bluuebunny/crossref_metadata_2025 huggingface dataset:
Reducing time to complete neuropsychological assessments within a memory assessment service and evaluating the wider impact
Authors: Donovan Helen , Ellis Emma , Cole Laura , Townsend Emma , Cases Alejandra
Published: July 2020

In 2016, the Older People’s Mental Health Service (OPMHS) within Bedfordshire and Luton (provided by East London Foundation National Health Service Trust) faced considerable challenges in providing an accessible service for assessment of suspected dementia. Those referred to the Memory Assessment Service (MAS) encountered waiting times exceeding national recommendations. A quality improvement (QI) project was initiated by OPMHS Psychologists within all four multidisciplinary MAS clinics in Bedfordshire and Luton. The project aimed to reduce the time from the date of referral for within-team neuropsychological assessment to finalisation of the report to 6 weeks (42 days) by April 2017. In parallel to the initiative, the wider impact of the QI project was investigated. Through the combination of change ideas tested and implemented, all four MAS clinics were successful in meeting the primary project aim. The combined mean time between referral received by psychology and report finalised reduced by 28.76 days from 65.1 to 36.34 days, and with reduced variation across the clinics. These changes were sustained throughout the duration of the project and beyond, and successful change ideas were incorporated into routine practice with control methods developed. Exploring the wider impact, a focus group with six psychology staff members involved in the project was also completed. Thematic analysis identified three themes from the focus group: staff impact, service impact and service user impact. Further subthemes were identified regarding both desirable and undesirable impact across the system. The approaches used may be useful for other services embarking on reduced wait time initiatives for access to care. Additionally, understanding ongoing areas of impact on staff, the wider service and service users can help reduce or mitigate undesirable or unintended consequences and work towards sustainability of such changes.
Occupational therapy consensus recommendations for functional neurological disorder
Authors: Nicholson Clare , Edwards Mark J , Carson Alan J , Gardiner Paula , Golder Dawn , Hayward Kate , Humblestone Susan , Jinadu Helen , Lumsden Carrie , MacLean Julie , Main Lynne , Macgregor Lindsey , Nielsen Glenn , Oakley Louise , Price Jason , Ranford Jessica , Ranu Jasbir , Sum Ed , Stone Jon
Published: July 2020

Background

People with functional neurological disorder (FND) are commonly seen by occupational therapists; however, there are limited descriptions in the literature about the type of interventions that are likely to be helpful. This document aims to address this issue by providing consensus recommendations for occupational therapy assessment and intervention.

Methods

The recommendations were developed in four stages. Stage 1: an invitation was sent to occupational therapists with expertise in FND in different countries to complete two surveys exploring their opinions regarding best practice for assessment and interventions for FND. Stage 2: a face-to-face meeting of multidisciplinary clinical experts in FND discussed and debated the data from stage 1, aiming to achieve consensus on each issue. Stage 3: recommendations based on the meeting were drafted. Stage 4: successive drafts of recommendations were circulated among the multidisciplinary group until consensus was achieved.

Results

We recommend that occupational therapy treatment for FND is based on a biopsychosocial aetiological framework. Education, rehabilitation within functional activity and the use of taught self-management strategies are central to occupational therapy intervention for FND. Several aspects of occupational therapy for FND are distinct from therapy for other neurological conditions. Examples to illustrate the recommendations are included within this document.

Conclusions

Occupational therapists have an integral role in the multidisciplinary management of people with FND. This document forms a starting point for research aiming to develop evidence-based occupational therapy interventions for people with FND.
Before compassion: sympathy, tact and the history of the ideal nurse
Authors: Chaney Sarah
Published: July 2020

The word ‘compassion’ is ubiquitous in modern healthcare. Yet few writers agree on what the term means, and what makes it an essential trait in nursing. In this article, I take a historical approach to the problem of understanding compassion. Although many modern writers have assumed that compassion is a universal and unchanging trait, my research reveals that the term is extremely new to healthcare, only becoming widely used in 2009. Of course, even if compassion is a new term in nursing, the concept could have previously existed under another name. I thus consider the emotional qualities associated with the ideal nurse during the interwar period in the UK. While compassion was not mentioned in nursing guidance in this era another term, ‘sympathy’, made frequent appearance. The interwar concept of sympathy, however, differs significantly from the modern one of compassion. Sympathy was not an isolated concept. In the interwar era, it was most often linked to the nurse’s tact or diplomacy. A closer investigation of this link highlights the emphasis laid on patient management in nursing in this period, and the way class differentials in emotion between nurse and patient were considered essential to the efficient running of hospitals. This model of sympathy is very different from the way the modern ‘compassion’ is associated with patient satisfaction or choice. Although contemporary healthcare policy assumes ‘compassion’ to be a timeless, personal characteristic rooted in the individual behaviours and choices of the nurse, this article concludes that compassionate nursing is a recent construct. Moreover, the performance of compassion relies on conditions and resources that often lie outside of the nurse’s personal control. Compassion in nursing—in theory and in practice—is inseparable from its specific contemporary contexts, just as sympathy was in the interwar period.
Dural venous sinus stenting for treatment of pediatric idiopathic intracranial hypertension
Authors: Lee Katriel E , Zehri Aqib , Soldozy Sauson , Syed Hasan , Catapano Joshua S , Maurer Robert , Albuquerque Felipe C , Liu Kenneth C , Wolfe Stacey Q , Brown Sandra , Levitt Michael R , Fargen Kyle M
Published: July 2020

Background

Dural venous sinus stenting (VSS) is an effective treatment for idiopathic intracranial hypertension (IIH) in adult patients. There are no published series to date evaluating safety and efficacy of VSS in pediatric patients.

Objective

To report on procedural device selection and technique as well as safety and efficacy of VSS for pediatric patients with medically refractory IIH due to underlying venous sinus stenosis.

Methods

A multi-institutional retrospective case series identified patients with medically refractory IIH aged less than 18 years who underwent VSS.

Results

14 patients were identified at four participating centers. Patient ages ranged from 10 to 17 years, and 10 patients (71.4%) were female. Mean body mass index was 25.7 kg/m2(range 15.8–34.6 kg/m2). Stenting was performed under general endotracheal anesthesia in all except two patients. The average trans-stenotic gradient during diagnostic venography was 10.6 mm Hg. Patients had stents placed in the superior sagittal sinus, transverse sinus, sigmoid sinus, occipital sinus, and a combination. Average follow-up was 1.7 years after stenting. Six patients out of 10 (60%) had reduced medication dosing, 12 of 14 patients (85.7%) had improvements in headaches, two patients (100%) with pre-stent tinnitus had resolution of symptoms, and four (80%) of five patients with papilledema had improvement on follow-up ophthalmological examinations. Two patients (14.3%) developed postprocedural groin hematomas, one patient (7.1%) developed a groin pseudoaneurysm, and one patient (7.1%) had postprocedural groin bleeding. No other procedural complications occurred. Four patients (28.6%) required further surgical treatment (cerebrospinal shunting and/or stenting) after their first stenting procedure.

Conclusions

This series suggests that VSS is feasible in a pediatric population with IIH and has a low complication rate and good clinical outcomes.
β-adrenergic blockade is associated with a reduced risk of 90-day mortality after surgery for hip fractures
Authors: Mohammad Ismail Ahmad , Borg Tomas , Sjolin Gabriel , Pourlotfi Arvid , Holm Sebastian , Cao Yang , Wretenberg Per , Ahl Rebecka , Mohseni Shahin
Published: July 2020

Background

There is a significant postoperative mortality risk in patients subjected to surgery for hip fractures. Adrenergic hyperactivity induced by trauma and subsequent surgery is thought to be an important contributor. By downregulating the effect of circulating catecholamines the increased risk of postoperative mortality may be reduced. The aim of the current study is to assess the association between regular β-blocker therapy and postoperative mortality.

Methods

This cohort study used the prospectively collected Swedish National Quality Registry for hip fractures to identify all patients over 40 years of age subjected to surgery for hip fractures between 2013 and 2017 in Örebro County, Sweden. Patients with ongoing β-blocker therapy at the time of surgery were allocated to the β-blocker-positive cohort. The primary outcome of interest was 90-day postoperative mortality. Risk factors for 90-day mortality were evaluated using Poisson regression analysis.

Results

A total of 2443 patients were included in this cohort of whom 900 (36.8%) had ongoing β-blocker therapy before surgery. The β-blocker positive group was significantly older, less fit for surgery based on their American Society of Anesthesiologists classification and had a higher prevalence of comorbidities. A significant risk reduction in 90-day mortality was detected in patients receiving β-blockers (adjusted incidence rate ratio=0.82, 95% CI 0.68 to 0.98, p=0.03).

Conclusions

β-blocker therapy is associated with a significant reduction in 90-day postoperative mortality after hip fracture surgery. Further investigation into this finding is warranted.

Level of evidence

Therapeutic study, level III; prognostic study, level II.
Periodic invasions during El Niño events by the predatory lined shore crab (Pachygrapsus crassipes): forecasted effects of its establishment on direct-developing indigenous prey species (Littorinaspp.)
Authors: Boulding E.G. , Behrens Yamada S. , Schooler S.S. , Shanks A.L.
Published: July 2020

Coevolutionary arms races between shelled gastropods and their predators are more escalated near the equator. Therefore, temperate gastropods are predicted to be maladapted to highly specialized tropical shell-crushing crabs. The northern geographical limit of the lined shore crab (Pachygrapsus crassipes J.W. Randall, 1840) does not usually overlap with the southern limit of the Sitka periwinkle (Littorina sitkana Philippi, 1846), which lacks a pelagic larval stage. Large El Niño events increased the winter abundance and poleward transport of P. crassipes larvae from California (USA) in the Davidson Current. Temporary intertidal crab populations that included females with eggs were observed 1–4 years later, >1000 km north of its usual geographical range. Laboratory experiments showed that L. sitkana did not have a size refuge from adult P. crassipes. Moreover, consumption rates of adult L. sitkana by P. crassipes were 10-fold higher than those published for indigenous purple shore crabs (Hemigrapsus nudus (Dana, 1851)) with similar claw sizes. Additionally, the upper intertidal limit of invading P. crassipes was higher than that of H. nudus. Consequently, the invasion of P. crassipes reduced the width of L. sitkana‘s spatial refuge from predation. The permanent presence of this subtropical predator could reduce the intertidal distribution of this temperate gastropod, thereby causing contraction of its southern range limit.
Understanding nonequilibrium scaling laws governing collapse of a polymer
Authors: Majumder Suman , Christiansen Henrik , Janke Wolfhard
Published: July 2020

Recent emerging interest in experiments of single-polymer dynamics urge computational physicists to revive their understandings, particularly in the nonequilibrium context. Here we briefly discuss the currently evolving approaches of investigating the evolution dynamics of homopolymer collapse using computer simulations. Primary focus of these approaches is to understand various dynamical scaling laws related to coarsening and aging during the collapse in space dimensiond= 3, using tools popular in nonequilibrium coarsening dynamics of particle or spin systems. In addition to providing an overview of those results, we also present new preliminary data ford= 2.

Graphical abstract
Toward link prediction in directed social networks based on common interest and local community
Authors: Li Jinsong , Peng Jianhua , Liu Shuxin , Wang Kai , Li Cong
Published: July 2020

Link prediction has been widely applied in social network analysis. Existing studies on link prediction assume the network to be undirected, while most realistic social networks are directed. In this paper, we design a simple but effective method of link prediction in directed social networks based on common interest and local community. The proposed method quantifies the contributions of neighbors with analysis on the information exchange process among nodes. It captures both the essential motivation of link formation and the effect of local community in social networks. We validate the effectiveness of our method with comparative experiments on nine realistic networks. Empirical studies show that the proposed method is able to achieve better prediction performance under three standard evaluation metrics, with great robustness on the size of training set.
ANALYSIS OF THE BRI AND CHINA’S OFDI IN SUB-SAHARAN AFRICA
Authors: WANG ZHIKAI , LU YANGYANG , ZHANG SIMIN , NEGASH ENGIDAW SISAY
Published: July 2020

The “Belt and Road Initiative” (BRI) has been launched by the Chinese government in 2013. The aim was to stimulate cross-border economic development in massive geographical areas covering Asia, Oceania, Europe, Africa, and Latin America which accounts for 80% and 40% of the world population and gross domestic product (GDP), respectively. The BRI has devised an extension of the “going global” strategy to reconfigure China’s overseas sector in order to extend its spillovers, and create more development opportunities for participating countries. In practice, cross-border infrastructure was a comprehensive role to reduce transportation cost; however, the BRI was vast by nature that includes financial support, policy cooperation, investment, trade facilitation, and people-to-people exchanges for the humanitarian strategy. Against this backdrop, the overarching objective of this study was to analyze the impact of the BRI and Chinese outward foreign direct investment (OFDI) on the bilateral trade between China and Sub-Saharan Africa countries. The investigation was carried out using a trade gravity model, balanced panel dataset, and multivariate regression estimation strategy for robustness checks covering 16 years. The result showed that Chinese OFDI, home, and host country’s GDP and GDP per capita income variables have a positive and statistically significant impact on the bilateral trade. Moreover, the BRI has explained positively on the bilateral trade; however, it does not have enough evidence to stimulate significantly, and it usually takes a long time for the effects of the BRI investment on trade and OFDI. The study also found that geographical distance and official exchange rates have explained negatively and statistically significant impact on the bilateral trade.
Influence of final-state interaction on double spin asymmetries in incoherent π+-photoproduction on the deuteron near threshold
Authors: Darwish E. M. , Al-Ghamdi H. M.
Published: July 2020

Incoherent [Formula: see text]-photoproduction on the deuteron is investigated for photon energies near threshold with particular focus on beam-target double spin asymmetries. The analysis is based on a [Formula: see text] reaction model in which realistic elementary amplitudes for [Formula: see text], [Formula: see text] and [Formula: see text] are incorporated. Numerical results on all possible beam-target double spin asymmetries of the differential and total cross-sections in the photon energy region near threshold are presented. Effects of [Formula: see text] and [Formula: see text] final-state interactions are investigated and their roles are found to be important.
Thinking outside the macrocycle: Potential biomedical roles for nanostructured porphyrins and phthalocyanines — a SPP/JPP Young Investigator Award paper
Authors: Lovell Jonathan F.
Published: July 2020

Porphyrins and phthalocyanines feature strong light absorption, capacity for metal chelation, and a track record of use in human therapeutic applications. Various conjugates and formulations of these macrocycles have shown potential to forge new applications in the biomedical sciences. Our lab has explored several such approaches including porphyrin polymer hydrogels, porphyrin-lipid nanovesicles, and surfactant-stripped micelles. These all feature in common a high density of tetrapyrroles, as well as unique functional properties. Porphyrin polymer hydrogels with high porphyrin density and bright fluorescence emission were demonstrated for use as a new class of implantable biosensors. Porphyrin-lipid nanovesicles hold potential for phototherapy, imaging, and also drug and vaccine delivery. Surfactant-stripped micelles have been developed for high-contrast photoacoustic imaging. In this ICPP Young Investigator Award brief perspective, we discuss our own efforts on these fronts. Taken together, the results show that tetrapyrroles enable new approaches for tackling biomedical problems and also confirm what was already well-known to members of the Society of Porphyrins and Phthalocyanines: that these molecules are remarkably versatile and enable research to flow in unexpected directions.
Numerical analytic method for solving a large class of generalized non-homogeneous variable coefficients KdV problems based on lie symmetries
Authors: Moghaddam Azadeh R. , Gachpazan Mortaza
Published: July 2020

In this study, we use Lie symmetry method to reduce a generalized KdV equation with initial and boundary conditions with non-homogeneous variable coefficients to initial value problem. In particular, we concentrate on the cases that the reduced IVP cannot be solved analytically. We also compare the approximated solutions of IVP using numerical methods with IBVP, and note that they are more efficient than doing the same procedure for IBVP. In fact, it is shown that reducing IBVP to IVP and solving the reduced problem numerically will lead to more accurate solutions.
Design of Absorption Refrigeration System Using Solar Energy Resource
Authors: Al-Samari Ahmed , Almahdawi Yasseen A. J. , Abd hasnawi Al-Rubaye Laith
Published: July 2020

This study aims to design an absorption refrigeration system and estimate the heat energy demand. Moreover, this paper investigates the opportunity of using alteration of energy resources such as solar energy. The trough parabolic solar collectors TPC system is suggested and analyzed as a heat energy resource. Actual data of TPC are presented in this work to evaluate the size needed to guarantee enough heat sources that is running the refrigeration system. The outcome of this calculation proved that each 1[Formula: see text]T.R needs about 11.1[Formula: see text]kW of heat energy. The COP of the refrigeration system is found to be about 0.313. Moreover, the TPC generates about 100[Formula: see text]W/m2. However, the optimum TPC may generate about 380[Formula: see text]W/m2 in Iraqi climate. This value of heat generated represents the maximum energy at clear sky. The calculations are validated based on experimental and proven data.
Policy Note: A Universal Equity–Efficiency Model for Pricing Water
Authors: Beecher Janice A.
Published: July 2020

Drawing on theoretical, practical, and normative rationales, the analysis presented here calls for revisiting the prevailing water service paradigm, and the values and frames it reflects. As is increasingly apparent, current pricing policies may not be sufficiently responsive, pragmatic, or durable, particularly in reconciling competing objectives often cast as the equity–efficiency conundrum. Water is a social good that confers both private and public benefits. The proposed universal (all-inclusive) pricing model envisions five concurrent elements: recognize public functionality in cost allocation (scope economies), calibrate a minimum bill to property assessment (capacity value), provide an essential-use allowance for all households (public health), design cost-based rates for variable water usage (resource management), and prohibit disconnection and deploy service limiters instead (water security). The model advances meaningful structural progress toward social equity while comporting with generally accepted principles to fairly allocate costs and send economic price signals where they make sense.
On the efficacy of optimized exit rule for mean reversion trading
Authors: Lee Donovan , Leung Tim
Published: July 2020

We investigate the effect of using an optimized exit rule on pairs trading. For every asset pair, we optimize the positions so that resulting intraday portfolio value is best fitted to an Ornstein–Uhlenbeck (OU) process through maximum likelihood estimation. Using various asset pairs, we examine the risks and returns of pairs trading strategies with and without an optimize exit rule. We provide empirical evidence that using an optimized exit rule improves the profitability of the trades and reduces turnovers.
Inspiratory muscle strength training lowers blood pressure and sympathetic activity in older adults with OSA: a randomized controlled pilot trial
Authors: Ramos-Barrera Guadalupe Elizabeth , DeLucia Claire M. , Bailey E. Fiona
Published: July 2020

Older, obese adults with moderate-severe obstructive sleep apnea who perform 5 min/day high-intensity inspiratory muscle strength training (IMST) exhibit lowered casual and nighttime systolic blood pressure and sympathetic nervous outflow. In contrast, adults assigned to a control (low-intensity) intervention exhibit no change in casual blood pressure or muscle sympathetic nerve activity and a trend toward increased overnight blood pressure. Remarkably, adherence to IMST even among sleep-deprived and exercise-intolerant adults is high (96%).
Acute, Subacute, and Genotoxicity Assessments of a Proprietary Blend of Garcinia mangostana Fruit Rind and Cinnamomum tamala Leaf Extracts (CinDura®)
Authors: Dodda Sundararaju , Alluri Venkata Krishnaraju , Golakoti Trimurtulu , Sengupta Krishanu
Published: July 2020

The present communication describes a battery of toxicity studies that include an acute oral toxicity, a subacute twenty-eight-day repeated oral dose toxicity, and genotoxicity studies on a herbal formulation CinDura® (GMCT). This proprietary herbal composition contains the extracts of the Garcinia mangostana fruit rind (GM) and the Cinnamomum tamala leaf (CT). The toxicological evaluations were performed following the Organization for Economic Cooperation and Development (OECD) guidelines. The acute oral toxicity study in Wistar rats suggests that the median lethal dose of CinDura® is at least 2000 mg/kg body weight. Acute dermal and eye irritation tests in New Zealand white rabbits indicate that the test item is nonirritant to the skin and eyes. A twenty-eight-day repeated dose oral toxicity study was conducted in male and female Wistar rats using daily doses of 250, 500, and 1000 mg/kg body weight, followed by a fourteen-day reversal period for two satellite groups. The CinDura®-supplemented animals did not show any sign of toxicity on their body weights, organ weights, and on the hematobiochemical parameters. The gross pathology and histopathological examinations indicated no treatment-related changes in the experimental animals. Overall, the no-observed-adverse-effect level (NOAEL) of the herbal blend is 1000 mg/kg body weight, the highest tested dose. Also, the results of the bacterial reverse mutation test and the erythrocyte micronucleus assay in mouse bone marrow suggest that CinDura® (GMCT) is neither mutagenic nor clastogenic.
Study on Evolution and Interaction of Service Industry Agglomeration and Efficiency of Hebei Province China
Authors: Liu Jianguo , Zhao Mingyu
Published: July 2020

Using data from 2008 to 2017 regarding the service sector in 11 cities of the Hebei Province, this study measures the degree of agglomeration and efficiency of service subsectors, analyzes their spatiotemporal evolution, and discusses the interactive relationship between them using panel vector autoregressive (PVAR) models and GMM dynamic panel model. The findings are summarized as follows: (1) from 2008 to 2017, service subsectors in Hebei’s cities have a high degree of agglomeration and benefit significantly from specialization; (2) the service in Hebei’s cities is severely inefficient (i.e., efficiency loss is grave). The empirical results of PVAR models reveal that service sector agglomeration is primarily reliant on its own development momentum and while that can improve technical efficiency and pure technical efficiency, it can also inhibit technical change efficiency. The variance decomposition results reveal that service sector efficiency is influenced more significantly by itself than by service sector agglomeration. With the passage of time, the self-influence of efficiency decreases and the influence of service sector agglomeration on efficiency increases.
Cerebral Cavernous Malformations, Developmental Venous Anomaly, and Its Coexistence: A Review
Authors: Idiculla Pretty Sara , Gurala Dhineshreddy , Philipose Jobin , Rajdev Kartikeya , Patibandla Prateek
Published: July 2020

Background: Cerebral cavernous malformations (CCMs) are intracranial vascular malformations that can exist as a single lesion or mixed vascular lesions. The most common mixed form is the coexistence of CCM with an associated developmental venous anomaly (DVA). In this paper, we aim to give a comprehensive review of CCM, DVA, and their coexistence as mixed lesions. A PubMed search using the keywords “Cerebral cavernous malformations, Developmental venous anomaly, Mixed Cerebral cavernous malformations with Developmental venous anomaly” was done. All studies in the English language in the past 10 years were analyzed descriptively for this review. Summary: The search yielded 1,249 results for “Cerebral cavernous malformations,” 271 results for “Developmental venous anomaly,” and 5 results for “Mixed Cerebral cavernous malformations with Developmental venous anomaly.” DVA is the most common intracranial vascular malformation, followed by CCM. CCM can have a wide array of clinical presentations like hemorrhage, seizures, or focal neurological deficits or can also be an incidental finding on brain imaging. DVAs are benign lesions by nature; however, venous infarction can occur in a few patients due to acute thrombosis. Mixed CCM with DVA has a higher risk of hemorrhage. CCMs are angiographically occult lesion, and cerebral digital subtraction angiography is the gold standard for the diagnosis of DVA. Mixed lesions, on the other hand, are best diagnosed with magnetic resonance imaging, which has also been effective in detecting specific abnormalities. Asymptomatic lesions are treated through a conservative approach, while clinically symptomatic lesions need surgical management. Conclusion: Individual CCM or DVA lesions have a benign course; however, when they coexist in the same individual, the hemorrhagic risk is increased, which prompts for rapid diagnosis and treatment.
Induced Remission of Metastatic Squamous Cell Carcinoma with an Immune Checkpoint Inhibitor in a Patient with Recessive Dystrophic Epidermolysis Bullosa
Authors: Khaddour Karam , Gorell Emily S. , Dehdashti Farrokh , Tang Jean Y. , Ansstas George
Published: July 2020

Recessive dystrophic epidermolysis bullosa (RDEB) is a genodermatosis that leads to skin fragility and chronic wound formation. Patients with RDEB are at risk for cutaneous squamous cell carcinoma (SCC) which is a major cause of morbidity and mortality in these patients. No standard of care exists for the treatment of SCC in this patient population and therapy is based on anecdotal reports and expert opinion. We report a 32-year-old man with RDEB with previously localized SCC who later developed metastatic SCC. He was started on cemiplimab (an immune checkpoint inhibitor) 350 mg IV every 3 weeks. An objective radiological response was noted within 3 cycles. On 14 months follow-up, there was a durable response to treatment clinically and on imaging, without immune-related adverse events. To our knowledge, this is the first case report describing safe administration of immune checkpoint inhibitors in a patient with RDEB with objective and durable response of metastatic SCC. Larger case series and controlled clinical trials are needed to further investigate these medications in the RDEB population, given their high burden of aggressive and often lethal SCC.
Targeted Intraoperative Radiotherapy Is a Safe Approach for Patients with Pacemakers: A Case Study and Literature Review
Authors: Ramdas Yastira , Benn Carol-Ann , Grubnik Alexandra , Mayat Yasmin , Holmes Dennis R.
Published: July 2020

Case reports detailing the effects of targeted intraoperative radiation therapy (IORT) on patients with cardiac pacemakers (PMs) are rare. This growing population sub-group requiring IORT and lack of standardized guidelines necessitate more practical published research. An 81-year-old patient with clinical stage II, T1 N0 grade III, triple-negative invasive ductal carcinoma and an implanted single-lead chamber PM (VVIR mode, model: Biotronik, type Effecta SR) received targeted intraoperative radiotherapy at the time of wide local excision and sentinel lymph node biopsy. It presents the shortest distance between the outer diameter of the PM and IORT applicator in literature. Target IORT was performed utilizing an Intrabeam device (50 kV, Carl Zeiss Surgical, Oberkochen, Germany). This case elucidates the successful use of targeted IORT for breast-conserving surgery in a patient with a single ipsilateral chamber VVIR mode PM. No device failure or malfunction was reported for the PM before, during, or after the procedure. These findings support the use of targeted IORT for patients diagnosed with early-stage breast carcinomas who have a PM implanted. However, further research is needed to understand the safety of other methods and devices for IORT patients with cardiac implantable electronic devices.
Babinski, Bektherev, Cerletti, Head, and Hitzig: European Neurologists Nominated for the Nobel Prize 1901–1950
Authors: Hansson Nils , Palmen Lotte , Padrini Giacomo , Karenberg Axel
Published: July 2020

Introduction: This article provides for the first time an overview of the most often nominated European neurologists for the Nobel Prize, who never received the award. It sheds light on candidates from France, Germany, Italy, Russia, and the UK during the first half of the 20th century. The aim is to highlight the candidates in the field of neurology, to discuss key arguments in the nomination letters, and to raise questions about research trends and hotspots in European neurology 1901–1950. Methods: Using the Nobel nomination database which contains >5,000 nominations in the prize category physiology or medicine from 1901 to the early 1950s, we listed European neurologists who were nominated more than once during this time period. We then collected nomination letters and jury reports of the prime candidates in the archive of the Nobel Committee for physiology or medicine in Sweden to explore nomination networks and motives. Results: We pinpointed scholars like Joseph Babinski, Vladimir Bektherev, Sir Henry Head, Eduard Hitzig, and Ugo Cerletti. The nomination motives were diverse, ranging from “lifetime” achievements and textbooks to singular (eponymous) discoveries. Issues of scientific priority disputes were central in most nomination letters. Conclusion: Nobel Prize nominations constitute a lens through which credit and recognition around major contributions in neurology during the 20th century can be examined. They are unique sources that enable the reconstruction of both research trends in the field and the reputation of individual neurologists.
To Be or Not to Be Improved: Patients’ Perception of Symptom Improvement – Linking the SCL-90-R to Patient-Rated Global Improvement in a Large Real-World Treatment Sample
Authors: Leichsenring Falk , Jaeger Ulrich , Masuhr Oliver , Dally Andreas , Dümpelmann Michael , Fricke-Neef Christian , Spitzer Carsten , Steinert Christiane
Published: July 2020

Introduction: From both a clinical and research perspective, it is important to determine what constitutes a perceivable change in commonly used outcome measures. Objective: We aimed to do so for the Symptom Checklist-90-Revised (SCL-90-R). Methods: Patients from a large real-world sample treated with inpatient psychotherapy (n = 4,791) rated improvements in symptoms on a global 5-point Likert scale at discharge. These ratings were related to pre-post changes in the Global Severity Index (GSI) of the SCL-90-R by use of equipercentile linking. Results: A patient rating of 5 (“clearly improved”) was found to be equivalent to an absolute pre-post difference in the GSI of 0.67 or to a percentage improvement of 54%, with the latter corresponding to the common definition of response as a 50% reduction in symptoms. A rating of 1 (“clearly worse”) was equivalent to an increase in the GSI >0.50 and to a percentage worsening >55%. “Slightly improved” or “slightly worse” (ratings of 4 or 2) corresponded to pre-post changes in the GSI of 0.07 and 0.50. For severely disordered patients, larger changes were required for ratings of improvement, and for less severely disordered patients, larger changes were required for ratings of worsening. Results for depressive, anxiety, and personality disorders were widely consistent with those of the total sample. Conclusions: This study is the first to link patient ratings of improvement or worsening to changes in the SCL-90-R. Results are relevant to both the interpretation of changes in individual patients and of effect sizes in outcome research. Results require replication.
Immuncheckpoint-Blockade: Neue Hoffnung für Patienten mit Aderhautmelanom?
Authors: Wessely Anja
Published: July 2020

Uveal melanoma (UM) represents the most common intraocular malignancy in adults and accounts for about 5% of all melanomas. Primary disease can be effectively controlled by several local therapy options, but UM has a high potential for metastatic spread, especially to the liver. Despite its clinical and genetic heterogeneity, therapy of metastatic UM has largely been adopted from cutaneous melanoma (CM) with discouraging results until now. The introduction of antibodies targeting CTLA-4 and PD-1 for immune checkpoint blockade (ICB) has revolutionized the field of cancer therapy and has achieved pioneering results in metastatic CM. Thus, expectations were high that patients with metastatic UM would also benefit from these new therapy options. This review provides a comprehensive and up-to-date overview on the role of ICB in UM. We give a summary of UM biology, its clinical features, and how it differs from CM. The results of several studies that have been investigating ICB in metastatic UM are presented. We discuss possible reasons for the lack of efficacy of ICB in UM compared to CM, highlight the pitfalls of ICB in this cancer entity, and explain why other immune-modulating therapies could still be an option for future UM therapies.
Associations of Ganglion Cell-Inner Plexiform Layer and Optic Nerve Head Parameters with Visual Field Sensitivity in Advanced Glaucoma
Authors: Hu Haijian , Li Ping , Yu Xueqing , Wei Wei , He Hai , Zhang Xu
Published: July 2020

Purpose: To evaluate the associations of optical coherence tomography (OCT)-derived macular ganglion cell-inner plexiform layer thickness (mGCIPLT), circumpapillary retinal nerve fiber layer thickness (cpRNFLT), and optic nerve head (ONH) parameters with visual field (VF) sensitivity in advanced glaucoma. Methods: In this cross-sectional study, 102 eyes from 102 patients with advanced glaucoma (defined as a 24-2 VF mean deviation (MD) of ≤−12 dB) were included. mGCIPLT, cpRNFLT, and ONH parameters (including the rim area, average cup-to-disc [C:D] ratio, and vertical C:D ratio) were measured using Cirrus high-definition OCT, and 24-2 and 10-2 VF sensitivity tests were performed using standard automated perimetry. Pearson correlations and linear models were used to analyze relationships between OCT-derived parameters and VF parameters. Results: The mGCIPLT and rim area were significantly positively correlated with the 24-2 VF MD, 24-2 VF pattern standard deviation, 24-2 VF visual field index, and 10-2 VF MD, but cpRNFLT was not significantly correlated with VF parameters. In addition, the average and vertical C:D ratios were significantly negatively correlated with VF parameters. The mGCIPLT and rim area were significantly positively correlated with the 10-2 VF MD (r ranging between 0.542 and 0.621, p < 0.001), while the average and vertical C:D ratios were significantly negatively correlated with the 10-2 VF MD (r = −0.537, p < 0.001, and r = −0.428, p < 0.001, respectively). Each 1-µm change in the average mGCIPLT was associated with an approximately 0.368-dB change in the 24-2 VF MD and 0.677-dB change in the 10-2 VF MD (R2 = 0.268, p < 0.001, and R2 = 0.385, p < 0.001, respectively). The 10-2 VF MD showed a significantly stronger association with inferonasal mGCIPLT than did the 24-2 VF MD in advanced glaucoma (p = 0.007). Conclusions: mGCIPLT and ONH parameters were associated with the severity of VF damage and reflected functional damage better than cpRNFLT in advanced glaucoma. Our results suggested that structural measurements of mGCIPLT and ONH parameters and functional measurement of the 10-2 VF may be useful for monitoring progression in advanced glaucoma.
Manual técnico de operaciones, v. 1: procedimientos de bioseguridad para la prevención de la Covid-19 en las rutinas productivas entre técnicos, extensionistas y productores rurales de cerdos
Authors:   niversidade de São Paulo. Faculdade de Medicina Veterinária e Zootecnia, Zanella Adroaldo José , Zanella Márcia I. Grapéggia ,   Universidade de São Paulo. Faculdade de Medicina Veterinária e Zootecnia, Zuin Luís Fernando Soares ,   Universidade de São Paulo. Faculdade de Zootecnia e Engenharia de Alimentos, Araujo Michelle Silva ,   Unyleya, Brandão Paulo Eduardo ,   Universidade de São Paulo. Faculdade de Medicina Veterinária e Zootecnia, Sarmiento Marisol Parada ,   Universidade de São Paulo. Faculdade de Medicina Veterinária e Zootecnia, Holmes Mark Adrian ,   Universidade de Cambridge, Bartlett Harriet ,   Universidade de Cambridge
Published: July 2020

El lector está recibiendo un Manual Técnico de Operaciones desarrollado por investigadores de la Universidad de São Paulo (USP, Brasil) y de la Universidad de Cambridge (Reino Unido). Este documento pretende ofrecerle a los técnicos extensionistas, un conjunto de orientaciones que pretenden disminuir el riesgo de propagación del Coronavirus (Sars.CoV2), para las diversas situaciones que puedan presentarse en su trabajo junto a los productores rurales, funcionarios y familiares; que suceden en las rutinas productivas de las granjas de cerdos visitadas. Debido a la pandemia global de la COVID-19, es importante que medidas de bioseguridad sean tomadas para evitar la contaminación de los técnicos, productores de cerdos, su familia y funcionarios, en busca de asegurar y mantener la salud de esas personas en sus territorios rurales. Complementariamente, este manual técnico también pretende contribuir con el mantenimiento de los procesos productivos de los mataderos. Actualmente la ciencia está todos los días haciendo nuevos descubrimientos sobre la COVID-19, y, por lo tanto, el contenido de este manual será actualizado en la medida de lo posible.
Highest Obesity Category Associated With Largest Decrease in N‐Terminal Pro‐B‐Type Natriuretic Peptide in Patients Hospitalized With Heart Failure With Preserved Ejection Fraction
Authors: Vaishnav Joban , Chasler Jessica E. , Lee Yizhen J. , Ndumele Chiadi E. , Hu Jiun‐Ruey , Schulman Steven P. , Russell Stuart D. , Sharma Kavita
Published: July 2020

Background

Heart failure with preserved ejection fraction (
HF
p
EF
) constitutes half of hospitalized
heart failure
cases and is commonly associated with obesity. The role of natriuretic peptide levels in hospitalized obese patients with
HF
p
EF
, however, is not well defined. We sought to evaluate change in
NT
‐pro
BNP
(N‐terminal pro‐B‐type natriuretic peptide) levels by obesity category and related clinical outcomes in
patients with HF
p
EF
hospitalized for acute heart failure.

Methods and Results

A total of 89
patients with HF
p
EF
hospitalized with acute decompensated
heart failure
were stratified into 3 obesity categories: nonobese (
body mass index [BMI]
<30.0 kg/m
2
, 19%), obese (
BMI
30.0–39.9 kg/m
2
, 29%), and severely obese (
BMI
≥40.0 kg/m
2
, 52%), and compared for percent change in
NT
‐pro
BNP
during hospitalization and clinical outcomes. Clinical characteristics were compared between patients with normal
NT
‐pro
BNP
(≤125 pg/
mL
) and elevated
NT
‐pro
BNP
. Admission
NT
‐pro
BNP
was inversely related to
BMI
category (nonobese, 2607 pg/
mL
[interquartile range, IQR: 2112–5703]; obese, 1725 pg/
mL
[IQR: 889–3900]; and severely obese, 770.5 pg/
mL
[IQR: 128–1268];
P
<0.01). Severely obese patients had the largest percent change in
NT
‐pro
BNP
with diuresis (−64.8% [95% CI, −85.4 to −38.9] versus obese −40.4% [95% CI, −74.3 to −12.0] versus nonobese −46.9% [95% CI, −57.8 to −37.4];
P
=0.03). Nonobese and obese patients had significantly worse 1‐year survival compared with severely obese patients (63% versus 76% versus 95%, respectively;
P
<0.01). Patients with normal
NT
‐pro
BNP
(13%) were younger, with higher
BMI
, less atrial fibrillation, and less structural heart disease than those with elevated
NT
‐proBNP.

Conclusions

In hospitalized patients with
HF
p
EF
,
NT
‐pro
BNP
was inversely related to
BMI
with the largest decrease in
NT
‐pro
BNP
seen in the highest obesity category. These findings have implications for the role of
NT
‐pro
BNP
in the diagnosis and assessment of treatment response in obese patients with
HF
p
EF
.
Up to 206 Million People Reached and Over 5.4 Million Trained in Cardiopulmonary Resuscitation Worldwide: The 2019 International Liaison Committee on Resuscitation World Restart a Heart Initiative
Authors: Böttiger Bernd W. , Lockey Andrew , Aickin Richard , Carmona Maria , Cassan Pascal , Castrén Maaret , Chakra Rao SSC , De Caen Allan , Escalante Raffo , Georgiou Marios , Hoover Amber , Kern Karl B. , Khan Abdul Majeed S. , Levi Cianna , Lim Swee H. , Nadkarni Vinay , Nakagawa Naomi Kondo , Nation Kevin , Neumar Robert W. , Nolan Jerry P. , Mellin‐Olsen Jannicke , Pagani Jacopo , Sales Monica , Semeraro Federico , Stanton David , Toporas Cristina , van Grootven Heleen , Wang Tzong‐Luen , Wijesuriya Nilmini , Wong Gillian , Perkins Gavin D.
Published: July 2020

Sudden out‐of‐hospital cardiac arrest is the third leading cause of death in industrialized nations. Many of these lives could be saved if bystander cardiopulmonary resuscitation rates were better. “All citizens of the world can save a life—CHECK—CALL—COMPRESS.” With these words, the International Liaison Committee on Resuscitation launched the 2019 global “World Restart a Heart” initiative to increase public awareness and improve the rates of bystander cardiopulmonary resuscitation and overall survival for millions of victims of cardiac arrest globally. All participating organizations were asked to train and to report the numbers of people trained and reached. Overall, social media impact and awareness reached up to 206 million people, and >5.4 million people were trained in cardiopulmonary resuscitation worldwide in 2019. Tool kits and information packs were circulated to 194 countries worldwide. Our simple and unified global message, “CHECK—CALL—COMPRESS,” will save hundreds of thousands of lives worldwide and will further enable many policy makers around the world to take immediate and sustainable action in this most important healthcare issue and initiative.
Ecological study based on the distribution of recent foraminifers from southeast of Buenos Aires province, Argentinean Continental Shelf
Authors: BERNASCONI EMILIANA
Published: July 2020

The study about the distribution of benthic foraminifers in relationship with the type of substrate is presented. Samples of surface sediments from 15 to 60 m of depth from the southeast coast of the province of Buenos Aires (40º 30´ - 42ºS), Argentina were analysed. The foraminiferal assemblage was constituted by forty-eight species that belong to 22 genera. It was characterized mostly by the free-living style, epifaunal microhabitats, oxic levels and a detritivore trophic strategy. Based on statistical analysis, three zones were determinated: at 15 m depth , characterized mainly by Buccella peruviana (d´Orbigny), and species of Bolivina reflected a littoral environment with sandy sediments and the most important clay contribution, whereas it also presented the lowest oxygen levels were determinated; between 24-48 m depth, associted by Ammonia parkinsoniana (d´Orbigny), Buccella peruviana and Quinqueloculina seminula (Linné), this zone displayed an oxygenated environment with coarse grainsize from inner shelf where local water circulation may explain the high energy observed; and the last one located between 36 to 58 m of depth was characterized by Buccella peruviana, Ammonia parkinsoniana, Elphidium macellum (Fichtel & Moll), Cibicides dispars (d´Orbigny) and Cibicides aknerianus (d´Orbigny) regflecting an inner shelf environment with sandy sediments, the lowest water temperature and the highest oxygen levels.
Eimeria ferreirai n. sp. (Chromista: Miozoa: Eimeriidae) from doves Leptotila spp. (Columbiformes: Columbidae) from Brazil
Authors: OLIVEIRA MARIANA S. , GENOVEZ-OLIVEIRA JHON LENNON , ORTÚZAR-FERREIRA CARLOS NEI , MARONEZI CARLA , THODE-FILHO SERGIO , CARDOZO SERGIAN V. , OLIVEIRA ÁGUIDA A. , LIMA VIVIANE M. , BERTO BRUNO P.
Published: July 2020

The doves and pigeons constitute a taxonomic group (Columbiformes: Columbidae) of granivorous and frugivorous birds with a worldwide distribution. The current work aims to describe morphologically and molecularly a new protozoan from white-tipped doves Leptotila verreauxi Bonaparte, 1855 and grey-fronted doves Leptotila rufaxilla (Richard & Bernard, 1792) in Southeastern Brazil. Eimeria ferreirai n. sp. has oocysts that are sub-spherical to ellipsoidal, 21.4 × 18.8 μm, with smooth, bilayered wall, ~1.6 μm thick. Micropyle present. Oocyst residuum absent, but one to two polar granules are present. Sporocysts are elongate ovoidal to boomerang-shaped, 13.4 × 6.9 μm. Stieda body triangular to lozengal. Sporocyst residuum is composed of granules of different sizes. Sporozoites are vermiform with refractile body and nucleus. Sequencing of the mitochondrial cytochrome c oxidase subunit 1 (COI) gene and the subsequent phylogenetic molecular comparisons supported the description of the new species, since the maximum similarity was 90-95% with eimeriid species of Columbiformes, Anseriformes, Galliformes and Passeriformes. Thus, this is the first coccidian species reported from Leptotila spp. and the twentieth description of an eimerian from Columbiformes in the World.