new emerging hotspots of oncology research were discussed, and the challenges and future directions were highlighted.
Effectiveness of mesenchymal stem cell-conditioned medium in bone regeneration in animal and human models: a systematic review and meta-analysis
Authors: Benavides-Castellanos Maria Paula , Garzón-Orjuela Nathaly , Linero Itali
Published: October 2021

Background

Given the limitations of current therapies for the reconstruction of bone defects, regenerative medicine has arisen as a new therapeutic strategy along with mesenchymal stem cells (MSCs), which, because of their osteogenic potential and immunomodulatory properties, have emerged as a promising alternative for the treatment of bone injuries. In vivo studies have demonstrated that MSCs have a positive effect on regeneration due to their secretion of cytokines and growth factors that, when collected in conditioned medium (MSC-CM) and applied to an injured tissue, can modulate and promote the formation of new tissue.

Objective

To evaluate the effectiveness of application of conditioned medium derived from mesenchymal stem cells in bone regeneration in animal and human models.

Methods

We conducted a systematic review with a comprehensive search through February of 2018 using several electronic databases (MEDLINE, EMBASE, SCOPUS, CENTRAL (Ovid), and LILACS), and we also used the “snowballing technique”. Articles that met the inclusion criteria were selected through abstract review and subsequent assessment of the full text. We assessed the risk of bias with the SYRCLE and Cochrane tools, and three meta-analyses were performed.

Results

We included 21 articles, 19 of which used animal models and 2 of which used human models. In animal models, the application of MSC-CM significantly increased the regeneration of bone defects in comparison with control groups. Human studies reported early mineralization in regenerated bones, and no bone resorption, inflammation, nor local or systemic alterations were observed in any case. The meta-analysis showed an overall favorable effect of the application of MSC-CM.

Conclusions

The application of MSC-CM to bone defects has a positive and favorable effect on the repair and regeneration of bone tissue, particularly in animal models. It is necessary to perform additional studies to support the application of MSC-CM in clinical practice.
Dedifferentiation: the return road to repair the intestinal epithelium
Authors: Liu Yuan , Xiong Xiaochen , Chen Ye-Guang
Published: October 2021

In the March 5 issue of Cell Stem Cell, (Murata K et al. Cell Stem Cell. 26(377–390):e376 2020) reported that intestinal stem cell recovery after injury is principally through Ascl2-dependent dedifferentiation of absorptive and secretory precursors in mice. This study provides evidence for robust regenerative capability of the intestinal epithelium via dedifferentiation of absorptive and secretory progenitors in the crypt.
The roles and activation of endocardial Notch signaling in heart regeneration
Authors: Li Huicong , Chang Cheng , Li Xueyu , Zhang Ruilin
Published: October 2021

As a highly conserved signaling pathway in metazoans, the Notch pathway plays important roles in embryonic development and tissue regeneration. Recently, cardiac injury and regeneration have become an increasingly popular topic for biomedical research, and Notch signaling has been shown to exert crucial functions during heart regeneration as well. In this review, we briefly summarize the molecular functions of the endocardial Notch pathway in several cardiac injury and stress models. Although there is an increase in appreciating the importance of endocardial Notch signaling in heart regeneration, the mechanism of its activation is not fully understood. This review highlights recent findings on the activation of the endocardial Notch pathway by hemodynamic blood flow change in larval zebrafish ventricle after partial ablation, a process involving primary cilia, mechanosensitive ion channel Trpv4 and mechanosensitive transcription factor Klf2.