bluuebunny/crossref_metadata_2025 huggingface dataset:
Patterns of Resistance Differ in Patients with Acute Myeloid Leukemia Treated with Type I versus Type II FLT3 Inhibitors
Authors: Alotaibi Ahmad S. , Yilmaz Musa , Kanagal-Shamanna Rashmi , Loghavi Sanam , Kadia Tapan M. , DiNardo Courtney D. , Borthakur Gautam , Konopleva Marina , Pierce Sherry A. , Wang Sa A. , Tang Guilin , Guerra Veronica , Samra Bachar , Pemmaraju Naveen , Jabbour Elias , Short Nicholas J. , Issa Ghayas C. , Ohanian Maro , Garcia-Manero Guillermo , Bhalla Kapil N. , Patel Keyur P. , Takahashi Koichi , Andreeff Michael , Cortes Jorge E. , Kantarjian Hagop M. , Ravandi Farhad , Daver Naval
Published: December 2020

Despite promising results with FLT3 inhibitors (FLT3i), response durations remain short. We studied pretreatment and relapse bone marrow samples from patients with FLT3-mutated acute myeloid leukemia (AML) treated with FLT3i-based therapies (secondary resistance cohort), and pretreatment bone marrow samples from patients with no response to FLT3i-based therapies (primary resistance cohort). Targeted next-generation sequencing (NGS) at relapse identified emergent mutations involving on-target FLT3, epigenetic modifiers, RAS/MAPK pathway, and less frequently WT1 and TP53. RAS/MAPK and FLT3-D835 mutations emerged most commonly following type I and II FLT3i-based therapies, respectively. Patients with emergent mutations at relapse had inferior overall survival compared with those without emergent mutations. Among pretreatment RAS-mutated patients, pretreatment cohort-level variant allelic frequencies for RAS were higher in nonresponders, particularly with type I FLT3i-based therapies, suggesting a potential role in primary resistance as well. These data demonstrate distinct pathways of resistance in FLT3-mutated AML treated with type I versus II FLT3i.

Significance:

Sequential NGS-based mutational analysis at relapse after FLT3i-based therapies showed distinct pathways of secondary resistance between type I and II FLT3i. FLT3 mutations may be lost at relapse after FLT3i-based therapies. Pretreatment RAS/MAPK mutations may also be associated with primary resistance in patients treated with type I FLT3i.

See related commentary by Shastri et al., p. 113.
Understanding FLT3 Inhibitor Resistance to Rationalize Combinatorial AML Therapies
Authors: Shastri Aditi , Gonzalez-Lugo Jesus , Verma Amit
Published: December 2020

Patients treated with Fms-like tyrosine kinase 3 (FLT3) inhibitor–based acute myeloid leukemia therapies nearly always develop resistance. In this issue, Alotaibi and colleagues describe the patterns of mutations that emerge upon relapse after FLT3 inhibitor therapy after initial response, as well as in treatment-refractory disease in a single-institution study; the findings offer insights for sequential therapies targeting the dominant clone at the time of relapse.

See related article by Alotaibi et al., p. 125.
Inventory of Youth Adaptation to Loss (IYAL): Psychometric Testing of a New Instrument for Bereaved Youth to Assess Social Support and Coping
Authors: Kaplan Jennifer , Block Rebecca , Gillard Ann , Putnam Michelle
Published: December 2020

The Inventory of Youth Adaptation to Loss (IYAL) was developed to understand the feelings and social supports experienced by bereaved youth to develop an evidence-base for bereavement interventions. The sample included 400 youth ages 9–17, permitting robust psychometric testing of the IYAL. To evaluate the reliability of the IYAL, the sample framework was national in scope, encompassed a range of different types of youth bereavement programs, and purposively sought diversity in the sample. Exploratory factor analysis identified five factors with distinct sub-scales indicating that the IYAL is a valid and reliable assessment instrument of youth coping with grief and their social support relationships.
Bayesian Network Structure and Predictability of Autistic Traits
Authors: Briganti Giovanni , Williams Donald R. , Mulder Joris , Linkowski Paul
Published: December 2020

The aim of this work is to explore the construct of autistic traits through the lens of network analysis with recently introduced Bayesian methods. A conditional dependence network structure was estimated from a data set composed of 649 university students that completed an autistic traits questionnaire. The connectedness of the network is also explored, as well as sex differences among female and male subjects in regard to network connectivity. The strongest connections in the network are found between items that measure similar autistic traits. Traits related to social skills are the most interconnected items in the network. Sex differences are found between female and male subjects. The Bayesian network analysis offers new insight on the connectivity of autistic traits as well as confirms several findings in the autism literature.
Determination of the strength and elongation distribution of single wool through fiber bundle testing based on acoustic emissions
Authors: Lu Di , Yu Weidong , Pan Ning
Published: December 2020

The method to obtain the breaking strength and elongation distribution of fiber through numerous single fiber tests is tedious and time-consuming. In the present work, a method based on acoustic emission (AE) signals generated by fiber fracture during the fiber bundle test has been developed for estimating the distribution of single wool breaking strength and elongation. AE detection is performed simultaneously during the fiber extension. According to the AE signal, it is proved that every individual fiber break can be detected, and the failure probability distribution of wool elongation can be obtained. Based on this, the single wool breaking strength is estimated from the tensile response of the fiber bundle, and then its distribution can be deduced. Finally, the distributions of breaking strength and elongation determined by the bundle test are compared with that obtained from the single fiber samples. The results show that the method developed in this work can be used to estimate the breaking strength and elongation of the single fiber within the bundle. Their cumulative probability distributions are similar to the results of single fiber sample tests, especially the distribution of the breaking strength.
Superhydrophobic fabric mixed with polyester and cotton yarns modified by alkaline treatment and thermal aging
Authors: Kim Hyewon , Oh Ji-Hyun , Hee Park Chung
Published: December 2020

Superhydrophobic fabric composed of polyester and cotton single yarns was developed by alkali treatment and thermal aging. During the alkali treatment to make the nano-roughness of the polyester fibers, micro-roughness also increased due to differences in the thicknesses of the two yarns arising from the increased polyester surface roughness and swollen cotton. The superhydrophobicity, with a static contact angle of 155.8 ± 3.2° and shedding angle of 11.1 ± 0.8°, was achieved with 90% polyester/10% cotton fabric treated with 20% alkali concentration for 20 min under applied tension, then followed by 24 h thermal aging at 130℃. The tensile strength of the superhydrophobic polyester/cotton fabric (28.7 MPa) was higher than that of 100% polyester fabric (20.1 MPa). The breathability of the superhydrophobic polyester/cotton fabric was improved compared with 100% polyester fabric. In durability assessment, a static contact angle of ≥150° was shown for the tape tests. Five times of repeated adhesion with a clothing tape cleaner were conducted for the five samples each. Although washing and dry-cleaning decreased contact angles to as low as 137.7°, a static contact angle of 150° was achieved by additional thermal aging (130℃, 24 h). We developed a superhydrophobic fabric mixed with polyester and cotton yarns by exploiting differences in the characteristics of the two yarns induced by alkali treatment, which causes fabric surface roughness, and thermal aging without the use of any chemicals. Moreover, this superhydrophobic fabric has improved breathability.
‘Misplaced’ central venous catheter in a newborn: Reminder of a common congenital anomaly
Authors: Bhattacharya Deepanjan
Published: December 2020

Left superior vena cava is the commonest congenital anomaly of systemic venous return. We present the case of a newborn where left jugular venous placement of central venous catheter resulted in cannulation of the left superior vena cava.
A case of amoebic liver abscess complicated by bilhaemia and venous thrombosis
Authors: Goel Rohan , Roy Akash , Ray Debadrita , Chaluvashetty Sreedhara B , De Arka
Published: December 2020

Amoebic liver abscess is the most common extra-intestinal manifestation of amoebiasis. It usually responds well to treatment with metronidazole together with drainage, if indicated. Uncommonly, the abscess may rupture into the pleura, peritoneum or pericardium, bile duct at its hilum, or produce septic emboli. We present a patient with two rare complications: venous thrombosis and jaundice secondary to bilhaemia.
Emphysematous cystitis – An uncommon yet fatal urinary tract infection
Authors: Rohith Gorrepati , Rajesh Bachavarahalli S , Shanmugam Dasarathan , Tajudeen Muhamed
Published: December 2020

Emphysematous cystitis is an uncommon form of complicated urinary tract infection mostly caused by Gram-negative organisms in elderly, debilitated or immune-compromised patients. It has a varied spectrum of clinical manifestations ranging from asymptomatic to generalised sepsis. Radiological investigations such as conventional abdominal radiography and computed tomography are quintessential for diagnosis. Treatment with culture-specific antibiotics forms the mainstay of management. We present the case of an elderly patient who presented with gastric carcinoma and, during his stay, developed an unexplained fever with rapid clinical deterioration. Emphysematous cystitis was diagnosed radiologically, and urinalysis revealed Klebsiella pneumoniae. Culture-specific antibiotics were started after obtaining the culture report, and despite early and aggressive management, the patient succumbed to generalised septicaemia. Although Emphysematous cystitis is known to have lower mortality compared to other gas-forming infections of the urinary tract, high degrees of clinical suspicion and early management are of paramount importance in obtaining a favourable outcome.
Neonatal Chikungunya: A case series
Authors: Meena Shyam S , Arya Sugandha , Meena Deepika , Matlani Monika , Salhan Meetu
Published: December 2020

Chikungunya virus is an RNA virus that belongs to the family Togaviridae, genus Alphavirus, transmitted by Aedes mosquitoes. The disease usually manifests as fever, arthralgia and petechial or maculopapular rash. The illness is usually self-limiting. We report a series of neonates infected with Chikungunya virus, confirmed by ELISA test, showing that viral Chikungunya can be transmitted from mother to babies and its clinical presentation is that of septicemia or meningitis.
Associations Between Burnout and Mental Disorder Symptoms Among Nurses in Canada
Authors: Stelnicki Andrea M. , Jamshidi Laleh , Angehrn Andréanne , Hadjistavropoulos Heather D. , Carleton R. Nicholas
Published: December 2020

Background

Nurses appear to be at a greater risk of burnout compared to other medical professionals. Higher levels of burnout are significantly associated with higher levels of anxiety, stress, and depression symptoms.

Purpose

The current study was designed to estimate levels of burnout among Canadian nurses, examine the association between burnout and mental disorder symptoms, and identify characteristics that may increase the risk for reporting symptoms of burnout.

Method

Canadian nurses ( n = 3257; 94.3% women) were surveyed online in both English and French. The survey assessed current symptoms of burnout and mental disorders (i.e., Posttraumatic Stress Disorder, Major Depressive Disorder, Generalized Anxiety Disorder, Panic Disorder).

Results

Most nurses (63.2%) reported at least some symptoms of burnout and many (29.3%) reported clinically significant levels of burnout. Age and years of service were the only demographic variables that explained burnout rates. Participants reporting clinically significant levels of burnout were significantly more likely than participants with no burnout to screen positive for all mental disorders, but particularly for Major Depressive Disorder.

Conclusions

Monitoring burnout may be an effective way to identify nurses at risk of developing symptoms of mental disorders. Younger and early-career nurses are an important group to target for prevention programs.
Effects of Rurality and Geographical Distance on Unplanned Emergency Department Utilization for Children With Asthma: A Population Level Retrospective Cohort Study
Authors: Wilson Jennifer , Gedcke-Kerr Laurie , Woo Kevin , Plazas Pilar Camargo , Tranmer Joan
Published: December 2020

Background

Asthma is a highly prevalent chronic disease among Ontario children; however, the extent to which rural status and distance are associated with unplanned emergency department (ED) use by this population is largely unknown.

Objective

To explore the impact of rurality and geographical distance to primary and specialist care services on healthcare utilization by analyzing the use of unplanned ED services.

Methods

A population level retrospective cohort study of Ontario children ages 5–14 with newly diagnosed asthma was conducted using health administrative data from Institute for Clinical Evaluative Sciences (ICES). Adjusted logistic regression models were used to analyze the association between unplanned ED use with rural status and distance to general practitioner/family physician (GP/FP) and specialist healthcare services, while controlling for confounders.

Results

In total, 19,732 individuals met the inclusion criteria. Individuals who lived in rural locations (OR 2.00, 95% CI 1.64–2.44) and travelled >50 km to a GP/FP (OR 1.25, 95% CI 1.06–1.48) or specialist (OR 1.20, 95% CI 1.05–1.38) were more likely to utilize an ED.

Conclusion

Children with asthma utilize healthcare services differently based on rural status and distance to services. To ensure equitable access to care, there is a need to accommodate for these factors in the planning and provision of asthma healthcare services.
Do Gaming Simulations Substantiate That We Know More Than We Can Tell?
Authors: van Haaften M. A. , Lefter I. , Lukosch H. , van Kooten O. , Brazier F.
Published: December 2020

Background.

Revealing tacit knowledge often is seen as very valuable for organizations, although it is usually challenging to enunciate and share this type of knowledge.

Methods.

This study uses a participatory design and the application of a board gaming simulation as instruments to extract tacit knowledge. To illustrate this application, the gaming simulation is played with entrepreneurs from horticulture. Horticulture represents a complex social system where tacit knowledge plays a major role in the trade process. A participatory design process is used to explore whether the design and play of gaming simulations enable participants to explicate their tacit knowledge. Participants’ participation in designing the gaming simulation explicated that reconstructing reality was a prerequisite for their commitment.

Results.

The results from playing simulation sessions show that participants were able to: (1) narrow down the anecdotic behaviour to a few factors; (2) to structure these factors; (3) explore how these factors relate to trade barriers and (4) to explain which tactics are applied to foster trade.

Conclusion.

The educational value of this study is that it helped entrepreneurs in understanding complex real-life situations.
End-to-side versus side-to-side anastomosis with distal vein ligation for arteriovenous fistula creation
Authors: ElKassaby Mohammed , Elsayed Nashaat , Mosaad Ahmed , Soliman Mosaad
Published: December 2020

Introduction

There is lack of compelling evidence about the best technique to carry out the anastomosis between the artery and the vein: end to side or side to side. This issue was addressed by very few randomized controlled studies. This topic has recently re-emerged with the advent of the endovascular fistula creation using the side-to-side technique. Objectives: To compare the results of both surgical techniques for the creation of arteriovenous anastomosis.

Methods

This is a randomized controlled prospective study. All renal failure patients, 18 years and older, referred to our institution requiring creation of a new arm arteriovenous fistulas, including distal radio-cephalic, ulno-basilic, proximal brachio-cephalic or brachio-basilic configurations were included.

Results

Between February 2018 and October 2018, 378 patients underwent creation of permanent haemodialysis access. A total of 100 patients were randomized equally into the end-to-side and side-to-side groups. Follow-up for the study purpose continued until May 2019 (mean = 9 months, range 1–12). Patients’ age ranged from 19 to 68 years. Sevety-seven arteriovenous fistulas were created at the elbow (37 brachio-basilic and 40 brachio-cephalic). Radio-cephalic fistulae were 23, created at wrist and in the forearm. Primary technical success was 97%, and 35 (70%) and 17 (34%) cases achieved functionally maturation in the end-to-side and side-to-side groups, respectively (P = 0.0001). Primary and secondary patency rates at 12 months were 76% end to side versus 78% STS (P = 0.381) and 84% end to side versus 86% STS (P = 0.225), respectively.

Conclusion

End-to-side technique should be used in all instances of arteriovenous fistulas creation.
Diagnostic value of miR-637 in patients with atherosclerosis and its predictive significance for the future cardiovascular events
Authors: Xu Yuxia , Zhao Lixiang , Liu Hai , Sun Bin , Zhao Xinxiang
Published: December 2020

Objectives

Atherosclerosis is a common vascular disease. MiR-637 has been demonstrated to be low-expressed in hypertensive patients, and atherosclerosis is closely related to hypertension. Therefore, this study speculated that miR-637 may play an important role in the development of atherosclerosis. In brief, this study examined the expression level of miR-637 in patients with atherosclerosis and further analyzed its clinical value in patients with atherosclerosis.

Methods

The expression level of miR-637 was detected in serum from 86 patients with atherosclerosis and 75 healthy controls by using quantitative reverse transcription-polymerase chain reaction. The receiver operating characteristic curve was used to assess the diagnostic value of miR-637 in atherosclerosis. Pearson’s correlation analysis was performed to evaluate the relationship between serum miR-637 and different clinical parameters. The prognostic value of miR-637 in atherosclerosis was analyzed by the Kaplan–Meier survival curve and multivariate cox regression analysis.

Results

Compared with healthy individuals, miR-637 was downregulated in the serum of atherosclerosis patients. The receiver operating characteristic curve suggested the high diagnostic value of miR-637 for atherosclerosis, with the AUC of 0.853, specificity of 77.9%, and sensitivity of 80.0%. The expression level of miR-637 was negatively correlated with CIMT (r = –0.8101, P <  0.0001) and CRP (r = –0.6154, P <  0.0001), respectively. Survival analysis indicated that miR-637 was also found to be an independent prognostic factor for atherosclerosis.

Conclusions

MiR-637 is a potential noninvasive diagnostic marker of atherosclerosis and has important predictive value for the occurrence of future cardiovascular events.
Contemporary practices of strength and conditioning coaches in professional cricket
Authors: Weldon Anthony , Duncan Michael J , Turner Anthony , Christie Candice J , Pang Cecilia MC
Published: December 2020

This study describes the contemporary practices of strength and conditioning (S&C) coaches in male professional cricket. Thirty-three S&C coaches working with international and professional club teams across seven countries completed an online survey. The survey consisted of 45 questions (35 fixed responses and 10 open-ended), with eight sections: (a) background information, (b) muscular strength and power development, (c) speed development, (d) plyometrics, (e) flexibility development, (f) physical testing, (g) technology use, and (h) programing. Most S&C coaches were educated to degree level (97%) or higher, with 91% of degrees being in a sports science-related field. Furthermore, 73% held S&C and 40% cricket coaching certifications. Isometric type resistance training exercises (94%) were frequently programed by S&C coaches, with squats and deadlifts (including variations) deemed the most important strength development exercises. Ratings of perceived exertion (58%) was most used for determining set loads. Hang clean (64%) and multiple hops/lunges (85%) were the most prescribed Olympic weightlifting and plyometric exercises. Speed gates (85%) were the most used technology-based equipment. Open-ended questions revealed, 45% of S&C coaches believed time constraints, scheduling and fixtures are the main issues faced in their role. Position-specific demands (61%) was the predominant method used for individualizing players training strategies. The information presented in this study is valuable for those pursuing or currently working as an S&C coach in professional cricket to align, compare, and explain their practices. Furthermore, will provide insight for the wider athlete support team (e.g., sports coaches and physiotherapists) on the practices of S&C coaches.
Characterizing adaptations of serve indicators in top-level male volleyball among seasons
Authors: Sotiropoulos Konstantinos , Drikos Sotirios , Papadopoulou Sophia D , Barzouka Karolina
Published: December 2020

The purpose of this study was to analyse selected serve characteristics in top-level male volleyball, with a special focus on detecting adaptations of the serve skill among seasons. The indicators examined were type, position, direction and quality of serve. The sample consisted of 5482 serves from three final phases of different top-level tournaments (Olympic Games 2012, N = 1942, World League 2017, N = 1883, World Championship 2018, N = 1657). The interrelationships between variables were analyzed using chi-squared tests, log-linear modelling and multiple correspondence analysis. The results showed that the interaction of all serve indicators are statistically important, but the combination of the variables’ categories that were more responsible for association alternated across the seasons under study. A 3-way association term was revealed for season 2012 (type/position/direction) and 2018 (type/position/quality), while for season 2017 multiple 2-way interactions were found (type/position, type/direction, position/quality, direction/quality). The direction of the serve to the horizontal axis of the court was correlated to the quality of serve and consequently with the advantage of the serving team, while a more tactical perspective for serve skill is formed over periods in top level male volleyball.
COVID-19 – Changes in the presentation and management of shoulder and elbow trauma in a UK district general hospital orthopaedic department
Authors: Faria Giles , Virani Siddharth , Shaeir Mohammed , Velazquez-Ruta Patricia , Tadros Baha John , Arealis Georgios , Dhinsa Baljinder Singh , Relwani Jai
Published: December 2020

Introduction

COVID-19 has had a significant impact on healthcare systems. We aim to quantify the impact of this outbreak on shoulder and elbow trauma in our institution.

Methods

We prospectively collected data on patients presenting to our hospital with shoulder and elbow injuries during COVID-19. This included the number of attendances to the emergency department, fracture clinic, inpatient admissions and operative treatments. This was compared to a pre-COVID-19 period. We also assessed the efficacy of telephone clinics.

Results

There has been a noticeable decrease in the number of emergency department and fracture clinic attendances with upper limb complaints. The number of in-person fracture clinic reviews also decreased, with a reciprocal exponential increase in telephone consultations. We recorded a decrease in the number of shoulder and elbow trauma procedures performed. There was a small increase in the proportion of injuries treated conservatively during COVID-19. Our telephone clinics yielded a diagnosis and management plan in many cases and patient perspective appeared favourable.

Conclusion

We have noted significant change in the upper limb caseload. Certain injuries have reduced, likely due to COVID-19 lockdown. Moreover, we consider several changes to current practices could be taken forward after the pandemic.
Arthroscopic management of synovial chondromatosis of the shoulder: a systematic review of literature
Authors: Park J Patrick , Marwan Yousef , Alfayez Saud M , Burman Mark L , Martineau Paul A
Published: December 2020

Background

Synovial chondromatosis (SC) of the shoulder is rare, with limited literature on its management. This systematic review of literature aimed to characterize common arthroscopic techniques for the treatment of shoulder SC and patient outcomes. We hypothesized that arthroscopy is an effective operative modality for the management of shoulder SC.

Methods

PubMed and Embase databases were searched for articles on arthroscopic management of shoulder SC, published before 6 August 2020. All articles meeting inclusion criteria received an independent full-text review by two authors.

Results

An initial search found 64 articles. Following duplicate removal and title, abstract, and full-text reviews, 27 articles (48 patients) remained eligible. The mean age of patients was 33.0 years, with 2:1 male-to-female ratio. The mean follow-up was 41.8 months. SC was found to affect various intra- and extra-articular locations of the shoulder. Overall, arthroscopic treatment of shoulder SC was successful in 70.8%. Treatment failure was common in SC involving the bicipital tendon sheath. Disease recurrence was seen in 14.7%.

Conclusion

Literature on arthroscopic management of shoulder SC is limited, and significant heterogeneity in arthroscopic techniques was observed. Although arthroscopic management of shoulder SC is effective, further optimization is necessary to minimize treatment failure and disease recurrence.
Sinonasal Anatomic Variants in Allergic Fungal Rhinosinusitis
Authors: Makary Chadi A. , Parman Brock , Gill Brittany , Unsal Aykut , Holmes Thomas , Reyes Camilo , Kountakis Stilianos E.
Published: December 2020

Background

The pathophysiology of allergic fungal rhinosinusitis (AFRS) is not well understood.

Objectives

To study the incidence of sinonasal anatomic variants (AVs) in AFRS.

Methods

Retrospective cohort study. Patients with AFRS presenting to our clinic from 2008 to 2018 were reviewed for laterality of the disease. Patients with unilateral involvement were further studied for AV presence by reviewing their preoperative sinus CT scan at original presentation. Each patient’s uninvolved side served as its own control. AVs studied include agger nasi (AN), Haller’s cells (HC), concha bullosa (CB) and supraorbital ethmoid cells (SOEC).

Results

A total of 155 patients with AFRS were identified. 30 patients (19.3%) had unilateral disease involvement. Of these, 16 patients had left sided and 14 patients had right sided disease. AV were present in 26 of the 30 AFRS sides (86.7%) and in 21 of the 30 healthy sides (70%), (chi squared = 2.45, p = 0.117). CB were present in 12 of 30 AFRS sides (40%) and only in 1 of 30 healthy sides (3%), (chi squared = 11.88, p = 0.0006). The presence of HC was more common in the AFRS vs healthy sides (7 of 30, 23.3% vs 2 of 30, 6.7%, respectively, p = 0.071). AN and SOEC presence was similar in both AFRS and healthy sides (p = 0.598 and p = 0.718 respectively).

Conclusion

AV are more common on the sides with AFRS compared to healthy sides, with the presence of CB reaching unquestionable statistical significance. Further study is needed to determine the possible association of AV, especially concha bullosa, with the pathophysiology of AFRS.
Multidisciplinary approach to enhancing provider well-being in a metropolitan medical group in the United States
Authors: Shields Lisa B. E. , Jennings James T. , Honaker Joshua T.
Published: December 2020

Background

Physician burnout refers to depersonalization, emotional exhaustion, and a sense of lower personal accomplishment. Affecting approximately 50% of physicians in the United States, physician burnout negatively impacts both the physician and patient. Over a 3-year-period, this prospective study evaluated the multidisciplinary approach to decreasing provider burnout and improving provider well-being in our metropolitan community.

Methods

A multidisciplinary Well-Being Task Force was established at our Institution in 2017 to assess the myriad factors that may play a role in provider burnout and offer solutions to mitigate the stressors that may lead to decreased provider well-being. Four multifaceted strategies were implemented: (1) provider engagement & growth; (2) workflow/office efficiencies; (3) relationship building; and (4) communication. Providers at our Institution took the Mayo Clinic’s well-being index survey on 3 occasions over 3 years. Their scores were compared to those of providers nationally at baseline and at 1 and 2 years after implementing organizational and individualized techniques to enhance provider well-being. Lower well-being index scores reflected better well-being.

Results

The average overall well-being index scores of our Institution’s providers decreased from 1.76 at baseline to 1.32 2 years later compared to an increase in well-being index scores of physicians nationally (1.73 to 1.85). Both male and female providers’ average well-being index scores at our Institution decreased over the 3 years of this study, from 1.72 to 1.58 for males and 1.78 to 1.21 for females, while physicians’ scores nationally increased for both genders. The average well-being index scores were highest for providers at our Institution who graduated from medical school less than 5 years earlier (2.0) and who graduated 15–24 years earlier (2.3), whereas the average lowest scores were observed in providers who graduated ≥25 years earlier (1.37). Obstetricians/gynecologists and internal medicine physicians had the highest average well-being index scores (2.48 and 2.4, respectively) compared to other medical specialties. The turnover rate of our Institution’s providers was 5.6% in 2017 and 3.9% in 2019, reflecting a 30% decrease.

Conclusion

This study serves as a model to reduce provider burnout and enhance well-being through both organizational and individual interventions.
Change in mean salt intake over time using 24-h urine versus overnight and spot urine samples: a systematic review and meta-analysis
Authors: Santos Joseph Alvin , Li Ka Chun , Huang Liping , Mclean Rachael , Petersen Kristina , Di Tanna Gian Luca , Webster Jacqui
Published: December 2020

Background

Little is known about the capacity of overnight and spot urine samples to estimate changes in mean salt intake over time. The objective of this review was to compare the estimates of change in mean population salt intake based on 24-h urine and overnight/spot urine samples.

Methods

Studies were systematically identified through searches of peer-reviewed databases (Medline, Embase, Global Health, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews) and grey literature. Studies that reported estimates of mean salt intake for at least two time points based on both 24-h and overnight/spot urines were deemed eligible. The capacity of overnight/spot urine samples to estimate the change in mean salt intake was assessed both at the individual-study level and overall through random-effects meta-analyses. The level of heterogeneity was assessed through the I2 statistic. Subgroup and sensitivity analyses were conducted to explore possible sources of heterogeneity, and check the robustness of the findings from the primary analysis.

Results

A total of 1244 records were identified, 50 were assessed as full text, and 14 studies met the criteria, capturing data on 7291 participants from seven countries. Nine and five studies collected overnight and spot urines, respectively. The comparison of the change in mean salt intake between 24-h and overnight/spot urines showed some inconsistencies at the individual study-level. The pooled mean change in salt intake was − 0.43 g/day (95% CI − 1.16 to 0.30; I2 = 95%) using 24-h urines, and − 0.22 g/day (− 0.65 to 0.20; I2 = 87%) using overnight/spot urines, with a pooled difference-in-differences between the two methods of 0.27 g/day (− 0.23 to 0.77; I2 = 89%). Subgroup analyses showed substantial heterogeneity for most subgroups. Sensitivity analyses did not change the effect observed in the primary analysis.

Conclusion

The evidence for the capacity of overnight/spot urines to estimate changes in mean salt intake over time is uncertain. More research where overnight/spot urines are collected in parallel with 24-h urines is needed to enable a more in-depth evaluation of these alternative approaches to estimating change in mean salt intake.
Predictive value of clinical toxicities of chemotherapy with fluoropyrimidines and oxaliplatin in colorectal cancer by DPYD and GSTP1 gene polymorphisms
Authors: Deng Xunwei , Hou Jingyuan , Deng Qiaoting , Zhong Zhixiong
Published: December 2020

Background

Fluoropyrimidines and platinum are still widely used for colorectal cancer (CRC) management. Several studies have reported that mutations of dihydropyrimidine dehydrogenase (DPYD) and glutathione S-transferase pi-1 (GSTP1) polymorphisms are related to chemotherapy-related adverse events. In the present study, we purposed to assess the impact ofDPYDandGSTP1variants on the toxicity of adjuvant chemotherapy risk among the Hakka population, minimize adverse events, and to maximize therapy outcome for individualized treatment.

Methods

Genotyping was examined in 104 patients diagnosed with CRC cases and receiving fluoropyrimidine and platinum drug-based chemotherapy regimen by direct sequencing ofDPYDandGSTP1polymorphisms. ThreeDPYDvariants including *2A, *5A, *9A, andGSTP1c.313A>G were analyzed and clinical outcomes were assessed.

Results

The data suggest that the incidence ofDPYD*5A,DPYD*9A, andGSTP1c.313A>G variants were 38.4%, 24%, and 32.7%, respectively.DPYD*2Avariant was not found. A total of 23 patients (22.1%) suffered severe vomiting and 19 patients (18.3%) suffered severe anemia.DPYD*5Apolymorphism was found significantly associated with grade 3/4 ulceration (p= 0.001).GSTP1was determined to be an independent risk factor for severe vomiting and skin ulceration (p= 0.042 andp= 0.018, respectively). Patients withGSTP1c. 313A>G mutant type contributed to a higher risk for grade severe toxicity compared with wild genotype (p= 0.027). Nevertheless, no significant difference was found between patients withDPYD*2A,*5A, and*9Afor chemotherapeutic toxicity.

Conclusions

The results demonstrated thatGSTP1polymorphisms were useful predictors of severe events. Screening of single-nucleotide polymorphisms ofGSTP1in colorectal cancer patients before chemotherapy may help to realize personalized therapy.
Experiences of loneliness: a study protocol for a systematic review and thematic synthesis of qualitative literature
Authors: McKenna-Plumley Phoebe E. , Groarke Jenny M. , Turner Rhiannon N. , Yang Keming
Published: December 2020

Background

Loneliness is a highly prevalent, harmful, and aversive experience which is fundamentally subjective: social isolation alone cannot account for loneliness, and people can experience loneliness even with ample social connections. A number of studies have qualitatively explored experiences of loneliness; however, the research lacks a comprehensive overview of these experiences. We present a protocol for a study that will, for the first time, systematically review and synthesise the qualitative literature on experiences of loneliness in people of all ages from the general, non-clinical population. The aim is to offer a fine-grained look at experiences of loneliness across the lifespan.

Methods

We will search multiple electronic databases from their inception onwards: PsycINFO, MEDLINE, Scopus, Child Development & Adolescent Studies, Sociological Abstracts, International Bibliography of the Social Sciences, CINAHL, and the Education Resource Information Center. Sources of grey literature will also be searched. We will include empirical studies published in English including any qualitative study design (e.g. interview, focus group). Studies should focus on individuals from non-clinical populations of any age who describe experiences of loneliness. All citations, abstracts, and full-text articles will be screened by one author with a second author ensuring consistency regarding inclusion. Potential conflicts will be resolved through discussion. Thematic synthesis will be used to synthesise this literature, and study quality will be assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. The planned review will be reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement.

Discussion

The growing body of research on loneliness predictors, outcomes, and interventions must be grounded in an understanding of the lived experience of loneliness. This systematic review and thematic synthesis will clarify how loneliness is subjectively experienced across the lifespan in the general population. This will allow for a more holistic understanding of the lived experience of loneliness which can inform clinicians, researchers, and policymakers working in this important area.

Systematic review registration

PROSPERO CRD42020178105.
A longterm prospective follow-up study of resurfacing miniprosthesis suitable for patients above sixtyfive years with localized cartilage lesions or early osteoarthritis in the knee
Authors: Laursen Jens Ole , Lind Martin , Mogensen Christian Backer , Skjøt-Arkil Helene
Published: December 2020

Purpose

The aim of the study was to investigate the long-term outcomes of the Focal Femoral Condyle Resurfacing Prosthesis for treatment of localized cartilage lesion in patients > 65 years.

Methods

This was a prospective case series study. Non-reopererated patients initially treated with resurfacing condylar miniprothesis (HemiCAP/UniCAP) were evaluated clinically and radiographically at 7–10 years follow-up (mean 9 years). The clinical examination included the Knee Society Score (KSS) and Visual Analogue Scale (VAS) pain score and EQ5D. The radiographic examination included the Kellgren-Lawrence (KL) grade for investigate of OA progression. A comparison analysis of the preoperative and follow-up subjective outcome data and a Kaplan-Meier implant survival analysis were performed.

Results

Twenty-three patients were included in the study (9 HemiCAP and 14 UniCAP). There were seven revisions (one HemiCap and six UniCap respectively) (30%) and three patients had died. Follow-up examinations were performed on 10 patients. When comparing follow-up with the preoperative state, there were significant increases in the KSS objective (50.0 ± 8.3) vs. 90.0 ± 6.3)) and KSS function (45.0 ± 11.7) vs. 85.0 ± 4.7)) scores, a decrease in the pain VAS score (7.0 ± 0.9) vs. (4.0 ± 1.9)). Radiographic evaluation demonstrated increase in osteoarthritis development with a KL medial score (2.0 ± 0.6) and KL lateral score (1.4 ± 0.6) vs. (2.0 ± 0.9)).The EQ5D-score was 86 ± 8.4 and patients Health-score was 85 ± 18).

Conclusions

Resurfacing implant treatment for early OA in patients above 65 years can require revision to knee arthroplasty in 30% of patients. But in patients that are not revised long-term improvements in subjective clinical outcome was demonstrated. This suggests that even elderly patients with isolated cartilage lesions or early OA might benefit from the limited invasive resurfacing implant treatment.

Level of evidence

IV
Association between genetic polymorphism of XRCC6 T-991C and risk of varicocele
Authors: Namvaran Mohammad Reza , Beyzaei Zahra , Mokhtari Mohammad Javad , Geramizadeh Bita
Published: December 2020

Background

The DNA non-homologous end-joining repair gene XRCC6 (Ku70) plays an essential role in the DNA double-strand break (DSB) repairs. Defects in the DSB repair pathway results in genomic instability. Varicocele is characterized by high pressure and stasis in the veins of the testis. There is little knowledge about the molecular mechanisms underlying varicocele. One of the reasons for increased spermatozoa DNA damage is high concentrations of reactive oxygen species (ROS), which leads to DNA-DSBs. We assumed that a promoter T-991C (rs5751129) polymorphism in the XRCC6 gene was associated with susceptibility to varicocele in infertile men. Therefore, 63 infertile varicocele men and 150 healthy controls were recruited in our study. The healthy controls had no history of varicocele, and they were matched with patients by age.

Results

Our results showed that infertile varicocele patients and control groups had significant differences in the distribution of their genotypic and allelic frequency (p = 0.00) in the XRCC6 promoter T-991C polymorphism. Men who carried CC genotype had a 5.22-fold increased odds ratio of developing infertile varicocele compared to those who carried the wild-type TT genotype (95% CI 2.31–11.81, P < 0.001).

Conclusions

Our results suggested that the CC genotype and the C allele in the promoter region of XRCC6 gene might play an important role in developing infertility in the varicocele men. Further research is needed to provide the effect of this polymorphism.
LEPTOSPIROSIS IN HISTORICAL AND MODERN FACETS OF THE SCIENTIFIC PARADIGM
Authors: Goloverova Yuliya
Published: December 2020

The monograph presents data on the incidence and outbreaks of leptospirosis in the world among the population at the turn of the XX and XXI centuries. The results of scientific research by domestic and foreign authors on the history, etiology and circulation of pathogens in various types of foci are summarized, and the features of the epidemic process and clinical and laboratory diagnostics of leptospirosis are highlighted. The role of preventive and antiepidemic measures in the foci of leptospirosis is considered. The article deals with the organization of prevention of hospital infections in the intensive care units when providing medical care to patients with severe forms of leptospirosis. It is intended for doctors of various specialties (epidemiologists, infectious diseases specialists, bacteriologists, microbiologists, veterinarians), laboratory diagnostics specialists, researchers, health care organizers, sanitary and epidemiological service specialists, students, interns, residents, students and teachers of the departments of infectious diseases and epidemiology of various medical educational institutions of higher professional, postgraduate and additional education. The book is illustrated with tables and drawings.
Collective representation and the founders’ culture in non-profit organisations: the case of Israel’s national association for autism
Authors: Rimon-Zarfaty Nitzan , Raz Aviad E. , Bar-Nadav Bosmat , Vaintropov Ella
Published: December 2020

Non-profit organisations (NPOs) have increased in numbers and importance, providing support, services and advocacy. However, who non-profits actually represent is still an open question. To provide an empirical basis for scrutinising how the representational roles of autism advocacy NPOs change (or not) as they develop, in this article we focus on the case of Alut – the Israeli national association for autism. Drawing on documentary analysis and semi-structured interviews conducted in 2015–17 with members, service recipients and office holders, our findings demonstrate the important role of the founders’ culture in setting the NPO’s agenda – in Alut’s case, service provision prioritising ‘low-functioning’ autistic people. The role of the founders’ culture is further highlighted in the context of organisational gaps between the association’s actual agenda and its espoused messages regarding collective representation and advocacy. We conclude by discussing the contributions of the findings to debates on NPOs’ development and the maintenance of stability through representational styles.
Lightsheet-based flow cytometer for whole blood with the ability for the magnetic retrieval of objects from the blood flow
Authors: Verkhovskii Roman A. , Kozlova Anastasiia A. , Sindeeva Olga A. , Kozhevnikov Ilya O. , Prikhozhdenko Ekaterina S. , Mayorova Oksana A. , Grishin Oleg V. , Makarkin Mikhail A. , Ermakov Alexey V. , Abdurashitov Arkady S. , Tuchin Valery V. , Bratashov Daniil N.
Published: December 2020

Detection and extraction of circulating tumor cells and other rare objects in the bloodstream are of great interest for modern diagnostics, but devices that can solve this problem for the whole blood volume of laboratory animals are still rare. Here we have developed SPIM-based lightsheet flow cytometer for the detection of fluorescently-labeled objects in whole blood. The bypass channel between two blood vessels connected with the external flow cell was used to visualize, detect, and magnetically separate fluorescently-labeled objects without hydrodynamic focusing. Carriers for targeted drug delivery were used as model objects to test the device performance. They were injected into the bloodstream of the rat, detected fluorescently, and then captured from the bloodstream by a magnetic separator prior to filtration in organs. Carriers extracted from the whole blood were studied by a number of in vitro methods.
Decoy-state phase-matching quantum key distribution with source errors
Authors: Yu Yang , Wang Le , Zhao Shengmei , Mao Qianping
Published: December 2020

The phase-matching quantum key distribution (PM-QKD), one of the variants of Twin-Field (TF) QKD protocol, was recently proposed to overcome the rate-distance limits of point to point protocol without quantum repeaters. In this paper, we propose a more practical PM-QKD protocol version with four-intensity decoy states and source errors, since neither the infinite decoy states nor the precise control of the light source is available in practice. We present the formulation of the secure key rate of the proposed protocol and analyze the performances of the protocol with and without source errors by numerical simulations.
Graphene-based electrically controlled terahertz polarization switching between a quarter-wave plate and half-wave plate
Authors: Qi XiangQian , Zou JingLan , Li Chao , Zhang JianFa , Guo ChuCai , Zhu ZhiHong
Published: December 2020

We theoretically present a high-efficiency switchable reflective terahertz polarization converter composed of a periodic array of rectangular-shaped metal-dielectric-graphene sandwich structure on a dielectric substrate supported by a thick metallic film. Graphene sheet together with the rectangular-shaped metal patch provides tunable anisotropic hybrid magnetic plasmon resonance to obtain tunable phase delay of 90° and 180°, corresponding to a quarter-wave plate (QWP) and half-wave plate (HWP), respectively. Results of numerical simulations indicate that the proposed structure can switch functions between a QWP and HWP at a certain frequency simply by adjusting the Fermi energy of graphene. Both the QWP and HWP have high energy conversion efficiency, respectively 83% and 90% at 15.96THz, and high polarization conversion ratio closed to 1.
Resampling the transmission matrix in an aberration-corrected Bessel mode basis
Authors: Pai Pritam , Bosch Jeroen , Mosk Allard P.
Published: December 2020

The study of the optical transmission matrix (TM) of a sample reveals important statistics of light transport through it. The accuracy of the statistics depends strongly on the orthogonality and completeness of the basis in which the TM is measured. While conventional experimental methods suffer from sampling effects and optical aberrations, we use a basis of Bessel modes of the first kind to faithfully recover the singular values, eigenvalues and eigenmodes of light propagation through a finite thickness of air.