bluuebunny/crossref_metadata_2025 huggingface dataset:
Aging With HIV: Health Policy and Advocacy Priorities
Authors: Brennan-Ing Mark , Ramirez-Valles Jesus , Tax Aaron
Published: January 2021

The aging of people with HIV (PWH) is a major public health accomplishment and a social and cultural phenomenon. It highlights the human capacity to overcome adversity, the effectiveness of public health strategies (e.g., prevention and treatment), and the new challenges as well. Our societies are not well prepared to address the needs of older PWH and the changes they are creating. Stigma toward HIV, older age, and homosexuality, along with racism, have kept PWH largely invisible, resulting in limited investment in prevention and medical and social services. It is imperative that we develop an effective policy response to address the unique needs of PWH. The purpose of this article is to highlight current knowledge and emerging issues in HIV and aging to serve as a foundation on which to develop policy and program recommendations that will meet the new challenge.
Hated but still human: Metadehumanization leads to greater hostility than metaprejudice
Authors: Landry Alexander P. , Ihm Elliott , Schooler Jonathan W.
Published: January 2021

Metadehumanization, the perception that members of an outgroup dehumanize your group, has been found to exacerbate intergroup conflict by inspiring reciprocal dehumanization of the offending outgroup. Moreover, metadehumanization is distinct from metaprejudice (i.e., the perception that an outgroup hates your group). Given the mutual animosity reported in public opinion polls toward the other side, we believed US–Russia relations would be a worthwhile context in which to extend this model. Therefore, we measured Americans’ levels of metadehumanization and metaprejudice of Russians to determine the association between these perceptions and their hostility toward Russians (Study 1). In this novel intergroup conflict, metadehumanization remained a consequential predictor of outgroup hostility over and above metaprejudice, suggesting that it can exacerbate a broader range of intergroup conflicts than those heretofore examined. Given these findings, we then sought to experimentally differentiate between metadehumanization and metaprejudice. In Study 2, we manipulated both metadehumanization and metaprejudice to (a) determine whether one or both cause greater outgroup hostility and (b) elucidate the underlying mechanisms by which they may produce this effect. Whereas metadehumanization produced greater hostility, metaprejudice did not. Moreover, although both metaperceptions inspired greater prejudice, only metadehumanization led to greater dehumanization. We conclude that metadehumanization may be a particularly potent fomenter of hostility because it inspires reciprocal dehumanization over and above more general negative bias.
Investigations of split injection properties on the spray characteristics using a solenoid high-pressure injector
Authors: Dhanji Meghnaa , Zhao Hua
Published: January 2021

An on-going challenge with Gasoline direct injection (GDI) engines is achieving rapid activation of the exhaust catalyst during cold starts, in order to reduce the Nitrogen Oxide (NOx) emissions. Injecting late in the compression stroke, in the efforts to form a stratified mixture, provides the fuel insufficient time to be entrained with the surrounding charge. This results in locally fuel rich diffusion combustion and the formation of high levels of particulate matter. Employing a split injection strategy can help tackle these issues. The current study examines the effects of a split injection strategy on the spray characteristics. Varying pulse width (PW) combinations, split ratios and dwell times are investigated using a Solenoid actuated high pressure injector. The injected quantity and the droplet characteristics of a target plume are investigated. The experiments were performed in a constant volume spray chamber. The droplet velocities and sizes were measured using Phase Doppler Particle Anemometry (PDA). Short and large PWs, in the range of 0.3–0.8 ms, were investigated. The results revealed that the highest injected quantity of fuel was measured with the shortest dwell time of 2 ms, owing to increased interactions between the injection events, which led to larger Sauter mean diameters (SMDs) measured. The SMDs for the shorter PW of 0.4 ms were generally larger than 0.8 ms PW. The droplets in this case were affected by the closely spaced opening and closing events of the Solenoid valve.
The effect of transient needle lift on the internal flow and near-nozzle spray characteristics for modern GDI systems investigated by high-speed X-ray imaging
Authors: Mamaikin Dmitrii , Knorsch Tobias , Rogler Philipp , Wang Jin , Wensing Michael
Published: January 2021

The development of the injector nozzle is a dynamic area in regard of several technical aspects. At first, the internal flow influences the near-field spray characteristics via various phenomena such as cavitation and turbulence. However, these phenomena are not fully understood due to their extremely fast, complex and multiscale nature. Furthermore, it governs the spray targeting inside the combustion chamber. High-speed X-ray imaging of GDI injector nozzles is performed in this study. The experimental results presented are related to the internal flow and primary breakup of discharged liquid jets. The injectors used are equipped with nozzles made of aluminum which have been specially developed for these investigations to enhance optical accessibility. The visualization of the needle motion, in-nozzle flow and the primary breakup region provides several exciting observations. First, the needle lift tracking exhibits short overshooting right before the steady-state of the injection phase. This event leads to a short-term, however, significant change in the associated performance of the breakup. This phenomenon is found to be a consequence of the transient behavior of the in-nozzle flow. It is shown that under some circumstances hydraulic flip may occur during this overshooting period. The primary jet breakup region is visualized and evaluated by means of image processing. Thus, the transient behavior of liquid jet expansion is quantified in the vicinity of the nozzle. It is observed that the liquid jet direction deviates from the hole axis already at the nozzle outlet, which is caused by internal flow characteristics.
Siblings and Discordant Eligibility for Gene Therapy Research: Considering Parental Requests for Non-Trial "Compassionate Use”
Authors: Webb Jamie , Shah Lesha D , Bateman-House Alison
Published: January 2021

Deciding whether to grant an expanded access request for a child whose sibling is enrolled in a gene therapy trial involves a number of complex factors: considering the best interests of the child, the psychosocial and economic impact on the family, and the concerns and obligations of researchers. Despite the challenges in coming to a substantively fair outcome in cases of discordant eligibility, creating a procedurally fair decision-making process to adjudicate requests is essential.
Emergent Triple-Branched TEVAR and Redistribution of the Branches to the Supra-Aortic Target Vessels for Treatment of a Contained Ruptured Descending Aortic Aneurysm Associated With a Chronic Type A Aortic Dissection
Authors: Stana Jan , Fernandes Prendes Carlota , Banafsche Ramin , Konstantinou Nikolaos , Rantner Barbara , Pichlmaier Maximilian , Tsilimparis Nikolaos
Published: January 2021

Purpose:

To demonstrate the feasibility of urgent endovascular treatment of a chronic type A dissection and contained rupture of the false lumen using a noncustomized triple-branched arch endograft, which necessitated reassignment of the branches to the supra-aortic vessels.

Case Report::

A 57-year-old patient with a contained rupture of the descending thoracic aorta, in the setting of a chronic type A dissection and a maximum aortic diameter of 85 mm, was converted to endovascular repair after failure of an open surgical approach. A custom-made triple-branched arch endograft designed for another patient was employed, with concomitant occlusion of the false lumen using a Candy Plug occluder. To adjust the graft’s configuration to the patient’s anatomy, the supra-aortic vessels were not assigned to the originally planned branches. The 12-month follow-up angiography demonstrated a satisfactory result.

Conclusion:

A noncustomized triple-branched arch endograft can be used in an emergency setting to treat chronic type A dissection, reassigning the branches to the supra-aortic vessels as needed.
Upregulation of miR-1269 Contributes to the Progression of Esophageal Squamous Cell Cancer Cells and Is Associated With Poor Prognosis
Authors: Bai Xiuhui , Wang Qiang , Rui Xueqi , Li Xiaohua , Wang Xianming
Published: January 2021

Background:

MicroRNA-1269 (miR-1269) has been identified upregulated in several cancers, as well as in esophageal cancer. In the present study, we investigated the clinical prognostic significance and potential functional role of miR-1269 in esophageal squamous cell carcinoma (ESCC).

Methods:

A total of 107 ESCC patients who underwent surgical resection were enrolled in this study. miR-1269 expression was measured using quantitative real-time PCR (qRT-PCR). Kaplan-Meier method and multivariate Cox regression analysis were used to explore the prognostic significance of miR-1269. CCK-8 assays and Transwell assays were used to investigate the effects of miR-1269 on cell proliferation, migration, and invasion. The direct association between miR-1269 and SOX6 was evaluated using a dual-luciferase reporter assay.

Results:

The expression of miR-1269 was significantly upregulated in ESCC tissues and cell lines compared with adjacent normal tissues and esophageal epithelial cell line, respectively. What’s more, the upregulation of miR-1269 was associated with positive lymph node metastasis and advanced TNM stage. ESCC patients with high miR-1269 expression had shorter overall survival than those with low miR-1269 expression levels. Compared with the control group, overexpression of miR-1269 promoted cell proliferation, migration, and invasion, while knockdown of miR-1269 inhibited cell proliferation, migration, and invasion. SOX6 was a direct target of miR-1269.

Conclusion:

These results suggest that miR-1269 plays an important role in the progression of ESCC by targeting SOX6 and may be a potential prognostic biomarker and the miR-1269/SOX6 axis may be a therapeutic target for the patient with ESCC.
Development of a Comprehensive Outcome Measure for Motor Coordination, Step 2: Reliability and Construct Validity in Chronic Stroke Patients
Authors: Molad Roni , Alouche Sandra R. , Demers Marika , Levin Mindy F.
Published: January 2021

Background

A comprehensive scale assessing motor coordination of multiple body segments was developed using a 3-phase content validation process. The Comprehensive Coordination Scale (CCS) evaluates motor coordination defined as the ability to produce context-dependent movements of multiple effectors in both spatial and temporal domains. The scale assesses motor coordination in individuals with neurological injuries at 2 levels of movement description: the motor performance level describes end point movements (ie, hand, foot), and the movement quality level describes limb joints/trunk movements contributing to end point movement.

Objective

To determine measurement properties of the scale in people with chronic stroke.

Methods

Standardized approaches determined the internal consistency (factor loadings), intrarater and interrater reliability (interclass correlation coefficient), measurement error (SEM; minimal detectable change [MDC]), construct validity, and interpretability (ie, ceiling and floor effects) of the CCS.

Results

Data from 30 patients with chronic stroke were used for the analysis. The internal consistency of the scale was high (0.94), and the scale consisted of separate factors characterizing end point motor performance and movement quality. Intrarater (intraclass correlation coefficient [ICC] = 0.97-0.97) and interrater (ICC=0.76-0.98) reliability of the whole scale and subscales were good to excellent. The CCS had an SEM of 1.80 points (total score = 69 points) and an MDC95 of 4.98 points. The CCS total score was related to Fugl-Meyer Assessment total and motor scores and had no ceiling or floor effects.

Conclusions

The CCS scale has strong measurement properties and may be a useful measure of spatial and temporal coordination deficits in chronic stroke survivors.
Predicting Working Memory Training Responsiveness in Parkinson’s Disease: Both “System Hardware” and Room for Improvement Are Needed
Authors: Ophey Anja , Rehberg Sarah , Giehl Kathrin , Eggers Carsten , Reker Paul , van Eimeren Thilo , Kalbe Elke
Published: January 2021

Background. Patients with Parkinson’s disease (PD) are highly vulnerable to develop cognitive dysfunctions, and the mitigating potential of early cognitive training (CT) is increasingly recognized. Predictors of CT responsiveness, which could help to tailor interventions individually, have rarely been studied in PD. This study aimed to examine individual characteristics of patients with PD associated with responsiveness to targeted working memory training (WMT). Methods. Data of 75 patients with PD (age: 63.99 ± 9.74 years, 93% Hoehn & Yahr stage 2) without cognitive dysfunctions from a randomized controlled trial were analyzed using structural equation modeling. Latent change score models with and without covariates were estimated and compared between the WMT group ( n = 37), who participated in a 5-week adaptive WMT, and a waiting list control group ( n = 38). Results. Latent change score models yielded adequate model fit (χ2-test p > .05, SRMR ≤ .08, CFI ≥ .95). For the near-transfer working memory composite, lower baseline performance, younger age, higher education, and higher fluid intelligence were found to significantly predict higher latent change scores in the WMT group, but not in the control group. For the far-transfer executive function composite, higher self-efficacy expectancy tended to significantly predict larger latent change scores. Conclusions. The identified associations between individual characteristics and WMT responsiveness indicate that there has to be room for improvement (e.g., lower baseline performance) and also sufficient “hardware” (e.g., younger age, higher intelligence) to benefit in training-related cognitive plasticity. Our findings are discussed within the compensation versus magnification account. They need to be replicated by methodological high-quality research applying advanced statistical methods with larger samples.
Canadian Platform for Trials in Noninvasive Brain Stimulation (CanStim) Consensus Recommendations for Repetitive Transcranial Magnetic Stimulation in Upper Extremity Motor Stroke Rehabilitation Trials
Authors: Edwards Jodi D. , Black Sandra E. , Boe Shaun , Boyd Lara , Chaves Arthur , Chen Robert , Dukelow Sean , Fung Joyce , Kirton Adam , Meltzer Jed , Moussavi Zahra , Neva Jason , Paquette Caroline , Ploughman Michelle , Pooyania Sepideh , Rajji Tarek K. , Roig Marc , Tremblay Francois , Thiel Alexander
Published: January 2021

Objective. To develop consensus recommendations for the use of repetitive transcranial magnetic stimulation (rTMS) as an adjunct intervention for upper extremity motor recovery in stroke rehabilitation clinical trials. Participants. The Canadian Platform for Trials in Non-Invasive Brain Stimulation (CanStim) convened a multidisciplinary team of clinicians and researchers from institutions across Canada to form the CanStim Consensus Expert Working Group. Consensus Process. Four consensus themes were identified: (1) patient population, (2) rehabilitation interventions, (3) outcome measures, and (4) stimulation parameters. Theme leaders conducted comprehensive evidence reviews for each theme, and during a 2-day Consensus Meeting, the Expert Working Group used a weighted dot-voting consensus procedure to achieve consensus on recommendations for the use of rTMS as an adjunct intervention in motor stroke recovery rehabilitation clinical trials. Results. Based on best available evidence, consensus was achieved for recommendations identifying the target poststroke population, rehabilitation intervention, objective and subjective outcomes, and specific rTMS parameters for rehabilitation trials evaluating the efficacy of rTMS as an adjunct therapy for upper extremity motor stroke recovery. Conclusions. The establishment of the CanStim platform and development of these consensus recommendations is a first step toward the translation of noninvasive brain stimulation technologies from the laboratory to clinic to enhance stroke recovery.
Real-time calculation of the initial angle of projection for fragments in cylindrical warheads
Authors: Felix David , Colwill Ian , Harris Paul
Published: January 2021

This paper presents an improvement in the speed and accuracy of calculating the initial angle of projection of fragments for exploding cylindrical shells. It is a fast tool that can be used by designers, where existing approaches, such as computationally intensive Finite Element Analysis, are preventively slow. An enhanced Taylor equation is presented using available experimental data and the effect of the changing shape of the warhead’s cylindrical casing on the fragment’s initial projection angle. The resulting equation is computationally fast as it uses uncomplicated equations and provides improved accuracy for estimating a fragment’s initial angle of projection in comparison to existing work.
Social group membership does not modulate automatic imitation in a contrastive multi-agent paradigm
Authors: De Souter Laura , Braem Senne , Genschow Oliver , Brass Marcel , Cracco Emiel
Published: January 2021

A key prediction of motivational theories of automatic imitation is that people imitate in-group over out-group members. However, research on this topic has provided mixed results. Here, we investigate the possibility that social group modulations emerge only when people can directly compare in- and out-group. To this end, we conducted three experiments in which we measured automatic imitation of two simultaneously shown hands: one in-group and one out-group hand. Our general hypothesis was that the in-group hand would be imitated more than the out-group hand. However, even though both explicit and implicit manipulation checks showed that we succeeded in manipulating participants’ feelings of group membership, we did not find support for the predicted influence of group membership on automatic imitation. In contrast to motivational theories, this suggests that group membership does not influence who we do or do not imitate, not even in a contrastive multi-agent paradigm.
Gendered Power at Work: Constituting Moral Worth in a Hyper-Masculine Organizational Culture
Authors: Karazi-Presler Tair
Published: January 2021

How do powerful women in a hyper-masculine organization talk about power? To answer this question, we should explore both cultural contents and gendered politics that inform women’s discourse about social power. This article investigates how women morally evaluate their own and others’ power. Based on in-depth interviews with 34 women serving in senior military positions, I argue that they achieve a sense of self-worth and professional subjectivity through moral work. This symbolic work involves three main discursive strategies regrading power: (1) Drawing symbolic moral boundaries between themselves and the morally ‘degenerate’ military environment; (2) Using ‘performances of authenticity’ to constitute their moral worth; and (3) (Non-)apology to counter the accusation implicit in the social expectation that they must apologize for their power as women. These strategies allow these women to talk about power in moral terms, bring power closer to themselves, and at the same time claim moral subjectivity. By morally justifying the use of military power, they make the internalized ‘brass ceiling’ transparent. Thus, I argue that although women are agentic in constituting their worth, this is not necessarily done by way of ‘resistance’, but rather through discursive maneuvering that relies on the same oppressive discursive patterns designed to restrict their power. Accordingly, their efforts to constitute their selves and ‘do power’ are carried out within, rather than outside, the gendered moral logic of the organizational culture.
The FRAIL-FIT 30 Study – Factors influencing 30-day mortality in frail patients admitted to ICU: A retrospective observational cohort study
Authors: Hewitt David , Ratcliffe Michael , Booth Malcolm G
Published: January 2021

Background

Frailty is a multi-dimensional syndrome of reduced reserve, resulting from overlapping physiological decrements across multiple systems. The contributing factors, temporality and magnitude of frailty’s effect on mortality after ICU admission are unclear. This study assessed frailty’s impact on mortality and life sustaining therapy (LST) use, following ICU admission.

Methods

This single-centre retrospective observational cohort study analysed data collected prospectively in Glasgow Royal Infirmary ICU. Of 684 eligible patients, 171 were frail and 513 were non-frail. Frailty was quantified using the Rockwood Clinical Frailty Scale (CFS). All patients were followed up 1-year after ICU admission. The primary outcome was all-cause mortality at 30-days post-ICU admission. Key secondary outcomes included mortality at 1-year and LST use.

Results

Frail patients were significantly less likely to survive 30-days post-ICU admission (61.4% vs 81.1%, p < 0.001). This continued to 1-year (48.5% vs 68.2%, p < 0.001). Frailty significantly increased mortality hazards in covariate-adjusted analyses at 30-days (HR 1.56; 95%CI 1.14–2.15; p = 0.006), and 1-year (HR 1.35; 95%CI 1.03–1.76; p = 0.028). Single-point CFS increases were associated with a 30-day mortality hazard of 1.23 (95%CI 1.13–1.34; p < 0.001) in unadjusted analyses, and 1.11 (95%CI 1.01–1.22; p = 0.026) after covariate adjustment. Frail patients received significantly more days of LST (median[IQR]: 5[3,11] vs 4[2,9], p = 0.008).

Conclusion

Frailty was significantly associated with greater mortality at all time points studied, but most notably in the first 30-days post-ICU admission. This was despite greater LST use. The accrual effect of frailty increased adverse outcomes. Point-by-point use of frailty scoring could allow for more informed decision making in ICU.
Acute myeloid leukemia with CPSF6–RARG fusion resembling acute promyelocytic leukemia with extramedullary infiltration
Authors: Han Xiaoyan , Jin Chunxiang , Zheng Gaofeng , Li Yi , Wang Yungui , Zhang Enfan , Zhu Honghu , Cai Zhen
Published: January 2021

Some subtypes of acute myeloid leukemia (AML) share morphologic, immunophenotypic, and clinical features of acute promyelocytic leukemia (APL), but lack a PML–RARA (promyelocytic leukemia–retinoic acid receptor alpha) fusion gene. Instead, they have the retinoic acid receptor beta (RARB) or retinoic acid receptor gamma (RARG) rearranged. Almost all of these AML subtypes exhibit resistance to all-trans retinoic acid (ATRA); undoubtedly, the prognosis is poor. Here, we present an AML patient resembling APL with a novel cleavage and polyadenylation specific factor 6 ( CPSF6) –RARG fusion, showing resistance to ATRA and poor response to chemotherapy with homoharringtonine and cytarabine. Simultaneously, the patient also had extramedullary infiltration.
Active Participation of E-Consumer: A Qualitative Analysis From Fashion Retailer Perspective
Authors: Lorenzo-Romero Carlota , Andrés-Martínez María-Encarnación , Cordente-Rodríguez María , Gómez-Borja Miguel Ángel
Published: January 2021

This work aims to study the web innovation strategies used by Spanish companies in the fashion and accessories sector, with the specific aim of analyzing co-creation as an innovation strategy so that this link with customers will improve efficiency and effectiveness in decision-making. Qualitative research was carried out through in-depth interviews with Spanish professionals and companies in the fashion and accessories sector. Then, a theoretical model was proposed. This model integrates value co-creation, social networking, participation, engagement, feedback, and other variables. This qualitative analysis has relevant value for the professional sector because there are many papers from consumers’ perspective; however, studies from the retail sector’s perspective are less common in the literature. This study contributes ideas for the strategy of co-participation with clients to improve the activity and management of fashion companies.
Real-World Experiences With Yoga on Cancer-Related Symptoms in Women With Breast Cancer
Authors: Patel Shruti R , Zayas Jacqueline , Medina-Inojosa Jose R , Loprinzi Charles , Cathcart-Rake Elizabeth J , Bhagra Anjali , Olson Janet E , Couch Fergus J , Ruddy Kathryn J
Published: January 2021

Purpose

Integrative therapies such as yoga are potential treatments for many psychological and physical symptoms that occur during and/or after treatment for cancer. The purpose of the current study was to evaluate the patient-perceived benefit of yoga for symptoms commonly experienced by breast cancer survivors.

Methods

1,049 breast cancer survivors who had self-reported use of yoga on a follow up survey, in an ongoing prospective Mayo Clinic Breast Disease Registry (MCBDR), received an additional mailed yoga-focused survey asking about the impact of yoga on a variety of symptoms. Differences between pre- and post- scores were assessed using Wilcoxon Signed Rank Test.

Results

802/1,049 (76%) of women who were approached to participate, consented and returned the survey. 507/802 (63%) reported use of yoga during and/or after their cancer diagnosis. The vast majority of respondents (89.4%) reported some symptomatic benefit from yoga. The most common symptoms that prompted the use of yoga were breast/chest wall pain, lymphedema, and anxiety. Only 9% of patients reported that they had been referred to yoga by a medical professional. While the greatest symptom improvement was reported with breast/chest wall pain and anxiety, significant improvement was also perceived in joint pain, muscle pain, fatigue, headache, quality of life, hot flashes, nausea/vomiting, depression, insomnia, lymphedema, and peripheral neuropathy, (all p-values <0.004).

Conclusion

Data supporting the use of yoga for symptom management after cancer are limited and typically focus on mental health. In this study, users of yoga often reported physical benefits as well as mental health benefits. Further prospective studies investigating the efficacy of yoga in survivorship are warranted.
Effectiveness of Antianxiety Drugs on Postoperative Pain Perception After Implant Placement: An In Vivo Study
Authors: Tulsani Minal Gopal , Ganapathy Dhanraj , Rupawat Divya , Devi Sanjana
Published: January 2021

Aim:

To evaluate the effectiveness of midazolam and zolpidem on postoperative pain perception in patients undergoing implant placement.

Materials and Methods:

In the present in vivo study 60 patients undergoing implant placement were selected based on the inclusion criteria framed and were randomly allocated using sequentially numbered, opaque, and sealed envelope (SNOSE) method into 3 groups with 20 patients each after obtaining informed consent. Group A was the control group, Group B received midazolam 7.5 mg 30 minutes before the procedure. Group C received zolpidem 5 mg 30 minutes before the procedure. The anxiety level of patients was recorded using the Corah scale and postoperative pain was recorded after 2 hours of implant placement using the VAS scale. Statistical analysis was done using analysis of variance (ANOVA), one-way multivariate analysis of variance (one-way MANOVA), and then Tukey’s Honestly Significant Difference (HSD) test for comparison among groups at the 0.05 level of significance.

Results:

Group A had a mean anxiety level of 16 ± 1.451, Group B had a mean anxiety level of 11.2 ± 2.858, and Group C had a mean anxiety level of 13 ± 2.9019 and a statistically significant difference between the groups was observed ( P < .05). The mean for the postoperative pain perception for Group A was 6.8 ± 1.1965, for Group B was 3.8 ± 1.3611, and Group C was 5 ± 1.451 and a statistically significant difference between the groups was observed ( P < .05).

Conclusion:

This study concluded that both midazolam and zolpidem significantly reduced anxiety levels and postoperative pain in patients undergoing implant placement.
Patient and Provider Satisfaction With Telemedicine in Otolaryngology
Authors: Riley Phoebe Elizabeth , Fischer Jakob L. , Nagy Ryan E. , Watson Nora L. , McCoul Edward D. , Tolisano Anthony M. , Riley Charles A.
Published: January 2021

Objective

The objective of this study is to evaluate patient and provider satisfaction with telemedicine encounters across 3 otolaryngology practices.

Study Design

Cross‐sectional survey.

Setting

A military community hospital, an academic military hospital, and a nonmilitary academic center.

Methods

A telephone‐based survey of patients undergoing telemedicine encounters for routine otolaryngology appointments was performed between April and July 2020. Patients were asked about their satisfaction, the factors affecting care, and demographic information. A provider survey was emailed to staff otolaryngologists. The survey asked about satisfaction, concerns for reimbursement or liability, encounters best suited for telemedicine, and demographic information. The results were analyzed with descriptive statistics and a multivariable logistic linear regression model to determine odds ratios.

Results

A total of 325 patients were surveyed, demonstrating high satisfaction with telemedicine (average score, 4.49 of 5 [best possible answer]). Patients perceived “no negative impact” or “minor negative impact” on the encounter due to the lack of a physical examination or face‐to‐face interaction (1.86 and 1.95 of 5, respectively). High satisfaction was consistent across groups for distance to travel, age, and reason for referral. A total of 25 providers were surveyed, with an average satisfaction score of 3.44 of 5. Providers reported “slight” to “somewhat” concern about reimbursement (40%) and liability (32%).

Conclusion

Given patients’ and providers’ levels of satisfaction, there is likely a role for telemedicine in otolaryngology practice that may benefit patient care independent of the COVID‐19 pandemic.
ROR1 targeting with the antibody-drug conjugate VLS-101 is effective in Richter syndrome patient–derived xenograft mouse models
Authors: Vaisitti Tiziana , Arruga Francesca , Vitale Nicoletta , Lee Thanh-Trang , Ko Mira , Chadburn Amy , Braggio Esteban , Di Napoli Arianna , Iannello Andrea , Allan John N. , Miller Langdon L. , Lannutti Brian J. , Furman Richard R. , Jessen Katti A. , Deaglio Silvia
Published: January 2021

Richter syndrome (RS) represents the transformation of chronic lymphocytic leukemia (CLL), typically to an aggressive lymphoma. Treatment options for RS are limited and the disease is often fatal. Receptor tyrosine kinase–like orphan receptor 1 (ROR1) is expressed on CLL cells and other cancers but not on healthy adult tissues, making it an attractive, tumor-specific therapeutic target. VLS-101 is being developed as an antibody-drug conjugate (ADC) for therapy of ROR1-expressing (ROR1+) cancers. VLS-101 comprises UC-961 (a humanized immunoglobulin G1 monoclonal antibody that binds an extracellular epitope of human ROR1), a maleimidocaproyl-valine-citrulline-para-aminobenzoate linker, and the antimicrotubule cytotoxin monomethyl auristatin E (MMAE). VLS-101 binding to ROR1 results in rapid cellular internalization and delivery of MMAE to induce tumor cell death. We studied 4 RS patient-derived xenografts (RS-PDXs) with varying levels of ROR1 expression (11%, 32%, 85%, and 99% of cells). VLS-101 showed no efficacy in the lowest-expressing RS-PDX but induced complete remissions in those with higher levels of ROR1 expression. Responses were maintained during the posttherapy period, particularly after higher VLS-101 doses. In systemic ROR1+ RS-PDXs, VLS-101 dramatically decreased tumor burden in all RS-colonized tissues and significantly prolonged survival. Animals showed no adverse effects or weight loss. Our results confirm ROR1 as a target in RS and demonstrate the therapeutic potential of using an ADC directed toward ROR1 for the treatment of hematological cancers. A phase 1 clinical trial of VLS-101 (NCT03833180) is ongoing in patients with RS and other hematological malignancies.
Assessment of recent evidence for the management of patients with systemic sclerosis-associated interstitial lung disease: a systematic review
Authors: Hoffmann-Vold Anna-Maria , Maher Toby M. , Philpot Edward E. , Ashrafzadeh Ali , Distler Oliver
Published: January 2021

This systematic review summarises current evidence to help guide treatment decisions for patients with systemic sclerosis (SSc)-associated interstitial lung disease (ILD). A systematic search of the literature (January 2012 to April 2018), including grey literature (searched between 1992 and 2011), was conducted using multiple electronic databases. Guidelines, meta-analyses, randomised controlled trials and observational studies reporting on risk stratification, screening, diagnosis, treatment and management outcomes for patients with SSc-ILD were included. A quality assessment of the included evidence was undertaken.

In total, 2464 publications were identified and 280 included. Multiple independent risk factors for ILD in patients with SSc were identified, including older age, male sex and baseline pulmonary function. High-resolution computed tomography (HRCT) has been used for characterising ILD in patients with SSc, and pulmonary function tests are a key adjunctive component in the diagnostic and monitoring pathway. The clinical value of biomarkers relating to SSc-ILD diagnosis or assessment for disease progression is unknown at present. Immunosuppressive therapy (monotherapy or combined therapy) is the current standard of care for SSc-ILD; long-term evidence for effective and safe treatment of SSc-ILD is limited.

Identification of patients at risk for SSc-ILD remains challenging. HRCT and pulmonary function tests are key to diagnosing and monitoring for disease progression. Although immunosuppressive therapy is considered current first-line treatment, it is partly associated with adverse effects and long-term follow-up evidence is limited. Novel therapies and biomarkers should be further explored in well-controlled clinical studies.
Respiratory impedance measured using impulse oscillometry in a healthy urban population
Authors: Berger Kenneth I. , Wohlleber Margaret , Goldring Roberta M. , Reibman Joan , Farfel Mark R. , Friedman Stephen M. , Oppenheimer Beno W. , Stellman Steven D. , Cone James E. , Shao Yongzhao
Published: January 2021

This study derives normative prediction equations for respiratory impedance in a healthy asymptomatic urban population using an impulse oscillation system (IOS). In addition, this study uses body mass index (BMI) in the equations to describe the effect of obesity on respiratory impedance.

Data from an urban population comprising 472 healthy asymptomatic subjects that resided or worked in lower Manhattan, New York City were retrospectively analysed. This population was the control group from a previously completed case–control study of the health effects of exposure to World Trade Center dust. Since all subjects underwent spirometry and oscillometry, these previously collected data allowed a unique opportunity to derive normative prediction equations for oscillometry in an urban, lifetime non-smoking, asymptomatic population without underlying respiratory disease.

Normative prediction equations for men and women were successfully developed for a broad range of respiratory oscillometry variables with narrow confidence bands. Models that used BMI as an independent predictor of oscillometry variables (in addition to age and height) demonstrated equivalent or better fit when compared with models that used weight. With increasing BMI, resistance and reactance increased compatible with lung and airway compression from mass loading.

This study represents the largest cohort of healthy urban subjects assessed with an IOS device. Normative prediction equations were derived that should facilitate application of IOS in the clinical setting. In addition, the data suggest that modelling of lung function may be best performed using height and BMI as independent variables rather than the traditional approach of using height and weight.
Safety and efficacy of mini-percutaneous nephrolithotomy as daycare procedure: a prospective observational study
Authors: Aarthy P. , Thangarasu Mathisekaran , Prakash J. Sanjay , Raghavan Deepak , Jain Nitesh , Balakrishnan Arunkumar , Chandranathan M. , Bafna Sandeep , Paul Rajesh , Selvaraj Nivash
Published: January 2021

Background

To evaluate the safety, feasibility of mini-percutaneous nephrolithotomy (mPCNL) being carried out as a daycare surgery and to study the re-admission, stone clearance rate and complication rates following mPCNL. We also sought to find out the rate of requirement of ancillary procedure, after mPCNL.

Methods

In this prospective observational study, easily accessible patients above 18 years of age with renal and/or upper ureteric calculi, who underwent mPCNL between September 2018 and February 2020, were included. Seventy patients were selected, as per statistical methods. Preoperative evaluation including history, blood and urine investigations and radiological images was collected. Intra-operative and post-operative events were analyzed. Written consent was obtained from the patients to participate in the study and to publish their data. Institutional Ethical and scientific committee clearance was obtained.

Results

Out of 70 patients who underwent mPCNL in the study, in the age group ranging from 24–68 years, most of the cases were partial staghorn with maximum size of stone up to about 3.5 cm. Inferior calyx was most frequently punctured. Six cases had multipuncture mPCNL, four patients had bilateral procedure, and two had supra-costal puncture. Eighteen patients had tubeless mPCNL, of which four were totally tubeless procedures. Four patients had hematuria, none requiring transfusion. Two patients had sepsis, managed with higher antibiotics. Limitation of the study was the sample size. To derive a sturdy conclusion, large scale studies are recommended.

Conclusions

We can conclude that mPCNL can be safely done as daycare or ambulatory surgery in properly selected patients. In centers with experienced urologists, bilateral and multipuncture mPCNL can be done as an ambulatory surgery. Thus, this addresses the stone disease as well as cost containment, without patient safety being compromised. Bed occupancy rate is reduced, helping effective utilization of hospital resources.
Pathological correlation between prostate biopsies and the radical prostatectomy, about 30 cases
Authors: Aboubakry Sow , Fadl Tazi Mohammed , Moustapha Ahsaini , Soufiane Mellas , Eddine El Ammari Jalal , Jamal El Fassi Mohammed , Hassan Farih My
Published: January 2021

Background

Since the advent of the massive prostate-specific antigen (PSA) testing, prostate cancer has become a major public health problem. It is currently the most common cancer and the second leading cause of cancer death in men. The diagnosis is based on the histopathological study of prostate biopsies. The aim of our work was to study the correlation of the grade group (GG) using the ISUP 2016 classification between the prostate needle biopsies and radical prostatectomy specimen.

Methods

This was a retrospective study of 30 patients. We studied the correlation of the grade group (GG) according to the new classification ISUP (2016) between prostate biopsies and radical prostatectomy specimen.

Results

The average age of our patients was 65 years, the diagnosis was discovered on an individual screening in 15% of the cases, and 65% of our patients were diagnosed with LUTS due to an associated benign prostatic hyperplasia. The average PSA level in our study was 11 ng/ml. In the biopsies group, the grade 1 and 2 groups were in the majority with 40% of the cases each of them. We noted that GG 3 (Gleason 4 + 3) was represented in 16.66% of cases, while GG4 was only present in 3% of cases. On the prostatectomy specimen group, GG1 was represented in 33.33% of cases, GG2 in 40% of cases and GG3 in 20% of cases. GG4 was represented in 6.66% of cases. Among GG1 patients, identical staging was noted in 75% of cases, and under-staging in 25% of cases. For GG2 patients, over-staging in 8.3% of cases, identical staging in 83.3% of cases and under-staging of 8.3%. Among GG 3 patients, there was an 80% identical staging, while an under-staging was present in 20% of cases. The GG 4 is perfectly correlated. Combining all groups in our study, we noted an exact staging in 80% of the cases, an under-staging in 16.33% of the cases, and an over-staging in 3.33% of the cases. The Kappa concordance index was 0.4.

Conclusions

The correlation of the grade group between the prostate biopsies and the radical prostatectomy specimen was imperfect; the more the cancer increases in the grade group, the better was the correlation.
LncRNAs and their regulatory networks in breast muscle tissue of Chinese Gushi chickens during late postnatal development
Authors: Li Yuanfang , Jin Wenjiao , Zhai Bin , Chen Yi , Li Guoxi , Zhang Yanhua , Guo Yujie , Sun Guirong , Han Ruili , Li Zhuanjian , Li Hong , Tian Yadong , Liu Xiaojun , Kang Xiangtao
Published: January 2021

Background

Chicken skeletal muscle is an important economic product. The late stages of chicken development constitute the main period that affects meat production. LncRNAs play important roles in controlling the epigenetic process of growth and development. However, studies on the role of lncRNAs in the late stages of chicken breast muscle development are still lacking. In this study, to investigate the expression characteristics of lncRNAs during chicken muscle development, 12 cDNA libraries were constructed from Gushi chicken breast muscle samples from 6-, 14-, 22-, and 30-week-old chickens.

Results

A total of 1252 new lncRNAs and 1376 annotated lncRNAs were identified. Furthermore, 53, 61, 50, 153, 117, and 78 DE-lncRNAs were found in theW14vs.W6, W22vs.W14, W22vs.W6, W30vs.W6, W30vs.W14, andW30vs.W22comparison groups, respectively. After GO enrichment analysis of the DE-lncRNAs, several muscle development-related GO terms were found in theW22vs.W14comparison group. Moreover, it was found that the MAPK signaling pathway was one of the most frequently enriched pathways in the different comparison groups. In addition, 12 common target DE-miRNAs of DE-lncRNAs were found in different comparison groups, some of which were muscle-specific miRNAs, such as gga-miR-206, gga-miR-1a-3p, and miR-133a-3p. Interestingly, the precursors of four newly identified miRNAs were found to be homologous to lncRNAs. Additionally, we found some ceRNA networks associated with muscle development-related GO terms. For example, the ceRNA networks contained theDYNLL2gene with 12 lncRNAs that targeted 2 miRNAs. We also constructed PPI networks, such asIGF-I-EGFandFZD6-WNT11.

Conclusions

This study revealed, for the first time, the dynamic changes in lncRNA expression in Gushi chicken breast muscle at different periods and revealed that the MAPK signaling pathway plays a vital role in muscle development. Furthermore,MEF2Cand its target lncRNA may be involved in muscle regulation through the MAPK signaling pathway. This research provided valuable resources for elucidating posttranscriptional regulatory mechanisms to promote the development of chicken breast muscles after hatching.
Comparison of rectal swab, glove tip, and participant-collected stool techniques for gut microbiome sampling
Authors: Short Meghan I. , Hudson Robert , Besasie Benjamin D. , Reveles Kelly R. , Shah Dimpy P. , Nicholson Susannah , Johnson-Pais Teresa L. , Weldon Korri , Lai Zhao , Leach Robin J. , Fongang Bernard , Liss Michael A.
Published: January 2021

Background

Studies of the gut microbiome are becoming increasingly important. Such studies require stool collections that can be processed or frozen in a timely manner so as not to alter the microbial content. Due to the logistical difficulties of home-based stool collection, there has been a challenge in selecting the appropriate sample collection technique and comparing results from different microbiome studies. Thus, we compared stool collection and two alternative clinic-based fecal microbiome collection techniques, including a newer glove-based collection method.

Results

We prospectively enrolled 22 adult men from our prostate cancer screening cohort SABOR (San Antonio Biomarkers of Risk for prostate cancer) in San Antonio, TX, from 8/2018 to 4/2019. A rectal swab and glove tip sample were collected from each participant during a one-time visit to our clinics. A single stool sample was collected at the participant’s home. DNA was isolated from the fecal material and 16 s rRNA sequencing of the V1-V2 and V3-V4 regions was performed. We found the gut microbiome to be similar in richness and evenness, noting no differences in alpha diversity among the collection methods. The stool collection method, which remains the gold-standard method for the gut microbiome, proved to have different community composition compared to swab and glove tip techniques (p< 0.001) as measured by Bray-Curtis and unifrac distances. There were no significant differences in between the swab and glove tip samples with regard to beta diversity (p> 0.05). Despite differences between home-based stool and office-based fecal collection methods, we noted that the distance metrics for the three methods cluster by participant indicating within-person similarities. Additionally, no taxa differed among the methods in a Linear Discriminant Analysis Effect Size (LEfSe) analysis comparing all-against-all sampling methods.

Conclusion

The glove tip method provides similar gut microbiome results as rectal swab and stool microbiome collection techniques. The addition of a new office-based collection technique could help easy and practical implementation of gut microbiome research studies and clinical practice.