bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of headache disorders with acupuncture: a 6-year retrospective study
Authors: Mata Javier , Sanchís Pilar , Valentí Pedro , Hernández Beatriz , Aguilar Jose Luis
Published: February 2021

Objective:

Existing systematic reviews and meta-analyses indicate that acupuncture has similar clinical effectiveness in the prevention of headache disorders (HDs) as drug therapy, but with fewer side effects. As such, examining acupuncture’s use in a pragmatic, real-world setting would be valuable. The purpose of this study was to compare the effects of acupuncture and prophylactic drug treatment (PDT) on headache frequency in patients with HDs, under real-world clinical conditions.

Methods:

Retrospective cohort study of patients with HDs referred to a pain clinic, using electronic health record data. Patients continued with tertiary care (treatment of acute headache attacks and lifestyle, meditation, exercise and dietary instructions) with PDT, or received 12 sessions of acupuncture over 3 months, instead of PDT under conditions of tertiary care. The primary outcome data were the number of days with headache per month, and groups were compared at baseline and at the end of the third month of treatment.

Results:

Data were analysed for 482 patients with HDs. The number of headache days per month decreased by 3.7 (standard deviation (SD) = 2.9) days in the acupuncture group versus 2.9 (SD = 2.3) in the PDT group (p = 0.007). The proportion of responders was 39.5% versus 16.3% (p < 0.001). The number needed to treat was 4 (95% confidence interval = 3–7).

Conclusion:

Our study has shown that patients with HDs in tertiary care who opted for treatment with acupuncture appeared to receive similar clinical benefits to those that chose PDT, suggesting these treatments may be similarly effective of the prevention of headache in a real-world clinical setting.
Broadband signal reconstruction for SHM: An experimental and numerical time reversal methodology
Authors: Falcetelli Francesco , Venturini Nicolas , Romero Maria Barroso , Martinez Marcias J , Pant Shashank , Troiani Enrico
Published: February 2021

Structural Health Monitoring (SHM) aims to shift aircraft maintenance from a time-based to a condition-based approach. Within all the SHM techniques, Acoustic Emission (AE) allows for the monitoring of large areas by analyzing Lamb waves propagating in plate like structures. In this study, the authors proposed a Time Reversal (TR) methodology with the aim of reconstructing an original and unaltered signal from an AE event. Although the TR method has been applied in Narrow-Band (NwB) signal reconstruction, it fails when a Broad-Band (BdB) signal, such as a real AE event, is present. Therefore, a novel methodology based on the use of a Frequencies Compensation Transfer Function (FCTF), which is capable of reconstructing both NwB and real BdB signals, is presented. The study was carried out experimentally using several sensor layouts and materials with two different AE sources: (i) a Numerically Built Broadband (NBB) signal, (ii) a Pencil Lead Break (PLB). The results were validated numerically using Abaqus/CAETM with the implementation of absorbing boundaries to minimize edge reflections.
Colorectal Cancer in Lebanon: Incidence, Temporal Trends, and Comparison to Regional and Western Countries
Authors: Lakkis Najla A. , El-Kibbi Ola , Osman Mona H.
Published: February 2021

Global trends in the incidence and mortality rates of colorectal cancer show a steady increase with significant predilection to western developed countries, possibly linking it to westernized lifestyles among other risk factors. This study aims to investigate the incidence and trends of colorectal cancer in Lebanon, a country in the Middle East and North Africa region, and to compare these rates to those in regional and western countries. Colorectal cancer incidence data were extracted from the Lebanese National Cancer Registry for the currently available years 2005 to 2016. The calculated age-standardized incidence rates and age-specific rates were expressed as per 100,000 population. The age-standardized incidence rates of colorectal cancer in Lebanon increased from 16.3 and 13.0 per 100,000 in 2005 to 23.2 and 20.2 per 100,000 in 2016, among males and females, respectively. The incidences were higher for males, and they increased with age. The annual percent change was +4.36% and +4.45%, in males and females respectively (p-value < 0.05). There was a non-statistically significant trend of decrease in recent years (since 2012 in males and since 2011 in females). The age-standardized incidence rates in Lebanon were higher than those in the majority of the regional countries, but lower than the rates in developed western countries. There were high age-specific incidence rates at age groups 40-44 and 45-49 years in Lebanon in both males and females (with significant rising temporal trend) compared to other countries, including the ones reported to have the highest colorectal cancer age-standardized incidence rate worldwide. Therefore, the burden of colorectal cancer is significant in Lebanon. This raises the necessity to develop national strategies tailored to reduce colorectal cancer incidence through promoting healthy lifestyles, raising awareness, and early detection as of 40 years of age.
Retrospective survey from vascular access team Lombardy net in COVID-19 era
Authors: Gidaro Antonio , Vailati Davide , Gemma Marco , Lugli Francesca , Casella Francesco , Cogliati Chiara , Canelli Antonio , Cremonesi Nadia , Monolo Davide , Cordio Giuseppe , Frosi Chiara , Destefanis Riccardo , Rossi Anna , Alemanno Maria Chiara , Valenza Franco , Luisoni Mara Dina , Elli Stefano , Caldarini Andrea , Lucchini Alberto , Paglia Stefano , Baroni Monica , Giustivi Davide
Published: February 2021

Background:

Venous Access Devices (VADs) are the most used devices in COVID-19 patients.

Objective:

Identify VADs implanted, catheter related thrombosis (CRT), catheter-related bloodstream infection (CRBSI), and accidental remove of VADs in both COVID-19 positive and COVID-19 free patients. Successive analysis was conducted comparing COVID-19 positive patients with COVID-19 free with inverse probability propensity score weights using simple regression to account for these two confounders (peripheral tip as central/peripheral and hospitalization as no/yes).

Methods:

This multicenter, retrospective cohort study collected data from seven hospitals in Lombardy during the pandemic period from February 21st to May 31st 2020.

Results:

A total of 2206 VADs were evaluated, 1107 (50.2%) of which were inserted in COVID-19 patients. In COVID-19 cohort the first choice was Long Peripheral Cannula in 388 patients (35.1%) followed by Midline Catheter in 385 (34.8%). The number of “central tip” VADs inserted in COVID-free inpatients and COVID-19 positive were similar (307 vs 334). We recorded 42 (1.9%) CRT; 32 (79.2%) were observed in COVID-19 patients. A total of 19 CRBSI were diagnosed; 15 (78.95%) were observed in COVID-19. Accidental removals were the more represented complication with 123 cases, 85 (69.1%) of them were in COVID-19. COVID-19 significantly predicted occurrence of CRT (OR = 2.00(1.85–5.03); p < 0.001), CRSB (OR = 3.82(1.82–8.97); p < 0.001), and Accidental Removal (OR = 2.39(1.80–3.20); p < 0.001) in our propensity score weighted models.

Conclusions:

CRT, CRBSI, and accidental removal are significantly more frequent in COVID-19 patients. Accidental removals are the principal complication, for this reason, the use of subcutaneously anchored securement is recommended for a shorter period than usual.
Understanding students’ novelty satisfaction in physical education: Associations with need-supportive teaching style and physical activity intention
Authors: Aibar Alberto , Abós Ángel , García-González Luis , González-Cutre David , Sevil-Serrano Javier
Published: February 2021

Novelty satisfaction has recently been associated with positive outcomes in physical education (PE) lessons. Grounded in self-determination theory, this study aimed to examine the relationships between need-supportive teaching behaviours in PE and students’ satisfaction of basic psychological needs (BPNs), novelty satisfaction, and intention to be physically active. From a final sample of 1118 students (49.1% boys; 50.9% girls; mean age = 14.11 ± 1.50 years), the adolescents’ perception of need-support from PE teachers, BPN satisfaction, novelty satisfaction, and intention to be physically active were measured through different validated questionnaires. Results from structural equation modelling showed that students’ perceptions of autonomy, competence, and relatedness support from PE teachers positively predicted BPN and novelty satisfaction. Furthermore, BPN and novelty satisfaction positively predicted intention to be physically active. Our results seem to support the argument that need-supportive environments could be directly associated with novelty satisfaction. Likewise, novelty satisfaction seems to have an additional role in explaining intention to be physically active. These findings suggest the importance of designing need-supportive strategies in PE lessons to satisfy not only BPNs but also novelty, which can help to develop an active lifestyle among adolescents. Nevertheless, future research should also develop specific strategies aimed at supporting students’ novelty in PE lessons.
Safety and Efficacy of Endovascular Treatment of Portal Vein Stenosis in Liver Transplant Recipients: A Systematic Review
Authors: Sare Antony , Chandra Vishnu , Shanmugasundaram Srinidhi , Shukla Pratik A. , Kumar Abhishek
Published: February 2021

Purpose:

To evaluate the efficacy of Angioplasty and Stent Placement for the treatment of Portal Vein Stenosis in Liver Transplant Recipients by performing a systematic review.

Materials and Methods:

The PubMed Database was extensively searched for articles describing Portal Vein Stenosis (PVS) as a complication in Liver Transplant (LT) patients. The initial database search yielded 488 unique records published in the PubMed Database, 19 of which were deemed to meet the inclusion criteria. Outcomes were separated into 2 groups (Group A included patients with primary angioplasty, Group B included patients with primary stent placement), and further subdivided into Adult and Pediatric populations.

Results:

Group A included a total of 282 LT patients with portal vein stenosis. The population was predominantly pediatric (n = 243). Group B included a total of 111 LT patients with portal vein stenosis. This population was predominantly adult (n = 66). Technical success was significantly higher in both Group B pediatric (100%) and adults (97%) compared to Group A (69.5%) and (66.7%) respectively. Re-stenosis rates were significantly lower in Group B pediatric group compared to Group A (2.3% vs 29.7%, χ2 = 13.9; p < 0.001). Overall major (3.1%) and minor complications rates (1.5%) were low.

Conclusion:

Primary stent placement appears to have higher technical success in both populations and lower re-stenosis rates for treatment of PVS in pediatric populations.
White Armband Day: From global social media campaign to transnational commemoration day
Authors: Paul Johanna
Published: February 2021

This article is concerned with White Armband Day ( Dan Bijelih Traka), marked on 31 May in memory of the genocidal campaign against Prijedor’s non-Serb population during the war in Bosnia-Herzegovina (1992–95). What started spontaneously in 2012 as a global social media campaign against genocide denial has become a commemoration day marked in Prijedor, the post-Yugoslav region, across the world and in virtual spaces. Its widespread recognition and impact on alternative memory discourses rendered it one of the most successful civil society initiatives engaging in dealing with the past in the region. Drawing on a transnational mobilisation perspective, the article explores how the initiative emerged and what factors contributed to White Armband Day’s establishment as a transnational commemoration day. Findings from multi-sited research indicate that beyond rapid online mobilisation, two prerequisites have been key to its success: displacement-based (trans)local networks of Prijedorčani and its ability to mobilise young people across ethnic divisions.
Efficacy of oral vancomycin prophylaxis for prevention of Clostridioides difficile infection: a systematic review and meta-analysis
Authors: Tariq Raseen , Laguio-Vila Maryrose , Tahir Muhammad Waqas , Orenstein Robert , Pardi Darrell S. , Khanna Sahil
Published: February 2021

Background:

Prevention of recurrent Clostridioides difficile infection (CDI) is a challenge in clinical practice, particularly in patients who need systemic antimicrobial therapy. We aimed to evaluate the role of oral vancomycin prophylaxis (OVP) in prevention of primary or future CDI in patients on systemic antimicrobial therapy.

Methods:

A systematic search of MEDLINE, Embase, and Web of Science was performed from 2000 to January 2020. We included case-control or cohort studies that included patients on systemic antimicrobial therapy who did or did not receive oral vancomycin prophylaxis (OVP) and were evaluated for development of CDI. Odds ratio (OR) estimates with 95% confidence intervals (CI) were calculated.

Results:

Four studies including 1352 patients evaluated OVP for primary CDI prevention, with CDI occurring in 29/402 patients on OVP (7.4%) compared with 10.4% (99/950) without OVP. Meta-analysis revealed no significant decrease in risk of CDI in patients who received OVP (OR, 0.18; 95% CI, 0.03–1.03; p = 0.06). There was significant heterogeneity with I2 = 76%. Ten studies including 9258 patients evaluated OVP for secondary CDI prevention. Future CDI occurred in 91/713 patients on OVP (13.3%) compared with 21.9% (1875/8545) who did not receive OVP. Meta-analysis revealed a statistically significant decreased risk of future CDI (OR, 0.34; 95% CI, 0.20–0.59; p < 0.00001). Significant heterogeneity was seen with I2 = 59%.

Discussion:

Based on observational data, OVP appears to decrease the risk of future CDI in patients with prior CDI who require systemic antimicrobial therapy. However, OVP was not effective for primary prevention of CDI.
Gut microbiome and Clostridioides difficile infection: a closer look at the microscopic interface
Authors: Sehgal Kanika , Khanna Sahil
Published: February 2021

The pathogenesis of Clostridioides difficile infection (CDI) was recognized with its link to the use of antimicrobials. Antimicrobials significantly alter gut microbiota structure and composition, which led to the discovery of the association of this gut perturbation with the development of CDI. A number of factors implicated in its pathogenesis, such as advancing age, proton-pump inhibitors, and gastrointestinal diseases, are linked to gut microbiota perturbations. In an effort to better understand CDI, a multitude of studies have tried to ascertain protective and predictive microbial footprints linked with CDI. It has further been realized that CDI in itself can alter the gut microbiome. Its spore-forming capability poses as an impediment in the management of the infection and contributes to its recurrence. Antibiotic therapies used for its management have also been linked to gut microbiota changes, making its treatment a little more challenging. In an effort to exploit and utilize this association, gut microbial restoration therapies, particularly in the form of fecal microbial transplant, are increasingly being put to use and are proving to be beneficial. In this review, we summarize the association of the gut microbiome and microbial perturbation with initial and recurrent CDI.
Effect of immunotherapy on overall survival in limited-stage small cell lung carcinoma: a national cancer database analysis
Authors: Bilani Nadeem , Alley Evan , Elson Leah , Nahleh Zeina , Arteta-Bulos Rafael
Published: February 2021

Background:

While immune-based therapies have been approved for extensive-stage small cell lung cancer, there is limited data on the efficacy of immunotherapy in patients with limited-stage disease.

Methods:

We used the National Cancer Database to first evaluate factors associated with the inclusion of immunotherapy as part of the initial therapeutic course in patients diagnosed with limited-stage small cell lung cancer (LS-SCLC). Consequently, we evaluated the impact of this immunotherapy on 2-year and 5-year overall survival (OS). We did this by performing 1:1 matching for controls that did not receive immunotherapy, and comparing survival between cohorts using the Kaplan–Meier method.

Results:

A total of 98 patients with LS-SCLC received immunotherapy as part of their initial therapeutic regimen. Age and facility type were the only significant predictors of the use of immunotherapy. There was no statistically significant difference between matched case-control cohorts in median OS ( p = 0.985), 2-year OS ( p = 0.747), and 5-year OS ( p = 0.934).

Conclusion:

In this study using a large national database, we found that the inclusion of immunotherapy as part of the initial systemic therapy regimen was not significantly associated with improved OS in a cohort of LS-SCLC patients.
Socio-Economic Development and Infrastructure Cost Performance in China: Comparing Transport and Energy Sectors
Authors: Rabe Wiebke , Kostka Genia , Habich-Sobiegalla Sabrina
Published: February 2021

Socio-economic development is often linked to efficient infrastructure provision. In China, the government has rolled out ambitious infrastructure projects as part of its national development strategy. There is much to praise about China’s infrastructure provision, such as its remarkable scale and speed of infrastructure delivery. However, based on studying 153 infrastructure cases between 1983 and 2018 and two in-depth case studies, we find that China’s infrastructure performance is not as positive as often assumed. We show that infrastructure projects continuously arrive significantly over budget. We argue that this cost performance depends – similar to Western countries – on inaccurately anticipating technical hindrances and geographical challenges. In addition, however, we identify another important and so far less discussed project performance determinant specifically relevant to the Chinese context: population resettlements and land acquisition.
Antioxidant and Cytotoxic Activities of Myrtaceae Essential Oils Rich in Terpenoids From Brazil
Authors: Jerônimo Lucas Botelho , da Costa Jamile S. , Pinto Laine C. , Montenegro Raquel C. , Setzer William N. , Mourão Rosa Helena Veras , da Silva Joyce Kelly R. , Maia José Guilherme S. , Figueiredo Pablo Luis B.
Published: February 2021

This work analyzed the chemical compositions and evaluated the antioxidant and cytotoxic activities of essential oils (EO) of Eugenia patrisii (Epat), Eugenia stipitata (Esti), Myrcia splendens (Mspl), Myrcia sylvatica (Msyl), Psidium guajava (Pgua), and Psidium guineense (Pgui-1 and Pgui-2) from the Brazilian Amazon. Sesquiterpenoids were found in high concentrations in the oils of E. patrisii and M. splendens, which were rich in E-caryophyllene (32.0% and 45.8%); E. stipitata and M. sylvatica, which displayed germacrene D (11.8%) and germacrene B (24.5%); and P. guajava that showed epi-β-bisabolol (16.1%) as the main compound. However, P. guineense samples (Pgui-1 and Pgui-2) were rich in monoterpenoids such as limonene (Pgui-1: 30.2%; Pgui-2 30.4%) and α-pinene (Pgui-1: 22.5%; Pgui-2: 17.7%). The samples showed a weak and moderate antioxidant activities in the DPPH assay, displaying inhibition rates from 11.5% to 38.6% (at 10 mg/mL). All samples were cytotoxic against human cancer cells by the MTT method. Epat oil showed higher activity against melanoma (SKMEL-19, IC505.8 µg/mL), gastric (AGP01, IC503.2 µg/mL), and colon (HCT116, IC506.7 µg/mL). Meanwhile, the samples Pgua and Pgui were more active against breast cancer cells (MCF7, IC5012.4 µg/mL and 11.6 µg/mL, respectively).
Reoperation Rates Following Total Ankle Arthroplasty Versus Ankle Arthrodesis for Posttraumatic Indications
Authors: Ross Bailey J. , Savage-Elliott Ian , Wu Victor J. , Flick Travis R. , Sherman William F. , Rodriguez Ramon F.
Published: February 2021

Aims:

This studied aimed to compare rates of reoperation for patients who received primary ankle arthrodesis (AA) versus total ankle replacement (TAR) for posttraumatic indications between 2010 and 2016 Q2 using a nationwide claims database.

Methods:

A retrospective cohort study analyzing patients who received primary AA or TAR for posttraumatic indications was performed using PearlDiver. Reoperations assessed included prosthetic joint infection (PJI), hardware removal, adjacent joint fusion, and local open reduction internal fixation (ORIF). Multivariable logistic regression was used to compare rates of reoperations at 1 and 2 years postdischarge.

Results:

A total of 862 (74%) patients received AA and 318 (26%) patients underwent TAR for a posttraumatic indication. At 1 year, 305 (35.4%) AA patients had at least 1 reoperation compared with 55 (17.3%) TAR patients (OR 2.32; 95% CI, 1.68-3.26). At 2 years, 364 (42.2%) AA patients and 66 (20.8%) TAR patients had at least 1 reoperation (OR 2.51; 95% CI, 1.84-3.45). ORIF, hardware removal, and adjacent joint fusions were more likely for AA patients at both time intervals (all Ps < .05).

Conclusion:

Patients who received primary AA for posttraumatic indications exhibited higher rates of major reoperations in the short to medium term compared with patients who underwent TAR.

Levels of Evidence:

Level III: Retrospective cohort study
Differences in Lower Extremity Movement Quality by Level of Sport Specialization in Cadets Entering a United States Service Academy
Authors: Venrick CPT Connor B. , Miraldi Story F. , DiStefano Lindsay J. , Peck Karen Y. , Posner LTC Matthew A. , Houston Megan N. , Padua Darin A. , Marshall Stephen W. , Cameron Kenneth L.
Published: February 2021

Background:

Sport specialization in youth athletes is associated with increased risk for musculoskeletal injury; however, little is known about whether sport specialization is associated with lower extremity movement quality. The purpose of this study was to examine differences in lower extremity movement quality by level of sport specialization in US Service Academy cadets.

Hypothesis:

Cadets who report an increased level of sport specialization would have a lower level of movement quality than those who are less specialized.

Study Design:

Cross-sectional analysis from an ongoing prospective cohort study.

Level of Evidence:

Level 3.

Methods:

Cadets completed the Landing Error Scoring System (LESS) and a baseline questionnaire evaluating level of sport specialization during high school. Data were analyzed using separate 1-way analysis of variance models.

Results:

Among all participants (n = 1950), 1045 (53.6%) reported low sport specialization, 600 (30.8%) reported moderate sport specialization, and 305 (15.6%) reported high sport specialization at the time of data collection during the first week. Ages ranged from 17 to 23 years. Men (1491) and women (459) reported comparable specialization levels ( P = 0.45). There were no statistically significant differences in lower extremity movement quality by level of specialization for all subjects combined ( P = 0.15) or when only men were included in the analyses ( P = 0.69). However, there were statistically significant differences in movement quality by level of specialization in women ( P = 0.02). Moderately specialized women had the best movement quality (mean, 4.63; SD, 2.21) followed by those with high specialization (mean, 4.90; SD, 2.08) and those with low levels of specialization (mean, 5.23; SD, 2.07).

Conclusion:

Women reporting moderate sport specialization had improved movement quality and significantly better LESS scores compared to those with high/low specialization.

Clinical Relevance:

Athletes, especially women, should be encouraged to avoid early sport specialization to optimize movement quality, which may affect injury risk.
Socioeconomic position and quality of life among Colombian hypertensive patients: The mediating effect of perceived stress
Authors: Barradas Susana , Lucumi Diego , Agudelo Diana Maria , Mentz Graciela
Published: February 2021

This study aimed to assess the relationships between socioeconomic position, perceived stress and Health Related Quality of Life (HRQoL) of patients with hypertension. Data were obtained using the baseline survey of 258 patients from the Social Determinants and Inequities in the Control of Blood Hypertension Program (ProDSICHA). HRQoL was measured with SF-8 Health Survey. Socioeconomic position was measured using education, and the MacArthur Scale. Stress was measured with Perceived Stress Scale. A higher educational level was associated with a higher perception of stress (Coeff = 0.78, p = 0.019). Also, a lower position in the community was associated with a higher perception of stress (Coeff = −0.56, p = 0.027). A higher level of perceived stress was associated with a higher level of mental health (Coeff = 0.64, p = 0.000). No statistical differences were found in the relations between socioeconomic position and physical HRQoL. These findings warrant further research to understand the role of socioeconomic position in physical HRQoL.
Sialocoele associated with the molar salivary gland in a British Shorthair cat
Authors: Kilduff-Taylor Andrea , Gombert Alexis , Hahn Harriet , Dempsey Lara M
Published: February 2021

Case summary

A 16-year-old neutered female British Shorthair cat presented with a 5-year history of swelling lateral to the left mandible that intermittently discharged viscous, clear fluid from a small defect in the skin. CT, ultrasonography, physical characteristics and cytology of the fluid were suggestive of sialocoele. CT showed a large, cavitary, fluid-filled mass lateral to the left mandible. A ventral approach was used to resect the left mandibular, sublingual and molar salivary glands and sialocoele. Histopathology of the molar and mandibular and sublingual glands showed chronic active sialoadenitis with more severe changes in the molar gland. There were no signs of recurrence of the sialocoele 12 months after surgery.

Relevance and novel information

This is the first report of a cranial cervical sialocoele potentially involving the molar salivary gland in a cat. Resection of the mandibular, sublingual and molar salivary glands should be considered in cats that present with a cranial cervical sialocoele.
Musical Engagement is Linked to Posttraumatic Resilience: The Role of Gender, Personality, and Music Listening Styles After Childhood Trauma
Authors: Rosenberg Nora , Greenberg David M. , Lamb Michael E.
Published: February 2021

Previous research on the links between music and posttraumatic resilience have typically relied on small sample sizes and case studies from clinical settings. To address this important gap, we conducted an online study to measure childhood trauma and adult musical engagement in everyday life in non-clinical contexts. The present study ( N = 634) investigated these links by administering online questionnaires about musical engagement, personality, and demographics to adult survivors of childhood trauma. Hierarchical regression analyses showed that social music listening predicted increased well-being in males while affective music listening predicted decreased well-being in males. Gender moderated the interaction between affective engagement and well-being: affective engagement was linked to increased well-being in females and a decrease in males. Furthermore, neuroticism moderated the interaction between narrative listening and well-being: narrative listening was linked to increased well-being for participants with low neuroticism and a decrease for those with high neuroticism. These findings may reflect general gender differences in coping styles: emotional reflection for females and emotional distraction for males, and suggest gender differences in attentional biases, rumination, and capacities for disassociation. Taken together, the results show that there are individual differences in musical engagement and posttraumatic resilience based on gender and personality. These findings are useful for the development of music-based coping strategies that mental health professionals can tailor for individual clients.
Nursing Home Education During the COVID-19 Pandemic
Authors: Ferguson Claire C , Figy Sean C , Manley Natalie A
Published: February 2021

Objective:

To help older adults living in nursing homes (NHs) while educating medical and physician assistant (MD/PA) students during the COVID-19 pandemic.

Methods:

Using a multicomponent iterative process, we piloted multiple student led service-learning projects in 2 NHs and 1 hospice agency in the Midwest. Pre-post online student surveys were completed to match student interests with facility needs and to assess learning and obtain feedback regarding their experiences.

Results:

All 12 interested students completed the initial survey; n = 23 ultimately volunteered (word of mouth); n = 11 (48%) completed the follow-up survey. Opportunities were medical record transfer, grounds beautification, resident biographies, window entertainment, and No-One-Dies-Alone program. Students averaged 9.2 volunteer hours; stated the opportunities were enjoyable, clinically applicable, and socially distanced; and reported learning about unique experiences of older adults in NHs.

Discussion:

Despite limitations created by the pandemic, mutually beneficial and safe opportunities remain for education in the NH setting.
Achilles Tendon Repair With Modified Giftbox Technique Using Nonabsorbable Suture Loops
Authors: Miller Timothy L. , Welder Eric
Published: February 2021

Background:

Achilles tendon ruptures occur most commonly in male individuals aged between 30 and 60 years.

Indications:

Surgical options for treatment of acute midsubstance Achilles tendon ruptures in the athletically active population include open, mini-open, and percutaneous techniques.

Surgical Technique:

The giftbox suture configuration has been popularized by multiple authors. Here, a modified giftbox technique for Achilles tendon repair is shown in detail and uses nonabsorbable suture loops, a novel method for primarily repairing complete Achilles tendon ruptures.

Results:

This mini-open technique has demonstrated, at a minimum of 1-year follow-up, outcomes that are comparable with previously reported Achilles tendon repair procedures with no re-ruptures and low overall complication rates in the first 60 patients who have undergone this procedure. The mean time to release to unrestricted activity following repair by this technique is 24.3 weeks, which is earlier than most standard techniques.

Conclusion:

Achilles tendon repair using the modified gift box technique with nonabsorbable suture loops is a safe and reliable technique for repair of midsubstance tendon ruptures in athletically active patients. The mean time to release to unrestricted activity following repair by this technique is earlier than most standard techniques.
Genome-wide characterization of PEBP family genes in nine Rosaceae tree species and their expression analysis in P. mume
Authors: Zhang Man , Li Ping , Yan Xiaolan , Wang Jia , Cheng Tangren , Zhang Qixiang
Published: February 2021

Background

Phosphatidylethanolamine-binding proteins (PEBPs) constitute a common gene family found among animals, plants and microbes. Plant PEBP proteins play an important role in regulating flowering time, plant architecture as well as seed dormancy. Though PEBP family genes have been well studied in Arabidopsis and other model species, less is known about these genes in perennial trees.

Results

To understand the evolution of PEBP genes and their functional roles in flowering control, we identified 56 PEBP members belonging to three gene clades (MFT-like, FT-like, and TFL1-like) and five lineages (FT, BFT, CEN, TFL1, and MFT) across nine Rosaceae perennial species. Structural analysis revealed highly conserved gene structure and protein motifs among Rosaceae PEBP proteins. Codon usage analysis showed slightly biased codon usage across five gene lineages. With selection pressure analysis, we detected strong purifying selection constraining divergence within most lineages, while positive selection driving the divergence of FT-like and TFL1-like genes from the MFT-like gene clade. Spatial and temporal expression analyses revealed the essential role of FT in regulating floral bud breaking and blooming in P. mume. By employing a weighted gene co-expression network approach, we inferred a putative FT regulatory module required for dormancy release and blooming in P. mume.

Conclusions

We have characterized the PEBP family genes in nine Rosaceae species and examined their phylogeny, genomic syntenic relationship, duplication pattern, and expression profiles during flowering process. These results revealed the evolutionary history of PEBP genes and their functions in regulating floral bud development and blooming among Rosaceae tree species.
Validation of evaluating left ventricular diastolic function with estimated left atrial volume from anteroposterior diameter
Authors: Wang Yonghuai , Zhang Liang , Liu Shuang , Li Guangyuan , Kong Fanxin , Zhao Cuiting , Yang Jun , Ma Chunyan
Published: February 2021

Background

Left atrial (LA) volume (LAV) is one of the recommended key variables for evaluating left ventricular (LV) diastolic function. However, only LA anteroposterior diameter (LAAP) is available in numerous large-scale existing databases. Therefore, this study aimed to validate whether LV diastolic function could be evaluated with estimated LAV from LAAP.

Methods

A total of 552 inpatients with sinus rhythm were consecutively enrolled. LAV was measured by biplane Simpson’s disk summation method. LV diastolic function was evaluated according to the 2016 proposed recommendations. Best-fitting regression models of LAAP index (LAAPI)–LAV index (LAVI) were developed and equations with the highest F-value were chosen in the first 276 subjects (derivation set), and concordance for evaluating LV diastolic function between using estimated and observed LAVI was verified in the remaining 276 subjects (validation set).

Results

In the derivation set, the linear model has the highest F-value in all subjects and in the subjects with normal or depressed LV ejection fraction. In the validation set, using the linear equation (LAVI = 2.05 × LAAPI − 13.86), the higher area under curve and narrower range of difference were shown between estimated LAVI and observed LAVI, respectively. Further, concordance for diagnosis (overall proportion of agreement, 88.4%; κ = 0.79) and grading (overall proportion of agreement, 84.8%; κ = 0.74) of LV diastolic dysfunction was substantial between using estimated and observed LAVI.

Conclusions

LV diastolic function can be evaluated with estimated LAVI from LAAPI, which might provide a surrogate method when the direct measurement of LAV is not available.
Hepatitis B prevalence and incidence in the fishing communities of Lake Victoria, Uganda: a retrospective cohort study
Authors: Kitandwe Paul Kato , Muyanja Enoch , Nakaweesa Teddy , Nanvubya Annet , Ssetaala Ali , Mpendo Juliet , Okech Brenda , Bagaya Bernard S. , Kiwanuka Noah , Price Matt A.
Published: February 2021

Introduction

Hepatitis B is a serious potentially fatal hepatocellular disease caused by the hepatitis B virus. In the fishing communities of Lake Victoria Uganda, the hepatitis B virus infection burden is largely unknown. This study assessed the prevalence and incidence of hepatitis B in these communities.

Methods

This was a retrospective cohort study that tested serum samples collected from 13 to 49-year-old study participants that were residing in two Ugandan Lake Victoria fishing communities of Kasenyi (a mainland) and Jaana (an island). The samples were collected between 2013 and 2015 during the conduct of an HIV epidemiological cohort study in these communities. A total of 467 twelve-month follow-up and 50 baseline visit samples of participants lost to follow-up were tested for hepatitis B serological markers to determine prevalence. To determine hepatitis B virus incidence, samples that were hepatitis B positive at the follow-up visit had their baseline samples tested to identify hepatitis B negative samples whose corresponding follow-up samples were thus incident cases.

Results

The baseline mean age of the 517 study participants was 31.1 (SD ± 8.4) years, 278 (53.8%) of whom were females. A total of 36 (7%) study participants had hepatitis B virus infection, 22 (61.1%) of whom were male. Jaana had a higher hepatitis B virus prevalence compared to Kasenyi (10.2% vs 4.0%). In total, 210 (40.6%) study participants had evidence of prior hepatitis B virus infection while 48.6% had never been infected or vaccinated against this disease. A total of 20 (3.9%) participants had results suggestive of prior hepatitis B vaccination. Hepatitis B incidence was 10.5 cases/100PY (95% CI: 7.09–15.53). Being above 25 years of age and staying in Jaana were significant risk factors for hepatitis B virus acquisition (AOR 1.6, 95% CI: 1.1–2.2; p < 0.01 and 1.4, 95% CI: 1.1–1.8; p < 0.01 respectively).

Conclusion

Hepatitis B virus incidence in Lake Victoria fishing communities of Uganda is very high, particularly in the islands. Interventions to lower hepatitis B virus transmission in these communities are urgently needed.
New Zealand medical students’ views of euthanasia/assisted dying across different year levels
Authors: Nie Luke , Smith-Han Kelby , Iosua Ella , Walker Simon
Published: February 2021

Background

Previous studies report a majority of the general public support euthanasia/assisted dying (EAD), while a majority of doctors are opposed. In considering policy decisions about EAD, some may discount the views of doctors because they take them to be based on personal values or tradition, rather than reasons that the general public might share. One way to explore this notion is to examine whether medical students’ views change during their medical education.

The objective of this study was to learn how New Zealand medical students view EAD and whether students at different year levels have different views.

Methods

An on-line survey of undergraduate medical students was conducted asking whether they supported a law change to allow EAD. Quantitative data was analysed using unadjusted and multiple logistic regression. Thematic analysis was conducted with the qualitative data.

Results

A total of 326 students replied to the survey. The overall response rate was 28%. 65% of 2nd year students were supportive of EAD, compared to 39% in 5th year. The odds of 5th year students supporting a law change compared to 2nd year was 0.30 (95% CI: 0.15–0.60).

The predominant themes found in the qualitative results indicate that medical students support or oppose EAD for reasons similar to those found in the wider debate, and that their views are influenced by a range of factors. However, several at all year levels cited an aspect of medical school as having influenced their views. This was mentioned by participants who were supportive of, opposed to, or unsure about EAD, but it was the type of influence most often mentioned by those who were opposed.

Conclusions

The quantitative findings show students at the end of 5th year were less likely to support EAD than students at the end of 2nd year. We suggest that this difference is most likely due to their time in medical education. This suggests that the lower support found among doctors is in part related to medical education and medical work rather than age, personality, or social context. The qualitative findings indicate that this is not related to a particular educational experience at Otago Medical School but a range.
Maximizing Black applicant matriculation in U.S. PA programs: associations between the number of submitted applications and likelihood of matriculation
Authors: Honda Trenton , Henry Trenton D. , Mandel Ellen D. , Quella Alicia , Rodríguez José E. , Najmabadi Shahpar , Valentin Virginia L.
Published: February 2021

Background

Physician Assistants (PA) are important members of the medical team, and increasing diversity in healthcare professionals has been consistently associated with improved health outcomes for underrepresented minority patients. In this study of a national cohort of PA program applicants, we investigated whether the number of programs a student applied to (Application Number, AN) was significantly associated with increased likelihood of matriculation into a PA program.

Methods

We examined all applications (n = 27,282) to the 2017–2018 admissions cycle of the Central Application Service for Physician Assistants, which is utilized by over 90% of accredited PA programs in the US. As we a priori hypothesized that associations would be non-linear, we used natural cubic splines to estimate the associations between matriculation and AN, controlling for multiple metrics of academic achievement, experience, and applicant demographics. We subsequently used segmented regression analyses (modified poisson regression with robust error variance) to investigate log-linear associations above and below inflection points identified in the spline analyses. Additionally, we explored for effect modification by race/ethnicity.

Results

The strongest associations were observed between application number 2–7, and a threshold effect was observed at > 16 applications, beyond which there was no significant, incremental benefit in matriculation likelihood. Associations differed by race, particularly for application number 2–7, wherein the incremental benefit from each additional application was highest for Black applicants (Likelihood Ratio [LR]: 1.243, 95% CI: 1.136 to 1.360) vs non-Latinx White (LR: 1.098, 95% CI: 1.072 to 1.125), with no additional, incremental benefit beyond 7 program applications. For all other races, significant increased likelihoods of matriculation were observed until 16 program applications.

Conclusions

These findings can help guide pre-PA advisors and PA programs, providing recommended thresholds to applicants on the most cost effective ways to increase their likelihood of admissions, and the PA profession as a whole by providing actionable information that can potentially increase Race/Ethnic diversity in the PA profession and, by extension, medical teams.
Cardiologists’ perceptions on multidisciplinary collaboration in heart failure care - a qualitative study
Authors: Raat Willem , Smeets Miek , Vandewal Isolde , Broekx Lien , Peters Sanne , Janssens Stefan , Vaes Bert , Aertgeerts Bert
Published: February 2021

Background

Cardiologists play a key role in multidisciplinary care by guiding heart failure (HF) management in the hospital and in the community. Regional implementation of multidisciplinary health care interventions depends on how they perceive collaboration with other health care disciplines, yet research on this topic is limited. This study aimed to explore the views and opinions of cardiologists on multidisciplinary collaboration in HF care.

Methods

We conducted a qualitative study based on face-to-face semi-structured interviews with 11 Belgian cardiologists between September 2019 and February 2020. We used the Qualitative Analysis Guide of Leuven (QUAGOL) method as guidance for data analysis until data saturation was reached.

Results

Cardiologists consider the general practitioner (GP) and HF nurse as the most important partners in HF management. Cardiologists identified four problems in current multidisciplinary collaboration: the communication of a HF diagnosis to the patient, advanced care planning, titration of HF medication by the GP and electronic data exchange and communication. Three themes emerged as ideas for improvement of HF care: 1) expansion of the role of the HF nurse, 2) implementation of a structured, patient-centered, and flexible model of disease management program and 3) integrated data approaches.

Conclusion

Cardiologists value close cooperation with GPs in HF management. They advocate an expanded future role for the HF nurse, increased eHealth, and structured disease management to optimize current HF care.
Sequential filtering for clinically relevant variants as a method for clinical interpretation of whole exome sequencing findings in glioma
Authors: Ülgen Ege , Can Özge , Bilguvar Kaya , Akyerli Boylu Cemaliye , Kılıçturgay Yüksel Şirin , Erşen Danyeli Ayça , Sezerman O. Uğur , Yakıcıer M. Cengiz , Pamir M. Necmettin , Özduman Koray
Published: February 2021

Background

In the clinical setting, workflows for analyzing individual genomics data should be both comprehensive and convenient for clinical interpretation. In an effort for comprehensiveness and practicality, we attempted to create a clinical individual whole exome sequencing (WES) analysis workflow, allowing identification of genomic alterations and presentation of neurooncologically-relevant findings.

Methods

The analysis workflow detects germline and somatic variants and presents: (1) germline variants, (2) somatic short variants, (3) tumor mutational burden (TMB), (4) microsatellite instability (MSI), (5) somatic copy number alterations (SCNA), (6) SCNA burden, (7) loss of heterozygosity, (8) genes with double-hit, (9) mutational signatures, and (10) pathway enrichment analyses. Using the workflow, 58 WES analyses from matched blood and tumor samples of 52 patients were analyzed: 47 primary and 11 recurrent diffuse gliomas.

Results

The median mean read depths were 199.88 for tumor and 110.955 for normal samples. For germline variants, a median of 22 (14–33) variants per patient was reported. There was a median of 6 (0–590) reported somatic short variants per tumor. A median of 19 (0–94) broad SCNAs and a median of 6 (0–12) gene-level SCNAs were reported per tumor. The gene with the most frequent somatic short variants was TP53 (41.38%). The most frequent chromosome-/arm-level SCNA events were chr7 amplification, chr22q loss, and chr10 loss. TMB in primary gliomas were significantly lower than in recurrent tumors (p = 0.002). MSI incidence was low (6.9%).

Conclusions

We demonstrate that WES can be practically and efficiently utilized for clinical analysis of individual brain tumors. The results display that NOTATES produces clinically relevant results in a concise but exhaustive manner.