bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of Fluoroquinolones or Sulfamethoxazole-Trimethoprim Compared to Β-Lactams for Oral Step-Down Therapy in Hospitalized Patients With Uncomplicated Enterobacterales Bacteremia
Authors: Mack Tyler , Hiles Jon J. , Wrin Justin , Desai Armisha
Published: June 2022

Background

Antibiotic therapy for uncomplicated Enterobacterales bacteremia from a urinary source has traditionally consisted of fluoroquinolones (FQs) and sulfamethoxazole-trimethoprim (SXT). However, adverse events associated with FQs and emerging antimicrobial resistance have led to alternative agents, specifically oral Β-lactams (OBLs), being utilized despite concern of subtherapeutic serum concentrations related to their low relative bioavailability.

Objective

To compare efficacy of antibiotic therapies with bioavailability differences in patients with uncomplicated bacteremia from a urinary source.

Methods

This was a retrospective study comparing clinical efficacy in hospitalized adult patients receiving OBL or FQ/SXT. Patients were required to receive at least 48 hours of appropriate intravenous antibiotic therapy and at least one dose of oral therapy. The primary outcome was all-cause hospital readmission within 30 days of discharge. Secondary outcomes included readmission with recurrent infectious etiology and readmission due to Clostridioides difficile infection.

Results

Of 210 eligible patients, 91 received FQ/SXT and 119 received OBL. There was no difference between the groups in all-cause hospital readmission (FQ/SXT: 16.5%; OBL: 14.3%) ( P = 0.660 [95% confidence interval, CI = −0.076, 0.120]) or readmission with recurrent bacteremia (FQ/SXT: 0%; OBL: 3.4%) ( P = 0.135). There was a significant difference in repeat hospital admission with recurrent urinary tract infection (UTI) (FQ/SXT: 0%, OBL: 5.0%) ( P = 0.037).

Conclusion and Relevance

OBLs appear to be non-inferior to FQ/SXT in the rate of all-cause hospital readmission within 30 days. However, OBLs may be associated with increased readmissions with recurrent UTI.
Antisemitic Attitudes Across the Ideological Spectrum
Authors: Hersh Eitan , Royden Laura
Published: June 2022

Concern about antisemitism in the U.S. has grown following recent rises in deadly assaults, vandalism, and harassment. Public accounts of antisemitism have focused on both the ideological right and left, suggesting a “horseshoe theory” in which the far left and the far right hold a common set of anti-Jewish prejudicial attitudes that distinguish them from the ideological center. However, there is little quantitative research evaluating left-wing versus right-wing antisemitism. We conduct several experiments on an original survey of 3500 U.S. adults, including an oversample of young adults. We oversampled young adults because unlike other forms of prejudice that are more common among older people, antisemitism is theorized to be more common among younger people. Contrary to the expectation of horseshoe theory, the data show the epicenter of antisemitic attitudes is young adults on the far right.
Development of the Mental Health Support Scale: A New Measure of Mental Health First Aid Behaviors
Authors: Morgan Amy J. , Wright Judith , Mackinnon Andrew J. , Reavley Nicola J. , Rossetto Alyssia , Jorm Anthony F.
Published: June 2022

Mental health first aid (MHFA) courses teach community members the knowledge and skills needed to recognize and respond to mental health problems until professional help is received or the crisis resolves. This study aimed to develop a reliable and valid measure of MHFA behaviors. A pool of actions that were recommended and not recommended were selected from MHFA guidelines and developed into two scales measuring either intended or provided support. Items were tested with a sample of 697 adults. Item response theory guided the selection of final items. The Mental Health Support Scale (MHSS) Intended version has 23 items across two subscales and the MHSS–Provided has 12 items across two subscales. These scales demonstrated convergent validity, discrimination between respondents with and without MHFA expertise, and acceptable measurement precision across a range of skill levels. Overall, findings suggest that the MHSS is a valid and useful measure of MHFA behaviors.
Startle Disease: New Molecular Insights into an Old Neurological Disorder
Authors: Schaefer Natascha , Harvey Robert J. , Villmann Carmen
Published: June 2022

Startle disease (SD) is characterized by enhanced startle responses, generalized muscle stiffness, unexpected falling, and fatal apnea episodes due to disturbed feedback inhibition in the spinal cord and brainstem of affected individuals. Mutations within the glycine receptor (GlyR) subunit and glycine transporter 2 (GlyT2) genes have been identified in individuals with SD. Impaired inhibitory neurotransmission in SD is due to pre- and/or postsynaptic GlyR or presynaptic GlyT2 dysfunctions. Previous research has focused on mutated GlyRs and GlyT2 that impair ion channel/transporter function or trafficking. With insights provided by recently solved cryo–electron microscopy and X-ray structures of GlyRs, a detailed picture of structural transitions important for receptor gating has emerged, allowing a deeper understanding of SD at the molecular level. Moreover, studies on novel SD mutations have demonstrated a higher complexity of SD, with identification of additional clinical signs and symptoms and interaction partners representing key players for fine-tuning synaptic processes. Although our knowledge has steadily improved during the last years, changes in synaptic localization and GlyR or GlyT2 homeostasis under disease conditions are not yet completely understood. Combined proteomics, interactomics, and high-resolution microscopy techniques are required to reveal alterations in receptor dynamics at the synaptic level under disease conditions.
Substance-Related Problems in Adolescents with ADHD-Diagnoses: The Importance of Self-Reported Conduct Problems
Authors: Heradstveit Ove , Askeland Kristin Gärtner , Bøe Tormod , Lundervold Astri Johansen , Elgen Irene Bircow , Skogen Jens Christoffer , Pedersen Mads Uffe , Hysing Mari
Published: June 2022

Background:

Attention-deficit/hyperactivity disorder (ADHD) is a known risk factor for substance-related problems (SRP) during adolescence, but the nature of this relationship and the importance of co-occurring conduct problems are not fully understood.

Methods:

Data stem from a linked dataset between a large population-based survey conducted in 2012 of Norwegian adolescents aged 16 to 19, and registry-based data from specialized child and adolescent mental health services ( n = 9,411).

Results:

Adolescents with “ADHD + high conduct problems” had increased risk of SRP (odds ratios = 2.37–10.14). Adolescents with “ADHD only” had very similar risk of SRP as adolescents from the general population with low symptoms of conduct problems. Relative to boys, girls with “ADHD + high conduct problems” appeared to have somewhat higher risk for SRP.

Conclusion:

The present study suggests that the risk for SRP among adolescent with ADHD is largely driven by co-existing conduct problems.
Behavioral Sleep Interventions for Children With ADHD: A Systematic Review and Meta-Analysis
Authors: Malkani Maya K. , Pestell Carmela F. , Sheridan Andrew M. C. , Crichton Alison J. , Horsburgh Georgia C. , Bucks Romola S.
Published: June 2022

Objective:

To evaluate intervention characteristics and components within behavioral sleep interventions in school-aged children with ADHD and examine evidence related to effectiveness.

Method:

A systematic review was conducted using PsycINFO, Embase, MEDLINE, PubMed, and OpenGray. The subsequent meta-analysis used sleep outcomes to produce comparable effect sizes (Hedges’ g) and compare intervention effects between randomized controlled trials and pre-post studies.

Results:

Eleven articles satisfied the inclusion criteria (562 children, across all groups, aged 5–14 years, M = 8.71). Studies reported improvements in sleep although there was marked heterogeneity between studies and limited use of objective sleep measures within them. On average, intervention groups improved more than control groups in the five randomized controlled trials (−0.46, 95% CI = [−0.58, −0.35], k = 4).

Conclusion:

The findings support the use of behavioral sleep interventions for school-aged children with ADHD. Findings suggest that brief, individualized intervention may be more effective than standardized.
Exploring Intended and Unintended Reactions to Healthy Weight and Lifestyle Advertisements: An Online Experiment
Authors: Jongenelis Michelle , Dixon Helen , Scully Maree , Morley Belinda
Published: June 2022

Background

To address concerns that healthy weight and lifestyle campaigns (HWLCs) could have unintended psychological or behavioral consequences, this study tested reactions to TV advertisements from two HWLCs: LiveLighter® (employs graphic health effects messaging) and Swap It Don’t Stop It (employs animation and light-hearted messaging).

Methods

An online between-subjects experiment tested reactions to one of five advertisements: “Toxic Fat”; “Sugary Drinks” (both from LiveLighter); “Become a Swapper”; “How to Swap It” (both from Swap It); and “HSBC Bank” (control) among 2,208 adults from Western Australia and Victoria, Australia. Responses assessed were cognitive and emotional reactions, behavioral intentions, internalized weight bias, antifat attitudes, self-esteem and body dissatisfaction.

Results

The HWLC advertisements prompted favorable cognitive reactions and weak to neutral positive and negative emotional responses. HWLC advertisements promoted stronger intentions to engage in adaptive lifestyle behaviors compared with the control advertisement. Intention to engage in maladaptive behaviors (e.g., skipping meals) was low overall and did not differ by condition. Compared with the control condition, participants who saw LiveLighter “Sugary Drinks” showed weaker disagreement with antifat attitudes; however, mean antifat attitude scores were still at the low end of the scale. HWLC advertisements did not promote internalized weight bias, reduced self-esteem or body dissatisfaction compared with the control advertisement.

Conclusions

Overall, HWLC advertisements performed favorably compared with the control advertisement and showed no clear evidence of adverse impacts. Findings suggest HWLC advertisements may not promote negative psychological and behavioral consequences and can continue to be used in obesity prevention efforts.
Role of platelet factor 4 in arteriovenous fistula maturation failure: What do we know so far?
Authors: Xiao Yuxuan , Vazquez-Padron Roberto I , Martinez Laisel , Singer Harold A , Woltmann Daniel , Salman Loay H
Published: June 2022

The rate of arteriovenous fistula (AVF) maturation failure remains unacceptably high despite continuous efforts on technique improvement and careful pre-surgery planning. In fact, half of all newly created AVFs are unable to be used for hemodialysis (HD) without a salvage procedure. While vascular stenosis in the venous limb of the access is the culprit, the underlying factors leading to vascular narrowing and AVF maturation failure are yet to be determined. We have recently demonstrated that AVF non-maturation is associated with post-operative medial fibrosis and fibrotic stenosis, and post-operative intimal hyperplasia (IH) exacerbates the situation. Multiple pathological processes and signaling pathways are underlying the stenotic remodeling of the AVF. Our group has recently indicated that a pro-inflammatory cytokine platelet factor 4 (PF4/CXCL4) is upregulated in veins that fail to mature after AVF creation. Platelet factor 4 is a fibrosis marker and can be detected in vascular stenosis tissue, suggesting that it may contribute to AVF maturation failure through stimulation of fibrosis and development of fibrotic stenosis. Here, we present an overview of the how PF4-mediated fibrosis determines AVF maturation failure.
Retuning music teaching: Online music tutorials preferences as predictors of amateur musicians’ music self-efficacy in informal music learning
Authors: Vaizman Tal , Harpaz Gal
Published: June 2022

Music self-efficacy has been acknowledged as a strong predictor of successful performance among musicians and music students, but is less researched among amateur musicians. The purpose of this study is to examine the connection between music self-efficacy and learning and playing habits of amateur musicians who had preferences for online music tutorials as an informal learning technique. Two hundred and twenty-two amateur musicians completed four research questionnaires: (a) a general background questionnaire including learning and playing habits, (b) music self-efficacy, (c) self-esteem, and (d) online music tutorials users’ preferences, which distinguish between autonomy online music tutorials (fostering independent learners, incorporating context, and background) and dependent online music tutorials (offering mainly imitation options and providing little further knowledge). The results of the study supported the hypotheses, which predicted high music self-efficacy to be associated with the use of autonomy online music tutorials, co-playing, studying with a teacher, and self-esteem, and low music self-efficacy to be associated with the use of dependent online music tutorials. As music self-efficacy is crucial for students’ learning processes, we argue that music educators could refer students to optimal use of online music tutorials, thus fostering autonomous learners. Further research is required for clarifying the impact of personal characteristics and playing habits among amateur musicians on their music self-efficacy.
Sluggish cognitive tempo: Association with neuropsychological test scores, motor incoordination, and dysgraphia in elementary school children
Authors: Mayes Susan D , Bangert Lauren , Kallus Rachel , Fosco Whitney , Calhoun Susan L , Waschbusch Daniel A
Published: June 2022

Research on the relationship between sluggish cognitive tempo (SCT) and scores on neuropsychological tests (such as those measuring processing speed and reaction time) is inconclusive, and the association between SCT and motor incoordination and dysgraphia has not been objectively investigated. Mothers of 413 elementary school children (6–12 years of age) rated their children on the Pediatric Behavior Scale (PBS), which yields psychological problem scores, including SCT. Children were administered an extensive battery of neuropsychological tests assessing processing and performance speed, working memory, immediate and delayed recall, sustained attention, response inhibition, cognitive flexibility, fine motor manipulative skill, verbal fluency and retrieval, set shifting, and interference control, as well as intelligence and reading and math achievement. Only three of the 19 correlations between SCT and neuropsychological scores were significant, and all involved graphomotor tests (two timed and one untimed). In regression analysis, the strongest independent predictor of SCT was the maternal PBS incoordination factor score, followed by ratings of autism, inattention, and depression. Neuropsychological test scores did not contribute significantly more to predicting SCT. Among the incoordination PBS factor items, clumsy and draws or writes poorly were significant SCT predictors. Our novel and unexpected findings showed that motor incoordination was a stronger correlate of SCT than other variables assessed in our study, including those previously linked with SCT. Future SCT research needs to include measures of incoordination and dysgraphia in order to replicate and expand upon the current findings. Our results suggest that SCT traits are not reliably measured by currently available neuropsychological tests.
The experiences of parents raising children with developmental disabilities in Ethiopia
Authors: Tekola Bethlehem , Kinfe Mersha , Girma Bayouh Fikirte , Hanlon Charlotte , Hoekstra Rosa A
Published: June 2022

The experiences of parents raising children with developmental disabilities have been widely researched, although most of this research comes from Western, high-income countries. In comparison, little is known about the lived experiences of parents of children with developmental disabilities in low- and middle-income countries and in Africa in particular. Parents’ lived experiences can provide insights into local conceptualizations of developmental disabilities, challenges children and their families face and their needs. This study explores the experiences of parents (14 mothers and 4 fathers) raising children with developmental disabilities in urban and rural Ethiopia using in-depth interviews. Cultural and religious beliefs played a role in the types of delays or differences in their child’s development that parents noticed early and the kinds of support they sought. Parents experienced stigma and lack of understanding from others. Their experiences regarding some of the challenges they faced such as lack of appropriate services varied based on where they lived (urban or rural). Single mothers especially were faced with multiple and intersecting struggles including poverty, stigma, and lack of social support. Implications for future research and interventions that aim to increase knowledge about developmental disabilities, tackle stigma and improve the lives of children and their families are discussed.

Lay abstract

The experiences of parents raising children with developmental disabilities have been widely researched, although most of this research comes from Western, high-income countries. In comparison, little is known about the lived experiences of parents of children with developmental disabilities in low- and middle-income countries and in Africa in particular. We interviewed 14 mothers and 4 fathers in Addis Ababa and the rural town of Butajira to explore what life is like for parents caring for children with developmental disabilities in Ethiopia. Cultural and religious beliefs played a role in the types of delays or differences in their child’s development that parents noticed early and the kinds of support they sought. Parents experienced stigma and lack of understanding from others. Their experiences regarding some of the challenges they faced such as lack of appropriate services varied based on where they lived (urban or rural). Single mothers especially were faced with multiple struggles including poverty, stigma, and lack of social support. Implications for future research and interventions that aim to increase knowledge about developmental disabilities, tackle stigma and improve the lives of children and their families are discussed.
The autistic experience of homelessness: Implications from a narrative enquiry
Authors: Stone Beth , Cameron Ailsa , Dowling Sandra
Published: June 2022

Emerging research suggests autistic people are disproportionately represented in homeless populations. Less is known about how autistic people experience homelessness and what prevents them from exiting homelessness. This article presents findings from a narrative enquiry investigating the link between autism and homelessness. Ten autistic adults consented to participate in narrative interviews which explored their life histories and pathways through homelessness. This article considers how participants experienced rough sleeping and sofa surfing before attempting to access hostels. It then examines how participants navigated support systems, arguing that barriers to accessing services perpetuated homelessness. Because of these barriers, some participants disengaged with services, preferring to sleep rough. The extent to which participants could be said to have ‘chosen’ homelessness is balanced with consideration of the lack of autonomy autistic adults are able to exercise over their lives. This article concludes with discussion of practical implications for services and policy in England.

Lay Abstract

Recent research suggests many autistic people experience homelessness. However, little is known about the types of homelessness autistic people experience and what barriers autistic people face when trying to exit homelessness. This study involved gathering life stories of autistic people who had experienced homelessness. Ten autistic participants talked about their pathways through homelessness and the difficulties they had in accessing support. After first becoming homeless, participants tended to experience rough sleeping and sofa surfing. When participants approached housing and homelessness services, they were often told they were not eligible for support. This could happen when support workers were not aware of autism, or when autism was not considered ‘severe’ enough. Overcrowding, confrontation and lack of control over routine and environment were particular issues for participants when they entered homelessness hostels. Some participants chose to sleep on the streets rather than stay in environments which increased social anxiety and sensory difficulties. This study discusses ways in which homelessness and housing services can increase accessibility and improve engagement for autistic people. It is important to increase awareness of autism while understanding that autistic people who experience homelessness may have complex needs. In addition, services need to listen to autistic people with lived experience of homelessness to decide what changes will have the most impact.
Reported costs of children with medical complexity—A systematic review
Authors: Sidra Michael , Sebastianski Meghan , Ohinmaa Arto , Rahman Sholeh
Published: June 2022

Examining reported costs for Children with Medical Complexity (CMCs) is essential because costing and resource utilization studies influence policy and operational decisions. Our objectives were to (1) examine how authors identified CMCs in administrative databases, (2) compare reported costs for the CMC population in different study settings, and (3) analyze author recommendations related to reported costs. We undertook a systematic search of the following databases: Medical Literature Analysis and Retrieval System Online, Excerpta Medica dataBase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library with a focus on CMCs as a heterogeneous group. The most common method used n = 11 (41%) to identify the CMC population in administrative data was the Complex Chronic Conditions methodology. The majority of included studies reported on health care service costs n = 24 (89%). Only n = 3 (11%) of the studies included costs from the family perspective. Author recommendations included standardizing how costs are reported and including the family perspective when making care delivery or policy decisions. Health system administrators and policymakers must consider the limitations of reported costs when assessing local costing studies or comparing costs across jurisdictions.
Investigation on improving fume hood performance via elimination of internal vortices: Experiments and CFD
Authors: Meng Chuang , Liu Dong , Gao Naiping , Li Lirong
Published: June 2022

The design elements of a fume hood and the synergy between them are essential for a fume hood to be used for containment in a chemical laboratory. A computational fluid dynamic simulation with an orthogonal design was validated and executed to determine the aerodynamic characteristics of the fume hood. The ventilation efficiency, that is, the ratio of tracer gas concentration in the exhaust outlet to the hood chamber was introduced as an indicator to evaluate fume hood performance. The ventilation efficiency was found to vary between 4.7 and 12.9 with different baffle opening ratios. The designed doorsill could effectively inhibit the separation of the air boundary layer and thus avoids vortex generation behind the doorsill. The auxiliary air supply would eliminate the eddies behind the sash and could further increase the ventilation efficiency to 13.9. All the designed elements above jointly contribute to the absence of vortices in the flow pattern that is within the hood chamber. The airflow would move from top to bottom and from outside to inside, which would minimize the spread of pollutants to the breathing zone. This paper is intended to contribute to the optimization of the aerodynamic design of fume hoods in chemical laboratories.
Repurposing the Ruin to Remember: Multimodal Rhetoric and Cultural Memory in the Post–Soviet Memorial Museum
Authors: Allison Marcia Clare
Published: June 2022

The memory turn in the humanities has been crucial for understanding the rhetorical work memorials and museums perform for the state. However, the postmodern development of the hybrid memorial museum remains underexamined as a unique rhetorical artifact. In this article, I combine postmodern museology with material rhetoric and multimodal argumentation to critique the particular trend of repurposing historical buildings from the commemorated moment in question into the physical memorial museum itself. Building from previous literature exploring juxtaposition as argument, I contend that repurposing ruins into memorial museums uses authenticity to create a kisceral rhetorical juxtaposition between the ruin’s former and current life as an argumentative strategy. Such work thus makes the repurposed memorial museum both a container and rhetorical object of memory. To exemplify this, I perform a rhetorical critique in situ of the Memorial Museum of the German Division of Marienborn ( Gedenkstätte Deutsche Teilung Marienborn [GDTM]): a former East German border crossing. I show how GDTM leverages its architectural authenticity through this Janus-faced juxtaposition to curate cultural memory discourses regarding German unification. In conclusion, I posit how further post-Soviet infrastructures and other repurposed memorial museums offer a critical rhetoric that in our political climes is never more needed.
Financial Acumen Improves After Financial Literacy Training in Individuals With Substance Use Disorder
Authors: Valdes Kristin , Lunsford Dianna , Castelli Jennifer
Published: June 2022

Financial literacy is a skill that may be affected by decreased cognitive processes that arise from substance use disorder. The aim of this mixed-methods study was to determine change in financial acumen after participating in a financial literacy program. Study participants were recruited from a drug and alcohol treatment center in the Southeastern United States. A total of 31 males participated. A t-test was conducted to compare the scores on the financial tests. There was a significant difference between the financial literacy pretest ( M = 74, SD = 13.58) and posttest ( M = 84, SD = 10.50) scores; t(30) = −3.14, p = .003. Categories that emerged when participants were asked how the information would help manage their finances included: goal setting, saving, and understanding financial institutions. This study “provides preliminary evidence” that supports financial literacy program for this population and indicates that occupational therapy is a profession suited to do so.
Wet aggregate stability modeling based on support vector machine in multiuse soils
Authors: Zhai Ruizhi , Wang Jianping , Yin Deshun , Shangguan Ziheng
Published: June 2022

Accurate assessment of wet aggregate stability is critical in evaluating soil quality. However, a few general models are used to assess it. In this work, we use the support vector machine to evaluate wet aggregate stability and compare it with a benchmark model based on artificial neural networks. One hundred thirty-four soil samples from various land uses, such as crops, grasslands, and bare land are adopted to verify the effectiveness of the proposed method and confirm the valid input parameters. We select 107 samples for calibrating the prediction model and the rest for evaluation. Experiments show that organic carbon is the main control parameter of wet aggregate stability, although the most influential factors for different land use are various. Comparing the determination coefficient and the root mean square error, it proves that the support vector machine method is superior to the artificial neural network method. In addition, the relative importance analysis shows that contents of organic carbon, silt, and clay are the primary input parameters. Finally, the impact of land use and management types is evaluated.
Event model retrieval and daily interference
Authors: Radvansky Gabriel A , O’Rear Andrea E
Published: June 2022

The differential fan effect was used to assess the influence of periods of daily, generalised interference. Experiment 1 replicated the differential forgetting effect as a control for the other experiments. Experiment 2 involved fact learning in either the morning or the evening with a 12-hr testing delay. It might be expected that experiencing more generalised interference during the retention interval would impair memory, but no differences in response times were observed, and only very small differences in the error rates were observed. Experiment 3 replicated Experiment 2 but with a 24-hr delay. In this way, the influence on memory of the proximity of daily, generalised inference to the learning experience could be assessed. Although one might expect worse memory when more interference occurred closer to the learning phase, no clear differences were observed. This is consistent with the idea that event model memory is relatively stable soon after encoding.
RCA Revision
Authors: Kotecha Anish , Chawathey Kunal
Published: June 2022

Welcome to a new Recorded Consultation Assessment (RCA) revision section of the journal developed to provide focus for GP trainees preparing for the RCA. This section includes a ‘Doctor’s sheet’ and a ‘Patient’s sheet’ to facilitate practising consultations with your trainer and colleagues. An ‘Examiner’s sheet’ describes the areas trainees need to display in each of the marking domains and ﬁnishes with key points and tips for the trainee. It is important that trainees are familiar with the RCA pages on the RCGP website as this provides further highly relevant information and guidance.
Do Concepts Creep to the Left and the Right? Evidence for Ideologically Salient Concept Breadth Judgments Across the Political Spectrum
Authors: Harper Craig A. , Purser Harry , Baguley Thom
Published: June 2022

Concept creep explains how established social concepts expand to incorporate new phenomena, with such expansions fundamentally changing conceptual definitions and contributing to a loss of a shared social understanding. However, the existing work has focused on concept creep within a small number of categories that are typically more salient for those on the political left. In this work, we examined whether concept creep is a predominantly leftist phenomenon, or whether the same conceptual expansion is present for typically conservative-salient categories, by exploring judgments of concept breadth for a range of social topics. We found evidence for such symmetry when considering concept breadth for categories such as sexual deviance, terrorism, and personal responsibility—with some nuanced exceptions. We discuss our findings in relation to growing political polarization, intergroup relations, and the study of partisan differences using a variety of politically salient stimuli.
Impact of the abandonment of assistive technologies for mobility on the incidence of serious falls in older adults living at home: Results of the ECOCAT study
Authors: Sawadogo Abdoul Razak , Nys Jean-François , Tran Estelle , Gayot Caroline , Boyer Sophie , Cardinaud Noëlle , Thebaut Clémence , Tchalla Achille
Published: June 2022

Purpose

To examine the impact of discontinuing the use of assistive technology for mobility (ATM) devices on the 6-months incidence of falls in older adults (OA) living at home.

Materials and methods

A medico-socioeconomic survey was performed to collect information on the quality of life and well-being of older adults, before and 6 months after being loaned an ATM device. Personal data (medical, social, and economic) were collected via a geriatric survey.

Results

In all, 102 OA participated in the study. Over the 6-months observation period, 17 ( n = 81) serious falls were recorded among participants who were using their ATM device optimally; in those who discontinued device use, 12 falls ( n = 21) were recorded (57.1%; p = 0.001). Factors significantly associated with falls at home were living in an urban area (odds ratio [OR]: 11.46; 95% confidence interval [CI]: 1.48; 88.98; p = 0.020), an Instrumental Activities of Daily Living Scale score > 4 (OR: 34.04; 95% CI: 1.59; 727.86; p = 0.024), and discontinuation of ATM device use (OR: 17.41; 95% CI: 2.59; 117.02; p = 0.003).

Conclusion

Discontinuation of ATM device use was associated with an increased risk for serious falls.
Systemic air embolism following computed-tomography-guided transthoracic needle biopsy of lung lesion – a systematic search of case reports and case series
Authors: Pietersen Pia I , Kristjansdottir Björg , Laursen Christian , M Jørgensen Gitte , Graumann Ole
Published: June 2022

Background

Systemic air embolism is a rare, however potentially fatal, low incidence, complication to CT-guided transthoracic needle biopsy of lung lesions.

Purpose

The purpose of this review of case reports and series was to pool data about this rare complication and glance for a pattern or similarities in the patients’ initial symptoms and course, as well as the management of the patients in relation to current guidelines.

Material and methods

PubMed was searched for case reports and case series about systemic air embolisms following CT-guided transthoracic needle biopsy of lung lesions from inception to November 2021. A reviewer screened the results for eligibility and included studies which reported at least two outcomes of interest. Data was extracted by one author and a descriptive analysis was conducted.

Results

Of 1,136 studies screened, 83 were eligible for inclusion involving 97 patients. The mean age was 64.8±11.7 years and ≈60% of the patients were men. In 15 cases the outcome was fatal, and most of the fatal cases ( n = 12) had cardiac arrest as the primary initial symptom. In addition to conventional oxygen therapy, 34 patients received hyperbaric oxygen therapy, and in 30 cases the physician in charge chose to change the patient from standard supine position to – most often – Trendelenburg position.

Conclusion

No similarities were found that could lead to more rapid diagnosis or more correct management. The staff should keep systemic air embolisms in mind, when more common complications are ruled out, and consider hyperbaric oxygen therapy in case of suspicion.
Surgery for Anomalous Aortic Origin of a Coronary Artery (AAOCA) in Children and Adolescents: A Meta-Analysis
Authors: Ponzoni Matteo , Frigo Anna C. , Padalino Massimo A.
Published: June 2022

We conducted a systematic review and meta-analysis of the literature to assess the outcomes of surgery for the anomalous aortic origin of a coronary artery in children and young adults (<30 years). Thirteen publications were selected, including a total of 384 patients. Unroofing of the intramural segment was adopted in 92% (95% CI: 81%-98%) of cases, with pooled early and late mortality of 0% (95% CI: 0%-0.3%) and 0.1% (95% CI: 0%-1%), respectively. Reoperation for aortic regurgitation was anecdotal. Surgical management of anomalous aortic origin of coronary arteries can be achieved with excellent results in pediatric patients, but concerns remain about the durability of surgery.
Technique for Neo-Pulmonary Valve Creation With Living Tissue for Repair of Atrioventricular Septal Defect and Tetralogy of Fallot
Authors: Schulte Linda J. , Miller Paighton C. , Miller Jacob R. , Nath Dilip , Eghtesady Pirooz
Published: June 2022

Long-standing effects of pulmonary regurgitation after transannular patch repair in Tetralogy of Fallot (ToF) can be especially deleterious in the setting of combined ToF and complete atrioventricular septal defect (CAVSD). We present a technique for a complete repair of combined ToF/CAVSD using right atrial appendage tissue to create a competent neo-pulmonary valve. This technique provides advantages of right heart protection via pulmonary valve competence and the use of living tissue capable of growth with the patient, potentially obviating the need for repeat interventions.
Pediatric Surgical Pulmonary Valve Replacement Outcomes After Implementation of a Clinical Pathway
Authors: Katz Alex J , Lion Richard P , Martens Timothy , Newcombe Jennifer , Razzouk Anees , Shih Wendy , Amirnovin Rambod , Gordon Brent M
Published: June 2022

Background

Standardization of perioperative care can reduce resource utilization while improving patient outcomes. We sought to describe our outcomes after the implementation of a perioperative clinical pathway for pediatric patients undergoing elective surgical pulmonary valve replacement and compare these results to previously published national benchmarks.

Methods

A retrospective single-center descriptive study was conducted of all pediatric patients who underwent surgical pulmonary valve replacement from 2017 through 2020, after the implementation of a clinical pathway. Outcomes included hospital length of stay and 30-day reintervention, readmission, and mortality.

Results

Thirty-three patients (55% female, median age 11 [7, 13] years, 32 [23, 44] kg) were included in the study. Most common diagnosis and indication for surgery was Tetralogy of Fallot (61%) with pulmonary valve insufficiency (88%). All patients had prior cardiac surgery. Median hospital length of stay was 2 [2, 2] days, and longest length of stay was three days. There were no 30-day readmissions, reinterventions, or mortalities. Median follow-up time was 19 [9, 31] months.

Conclusions

Formalization of a perioperative surgical pulmonary valve replacement clinical pathway can safely promote short hospital length of stay without any short-term readmissions or reinterventions, especially when compared with previously published benchmarks. Such formalization enables the dissemination of best practices to other institutions to reduce hospital length of stay and limit costs.
Isolated Anomalous Right Superior Pulmonary Venous Return to the Inferior Vena Cava
Authors: Tinsay Maria Andrea Francesca M , Halpern Dan G , Small Adam J
Published: June 2022

Partial anomalous pulmonary venous connection is a rare congenital abnormality. We present images from an atypical case of isolated anomalous right superior pulmonary venous return to the inferior vena cava without other cardiac abnormalities.
Surgical Treatment Following Stent Angioplasty for High-Risk Neonates With Critical Coarctation of the Aorta
Authors: Grieshaber Philippe , Merbecks Moritz , Jaschinski Christoph , Fonseca Elizabeth , Arnold Raoul , Karck Matthias , Gorenflo Matthias , Loukanov Tsvetomir
Published: June 2022

Background

Neonatal coarctation of the aorta (CoA) is primarily treated by surgical repair. However, under certain high-risk constellations, initial stent angioplasty may be considered followed by surgical repair. We report our experience with this staged approach. Methods: All patients undergoing surgical CoA repair following prior stenting at our institution between January 2011 and December 2019 were included in this retrospective analysis. The patients were classified to be at high risk because of cardiogenic shock, associated complex cardiac malformations, neonatal infection, necrotizing enterocolitis, and extracardiac conditions, respectively. Outcomes were analyzed and compared with neonates who underwent surgical CoA repair without prior stenting in the same observation period.

Results

Twenty-six neonates received stent implantation at a median age of 20 days (IQR 9-33 days). Subsequent surgical repair was conducted at an age of 4.2 months (IQR 3.2-6.1 months) with a median body weight of 5.6 kg (IQR 4.5-6.5 kg). Cardiopulmonary bypass was applied in 96% of cases. Extended end-to-end anastomosis was possible in 11 patients. Extended reconstruction with patch material was necessary in the remaining patients. One fatality (3.8%) occurred 33 days postoperatively. At a median follow-up of 5.2 years after initial stenting, all remaining patients were alive; 15/25 patients (60%) were free from re-intervention. Of note, re-intervention rates were comparable in neonates (n = 76) who were operated on with native CoA (28/74 patients; 38%; P = .67).

Conclusions

Neonatal stent angioplasty for CoA results in increased complexity of the subsequent surgical repair. Nevertheless, this staged approach allows to bridge high-risk neonates to later surgical repair with reduced perioperative risk and acceptable midterm outcomes.
Fontan Palliation in Patients with Heterotaxy Syndrome: A Five Decade Experience
Authors: Stephens Elizabeth H. , Graham Gabriel , Dearani Joseph A. , Niaz Talha , Cetta Frank
Published: June 2022

Background

Patients with heterotaxy syndromes (right and left atrial isomerism) are at high risk of poor outcomes after single-ventricle palliation. However, the long-term outcomes and specific parameters associated with poor outcomes are incompletely understood.

Methods

A retrospective review was performed of all patients with atrial isomerism who had a Fontan at our institution from 1973 to 2020. Standard demographic, as well as pre-, peri-, and postoperative parameters were collected. Features and outcomes of patients with polysplenia were compared to asplenia. Outcomes were analyzed for effect during 4 eras: (1: 1973-1984; n = 27), (2: 1985-1994; n = 93), (3: 1995-2004; n = 28), and (4: 2005-2020; n = 10).

Results

Of the 1176 patients who had a Fontan operation, 158 (14%) had a heterotaxy syndrome. The median age at the time of Fontan was 8 (9) years. Early mortality was 20% and was greater in patients with asplenia compared to polysplenia (27% vs. 12%, p = .019). But it substantially improved over time (61% in era 1 vs. 7%-10% in the more recent eras ( p < .001)), as did transplant-free survival (22% at 10 years in era 1 vs. 88% in era 4, p < .001). Transplant-free survival was significantly lower in patients with asplenia versus those with polysplenia ( p = .014), and patients with heterotaxy had lower survival than nonheterotaxy ( p = .01). This was largely due to the asplenia group ( p < .001) (hazard ratio = 3.05, p = .007).

Conclusions

After Fontan operation, patients with heterotaxy, particularly asplenia, continue to demonstrate worse transplant-free survival than nonheterotaxy patients. Early mortality and long-term transplant-free survival have improved in more recent eras.
Surgical Outcomes in Children With Partial and Transitional Atrioventricular Septal Defect
Authors: Nakayama Yuki , Shinkawa Takeshi , Hoki Ryogo , Kobayashi Kei , Yoshida Hisashi , Sato Yasuto , Niinami Hiroshi
Published: June 2022

Background

This study aimed to evaluate the long-term outcomes of partial and transitional atrioventricular septal defect repair, focusing on left atrioventricular valve reoperation.

Methods

We conducted a retrospective review of 104 children who underwent partial or transitional atrioventricular septal defect repair between August 1983 and January 2021. The major outcomes included patient survival and left atrioventricular valve reoperation.

Results

Median age at repair was 4.0 (0.1-17.0) years, with 17 patients being infants (age ≤ 1 year; 16.3%). All but eight patients (92.3%) underwent left atrioventricular valve cleft closure. After initial repair, there were 18 cases of moderate-to-severe left atrioventricular valve regurgitation (17.3%). Three in-hospital deaths (2.9%) and four late deaths (3.8%) occurred. At follow-up (median 14.3 years), actuarial survival was 95.1% and 93.0% at 1 and 20 years, respectively, and 16 patients (15.4%) had undergone a total of 19 left atrioventricular valve reoperations. Initial repair performed during infancy was associated with significantly higher mortality than a repair performed after infancy (35.3% vs 1.5%, P < .01, hazard ratio = 26.4). On multivariable analysis, repair during infancy was associated with mortality ( P < .01, hazard ratio = 27.4, 95% confidence interval = 2.7-283). Partial or no cleft closure of left atrioventricular valve ( P = .03, hazard ratio = 4.7, 95% confidence interval = 1.2-18.8) and moderate-to-severe left atrioventricular valve regurgitation after repair ( P < .01, hazard ratio = 9.9, 95% confidence interval = 3.0-32.2) were associated with left atrioventricular valve reoperation.

Conclusions

Partial and transitional atrioventricular septal defect repair outcomes were generally satisfactory. However, repair during infancy had worse survival outcomes, and moderate-to-severe left atrioventricular valve regurgitation after a repair was associated with future left atrioventricular valve reoperation.
Conversion of Norwood-Rastelli Procedure to “Anatomic” Biventricular Circulation With Takedown of Aortopulmonary Amalgamation After Aortic Valve Growth
Authors: Sasahara Akihiro , Shikata Fumiaki , Hataoka Tsutomu , Miyaji Kagami
Published: June 2022

The pathways for biventricular repair of hypoplastic aortic arch with ventricular septal defect, small aortic valve, and normal-sized left ventricle vary depending on the disease spectrum. We report a case of an infant who underwent a staged Norwood-Rastelli procedure for aortic stenosis (bicuspid aortic valve), hypoplastic aortic arch, and coarctation of the aorta with ventricular septal defect and normal-sized left ventricle. Ten years after the initial surgery, normal circulatory physiology was achieved with a takedown of the aortopulmonary amalgamation and VSD closure. This became possible as a result of the growth of the aortic valve and annulus. We suggest that this may have been related to progressive narrowing of the surgically created pathway by which some of the left ventricular outflow had been routed through the ventricular septal defect to the native pulmonary valve.
Cardiac Arrest in Children Following Cardiac Surgery: A Scoping Review of Contributing Factors
Authors: Riley Christine M. , Murphy Lee D. , Mastropietro Christopher W.
Published: June 2022

Nearly half of children experiencing cardiac arrest following cardiac surgery do not survive hospital discharge and patients who survive often experience significant neurological impairment. Additionally, increased resource utilization following cardiac arrest translates into adverse logistical and financial consequences. Although some studies have identified patient characteristics that increase the risk of cardiac arrest after pediatric cardiac surgery, modifiable risk factors, which could provide a foundation for effective prevention strategies, have been elusive. This scoping review explores the current knowledge surrounding risk factors associated with cardiac arrest in children following cardiac surgery and provides recommendations for future research.