bluuebunny/crossref_metadata_2025 huggingface dataset:
Variation in restraint use between hospitals: a multilevel analysis of multicentre prevalence measurements in Switzerland and Austria
Authors: Thomann Silvia , Hahn Sabine , Bauer Silvia , Richter Dirk , Zwakhalen Sandra
Published: April 2021

Background

In restraint use in the somatic acute-care hospital setting, routine and institutional culture seem to play an important role. This implies that similar patient situations would be managed with restraints in one hospital, while in another hospital the situation would be managed without restraints. This practice variation appears to be ethically and legally questionable. The influence of organisation-specific factors such as the availability of guidelines is discussed. However, the relevance of such factors at the hospital level has been rarely investigated to date. Therefore, the aims of this study were a) to determine how much variance in restraint use can be explained on the hospital level (hospital general effect) and b) to examine the impact of organisational factors on restraint use (specific contextual effects).

Methods

A secondary data analysis of cross-sectional multicentre data was performed. Data were collected during three quality measurements (2016–2018) in acute-care hospitals in Switzerland and Austria. Hospitalised patients from different medical specialties aged 18+ with informed consent were included. Descriptive analysis and multilevel logistic regression analysis were performed.

Results

The study included 29,477 patients from a total of 140 hospitals. The 30-day prevalence rate of patients with at least one restraint was 8.7% (n = 2577). The availability of guidelines regarding restraint use and refresher courses for nursing staff were associated with less restraint use (odds ratios = 0.60 and 0.75). By adding the hospital as a random effect, the explained variance of the model increased from 24 to 55%.

Conclusions

The use of restraints varies widely between hospitals, even considering patient characteristics. The identification of situations in which restraints were used out of routine or institutional culture appears to be an important approach in restraint reduction. Investments in appropriate structures and employee knowledge can facilitate providing restraint-free care as much as possible.
Persistent luminescence nanoparticles for cancer theranostics application
Authors: Liu Nian , Chen Xiao , Sun Xia , Sun Xiaolian , Shi Junpeng
Published: April 2021

Persistent luminescence nanoparticles (PLNPs) are unique optical materials that emit afterglow luminescence after ceasing excitation. They exhibit unexpected advantages for in vivo optical imaging of tumors, such as autofluorescence-free, high sensitivity, high penetration depth, and multiple excitation sources (UV light, LED, NIR laser, X-ray, and radiopharmaceuticals). Besides, by incorporating other functional molecules, such as photosensitizers, photothermal agents, or therapeutic drugs, PLNPs are also widely used in persistent luminescence (PersL) imaging-guided tumor therapy. In this review, we first summarize the recent developments in the synthesis and surface functionalization of PLNPs, as well as their toxicity studies. We then discuss the in vivo PersL imaging and multimodal imaging from different excitation sources. Furthermore, we highlight PLNPs-based cancer theranostics applications, such as fluorescence-guided surgery, photothermal therapy, photodynamic therapy, drug/gene delivery and combined therapy. Finally, future prospects and challenges of PLNPs in the research of translational medicine are also discussed.
Effects of illness perceptions on health-related quality of life in patients with rheumatoid arthritis in China
Authors: Wang Juan , Yang Zhe , Zheng Yan , Peng Yaling , Wang Qing , Xia Hongli , Wang Yan , Ding Jin , Zhu Ping , Shang Lei , Zheng Zhaohui
Published: April 2021

Objectives

For patients with rheumatoid arthritis (RA) in China, little is known of how their illness perceptions affect their health-related quality of life (HRQoL). The present study investigated associations between specific illness perceptions due to RA and HRQoL features.

Methods

For 191 patients with RA, illness perceptions were measured using the Brief Illness Perceptions Questionnaire (BIPQ) comprising 8 domains. HRQoL was determined with the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Multivariate linear regression analyses were performed.

Results

The overall BIPQ of patients with RA was 49.09 ± 11.06. The highest and lowest scores were for concern (9.15 ± 1.81) and personal control (4.30 ± 2.52), respectively. Multivariate stepwise regression analyses showed that the overall BIPQ was significantly negatively associated with each HRQoL feature, and HRQoL total score (β = − 0.343, P < 0.001, 95% CI − 7.080 to − 4.077). Positive associations between BIPQ features and HRQoL included personal control (β = 0.119, P = 0.004, 95% CI 2.857–14.194) and treatment control (β = 0.084, P = 0.029, 95% CI 0.640–12.391). Negative associations with HRQoL were identity (β = − 0.105, P = 0.034, 95% CI − 13.159 to − 0.430) and emotional response (β = − 0.207, P < 0.001, 95% CI − 18.334 to − 6.811).

Conclusions

Patients with RA in China perceive their illness in ways that affect their HRQoL. These results suggest that strategies that target these perceptions may improve the quality of life of these patients.
Inhibition of MLKL-dependent necroptosis via downregulating interleukin-1R1 contributes to neuroprotection of hypoxic preconditioning in transient global cerebral ischemic rats
Authors: Zhan Lixuan , Lu Xiaomei , Xu Wensheng , Sun Weiwen , Xu En
Published: April 2021

Background

Our previous study indicated that hypoxic preconditioning reduced receptor interacting protein (RIP) 3-mediated necroptotic neuronal death in hippocampal CA1 of adult rats after transient global cerebral ischemia (tGCI). Although mixed lineage kinase domain-like (MLKL) has emerged as a crucial molecule for necroptosis induction downstream of RIP3, how MLKL executes necroptosis is not yet well understood. In this study, we aim to elucidate the molecular mechanism underlying hypoxic preconditioning that inactivates MLKL-dependent neuronal necroptosis after tGCI.

Methods

Transient global cerebral ischemia was induced by the four-vessel occlusion method. Twenty-four hours before ischemia, rats were exposed to systemic hypoxia with 8% O2 for 30 min. Western blotting was used to detect the expression of MLKL and interleukin-1 type 1 receptor (IL-1R1) in CA1. Immunoprecipitation was used to assess the interactions among IL-1R1, RIP3, and phosphorylated MLKL (p-MLKL). The concentration of intracellular free calcium ion (Ca2+) was measured using Fluo-4 AM. Silencing and overexpression studies were used to study the role of p-MLKL in tGCI-induced neuronal death.

Results

Hypoxic preconditioning decreased the phosphorylation of MLKL both in neurons and microglia of CA1 after tGCI. The knockdown of MLKL with siRNA decreased the expression of p-MLKL and exerted neuroprotective effects after tGCI, whereas treatment with lentiviral delivery of MLKL showed opposite results. Mechanistically, hypoxic preconditioning or MLKL siRNA attenuated the RIP3-p-MLKL interaction, reduced the plasma membrane translocation of p-MLKL, and blocked Ca2+ influx after tGCI. Furthermore, hypoxic preconditioning downregulated the expression of IL-1R1 in CA1 after tGCI. Additionally, neutralizing IL-1R1 with its antagonist disrupted the interaction between IL-1R1 and the necrosome, attenuated the expression and the plasma membrane translocation of p-MLKL, thus alleviating neuronal death after tGCI.

Conclusions

These data support that the inhibition of MLKL-dependent neuronal necroptosis through downregulating IL-1R1 contributes to neuroprotection of hypoxic preconditioning against tGCI.
The many faces of solitary fibrous tumor; diversity of histological features, differential diagnosis and role of molecular studies and surrogate markers in avoiding misdiagnosis and predicting the behavior
Authors: Tariq Muhammad Usman , Din Nasir Ud , Abdul-Ghafar Jamshid , Park Yong-Koo
Published: April 2021

Background

Solitary Fibrous Tumor (SFT) is a distinct soft tissue neoplasm associated with NAB2-STAT6 gene fusion. It can involve a number of anatomic sites and exhibits a wide spectrum of histological features.

Main body

Apart from diversity in morphological features seen even in conventional SFT, two histologic variants (fat-forming and giant cell-rich) are also recognized. In addition, a malignant form and dedifferentiation are well recognized. Owing to diverse histological features and involvement of diverse anatomic locations, SFT can mimic other soft tissue neoplasms of different lineages including schwannoma, spindle cell lipoma, dermatofibrosarcoma protuberans, liposarcoma, gastrointestinal stromal tumor (GIST), malignant peripheral nerve sheath tumor (MPNST), and synovial sarcoma. SFT is classified as an intermediate (rarely metastasizing) tumor according to World Health Organization Classification of Tumors of Soft tissue and Bone, 5th edition. The management and prognosis of SFT differs from its malignant mimics and correct diagnosis is therefore important. Although SFT expresses a distinct immunohistochemical (IHC) profile, the classic histomorphological and IHC profile is not seen in all cases and diagnosis can be challenging. NAB2-STAT6 gene fusion has recently emerged as a sensitive and specific molecular marker and its IHC surrogate marker signal transducer and activator of transcription 6 (STAT6) has also shown significant sensitivity and specificity. However, few recent studies have reported STAT6 expression in other soft tissue neoplasms.

Conclusion

This review will focus on describing the diversity of histological features of SFT, differential diagnoses and discussing the features helpful in distinguishing SFT from its histological mimics.
Factors associated with involuntary psychiatric hospitalization in Portugal
Authors: Silva Manuela , Antunes Ana , Azeredo-Lopes Sofia , Loureiro Adriana , Saraceno Benedetto , Caldas-de-Almeida José Miguel , Cardoso Graça
Published: April 2021

Background

Identifying which factors contribute to involuntary psychiatric hospitalization may support initiatives to reduce its frequency. This study examines the sociodemographic, clinical, and contextual factors associated with involuntary hospitalization of patients from five Portuguese psychiatric departments in 2002, 2007 and 2012.

Methods

Data from all admissions were extracted from clinical files. A Poisson generalized linear model estimated the association between the number of involuntary hospitalizations per patient in one year and sociodemographic, clinical, and contextual factors.

Results

An increment of involuntary hospitalizations was associated with male gender [exp($$\widehat{\upbeta }$$

β
^

) = 1.31; 95%CI 1.06–1.62, p < 0.05], having secondary and higher education [exp($$\widehat{\upbeta }$$

β
^

) = 1.45; 95%CI 1.05–2.01, p < 0.05, and exp($$\widehat{\upbeta }$$

β
^

) = 1.89; 95%CI 1.38–2.60, p < 0.001, respectively], a psychiatric diagnosis of psychosis [exp($$\widehat{\upbeta }$$

β
^

) = 2.02; 95%CI 1.59–2.59, p < 0.001], and being admitted in 2007 and in 2012 [exp($$\widehat{\upbeta }$$

β
^

) = 1.61; 95%CI 1.21–2.16, p < 0.01, and exp($$\widehat{\upbeta }$$

β
^

) = 1.73; 95%CI 1.31–2.32, p < 0.001, respectively]. A decrease in involuntary hospitalizations was associated with being married/cohabitating [exp($$\widehat{\upbeta }$$

β
^

) = 0.74; 95%CI 0.56–0.99, p < 0.05], having experienced a suicide attempt [exp($$\widehat{\upbeta }$$

β
^

) = 0.26; 95%CI 0.15–0.42, p < 0.001], and belonging to the catchment area of three of the psychiatric services evaluated [exp($$\widehat{\upbeta }$$

β
^

) = 0.65; 95%CI 0.49–0.86, p < 0.01, exp($$\widehat{\upbeta }$$

β
^

) = 0.67; 95%CI 0.49–0.90, p < 0.01, and exp($$\widehat{\upbeta }$$

β
^

) = 0.67; 95%CI 0.46–0.96, p < 0.05 for Hospital de Magalhães Lemos, Centro Hospitalar Psiquiátrico de Lisboa and Unidade Local de Saúde do Baixo Alentejo, respectively].

Conclusions

The findings suggest that involuntary psychiatric hospitalizations in Portugal are associated with several sociodemographic, clinical, and contextual factors. This information may help identify high-risk patients and inform the development of better-targeted preventive interventions to reduce these hospitalizations.
Development and validation of a web-based patient decision aid for immunotherapy for patients with metastatic melanoma: study protocol for a multicenter randomized trial
Authors: Grabbe Pia , Gschwendtner Kathrin M. , Maatouk Imad , Strobel Sophia B. , Salzmann Martin , Bossert Julia , Eich Wolfgang , Wild Beate , Meier Friedegund , Hassel Jessica C. , Bieber Christiane
Published: April 2021

Background

Patients with metastatic melanoma and their physicians are confronted with a complex decision regarding first-line therapy. Risks and benefits vary considerably between various treatment options. With this in mind, we aim to develop and evaluate a patient decision aid (PtDA) to inform patients about the risks and benefits of treatment options, namely, immunotherapy as monotherapy, immunotherapy as combination therapy, and treatment with BRAF/MEK inhibitors. We aim to test whether the use of this PtDA before medical consultation will increase patients’ knowledge of treatment options and thus promote shared decision-making (SDM) and patient decision satisfaction.

Methods

In total, 128 patients with metastatic melanoma from two German cancer centers will be randomized to the intervention group (IG), receiving access to the PtDA before medical consultation, or the control group (CG), receiving treatment as usual (TAU), i.e., medical consultation alone. There will be three major assessment points (before intervention, T0; after intervention, T1; and 3 months after intervention, T2). The main outcome is the patient’s knowledge of their treatment options, measured by a self-developed, piloted multiple-choice test at T1. Secondary outcome measures will include the extent of SDM during medical consultation, assessed by Observer OPTION 5, and patient decision satisfaction, assessed by the Satisfaction with Decision Scale (SwD), at T1 and T2.

Discussion

This trial will assess the effectiveness of a developed PtDA to enhance patient knowledge of treatment options for metastatic melanoma, SDM, and patient decision satisfaction. If the efficacy can be proven, the PtDA will be implemented nationwide in Germany to close a relevant gap in the education and care of patients with metastatic melanoma.

Trial registration

ClinicalTrials.gov NCT04240717. Registered on 27 January 2020
Mechanical transmission of SARS-CoV-2 by house flies
Authors: Balaraman Velmurugan , Drolet Barbara S. , Mitzel Dana N. , Wilson William C. , Owens Jeana , Gaudreault Natasha N. , Meekins David A. , Bold Dashzeveg , Trujillo Jessie D. , Noronha Leela E. , Richt Juergen A. , Nayduch Dana
Published: April 2021

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a recently emerged coronavirus that is the causative agent of the coronavirus disease 2019 (COVID-19) pandemic. COVID-19 in humans is characterized by a wide range of symptoms that range from asymptomatic to mild or severe illness including death. SARS-CoV-2 is highly contagious and is transmitted via the oral–nasal route through droplets and aerosols, or through contact with contaminated fomites. House flies are known to transmit bacterial, parasitic and viral diseases to humans and animals as mechanical vectors. Previous studies have shown that house flies can mechanically transmit coronaviruses, such as turkey coronavirus; however, the house fly’s role in SARS-CoV-2 transmission has not yet been explored. The goal of this work was to investigate the potential of house flies to mechanically transmit SARS-CoV-2. For this purpose, it was determined whether house flies can acquire SARS-CoV-2, harbor live virus and mechanically transmit the virus to naive substrates and surfaces.

Methods

Two independent studies were performed to address the study objectives. In the first study, house flies were tested for infectivity after exposure to SARS-CoV-2-spiked medium or milk. In the second study, environmental samples were tested for infectivity after contact with SARS-CoV-2-exposed flies. During both studies, samples were collected at various time points post-exposure and evaluated by SARS-CoV-2-specific RT-qPCR and virus isolation.

Results

All flies exposed to SARS-CoV-2-spiked media or milk substrates were positive for viral RNA at 4 h and 24 h post-exposure. Infectious virus was isolated only from the flies exposed to virus-spiked milk but not from those exposed to virus-spiked medium. Moreover, viral RNA was detected in environmental samples after contact with SARS-CoV-2 exposed flies, although no infectious virus was recovered from these samples.

Conclusions

Under laboratory conditions, house flies acquired and harbored infectious SARS-CoV-2 for up to 24 h post-exposure. In addition, house flies were able to mechanically transmit SARS-CoV-2 genomic RNA to the surrounding environment up to 24 h post-exposure. Further studies are warranted to determine if house fly transmission occurs naturally and the potential public health implications of such events.

Graphical abstract
Assessment of Babesia bovis 6cys A and 6cys B as components of transmission blocking vaccines for babesiosis
Authors: Alzan Heba F. , Bastos Reginaldo G. , Ueti Massaro W. , Laughery Jacob M. , Rathinasamy Vignesh A. , Cooke Brian M. , Suarez Carlos E.
Published: April 2021

Background

Babesia bovis reproduces sexually in the gut of its tick vector Rhipicephalus microplus, which involves expression of 6cys A and 6cys B proteins. Members of the widely conserved 6cys superfamily are candidates for transmission blocking vaccines (TBV), but intricacies in the immunogenicity of the 6cys proteins in the related Plasmodium parasites required the identification of transmission blocking domains in these molecules for vaccine design. Hereby, the immunogenic efficacy of recombinant (r) B. bovis 6cys A and B proteins as a TBV formulation was studied.

Methods

The immunogenicity of r6cys A and 6cys B proteins expressed in a eukaryotic system was evaluated in a cattle immunization trial (3 immunized and 3 control calves). A B. bovis sexual stage induction in vitro inhibition assay to assess the ability of antibodies to block the production of sexual forms by the parasite was developed.

Results

Immunized cattle generated antibodies against r6cys A and r6cys B that were unable to block sexual reproduction of the parasite in ticks. Additionally, these antibodies also failed in recognizing native 6cys A and 6cys B and peptides representing 6cys A and 6cys B functional domains and in inhibiting the development of sexual forms in an in vitro induction system. In contrast, rabbit antibodies generated against synthetic peptides representing predicted B-cell epitopes of 6cys A and 6cys B recognized recombinant and native forms of both 6cys proteins as well as peptides representing 6cys A and 6cys B functional domains and were able to neutralize development of sexual forms of the parasite in vitro.

Conclusions

These data, combined with similar work performed on Plasmodium 6cys proteins, indicate that an effective 6cys protein-based TBV against B. bovis will require identifying and targeting selected regions of proteins containing epitopes able to reduce transmission.

Graphical abstract
Leveraging unstructured data to identify hereditary angioedema patients in electronic medical records
Authors: Brouwer Emily S. , Bratton Emily W. , Near Aimee M. , Sanders Lynn , Mack Christina D.
Published: April 2021

Background

The epidemiologic impact of hereditary angioedema (HAE) is difficult to quantify, due to misclassification in retrospective studies resulting from non-specific diagnostic coding. The aim of this study was to identify cohorts of patients with HAE-1/2 by evaluating structured and unstructured data in a US ambulatory electronic medical record (EMR) database.

Methods

A retrospective feasibility study was performed using the GE Centricity EMR Database (2006–2017). Patients with ≥ 1 diagnosis code for HAE-1/2 (International Classification of Diseases, Ninth Revision, Clinical Modification 277.6 or International Classification of Diseases, Tenth Revision, Clinical Modification D84.1) and/or ≥ 1 physician note regarding HAE-1/2 and ≥ 6 months’ data before and after the earliest code or note (index date) were included. Two mutually exclusive cohorts were created: probable HAE (≥ 2 codes or ≥ 2 notes on separate days) and suspected HAE (only 1 code or note). The impact of manually reviewing physician notes on cohort formation was assessed, and demographic and clinical characteristics of the 2 final cohorts were described.

Results

Initially, 1691 patients were identified: 190 and 1501 in the probable and suspected HAE cohorts, respectively. After physician note review, the confirmed HAE cohort comprised 254 patients and the suspected HAE cohort decreased to 1299 patients; 138 patients were determined not to have HAE and were excluded. The overall false-positive rate for the initial algorithms was 8.2%. Across final cohorts, the median age was 50 years and > 60% of patients were female. HAE-specific prescriptions were identified for 31% and 2% of the confirmed and suspected HAE cohorts, respectively.

Conclusions

Unstructured EMR data can provide valuable information for identifying patients with HAE-1/2. Further research is needed to develop algorithms for more representative HAE cohorts in retrospective studies.
Multivalued nonmonotone dynamic boundary condition
Authors: Aayadi Khadija , Akhlil Khalid , Ben Aadi Sultana , El Ouali Mourad
Published: April 2021

In this paper, we introduce a new class of hemivariational inequalities, called dynamic boundary hemivariational inequalities, reflecting the fact that the governing operator is also active on the boundary. In our context, it concerns the Laplace operator with Wentzell (dynamic) boundary conditions perturbed by a multivalued nonmonotone operator expressed in terms of Clarke subdifferentials. We show that one can reformulate the problem so that standard techniques can be applied. We use the well-established theory of boundary hemivariational inequalities to prove that under growth and general sign conditions, the dynamic boundary hemivariational inequality admits a weak solution. Moreover, in the situation where the functionals are expressed in terms of locally bounded integrands, a “filling in the gaps” procedure at the discontinuity points is used to characterize the subdifferential on the product space. Finally, we prove that, under a growth condition and eventually smallness conditions, the Faedo–Galerkin approximation sequence converges to a desired solution.
Complement mediates neuroinflammation and cognitive decline at extended chronic time points after traumatic brain injury
Authors: Mallah Khalil , Couch Christine , Alshareef Mohammed , Borucki Davis , Yang Xiaofeng , Alawieh Ali , Tomlinson Stephen
Published: April 2021

Traumatic brain injury (TBI) can result in progressive cognitive decline occurring for years after the initial insult, and for which there is currently no pharmacological treatment. An ongoing chronic inflammatory response after TBI is thought to be an important factor in driving this cognitive decline. Here, we investigate the role of complement in neuroinflammation and cognitive decline for up to 6 months after murine TBI. Male C57BL/6 mice were subjected to open head injury using a controlled cortical impact device. At 2 months post TBI, mice were moved to large cages with an enriched environment to simulate rehabilitation therapy, and assigned to one of three treatment groups: 1. vehicle (PBS), 2. CR2Crry (3 doses over 1 week), 3. CR2Crry (continuous weekly dose until the end of the study). The study was terminated at 6 months post-TBI for all groups. Motor and cognitive function was analyzed, with histopathological analysis of brain tissue. Measured at 6 months after TBI, neither of the complement inhibition paradigms improved motor performance. However, mice receiving continuous CR2Crry treatment showed improved spatial learning and memory compared to both mice receiving only 3 doses and to mice receiving vehicle control. Analysis of brain sections at 6 months after injury revealed ongoing complement activation in the control group, with reduced complement activation and C3 deposition in the continuous CR2Crry treatment group. The ipsilateral hemisphere of continuously treated animals also showed a decrease in microglia/macrophage and astrocyte activation compared to vehicle. There was also increased astrocytosis in the contralateral hippocampus of vehicle treated vs. naïve mice, which was reduced in mice continuously treated with CR2Crry. This study demonstrates continued complement mediated neuroinflammation at extended chronic time points after TBI, and extends the potential treatment window for complement inhibition, which has previously been shown to improve outcomes after murine TBI.
Providing value-based care as a physiotherapist
Authors: Cook Chad E. , Denninger Thomas , Lewis Jeremy , Diener Ina , Thigpen Charles
Published: April 2021

Background

Despite millions spent in research funding, studies, and guidelines, outcomes involving musculoskeletal care continue to decline. The purpose of this Viewpoint is to describe value-based care and to suggest measures for its adoption by physiotherapists who manage individuals with musculoskeletal related pain disorders.

Discussion

The provision of value-based care is best defined as care that includes: 1) patient centeredness, 2) guideline-oriented, integrated strategies, 3) measurement of patient outcomes and experiences, and 4) cost effectiveness. Physiotherapists are well positioned to be leaders in the application of value-based care by assuring they address each of the four strategies during the daily patient encounter. This Viewpoint discusses strategies for application to clinical practice.

Conclusion

By implementing value-based care principals, physiotherapists could assure that patients with musculoskeletal related pain disorders receive the right care at the right time, by the right provider.
Down syndrome and congenital heart disease: perioperative planning and management
Authors: Delany Dennis R. , Gaydos Stephanie S. , Romeo Deborah A. , Henderson Heather T. , Fogg Kristi L. , McKeta Angela S. , Kavarana Minoo N. , Costello John M.
Published: April 2021

Approximately 50% of newborns with Down syndrome have congenital heart disease. Non-cardiac comorbidities may also be present. Many of the principles and strategies of perioperative evaluation and management for patients with congenital heart disease apply to those with Down syndrome. Nevertheless, careful planning for cardiac surgery is required, evaluating for both cardiac and noncardiac disease, with careful consideration of the risk for pulmonary hypertension. In this manuscript, for children with Down syndrome and hemodynamically significant congenital heart disease, we will summarize the epidemiology of heart defects that warrant intervention. We will review perioperative planning for this unique population, including anesthetic considerations, common postoperative issues, nutritional strategies, and discharge planning. Special considerations for single ventricle palliation and heart transplantation evaluation will also be discussed. Overall, the risk of mortality with cardiac surgery in pediatric patients with Down syndrome is no more than the general population, except for those with functional single ventricle heart defects. Underlying comorbidities may contribute to postoperative complications and increased length of stay. A strong understanding of cardiac and non-cardiac considerations in children with Down syndrome will help clinicians optimize perioperative care and long-term outcomes.
Fabrication of perfect plasmonic absorbers for blue and near-ultraviolet lights using double-layer wire-grid structures
Authors: Motogaito Atsushi , Tanaka Ryoga , Hiramatsu Kazumasa
Published: April 2021

This study proposes using double-layer wire-grid structures to create narrow-band, perfect plasmonic absorbers, which depend on polarization, for the short-wavelength visible and near-ultraviolet regions of the electromagnetic spectrum. A rigorous coupled-wave analysis reveals that the maximum absorption attained using Ag and Al is ~ 90% at 450 and 375 nm. Experiments using Ag yielded results similar to those predicted by simulations. These results demonstrate that narrow-band perfect plasmonic absorbers, which depend on the polarization, can be realized at 450 and 375 nm using Ag or Al.
Tensorial elastodynamics for anisotropic media
Authors: Konuk Tugrul , Shragge Jeffrey
Published: April 2021

Elastic wavefield solutions computed by finite-difference (FD) methods in complex anisotropic media are essential elements of elastic reverse time migration and full-waveform inversion analyses. Cartesian formulations of such solution methods, though, face practical challenges when aiming to represent curved interfaces (including free-surface topography) with rectilinear elements. To forestall such issues, we have developed a general strategy for generating solutions of tensorial elastodynamics for anisotropic media (i.e., tilted transversely isotropic or even lower symmetry) in non-Cartesian computational domains. For the specific problem of handling free-surface topography, we define an unstretched coordinate mapping that transforms an irregular physical domain to a regular computational grid on which FD solutions of the modified equations of elastodynamics are straightforward to calculate. Our fully staggered grid (FSG) with a mimetic FD (MFD) (FSG + MFD) approach solves the velocity-stress formulation of the tensorial elastic wave equation in which we compute the stress-strain constitutive relationship in Cartesian coordinates and then transform the resulting stress tensor to generalized coordinates to solve the equations of motion. The resulting FSG + MFD numerical method has a computational complexity comparable with Cartesian scenarios using a similar FSG + MFD numerical approach. Numerical examples demonstrate that our solution can simulate anisotropic elastodynamic field solutions on irregular geometries; thus, it is a reliable tool for anisotropic elastic modeling, imaging, and inversion applications in generalized computational domains including handling free-surface topography.
Neck Dissections Based on Sentinel Lymph Node Navigation Versus Elective Neck Dissections in Early Oral Cancers: A Randomized, Multicenter, and Noninferiority Trial
Authors: Hasegawa Yasuhisa , Tsukahara Kiyoaki , Yoshimoto Seiichi , Miura Kouki , Yokoyama Junkichi , Hirano Shigeru , Uemura Hirokazu , Sugasawa Masashi , Yoshizaki Tomokazu , Homma Akihiro , Chikamatsu Kazuaki , Suzuki Mikio , Shiotani Akihiro , Matsuzuka Takashi , Kohno Naoyuki , Miyazaki Masakazu , Oze Isao , Matsuo Keitaro , Kosuda Shigeru , Yatabe Yasushi ,   for the HNCMM Research Group
Published: April 2021

PURPOSE

This study aimed to compare patients with early oral cavity squamous cell carcinoma (OCSCC) (tumor category [T] 1-2, node-negative, and no distant metastasis) treated with traditional elective neck dissection (ND) with those managed by sentinel lymph node biopsy (SLNB) using survival and neck function and complications as end points.

METHODS

Sixteen institutions in Japan participated in the study (trial registration number: UMIN000006510). Patients of age ≥ 18 years with histologically confirmed, previously untreated OCSCC (Union for International Cancer Control TNM Classification of Malignant Tumors 7th edition T1-2, node-negative no distant metastasis), with ≥ 4 mm (T1) depth of invasion, were randomly assigned to undergo standard selective ND (ND group; n = 137) or SLNB-navigated ND (SLNB group; n = 134). The primary end point was the 3-year overall survival rate, with a 12% noninferiority margin; secondary end points included postoperative neck functionality and complications and 3-year disease-free survival. Sentinel lymph nodes underwent intraoperative multislice frozen section analyses for the diagnosis. Patients with positive sentinel lymph nodes underwent either one-stage or second-look ND.

RESULTS

Pathologic metastasis-positive nodes were observed in 24.8% (34 of 137) and 33.6% (46 of 134) of patients in the ND and SLNB groups, respectively ( P = .190). The 3-year overall survival in the SLNB group (87.9%; lower limit of one-sided 95% CI, 82.4) was noninferior to that in the ND group (86.6%; lower limit 95% CI, 80.9; P for noninferiority < .001). The 3-year disease-free survival rate was 78.7% (lower limit 95% CI, 72.1) and 81.3% (75.0) in the SLNB and ND groups, respectively ( P for noninferiority < .001). The scores of neck functionality in the SLNB group were significantly better than those in the ND group.

CONCLUSION

SLNB-navigated ND may replace elective ND without a survival disadvantage and reduce postoperative neck disability in patients with early-stage OCSCC.
Effects of Temperature on Cuticular Lipids and Water Balance in a Desert Drosophila: is Thermal Acclimation Beneficial
Authors: Gibbs Allen G. , Louie Angela K. , Ayala Jose A.
Published: April 2021

The desert fruit fly Drosophila mojavensis experiences environmental conditions of high temperature and low humidity. To understand the physiological mechanisms allowing these small insects to survive in such stressful conditions, we studied the effects of thermal acclimation on cuticular lipids and rates of water loss of adult D. mojavensis. Mean hydrocarbon chain length increased at higher temperatures, but cuticular lipid melting temperature (Tm) did not. Lipid quantity doubled in the first 14 days of adult life, but was unaffected by acclimation temperature. Despite these changes in cuticular properties, organismal rates of water loss were unaffected by either acclimation temperature or age. Owing to the smaller body size of warm-acclimated flies, D. mojavensis reared for 14 days at 33°C lost water more rapidly on a mass-specific basis than flies acclimated to 25°C or 17°C. Thus, apparently adaptive changes in cuticular lipids do not necessarily result in reduced rates of water loss. Avoidance of high temperatures and desiccating conditions is more likely to contribute to survival in nature than changes in water balance mediated by surface lipids.
COVID-19 vaccine-related lymph node activation – patterns of uptake on PET-CT
Authors: Shah Sweni , Wagner Thomas , Nathan Malavika , Szyszko Teresa
Published: April 2021

In a bid to end the current COVID-19 crisis, many countries including UK have begun a mass immunization programme. Immunization can cause transient inflammation thereby causing increased metabolic activity at injection site and hypermetabolic lymph nodes. Various vaccinations and local injections have been known to cause diagnostic dilemma due to false-positive uptake on FDG PET-CT.

In this pictorial case review, we present five cases demonstrating various patterns of uptake including an ipsilateral deltoid muscle, axillary, supraclavicular, and subpectoral lymph nodes post COVID-19 vaccination.

A careful history of COVID-19 vaccination and normal size and morphology of lymph node on unenhanced low-dose CT will aid the diagnosis. All patients undergoing FDG PET-CT will require detailed documentation of the vaccination history including the time interval since vaccination.

Knowledge about these patterns of uptake on PET-CT will ensure accurate interpretation by Nuclear Medicine physicians and radiologists during the current vaccination drive.
An MFDFA Study to find Herd Behaviour and Information Asymmetry during Demonetization
Authors: Balasubramanian Niranjana
Published: April 2021

The paper attempts to identify how the Indian stock market reacts to an unusual event like demonetization through the observation of herd behavior. The data set considered is the NIFTY 50 index collected on 9th November 2016. This method could become a failure if giant investors are well aware of the massive proceeding as stock markets are prone to information asymmetry. Thus, the existence of the same is checked using Hill estimator. The sectoral herding behavior is also captured for three selective sectors namely PSU banks, Energy sector, and Automobile sector as each sector may pose a different response towards the event. The volatility index is examined for a time period of 10 years from 2008 to 2018.
HR 20/20: Developing future-ready HR Capabilities
Authors: Balasundaram Sathiyaseelan
Published: April 2021

The rapid evolution of technology is having a significantimpact on work, workplaces and the HR function. Thefunction is under demand to address a range of questionsthat includes adding strategic value, greater use oftechnology in HR processes, and making the workforcemore agile. In the first part, the paper provides aconceptual overview of the complex forces of changeimpacting workplaces, work and HR. Next, currentliterature and industry reports have been reviewed tooffer insights on how companies could choose differentapproaches to respond to these complex forces of change -Pathfinding HR, Searching HR, and Disconnected HR.Finally, the paper makes recommendations on the fourHR capabilities - workforce shaping, passing the culturetest, employee experience by design and workforceinsights - companies need to develop to be future-ready.
From Risk Aversion to Risk Loving
Authors: Nyanga Takupiwa , Chindanya Andrew
Published: April 2021

Risk aversion is one of the major impediments to entrepreneurship, and the survival and growth of startups in the developing world. Female entrepreneurs portray even a higher risk averse attitude regarding starting new businesses or introducing new business lines in their existing businesses. The intention of this study is to explore strategies that can be employed to reduce risk aversion among female entrepreneurs. A qualitative research methodology was utilized to carry out the research, with the interview technique being used as the main data collection tool. Snowballing and convenience sampling techniques were utilized to select 8 organizations and 21 female entrepreneurs who participated in the study. The study found out that entrepreneurial literacy significantly reduces risk aversion among female entrepreneurs by providing them with quality education and training on financial and income generation skills and competencies. Risk aversion can also be reduced among female entrepreneurs by assigning them to reputable business mentors to inspire them and also assist them to break cultural and societal barriers. The ‘do not do it alone’ principle and motivation through the creation of entrepreneurship forums and stakeholder interventions and schemes that support female entrepreneurship also help to minimize risk aversion.
Pensamento e invenção: por uma formação outra
Authors: Dias Rosimeri De Oliveira , Rodrigues Heliana De Barros Conde
Published: April 2021

O artigo expõe análises das pesquisas-intervenção realizadas com formação e com estudos foucaultianos na Universidade do Estado do Rio de Janeiro. Cartografa movimentos que nos desprendem dos exercícios de poder, servindo de reveladores para as transformações do sujeito. Para tanto, traz três dispositivos. Primeiro, as linhas tecidas no dispositivo aula, recorrendo ao curso A Hermenêutica do Sujeito, de Michel Foucault, e colocando em pauta a anarqueologia como atitude prática para pensar/fazer uma formação que se desvincule de pedagogias capacitadoras. Em seguida, as linhas do dispositivo se delineiam por meio de entrevistas e de alguns escritos de intercessores de Foucault para indagar se a formação perspectivada pela invenção pode ser uma formação outra, problematizadora. Em um terceiro momento, apresentam-se estratégias singulares de formar professores que privilegiam práticas éticas e políticas regulares e trabalhos dotados de continuidade, porém sem efeitos de coerção.
Um salto no escuro: experimentalidades entre corpo, arte e clínica na formação em psicologia
Authors: Santos Adriana Rosa Cruz , Resende Catarina , Costa Clara Sym Cardoso de Souza , Araújo Luiza Silva Loyola de , Civiletti Maria Luiza de Carvalho Pardal
Published: April 2021

O estágio supervisionado na graduação em Psicologia é o plano de experimentação coletiva que emerge como aposta de formação na encruzilhada entre clínica e arte. Uma prática clínica transdisciplinar que se aproxima da arte de Hélio Oiticica como “forma de atividade” onde “possa emergir uma coletividade” por meio de apostas que propiciem “estados de invenção”. Desse modo, afirmamos a dimensão estética da clínica por meio de dispositivos que engajem os estudantes na criação de si mesmos como terapeutas e na invenção de relações de cuidado singulares entre o próprio grupo e com os clientes. Tal direção nos aproxima de Foucault e suas proposições do cuidado de si e da estética da existência para tomar a formação do psicólogo como construção de um ethos. Arte, corpo e clínica se entrelaçam na constituição de uma experiência de formação que transita entre os planos intensivo e extensivo da existência e expressa os efeitos deste trânsito como criação de si, de objetos, de mundos ao experimentar ressonâncias, dissonâncias e partilhas.
Rastros e percursos de uma pesquisa: sociedade civil e política educativa no Uruguai nos anos 1980-2010
Authors: Bissio Gabriela Rodríguez
Published: April 2021

Este artigo é baseado em um projeto de pesquisa voltado para organizações da sociedade civil uruguaia que participam da implementação de políticas públicas de educação. O estudo analisou entrevistas com profissionais dessas organizações que trabalham em programas educacionais para os pobres na cidade de Montevidéu. Este texto aborda algumas das decisões metodológicas e organizacionais que orientaram a análise do material obtido no trabalho de campo e examina algumas das considerações levantadas em relação à análise microfísica dos projetos educacionais e à lógica governamental a eles associada.
Poemética: corpo coletivo, narrativas polifônicas
Authors: Mattos Denise Da Silva , Rocha Mônica
Published: April 2021

Interferência-instalação-poema nômade, criada para ocupar transitoriamente espaços públicos de circulação de pessoas, montada e apresentada pelo coletivo de participantes do Projeto Laboratório de Sensibilidades e Devires - LSD - Extensão da Faculdade de Medicina da UFRJ/Departamentos de Fonoaudiologia e de Medicina em Atenção Primária à Saúde. A Poemética é apropriação livre inspirada nos penetráveis de Helio Oiticica. É ação política que se preocupa em gerar um espaço de libertação usando poesia como dispositivo de escape, falada em voz alta ou gritada dentro de um espaço vermelho protegido. O poema como grito de resistência e de vida diante da opressão que tenta calar. O poema como o “vômito do afogado”, como designa Deligny, o sinal que prenuncia seu retorno à vida. Com base nessas ideias, propomos a criação de um espaço que, ao mesmo tempo, acolha o participante e torne sua experiência uma possibilidade de deslocamento.
Co(n)tidianos: um cuidado das narrativas
Authors: Pinto Jéssica Fernandes , Vasconcelos Michele De Freitas Faria de
Published: April 2021

A partir de tremores consequentes de encontros cotidianos, o presente artigo ensaia uma político-ética da narratividade interessada nas miudezas e delicadezas dos restos, dos rastros de vida ordinária a contradizer memórias e narrativas oficiais. Em agenciamento com a dimensão artística intrínseca a toda forma de produção e atividade humana, inventamos, pela pesquisa e pela escrita, “contidianos”. Nesse texto, desdobramento de pesquisa de mestrado, trazemos um desses contos que tem como mote o costume condenável do uso de drogas, tracejando a história de uma personagem que atualiza a experiência de muitos. A aposta: o cotidiano como território de germinação e afirmação da vida e, assim, de produção de saúde. Entendendo que não há outro mundo, mas outros modos de existir, o caminho foi o de produzir sentidos provisórios e precários, narrar-se para transmutar.
No ar cartografias da resistência: construindo novos olhares através da produção audiovisual em um CAPS
Authors: Oliveira Dalmara Fabro de , Moehlecke Vilene
Published: April 2021

Esse artigo tem como base o memorial descritivo escrito por uma estagiária de Psicologia e sua supervisora, ao narrar a experiência de construção de uma produção audiovisual junto a usuários e trabalhadores de um CAPS, com o objetivo de tornar visíveis as forças de resistência que operam contra a exclusão da loucura. O trabalho parte das inquietações frente às inúmeras formas pelas quais a loucura foi e ainda é invisibilizada, mostrando que, apesar de tantas conquistas a partir da Reforma Psiquiátrica, ainda persistem formas de enclausuramento. Utilizamos como método de pesquisa a cartografia. A produção audiovisual é tomada como dispositivo estético, com a função de tornar visíveis e dizíveis as forças de resistência neste CAPS. Diferente de uma Psicologia construída na distância e servindo ao ideal de excluir o louco, buscamos um fazer com os sujeitos, superando fronteiras e manicômios mentais.
Usos de Foucault na revista Psicologia & Sociedade (1986-2017)
Authors: Magalhães Amanda Gabriella Borges , Lemos Flávia Cristina Silveira
Published: April 2021

Neste estudo investigamos a recepção do filósofo francês Michel Foucault (1926-1984) na Psicologia Social brasileira a partir da análise dos usos do autor nas publicações da Revista Psicologia & Sociedade (1986-2017), da Associação Brasileira de Psicologia Social (ABRAPSO). O corpo documental desta pesquisa histórica foi composto de 90 artigos que citaram nominalmente o autor. Caracterizou-se a produção levantada quanto ao ano de publicação, distribuição geográfica, vinculações institucionais das autorias, temas e delineamentos dos estudos. Foram encontradas citações do filósofo durante todo o recorte temporal estabelecido, sendo a primeira em 1986, e o ano com maior frequência, 2012. Os trabalhos ligam-se majoritariamente a Instituições de Ensino Superior Públicas brasileiras, especialmente das regiões Sudeste e Sul (74,4%). Dos 90 estudos, 54 foram teóricos, e 36, empíricos. Versaram sobre Reflexões conceituais e epistemológicas, Políticas Públicas, Reflexões sobre a Psicologia, Subjetivação, Gênero/Sexualidade/Feminismo, Infância/Adolescência/Juventude, Arte-Política e Outros.
Explaining nursing attrition through the experiences of return-to-practice students: a mixed-methods study
Authors: Garside Joanne , Stephenson John , Hayles Jean , Barlow Nichola , Ormrod Graham
Published: April 2021

Background:

Nurse shortage is an international issue that has adverse effects on health and the quality of care of whole populations.

Aims:

The study aimed to explore attrition experienced by return-to-practice students attending higher education institutions in England.

Methods:

A mixed-methods design, involving questionnaires (n=114) and in-depth interviews (n=20), was used.

Findings:

Just over half (52%) of respondents left nursing after ≥10 years. Most of these (84%) stayed in alternative employment during their break from nursing. There were two distinct reasons for leaving nursing: the inability to maintain a positive work/life balance and a lack of opportunity for career advancement while retaining nursing registration. Respondents reflected positively on their nursing experience yet frequently reported significant personal or professional incidents prompting their decision to leave.

Conclusion:

The reasons nurses leave are complex. Professional bodies and managers need to work together to address concerns many nurses have during their careers that lead to them deciding to leave the profession.
Practice makes perfect?
Authors: Foster Sam
Published: April 2021

Sam Foster, Chief Nurse, Oxford University Hospitals, considers how adapting nurse education during the pandemic has boosted interest in the role of practice simulation