bluuebunny/crossref_metadata_2025 huggingface dataset:
Instrument and Place Nouns in the Romance Languages
Authors: Rainer Franz
Published: August 2021

Even the most primitive hunter-gatherers occasionally had to give names to tools and places, and the need for instrument and place nouns has grown ever since in tandem with the unfolding of human culture. It is therefore no wonder that the majority of languages of the world, among them Latin and the Romance languages, have specific patterns of word formation to this effect. As is the case with other categories of word formation, those referred to with instrument noun and place noun do not constitute conceptually homogeneous sets, but sets of conceptually related subcategories. Instrument nouns comprise objects that can range from simple tools and gadgets to complex machines, but can also represent less prototypically instrumental objects like chemical substances or pieces of clothing and armor, as well as more abstract entities that are often referred to as means. Place names, in turn, cover subcategories as diverse as terrains, fields and groves, burrows, stalls and other buildings, countries, regions, and towns. Vessels represent a category located halfway between instrument and place nouns: an inkpot, for example, is an artifact designed to contain ink and as such close to an instrument, but can also be viewed as a place where ink is stored. Both instrument and place nouns can take as bases nouns and verbs, more rarely adjectives. This description of the two categories is essentially valid for both Latin and Romance. The category of place nouns has remained relatively stable at the conceptual level throughout the period considered here, although many changes can be observed for individual suffixes. Instrument nouns, by contrast, have suffered a major overhaul in the wake of the scientific and industrial revolutions.
Structural Semantics in the Romance Languages
Authors: Casas Gómez Miguel , Hummel Martin
Published: August 2021

Structural semantics is a primarily European structural linguistic approach to the content level of language which basically derives from two historical sources. The main inspiration stems from Ferdinand de Saussure’s Cours de linguistique générale (1916), where the Genevan linguist also formulates the fundamental principles of semantic analysis: the twofold character of the linguistic sign, the inner determination of its content by the—allegedly autonomous—linguistic system, the consequent exclusion of the extralinguistic reality, the notion of opposition inside the system, and the concept of “associative relations” in the domain of semantics. This tradition was later refined by Hjelmslev and Coseriu, who introduced theoretical and methodological strength and rigor, suggesting systematic analyses in terms of semantic features linked by (binary) opposition. The second source of inspiration was the more holistic concept elaborated by Wilhelm von Humboldt, who saw language as a means of structuring the world. In the second half of the 20th century, structural semantics was mainstream semantics (to the extent that semantic analysis was accepted at all). A long series of authors deepened these historical traditions in theoretical and empirical studies, some of them suggesting secondary and/or partial models. Finally, prototype semantics and cognitive semantics strove to downgrade structural semantics by turning back to a more holistic conception of meaning including the speakers’ knowledge of the world, although not without introducing the alternative structural notion of “network.”
Diez, Meyer-Lübke, and Co. The Founding of Romance Linguistics
Authors: Barbato Marcello
Published: August 2021

The study of Romance linguistics was born in the 19th-century German university, and like all linguistics of that era it is historical in nature. With respect to Indo-European and Germanic linguistics, a difference was immediately apparent: Unlike Indo-European and Common Germanic, Latin’s attestation is extensive in duration, as well as rich and varied: Romance linguists can thus make use of reconstruction as well as documentation.

Friedrich Diez, author of the first historical grammar and first etymological dictionary on Romance languages, founded Romance linguistics. His studies singlehandedly constructed the foundations of the discipline. His teaching soon spread not only across German-speaking countries, but also into France and Italy.

Subsequently, the most significant contributions came from two scholars trained in the Indo-European field: the German linguist Hugo Schuchardt, whose doctoral thesis studied with sharp theoretical awareness the passage from Latin to the Romance languages, and the Italian Graziadio Isaia Ascoli, who showed how the Romance panorama could be extraordinarily enriched by the analysis of nonstandard varieties.

The discipline thus developed fully and radiated out. Great issues came to be debated: models of linguistic change (genealogical tree, wave), the possibility of distinguishing dialect groups, the relative weight of phonology, and semantics in lexical reconstruction. New disciplines such as linguistic geography were born, and new instruments like the linguistic atlas were forged. Romance linguistics thus became the avant-garde of general linguistics.

Meanwhile, a new synthesis of the discipline had been created by a Swiss scholar, Wilhelm Meyer-Lübke, who published a historical grammar and an etymological dictionary of the Romance languages.
Italo-Romance: Venetan
Authors: Cordin Patrizia
Published: August 2021

Venetan belongs to the group of northern Italian dialects, which are characterized by the presence of some phonological and morphological features that are common to French dialects and are attributed to the Celtic substratum. However, numerous traces of the Venetic substratum distinguish the Venetan dialects from the other (Gallo-Italic) dialects.

In the linguistic history of the Venetan dialects, Venice played a central role due to the political power achieved by the Venetian Republic and its commercial expansion into many Adriatic and Mediterranean countries. There, the Venetian dialect laid the foundations for the development of a “colonial Venetian,” which has been used for several centuries.

In the 21st century, Venetan is still vital in three regions of northeastern Italy (Veneto, Trentino Alto-Adige, Friuli Venezia Giulia), in Istria, and in Dalmatia. Small Venetan-speaking communities are also found elsewhere in Europe as well as Canada, Australia, and North and South America. These were the destination countries for the numerous emigrants who left Veneto between the end of the 19th century and the first half of the 20th century.

Alongside several structural features that are common to the other northern Italian dialects, Venetan presents some distinctive properties. In phonology, apocope and syncope are restricted and consonant lenition in inter-vowel position is extensive. In verbal morphology, Venetan is characterized by the agglutination of the auxiliary ‘have’ with the clitic ghe, the alternation of the traditional Venetian form [ze] with the form [ɛ] for the auxiliary ‘be’ at present indicative 3rd persons, and the variety of past participle suffixes. In nominal derivation, some suffixes, such as the augmentatives -ón/-óne and -àso and the present participle suffix -ànte (which is used for the formation of nomina agentis) are very productive. In syntax, 2sg and 3sg/pl subject clitics are obligatory; dative and object clitics are used for doubling respectively datives and pronominal objects in the 1st and 2nd person; specific rules govern the structure of direct, indirect, and noncanonical interrogatives. The Venetan lexicon, which developed in several domains, particularly in marine (on the lagoon) and agricultural (on the mainland) contexts, mirrors the history of the region, revealing several traces of different strata (Celtic, Germanic, Greek, Slavic, Jewish, and French).
Green Infrastructure for Stormwater Runoff Control in China
Authors: Jia Haifeng , Yin Dingkun
Published: August 2021

In the early 21st century, high-intensity human activities have led to the rapid development and expansion of urban areas in many countries, and these have had several adverse impacts upon the water environment. In particular, urban runoff quantity and quality control have emerged as key concerns for municipal officials. China, as one of the countries with rapid urbanization, faces many challenges in this process. Since the year 2000, China has been promoting the protection of its urban water environment using ecological construction. Use of green infrastructure (GI) to solve urban stormwater issues have become the priority of urban green and sustainable development. The Sponge City (SPC) approach was proposed to emphasize the comprehensive construction of multi-objective stormwater drainage and flood mitigation systems, and to consider water ecology, public safety, environmental protection, and preservation of water resources. The goal of GI is to achieve storm runoff quality enhancement and pollution control, which is similar to the sustainable development concept of SPC. According to its major functions, GI can be divided into infiltration and retention GI, regulation GI, transmission GI, pollution interception and treatment GI. GI should be planned and designed according to the long-term runoff volume capture ratio, which is determined by the annual rainfall depth and the level of catchment development at the project site. Different structural layer materials and spatial layout of GI have significant impact on their effects. Upon the completion of a project, long-term monitoring is recommended for evaluating its effectiveness. In order to ensure the continuous efficiency of GI, it is necessary to carry out regular maintenance. Different types of GI demand various maintenance methods and frequencies. Appropriate maintenance methods can effectively extend the service life of GI.
Drug Policy Reform
Authors: Vakharia Sheila P.
Published: August 2021

Social workers are uniquely qualified to be effective drug policy advocates for effective and equitable policies through their commitment to advancing social welfare and promoting social justice. The prohibitionist antidrug policies that began at the turn of the 20th century have been a key driver for the criminalization of millions of Americans over time, a disproportionate number of whom have been people of color. The period beginning with President Richard Nixon’s “War on Drugs,” in addition to contributing to inequality and marginalization, has exacerbated a number of public health and safety harms, suggesting that past policy approaches have not met their intended aims. The North American opioid overdose crisis in the early 21st century is presented as an illustrative case study because its persistence and mounting death toll exemplify the challenges with the current model of drug prohibition. Areas for macro social work interventions include legislative advocacy through lobbying, provision of expert testimony in legislative hearings, engagement in reform through litigation, involvement in social action, and performing policy analysis and research.
Pandemics and Social Work
Authors: Lee Sangeun
Published: August 2021

A pandemic contains three key components: extensiveness, novelty, and severity. For the past century, humankind experienced the Spanish flu in 1918 and COVID-19 in 2020 as major pandemics. The global impact has been extensive in terms of their origin, international transmission, and mortality rates. Public health measures to slow and stop pandemics have been implemented. During the COVID-19 pandemic, disparate impacts on health in different populations have been witnessed due to existing social inequalities, detriments of health, and structured racism. The interests of social workers have been adversely impacted in those pandemic times. Spanish flu bolstered social work with a professional presence. COVID-19 has confirmed the need for community engagement and community development to follow large-scale social policy reforms as a response to the disproportionate impact on diverse marginalized communities, which is the core of macro social work practice and would be more strongly called on to prepare for future pandemics.
Llanes Escoda, Josefa
Authors: Ealdama Yolanda
Published: August 2021

Josefa Llanes Escoda (1898–1945) was one of the early social workers in the Philippines. As a social worker she moved from the residual approach and initiated sustainable welfare programs. She was also an advocate for decent work for women. She was able to merge her role as a social worker and as a suffragist by mobilizing members of the National Federation of Women’s Club (NFWC) of the Philippines to educate women on the importance of the right to vote. During World War II, when the social welfare system was in disarray, she mobilized members of the NFWC to feed prisoners of war and other displaced persons. In her own way, she was a freedom fighter.
FIVEx: an interactive eQTL browser across public datasets
Authors: Kwong Alan , Boughton Andrew P , Wang Mukai , VandeHaar Peter , Boehnke Michael , Abecasis Gonçalo , Kang Hyun Min
Published: August 2021

Expression quantitative trait loci (eQTLs) characterize the associations between genetic variation and gene expression to provide insights into tissue-specific gene regulation. Interactive visualization of tissue-specific eQTLs or splice QTLs (sQTLs) can facilitate our understanding of functional variants relevant to disease-related traits. However, combining the multi-dimensional nature of eQTLs/sQTLs into a concise and informative visualization is challenging. Existing QTL visualization tools provide useful ways to summarize the unprecedented scale of transcriptomic data but are not necessarily tailored to answer questions about the functional interpretations of trait-associated variants or other variants of interest. We developed FIVEx, an interactive eQTL/sQTL browser with an intuitive interface tailored to the functional interpretation of associated variants. It features the ability to navigate seamlessly between different data views while providing relevant tissue- and locus-specific information to offer users a better understanding of population-scale multi-tissue transcriptomic profiles. Our implementation of the FIVEx browser on the EBI eQTL catalogue, encompassing 16 publicly available RNA-seq studies, provides important insights for understanding potential tissue-specific regulatory mechanisms underlying trait-associated signals.

Availability and implementation

A FIVEx instance visualizing EBI eQTL catalogue data can be found at https://fivex.sph.umich.edu. Its source code is open source under an MIT license at https://github.com/statgen/fivex.

Supplementary information

Supplementary data are available at Bioinformatics online.
Impact of Antibiotic Stewardship Rounds in the Intensive Care Setting: A Prospective Cluster-Randomized Crossover Study
Authors: Seidelman Jessica L , Turner Nicholas A , Wrenn Rebekah H , Sarubbi Christina , Anderson Deverick J , Sexton Daniel J , Moehring Rebekah W
Published: August 2021

Background

Few groups have formally studied the effect of dedicated antibiotic stewardship rounds (ASRs) on antibiotic use (AU) in intensive care units (ICUs).

Methods

We implemented weekly ASRs using a 2-arm, cluster-randomized, crossover study in 5 ICUs at Duke University Hospital from November 2017 to June 2018. We excluded patients without an active antibiotic order, or if they had a marker of high complexity including an existing infectious disease consult, transplantation, ventricular assist device, or extracorporeal membrane oxygenation. AU during and following ICU stay for patients with ASRs was compared to the controls. We recorded the number of reviews, recommendations delivered, and responses. We evaluated change in ICU-specific AU during and after the study.

Results

Our analysis included 4683 patients: 2330 intervention and 2353 controls. Teams performed 761 reviews during ASRs, which excluded 1569 patients: 60% of patients off antibiotics, and 8% complex patients. Exclusions affected 88% of cardiothoracic ICU (CTICU) patients. The AU rate ratio (RR) was 0.97 (95% confidence interval [CI], .91–1.04). When CTICU was removed, the RR was 0.93 (95% CI, .89–.98). AU in the poststudy period decreased by 16% (95% CI, 11%–24%) compared to AU in the baseline period. Change in AU was differential among units: largest in the neurology ICU (–28%) and smallest in the CTICU (–2%).

Conclusions

Weekly multidisciplinary ASRs was a high-resource intervention associated with a small AU reduction. The noticeable ICU AU decline over time is possibly due to indirect effects of ASRs. Effects differed among specialty ICUs, emphasizing the importance of customizing ASRs to match unit-specific population, workflow, and culture.
The Chameleon on the branches: spectral state transition and dips in NGC 247 ULX-1
Authors: D’Aì A , Pinto C , Del Santo M , Pintore F , Soria R , Robba A , Ambrosi E , Alston W , Barret D , Fabian A C , Fürst F , Kara E , Kosec P , Middleton M , Roberts T , Rodriguez-Castillo G , Walton D J
Published: August 2021

Soft Ultra-Luminous X-ray (ULXs) sources are a subclass of the ULXs that can switch from a supersoft spectral state, where most of the luminosity is emitted below 1 keV, to a soft spectral state with significant emission above 1 keV. In a few systems, dips have been observed. The mechanism behind this state transition and the dips nature are still debated. To investigate these issues, we obtained a long XMM–Newton monitoring campaign of a member of this class, NGC 247 ULX-1. We computed the hardness–intensity diagram for the whole data set and identified two different branches: the normal branch and the dipping branch, which we study with four and three hardness–intensity resolved spectra, respectively. All seven spectra are well described by two thermal components: a colder (kTbb ∼ 0.1–0.2 keV) blackbody, interpreted as emission from the photosphere of a radiatively driven wind, and a hotter (kTdisc ∼ 0.6 keV) multicolour disc blackbody, likely due to reprocessing of radiation emitted from the innermost regions. In addition, a complex pattern of emission and absorption lines has been taken into account based on previous high-resolution spectroscopic results. We studied the evolution of spectral parameters and flux of the two thermal components along the two branches and discuss two scenarios possibly connecting the state transition and the dipping phenomenon. One is based on geometrical occultation of the emitting regions, the other invokes the onset of a propeller effect.
The history of metal enrichment traced by X-ray observations of high-redshift galaxy clusters
Authors: Flores Anthony M , Mantz Adam B , Allen Steven W , Morris R Glenn , Canning Rebecca E A , Bleem Lindsey E , Calzadilla Michael S , Floyd Benjamin T , McDonald Michael , Ruppin Florian
Published: August 2021

We present the analysis of deep X-ray observations of 10 massive galaxy clusters at redshifts 1.05 < z < 1.71, with the primary goal of measuring the metallicity of the intracluster medium (ICM) at intermediate radii, to better constrain models of the metal enrichment of the intergalactic medium. The targets were selected from X-ray and Sunyaev–Zel’dovich effect surveys, and observed with both the XMM–Newton and Chandra satellites. For each cluster, a precise gas mass profile was extracted, from which the value of r500 could be estimated. This allows us to define consistent radial ranges over which the metallicity measurements can be compared. In general, the data are of sufficient quality to extract meaningful metallicity measurements in two radial bins, r < 0.3r500 and 0.3 < r/r500 < 1.0. For the outer bin, the combined measurement for all 10 clusters, Z/Z⊙ = 0.21 ± 0.09, represents a substantial improvement in precision over previous results. This measurement is consistent with, but slightly lower than, the average metallicity of 0.315 solar measured at intermediate-to-large radii in low-redshift clusters. Combining our new high-redshift data with the previous low-redshift results allows us to place the tightest constraints to date on models of the evolution of cluster metallicity at intermediate radii. Adopting a power-law model of the form Z ∝ (1 + z)γ, we measure a slope $\gamma = -0.5^{+0.4}_{-0.3}$, consistent with the majority of the enrichment of the ICM having occurred at very early times and before massive clusters formed, but leaving open the possibility that some additional enrichment in these regions may have occurred since a redshift of 2.
The VMC survey – XLIV: mapping metallicity trends in the large magellanic cloud using near-infrared passbands
Authors: Choudhury Samyaday , de Grijs Richard , Bekki Kenji , Cioni Maria-Rosa L , Ivanov Valentin D , van Loon Jacco Th , Miller Amy E , Niederhofer Florian , Oliveira Joana M , Ripepi Vincenzo , Sun Ning-Chen , Subramanian Smitha
Published: August 2021

We have derived high-spatial-resolution metallicity maps covering ∼105 deg2 across the Large Magellanic Cloud (LMC) using near-infrared passbands from the VISTA Survey of the Magellanic Clouds. We attempt to understand the metallicity distribution and gradients of the LMC up to a radius of ∼6 kpc. We identify red giant branch (RGB) stars in spatially distinct Y, (Y − Ks) colour–magnitude diagrams. In any of our selected subregions, the RGB slope is used as an indicator of the average metallicity, based on calibration to metallicity using spectroscopic data. The mean LMC metallicity is [Fe/H] = −0.42 dex (σ[Fe/H] = 0.04 dex). We find the bar to be mildly metal-rich compared with the outer disc, showing evidence of a shallow gradient in metallicity (−0.008 ± 0.001 dex kpc−1) from the galaxy’s centre to a radius of 6 kpc. Our results suggest that the LMC’s stellar bar is chemically similar to the bars found in large spiral galaxies. The LMC’s radial metallicity gradient is asymmetric. It is metal-poor and flatter towards the southwest, in the direction of the Bridge. This hints at mixing and/or distortion of the spatial metallicity distribution, presumably caused by tidal interactions between the Magellanic Clouds.
Cavernous Malformations of the Optic Nerve and Optic Pathway: A Case Series and Systematic Review of the Literature
Authors: Srinivasan Visish M , Koester Stefan W , Wang Michele S , Rahmani Redi , Ma Kevin L , Catapano Joshua S , Labib Mohamed A , Lawton Michael T
Published: August 2021

BACKGROUND

Although rare, cavernous malformations (CMs) of the optic nerve and anterior optic pathway (optic pathway cavernous malformations [OPCMs]) can occur, as described in several single case reports in the literature.

OBJECTIVE

To describe the technical aspects of microsurgical management of CMs of the optic pathway on the basis of an extensive single-center experience and review of the literature.

METHODS

A systematic literature review was performed to augment an earlier review, using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. In addition, an institutional database was searched for all patients undergoing surgical resection of OPCMs. Patient information, surgical technique, and clinical and radiographic outcomes were assessed.

RESULTS

Since the previous report, 14 CMs were resected at this institution or by the senior author at another institution. In addition, 34 cases were identified in the literature since the systematic review in 2015, including some earlier cases that were not discussed in the previous report. Most OPCMs were resected via pterional, orbital-pterional, and orbitozygomatic craniotomies. Visual outcomes were similar to those in earlier reports, with 70% of patients reporting stable to normal vision postoperatively.

CONCLUSION

OPCMs can occur throughout the anterior visual pathway and may cause significant symptoms. Surgery is feasible and should be considered for OPCMs presenting to a surface of the nerve. Favorable results can be obtained with resection, although optimal results are obtained with patients who present with milder symptoms without longstanding damage to the optic apparatus.
Foreign Exchange Volume
Authors: Cespa Giovanni , Gargano Antonio , Riddiough Steven J , Sarno Lucio
Published: August 2021

We investigate the information contained in foreign exchange (FX) volume using a novel data set from the over-the-counter market. We find volume helps predict next-day currency returns and is economically valuable for currency investors. Predictability implies a stronger return reversal for currency pairs with abnormally low volume and is driven by the component of volume unrelated to volatility, liquidity, and order flow. We rationalize these findings via a simple model, in which FX volume helps reveal the degree of asymmetric information in currency markets. Testing this prediction shows that asymmetric information is uniform across currency pairs but varies across instruments.
Telemedicine for pediatric orthopedic visits: evaluating usability and satisfaction
Authors: Hanna Gabriel , Siddiqui Bilal , Jernigan Ebony A. , Edobor-Osula Folorunsho
Published: August 2021

The purpose of this study is to evaluate usability and patient satisfaction with telemedicine in pediatric orthopedics using validated questionnaires and to identify demographic and clinical factors that may impact these ratings. All caregivers of patients who had telemedicine visits with a single fellowship-trained pediatric orthopedic surgeon between 23 March 2020 and 3 June 2020 were eligible to participate. Patient Satisfaction Questionnaire (PSQ) and the Telehealth Usability Questionnaire (TUQ) rated on a 4-point Likert scale (1 = poor, 2 = fair, 3 = good and 4 = excellent) were used. Additional information regarding the level of education, mode of transportation, technology usage, demographics, visit diagnosis and length of visit were collected. Quantitative analysis was performed. A total of 68.6% (83/121) of the visits were done via telemedicine. Around 46 surveys were completed with a response rate of 55.4% (46/83). The PSQ mean score was 3.63 ± 0.39 with non-English-speaking caregivers scoring lower compared to their English-speaking counterparts (3.4 ± 0.47 vs. 3.72 ± 0.33; P = 0.017). PSQ mean score increased with increasing length of visit (r = 0.352; P = 0.018). A total of 86.8% (839/966) of all TUQ’s responses were good to excellent with 89.1% (41/46) of responders were satisfied with telemedicine and 91.3% (42/46) would use it again. Although the topic is an evolving one, and a lot of changes should be expected in the future, certain characteristics such as primary language and length of visit may affect the levels of satisfaction with the use of telemedicine in pediatric orthopedics. Knowledge regarding satisfaction ratings may allow orthopedic surgeons to improve patient care delivered through this technology. Level of Evidence: IV.
Circular noncoding RNA circ_0007334 sequestrates miR-577 to derepress KLF12 and accelerate colorectal cancer progression
Authors: Bai Liang , Gao Zhifeng , Jiang An , Ren Song , Wang Baotai
Published: August 2021

Colorectal cancer (CRC) is a prevalent malignant tumor with a poor prognosis. Circular RNA (circRNA) circ_0007334 is related to cell proliferation in CRC. This study is designed to explore the role and mechanism of circ_0007334 in CRC progression. Circ_0007334, microRNA-577 (miR-577) and kruppel-like factor 12 (KLF12) levels were measured by real-time quantitative PCR (RT-qPCR). Exosomes were detected by a transmission electron microscope and nanoparticle tracking analysis (NTA). CD63, TSG101, matrix metallopeptidase-2 (MMP-2), MMP-9, VEGFA and KLF12 protein levels were examined by western blot assay. The binding relationship between miR-577 and circ_0007334 or KLF12 was predicted by circRNA interactome or Starbase and verified by a dual-luciferase reporter and RNA immunoprecipitation (RIP) assays. Cell viability, colony number, migration, invasion and angiogenesis were detected by cell counting kit-8 (CCK-8), colony formation, wound healing, transwell and tube formation assays. The biological role of circ_0007334 was examined by the xenograft tumor model in vivo. Circ_0007334 and KLF12 were increased, and miR-577 was decreased in CRC tissues and cells. Also, circ_0007334 expression was upregulated in CRC cell-derived exosomes. Circ_0007334 deficiency repressed cell viability, colony formation, migration, invasion, and angiogenesis in CRC cells. Mechanically, circ_0007334 could regulate KLF12 expression by sponging miR-577. Circ_0007334 downregulation or exosomal circ_0007334 silencing blocked CRC tumor growth in vivo. These results presented that circ_0007334 deficiency exerts a tumor-suppressor by the miR-577/KLF12 axis in CRC, and indicated that exosomal circ_0007334 could hinder CRC tumor growth and angiogenesis in vivo. Our findings provided a novel therapeutic strategy for CRC.
Acute myeloid leukemia with cup-like blasts and FLT3-ITD and NPM1 mutations mimics features of acute promyelocytic leukemia: a case of durable remission after sorafenib and low-dose cytarabine
Authors: Sun Jie , Ning Shangyong , Feng Ru , Li Jiangtao , Wang Ting , Xing Baoli , Zhu Xiaoquan , Zhao Yanyang , Pei Lei , Liu Hui
Published: August 2021

Some previous researches raised the possibility of a novel acute myeloid leukemia (AML) entity presenting cup-like cytomorphology with mutations of both FLT3 and NPM1 or one of them. However, the clinical implications of this subtype remain unknown. We describe a 63-year-old patient belonging to this distinct AML subtype, who presented similar features of acute promyelocytic leukemia (APL) including nuclear morphology, negative for CD34 and HLA-DR, and abnormal coagulation. He had no response to both arsenic trioxide and CAG regimen (cytarabine, aclarubicin, and G-CSF). Given that the patient carried the FLT3-ITD mutation, we switched to a pilot treatment of FLT3 inhibitor sorafenib combined with low-dose cytarabine (LDAC). To date, the patient achieved durable complete remission over 58 months. These findings suggest that AML with cup-like blasts and FLT3-ITD and NPM1 mutations mimic APL, and the prognosis of this subtype may be improved by sorafenib combined with LDAC.
Conversion therapy, palliative chemotherapy and surgery, which of these is the best treatment for locally advanced and advanced pancreatic cancer?
Authors: Wang Mingxing , Zhu Pengfei , Chen Zheling , Yang Liu
Published: August 2021

A retrospective study was conducted to analyze which translational therapy, palliative chemotherapy and surgery is the best treatment for locally advanced and advanced pancreatic cancer, and to screen out the dominant population for the best treatment. A total of 83 patients with pancreatic cancer, including locally advanced and advanced pancreatic cancer, who had lost the opportunity for radical surgery and were admitted to Zhejiang Provincial People’s Hospital between January 2015 and July 2021 were collected. A total of 39 patients received palliative chemotherapy, 25 patients received conversion therapy and 19 patients tried surgery at the first visit. We conducted survival follow-up and prognostic evaluation of 83 patients. The median overall survival (mOS) and median progression-free survival (mPFS) of 25 pancreatic cancer patients who received conversion therapy were longer than those of pancreatic cancer patients who received palliative chemotherapy (mOS: 16 months vs. 9 months, P = 0.001; mPFS: 11 months vs. 7.5 months, P = 0.038) and surgery (mOS: 16 months vs. 9 months, P = 0.018; mPFS: 11 months vs. 5.5 months, P < 0.001). Multivariate and Kaplan–Meier analysis showed that age, distant metastasis, and the degree of CA199 declined after chemotherapy were independent factors affecting overall survival (OS) of pancreatic cancer patients who received conversion therapy. Conversion therapy can improve OS and progression-free survival in patients with locally advanced or advanced pancreatic cancer to a certain extent. Some patients with advanced pancreatic cancer have surprising results after receiving conversion therapy.
Just-In-Time Simulation Training for Nasopharyngeal Specimen Collection During the SARS-CoV-2 Pandemic
Authors: Carlson Kristy J. , Klute Lauren M. , Dowdall Jayme R. , Pate Samuel , Lyden Elizabeth R. , Stobbe Benjamin B. , Misra Asit , Barnes Christie A.
Published: August 2021

Introduction:

Rapid and accurate detection of the novel coronavirus using a nasopharyngeal specimen requires training for professionals who may have limited experience. To respond to the urgent need, an interprofessional team created a just-in-time (JIT) module to provide only what was needed, precisely when needed, and rapidly deployed training sessions to a large group of health professionals.

Methods:

In April and May 2020, health professionals from the hospital, ambulatory clinics, and public health attended training. Procedural comfort/knowledge and perception of the training were assessed with pre-survey and post-survey.

Results:

Comfort level in collecting a nasopharyngeal specimen among participating health professionals increased from 2.89 (n = 338) on the pre-survey to 4.51 (n = 300) on the postsurvey on a 5-point scale. Results revealed a significant difference (P < .01) between pre–post knowledge questions regarding the correct angle and depth of the swab to obtain an adequate sample from the nasopharynx.

Discussion:

This study demonstrates that a JIT intervention can improve knowledge and comfort regarding the nasopharyngeal swab procedure. In preparation for the prevention and mitigation of future viral outbreaks (ie, coronavirus and influenza), educators should consider creating JIT skills training for health care professionals who may be deployed to assist in mass testing efforts.
Association Between Body Mass Index and Survival Outcomes In Patients Treated With Immune Checkpoint Inhibitors: Meta-analyses of Individual Patient Data
Authors: Nie Run-Cong , Chen Guo-Ming , Wang Yun , Yuan Shu-Qiang , Zhou Jie , Duan Jin-Ling , Liu Wen-Wu , Chen Shi , Cai Mu-Yan , Li Yuan-Fang
Published: August 2021

Despite that immune checkpoint inhibitors (ICIs) had tremendous improved the survival of multiple solid tumors, only a limited proportion of patients are responsive to ICIs. Therefore, effective variables are urgently needed to predict the probability of response to ICIs. Systematic searches were conducted from inception up to May, 2020. Prospective or retrospective studies of ICIs that investigated the association between body mass index (BMI) and survival outcomes, including overall survival (OS) and/or progression-free survival (PFS), were selected. The association between each BMI category and survival outcomes was calculated using Cox proportional hazard regression models and quantified as hazard ratio (HR) with corresponding 95% confidence interval. Seven clinical studies involving data from 3768 individual patients were included. The median OS was 15.5 months (95% confidence interval: 14.7–16.2 mo) and the median PFS was 5.7 months (5.2–6.3 mo). The median OS was significantly longer in overweight/obese patients than in nonoverweight patients (20.7 vs. 11.3 mo; P<0.001). The difference in OS between overweight and obese patients was not statistically significant (HR: 1.14, P=0.098). Similar results were observed for PFS outcomes. Subgroup analysis demonstrated improved OS in overweight/obese patients with nonsmall-cell lung cancer (HR: 0.81, P=0.002), melanoma (HR: 0.66, P<0.001), renal cell carcinoma (HR: 0.53, P<0.001), and multiple cancer type (HR: 0.34, P<0.001), with parallel results noted regarding PFS outcomes. Results of the present study suggested that BMI may be a satisfactory prognostic factor for patients treated with ICIs.
Less invasive multivessel coronary artery bypass grafting: now is the time
Authors: Nambala Sathyaki , Mishra Yugal K. , Ruel Marc
Published: August 2021

Purpose of review

Less invasive multivessel coronary artery bypass grafting techniques have seen a progressive evolution over the last two decades. In their current state, they are easily reproduced and applicable to most patients requiring multivessel revascularization. The purpose of this review is to highlight their importance among a spectrum of evolving therapies and the accruing evidence in their favour.

Recent findings

The first large dual center experience with minimally invasive coronary artery bypass grafting (MICS CABG) demonstrated the feasibility of performing multivessel surgical revascularization without the need for sternotomy or cardiopulmonary bypass. Subsequent angiographic studies to assess graft patency showed excellent early results. Studies comparing MICS CABG to conventional CABG demonstrate faster recovery while reducing hospitalization and cost.

Multivessel less invasive coronary artery bypass grafting is basically limited to two procedures, MICS CABG and robotically assisted totally endoscopic CABG (TECAB). MICS CABG has evolved as a procedure that preserves the safety and efficacy of conventional CABG while avoiding the associated morbidity. It is reproducible, versatile and holds promise as the procedure of choice for multivessel coronary revascularization in the future. TECAB is likely the pinnacle of minimally invasive coronary surgery, the growth of which is hindered by widespread acceptance and industry involvement.
Advancing health equity through organizational change: Perspectives from health care leaders
Authors: Doherty Julia A. , Johnson Margaret , McPheron Heather
Published: August 2021

Background

Published literature on health care administration, management, and leadership and its impacts on health systems’ programs to address health care inequities is limited, as is information about how organizations integrate health equity in their cultures, missions, and strategic plans.

Purpose

The aims of this study were to identify the key components necessary for health systems to implement systematic organizational change to promote health equity and to describe approaches organizations have implemented.

Methodology/Approach

We conducted an environmental scan to identify central principles for implementing lasting change in health systems and experts working to advance health equity through organizational change. We interviewed 19 experts in health equity and hospital executives in 2020. Using iterative thematic analysis, we identified common themes.

Results

Consistent with the literature on organizational change, interviewees described a variety of systematic approaches to change, all of which involve the following core components: (a) committed and engaged leadership; (b) integrated organizational structure; (c) commitment to quality improvement and patient safety; (d) ongoing training and education; (e) effective data collection and analytics; and (f) stakeholder communication, engagement, and collaboration.

Conclusion and Practice Implications

There is no “one-size-fits-all” approach to advancing health equity. Decisions about which components require the most attention vary depending on an organization’s internal and external environment. Understanding those environments and identifying which levers will be most effective are essential. As provider organizations strive to develop more strategic and systematic approaches to addressing disparities, long-term vision and commitment are necessary to achieve sustainable organizational change.
Changes to ophthalmic clinical care during the coronavirus disease 2019 pandemic
Authors: Sundararajan Miel , Schallhorn Julie M. , Doan Thuy , Seitzman Gerami D.
Published: August 2021

Purpose of review

Given the impact that society as a whole, and medicine specifically, has experienced as a result of the COVID-19 pandemic, an examination of clinical care changes enacted in the field of ophthalmology is of interest to the specialty.

Recent findings

In order to adapt to the reality of the COVID-19 pandemic, measures, such as broadening telehealth capabilities, adopting universal masking, careful sanitation procedures, applying virtual teaching in academic environments, and deferring elective surgeries were put in place. These were aimed at reducing person-to-person spread of SARS-CoV-2. Though best efforts were made at triaging ophthalmic emergencies during these times, unfortunate delays in care were observed in some circumstances. Finally, a prospective study interrogating the risk of spread at slit lamp distances for short periods of time was encouraging, suggesting low risk of transmissibility, though limited by a small case-positive sample size.

Significant changes have been made in the design and delivery of ophthalmic care during the COVID-19 pandemic. Some of these, such as telemedicine, may provide value in a postpandemic world.
Systemic considerations with pigmented fundus lesions and retinal pigment epithelium hamartomas in Turcot syndrome
Authors: Mokhashi Nikita , Cai Louis Z. , Shields Carol L. , Benson William E. , Ho Allen C.
Published: August 2021

Purpose of review

To illustrate retinal pigment epithelium hamartomas (RPEHs) in a patient with known Turcot syndrome and to demonstrate the significance of these lesions in other colonic polyposis syndromes.

Recent findings

The presence of multiple, bilateral RPEHs is a specific marker for familial adenomatous polyposis (FAP). Recent studies have noted RPEHs in associated syndromes including Gardner and Turcot syndromes. Herein, we illustrate an 18-year-old male patient with known brain medulloblastoma who was documented 7 years later to have asymptomatic RPEHs in both eyes, demonstrating hypo-autofluorescence.

This patient with previous medulloblastoma and known Turcot syndrome was later found to have typical RPEHs, a feature that is important in family screening. Confirmation of RPEHs related to Turcot syndrome was made, and genetic evaluation confirmed germline mutation in the adenomatous polyposis coli (APC) gene. Observation was advised. Due to the fairly rapid progression to colorectal cancer if untreated, ophthalmologists should be aware that RPEHs can be the first extracolonic manifestation of FAP, Gardner syndrome, and Turcot syndrome.
Exploring COVID-19 at the single-cell level: a narrative review
Authors: Chen Yifan , Pu Jun
Published: August 2021

The coronavirus disease 2019 (COVID-19) pandemic has been an unmitigated disaster for society and the economy worldwide. However, much remains unknown about the pathogenesis of, treatment methods for, and preventive measures against COVID-19. Single-cell sequencing is a novel sequencing technology whose use has recently become prevalent in various life-science fields. This high-resolution technology is being used to analyze the COVID-19 pandemic at a single-cell level. In this review, we summarize the application of single-cell sequencing technology to the field of COVID-19-related research, including the biology of severe acute respiratory syndrome coronavirus 2, clinical concerns associated with COVID-19, neutralizing antibody screening, and vaccine development. We also address challenges to, and improvements in, existing single-cell research related to COVID-19.
Scalp-Ear-Nipple syndrome: first report of a Potassium channel tetramerization domain-containing 1 in-frame insertion and review of the literature
Authors: Butler Kameryn M. , Bahrambeigi Vahid , Merrihew Allie , Friez Michael J. , Cathey Sara S.
Published: August 2021

Objectives

Pathogenic missense variants in the potassium channel tetramerization domain-containing 1 (KCTD1) gene are associated with autosomal dominant Scalp-Ear-Nipple syndrome (SENS), a type of ectodermal dysplasia characterized by aplasia cutis congenita of the scalp, hairless posterior scalp nodules, absent or rudimentary nipples, breast aplasia and external ear anomalies. We report a child with clinical features of an ectodermal dysplasia, including sparse hair, dysmorphic facial features, absent nipples, 2–3 toe syndactyly, mild atopic dermatitis and small cupped ears with overfolded helices. We also review the published cases of SENS with molecularly confirmed KCTD1 variants.

Methods and results

Using whole-exome sequencing, we identified a novel, de novo in-frame insertion in the broad-complex, tramtrack and bric-a-brac (BTB) domain of the KCTD1 gene. By comparing to the previously reported patients, we found that our patient’s clinical features and molecular variant are consistent with a diagnosis of SENS.

Conclusions

This is only the 13th KCTD1 variant described and the first report of an in-frame insertion causing clinical features, expanding the mutational spectrum of KCTD1 and SENS.
Noninvasive continuous intradialytic blood pressure monitoring: the key to improving haemodynamic stability
Authors: Stewart Paul , Stewart Jill
Published: August 2021

Purpose of review

Intradialytic hypotension (IDH) occurs in 20% of haemodialysis treatments, leading to end-organ ischaemia, increased morbidity and mortality; and contributing to poor quality of life for patients. Treatment of IDH is reactive since brachial blood pressure (BP) is recorded only intermittently during haemodialysis, making early detection and prediction of hypotension impossible. Noninvasive continuous BP monitoring would allow earlier detection of IDH and thus support the development of methods for its prediction and consequently prevention.

Recent findings

Noninvasive continuous BP monitoring is not yet part of routine practice in renal dialysis units, with a small number of devices (e.g. finger cuffs) having occasionally been used in research settings. In use, patients frequently report pain or discomfort at measurement sites. Additionally, these devices can be unreliable in patients with reduced blood flow to the digits, often manifest in dialysis patients. All existing methods are sensitive to patient movement.

A new method for continuously estimating BP has been developed by monitoring arterial pressure near the arteriovenous fistula which can be achieved without any extraneous monitoring equipment attached to the patient. Additionally, artificial intelligence-based methods for real-time prediction of IDH are currently emerging.

Key monitoring technologies and computational methods are emerging to support the development of real-time IDH prediction.
Clinical usefulness of labyrinthine three-dimensional fluid-attenuated inversion recovery magnetic resonance images in idiopathic sudden sensorineural hearing loss
Authors: Yoon Ra Gyoung , Choi Yeonjoo , Park Hong Ju
Published: August 2021

Purpose of review

Literature on the use of current magnetic resonance imaging (MRI) for patients with idiopathic sudden sensorineural hearing loss (ISSNHL) is reviewed, emphasizing the role of three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) MRI. The discussion focuses on the diagnostic role of temporal bone MRI using 3D-FLAIR and the relationship between MRI findings, clinical symptoms, and hearing outcome.

Recent findings

The currently suggested MRI protocol for SSNHL includes a 3D T2-weighted steady-state free procession sequence or its equivalent, pre and postcontrast T1-weighted, and pre and postcontrast 3D-FLAIR sequences. The 3D-FLAIR image identifies an underlying labyrinthine condition in 24–57% of patients with ISSNHL, contributing to understanding the pathophysiologic mechanisms (e.g., labyrinthitis or labyrinthine hemorrhage). Recent studies demonstrated consistent results that initial hearing loss could be related to the signal change on the 3D-FLAIR image. Various results on 3D-FLAIR image value prediction for the final hearing outcome were shown.

3D-FLAIR MRI application identifies an underlying labyrinthine condition. Abnormal MRI findings correlate with initial hearing loss and accompanying symptoms and hearing outcome. Performing temporal bone MRI with 3D-FLAIR sequence may clarify probable ISSNHL pathophysiology, improve diagnostic accuracy, provide prognostic information to physicians, and possibly guide toward a more specific treatment.