bluuebunny/crossref_metadata_2025 huggingface dataset:
Intervention Adherence in REHAB‐HF: Predictors and Relationship With Physical Function, Quality of Life, and Clinical Events
Authors: Nelson M. Benjamin , Gilbert Olivia N. , Duncan Pamela W. , Kitzman Dalane W. , Reeves Gordon R. , Whellan David J. , Mentz Robert J. , Chen Haiying , Hewston Leigh Ann , Taylor Karen M. , Pastva Amy M.
Published: June 2022

Background

The REHAB‐HF (Rehabilitation Therapy in Older Acute Heart Failure Patients) trial showed that a novel, early, transitional, tailored, progressive, multidomain physical rehabilitation intervention improved physical function and quality of life in older, frail patients hospitalized for acute decompensated heart failure. This analysis examined the relationship between intervention adherence and outcomes.

Methods and Results

Adherence was defined as percent of sessions attended and percent of sessions attended adjusted for missed sessions for medical reasons. Baseline characteristics were examined to identify predictors of session attendance. Associations of session attendance with change in physical function (Short Physical Performance Battery [primary outcome], 6‐minute walk distance, quality of life [Kansas City Cardiomyopathy Questionnaire], depression, and clinical events [landmarked postintervention]) were examined in multivariate analyses. Adherence was 67%±34%, and adherence adjusted for missed sessions for medical reasons was 78%±34%. Independent predictors of higher session attendance were the following: nonsmoking, absence of myocardial infarction history and depression, and higher baseline Short Physical Performance Battery. After adjustment for predictors, adherence was significantly associated with larger increases in Short Physical Performance Battery (parameter estimate: β=0.06[0.03–0.10],
P
=0.001), 6‐minute walk distance (β=1.8[0.2–3.5],
P
=0.032), and Kansas City Cardiomyopathy Questionnaire score (β=0.62[0.26–0.98],
P
=0.001), and reduction in depression (β=−0.08[−0.12 to 0.04],
P
<0.001). Additionally, higher adherence was significantly associated with reduced 6‐month all‐cause rehospitalization (rate ratio: 0.97 [0.95–0.99],
P
=0.020), combined all‐cause rehospitalization and death (0.97 [0.95–0.99],
P
=0.017), and all‐cause rehospitalization days (0.96 [0.94–0.99],
P
=0.004) postintervention.

Conclusions

In older, frail patients with acute decompensated heart failure, higher adherence was significantly associated with improved patient‐centered and clinical event outcomes. These data support the efficacy of the comprehensive adherence plan and the subsequent intervention‐related benefits observed in REHAB‐HF.

Registration

URL:
https://clinicaltrials.gov/
; Unique identifier: NCT02196038.
Subcutaneous Versus Transvenous Implantable Defibrillator Therapy: A Systematic Review and Meta‐Analysis of Randomized Trials and Propensity Score–Matched Studies
Authors: Fong Khi Yung , Ng Colin Jun Rong , Wang Yue , Yeo Colin , Tan Vern Hsen
Published: June 2022

Background

Subcutaneous implantable cardioverter‐defibrillators (S‐ICDs) have been of great interest as an alternative to transvenous implantable cardioverter‐defibrillators (TV‐ICDs). No meta‐analyses synthesizing data from high‐quality studies have yet been published.

Methods and Results

An electronic literature search was conducted to retrieve randomized controlled trials or propensity score–matched studies comparing S‐ICD against TV‐ICD in patients with an implantable cardioverter‐defibrillator indication. The primary outcomes were device‐related complications and lead‐related complications. Secondary outcomes were inappropriate shocks, appropriate shock, all‐cause mortality, and infection. All outcomes were pooled under random‐effects meta‐analyses and reported as risk ratios (RRs) and 95% CIs. Kaplan–Meier curves of device‐related complications were digitized to retrieve individual patient data and pooled under a 1‐stage meta‐analysis using Cox models to determine hazard ratios (HRs) of patients undergoing S‐ICD versus TV‐ICD. A total of 5 studies (2387 patients) were retrieved. S‐ICD had a similar rate of device‐related complications compared with TV‐ICD (RR, 0.59 [95% CI, 0.33–1.04];
P
=0.070), but a significantly lower lead‐related complication rate (RR, 0.14 [95% CI, 0.07–0.29];
P
<0.0001). The individual patient data–based 1‐stage stratified Cox model for device‐related complications across 4 studies yielded no significant difference (shared‐frailty HR, 0.82 [95% CI, 0.61–1.09];
P
=0.167), but visual inspection of pooled Kaplan–Meier curves suggested a divergence favoring S‐ICD. Secondary outcomes did not differ significantly between both modalities.

Conclusions

S‐ICD is clinically superior to TV‐ICD in terms of lead‐related complications while demonstrating comparable efficacy and safety. For device‐related complications, S‐ICD may be beneficial over TV‐ICD in the long term. These indicate that S‐ICD is likely a suitable substitute for TV‐ICD in patients requiring implantable cardioverter‐defibrillator implantation without a pacing indication.
Risk Burden of Coronary Perforation in Chronic Total Occlusion Recanalization: Latin American CTO Registry Analysis
Authors: Ribeiro Marcelo Harada , Campos Carlos M. , Padilla Lucio , da Silva Antonio Carlos B. , de Paula João Eduardo T. , Alcantara Marco , Santiago Ricardo , Hanna Franklin , da Silva Franciele R. , Belli Karlyse C. , Azzalini Lorenzo , de Oliveira Pedro P. , Araujo Gustavo N. , Sucato Vincenzo , Mashayekhi Kambis , Galassi Alfredo R. , Abizaid Alexandre , Quadros Alexandre
Published: June 2022

Background

Coronary perforation is a life‐threatening complication of acute percutaneous coronary intervention (PCI) for chronic total occlusions (CTO), but data on midterm outcomes are limited.

Methods and Results

Data from LATAM (Latin American)‐CTO Registry (57 centers; 9 countries) were analyzed. We assessed the risk of 30‐day, 1‐year major adverse cardiac events of coronary perforation using time‐to‐event and weighted composite end point analysis having CTO PCI without perforation as comparators. Additionally, we studied the independent predictors of perforation in these patients. Of 2054 patients who underwent CTO PCI between 2015 and 2018, the median Multicenter CTO Registry in Japan and Prospective Global Registry for the Study of Chronic Total Occlusion Intervention‐Chronic total occlusions scores were 2.0 (1.0–3.0) and 1.0 (0.0–2.0), respectively. The perforation rate was 3.7%, of which 55% were Ellis class 1. After 1‐year coronary perforation had higher major adverse cardiac events rates (24.9% versus 13.3%;
P
<0.01). Using weighted composite end point, perforation was associated with increased bleeding and ischemic events at 6 months (
P
=0.04) and 1 year (
P
<0.01). We found as independent predictors associated with coronary perforation during CTO PCI: maximum activated clotting time (
P
<0.01), Multicenter CTO Registry in Japan score ≥2 (
P
=0.05), antegrade knuckle wire (
P
=0.04), and right coronary artery CTO PCI (
P
=0.05).

Conclusions

Coronary perforation was infrequent and associated with anatomical and procedural complexity, resulting in higher risk of hemorrhagic and ischemic events. Landmark and weighted analysis showed a sustained burden of major events between 6 months and 1 year follow‐up.
Cost‐Effectiveness of Cilostazol Added to Aspirin or Clopidogrel for Secondary Prevention After Noncardioembolic Stroke
Authors: Zhou Lily W. , Kraler Lironn , de Havenon Adam , Lansberg Maarten G.
Published: June 2022

Background

The objective of the study was to assess the cost‐effectiveness of cilostazol (a selective phosphodiesterase 3 inhibitor) added to aspirin or clopidogrel for secondary stroke prevention in patients with noncardioembolic stroke.

Methods and Results

A Markov model decision tree was used to examine lifetime costs and quality‐adjusted life years (QALYs) of patients with noncardioembolic stroke treated with either aspirin or clopidogrel or with additional cilostazol 100 mg twice daily. Cohorts were followed until all patients died from competing risks or ischemic or hemorrhagic stroke. Probabilistic sensitivity analysis using Monte Carlo simulation was used to model 10 000 cohorts of 10 000 patients. The addition of cilostazol to aspirin or clopidogrel is strongly cost saving. In all 10 000 simulations, the cilostazol strategy resulted in lower health care costs compared with aspirin or clopidogrel alone (mean $13 488 cost savings per patient; SD, $8087) and resulted in higher QALYs (mean, 0.585 more QALYs per patient lifetime; SD, 0.290). This result remained robust across a variety of sensitivity analyses, varying cost inputs, and treatment effects. At a willingness‐to‐pay threshold of $50 000/QALY, average net monetary benefit from the addition of cilostazol was $42 743 per patient over their lifetime.

Conclusions

Based on the best available data, the addition of cilostazol to aspirin or clopidogrel for secondary prevention following noncardioembolic stroke results in significantly reduced health care costs and a gain in lifetime QALYs.
Circulating S‐Glutathionylated cMyBP‐C as a Biomarker for Cardiac Diastolic Dysfunction
Authors: Zhou Xiaoxu , Jeong Euy‐Myoung , Liu Hong , Kaseer Bahaa , Liu Man , Shrestha Suvash , Imran Hafiz , Kavanagh Kylie , Jiang Ning , Desimone Lori‐Ann , Feng Feng , Shi Guangbin , Jeong Go Eun , Zhou Anyu , Stockwell Philip , Dudley Samuel C.
Published: June 2022

Background

cMyBP‐C (Cardiac myosin binding protein‐C) regulates cardiac contraction and relaxation. Previously, we demonstrated that elevated myocardial S‐glutathionylation of cMyBP‐C correlates with diastolic dysfunction (DD) in animal models. In this study, we tested whether circulating S‐glutathionylated cMyBP‐C would be a biomarker for DD.

Methods and Results

Humans, African Green monkeys, and mice had DD determined by echocardiography. Blood samples were acquired and analyzed for S‐glutathionylated cMyBP‐C by immunoprecipitation. Circulating S‐glutathionylated cMyBP‐C in human participants with DD (n=24) was elevated (1.46±0.13‐fold,
P
=0.014) when compared with the non‐DD controls (n=13). Similarly, circulating S‐glutathionylated cMyBP‐C was upregulated by 2.13±0.47‐fold (
P
=0.047) in DD monkeys (n=6), and by 1.49 (1.22–2.06)‐fold (
P
=0.031) in DD mice (n=5) compared with the respective non‐DD controls. Circulating S‐glutathionylated cMyBP‐C was positively correlated with DD in humans.

Conclusions

Circulating S‐glutathionylated cMyBP‐C was elevated in humans, monkeys, and mice with DD. S‐glutathionylated cMyBP‐C may represent a novel biomarker for the presence of DD.
Association Between Systolic Blood Pressure Variability and Major Adverse Cardiovascular Events in Korean Patients With Chronic Kidney Disease: Findings From KNOW‐CKD
Authors: Park Cheol Ho , Kim Hyung Woo , Joo Young Su , Park Jung Tak , Chang Tae Ik , Yoo Tae‐Hyun , Park Sue Kyung , Chae Dong‐Wan , Chung Wookyung , Kim Yong‐Soo , Oh Kook‐Hwan , Kang Shin‐Wook , Han Seung Hyeok ,   on the behalf of the KNOW‐CKD (Korean Cohort Study for Outcomes in Patients With Chronic Kidney Disease) Investigators
Published: June 2022

Background

Whether visit‐to‐visit systolic blood pressure (SBP) variability can predict major adverse cardiovascular events (MACE) in patients with chronic kidney disease is unclear.

Methods and Results

We investigated the relationship between SDs of visit‐to‐visit SBP variability during the first year of enrollment and MACE among 1575 participants from KNOW‐CKD (Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease). Participants were categorized into 3 groups according to tertiles of visit‐to‐visit SBP variability (SD). The study end point was MACE, defined as a composite of nonfatal myocardial infarction, unstable angina, revascularization, nonfatal stroke, hospitalization for heart failure, or cardiac death. During 6748 patient‐years of follow‐up (median, 4.2 years), MACE occurred in 64 participants (4.1%). Compared with the lowest tertile of visit‐to‐visit SBP variability (SD), the hazard ratios (HRs) for the middle and the highest tertile were 1.64 (95% CI, 0.80–3.36) and 2.23 (95% CI, 1.12–4.44), respectively, in a multivariable cause‐specific hazard model. In addition, the HR associated with each 5‐mm Hg increase in visit‐to‐visit SBP variability (SD) was 1.21 (95% CI, 1.01–1.45). This association was consistent in sensitivity analyses with 2 additional definitions of SBP variability determined by the coefficient of variation and variation independent of the mean. The corresponding HRs for the middle and highest tertiles were 2.11 (95% CI, 1.03–4.35) and 2.28 (95% CI, 1.12–4.63), respectively, in the analysis with the coefficient of variation and 1.76 (95% CI, 0.87–3.57) and 2.04 (95% CI, 1.03–4.03), respectively, with the variation independent of the mean.

Conclusions

Higher visit‐to‐visit SBP variability is associated with an increased risk of MACE in patients with chronic kidney disease.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01630486.
Genetic Determinants of Body Mass Index and Fasting Glucose Are Mediators of Grade 1 Diastolic Dysfunction
Authors: Vaitinadin Nataraja Sarma , Shi Mingjian , Shaffer Christian M. , Farber‐Eger Eric , Lowery Brandon D. , Agrawal Vineet , Gupta Deepak K. , Roden Dan M. , Wells Quinn S. , Mosley Jonathan D.
Published: June 2022

Background

Early (grade 1) cardiac left ventricular diastolic dysfunction (G1DD) increases the risk for heart failure with preserved ejection fraction and may improve with aggressive risk factor modification. Type 2 diabetes, obesity, hypertension, and coronary heart disease are associated with increased incidence of diastolic dysfunction. The genetic drivers of G1DD are not defined.

Methods and Results

We curated genotyped European ancestry G1DD cases (n=668) and controls with normal diastolic function (n=1772) from Vanderbilt’s biobank. G1DD status was explored through (1) an additive model genome‐wide association study, (2) shared polygenic risk through logistic regression, and (3) instrumental variable analysis using 2‐sample Mendelian randomization (the inverse‐variance weighted method, Mendelian randomization‐Egger, and median) to determine potential modifiable risk factors. There were no common single nucleotide polymorphisms significantly associated with G1DD status. A polygenic risk score for BMI was significantly associated with increased G1DD risk (odds ratio [OR], 1.20 for 1‐SD increase in BMI [95% CI, 1.08–1.32];
P
=0.0003). The association was confirmed by the inverse‐variance weighted method (OR, 1.89 [95% CI, 1.37–2.61]). Among the candidate mediators for BMI, only fasting glucose was significantly associated with G1DD status by the inverse‐variance weighted method (OR, 4.14 for 1‐SD increase in fasting glucose [95% CI, 1.55–11.02];
P
=0.005). Multivariable Mendelian randomization showed a modest attenuation of the BMI association (OR, 1.84 [95% CI, 1.35–2.52]) when adjusting for fasting glucose.

Conclusions

These data suggest that a genetic predisposition to elevated BMI increases the risk for G1DD. Part of this effect may be mediated through altered glucose homeostasis.
Faculty Development Approaches for Life Support Courses: A Scoping Review
Authors: Ko Ying‐Chih , Hsieh Ming‐Ju , Cheng Adam , Lauridsen Kasper G. , Sawyer Taylor L. , Bhanji Farhan , Greif Robert , Bray Janet , Breckwoldt Jan , Duff Jonathan P , Eastwood Kathryn , Gilfoyle Elaine , Lin Yiqun , Lockey Andrew , Matsuyama Tasuku , Nation Kevin , Patocka Catherine , Pellegrino Jeffrey L , Schnaubelt Sebastian , Yang Chih‐Wei , Yeung Joyce , Finn Judith
Published: June 2022

The aim of this scoping review initiated by the Education, Implementation and Teams Task Force of the International Liaison Committee on Resuscitation was to identify faculty development approaches to improve instructional competence in accredited life support courses. We searched PubMed, Ovid Embase, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Central Register of Controlled Trials to identify studies published from January 1, 1966 to December 31, 2021 on approaches to improve faculty development for life support courses. Data on participant characteristics, interventions, design, and outcomes of included studies were extracted. Of the initially identified 10 310 studies, we included 20 studies (5 conference abstracts, 1 short communication, 14 full‐length articles). Among them, 12 studies aimed to improve instructors/candidates’ teaching ability in basic life support courses. A wide variety of interventions were identified. The interventions were categorized into 4 themes: instructor qualification/training (n=9), assessment tools (n=3), teaching skills enhancement (n=3), and additional courses for instructors (n=5). Most studies showed that these interventions improved specific teaching ability or confidence of the instructors and learning outcomes in different kinds of life support courses. However, no studies addressed clinical outcomes of patients. In conclusion, the faculty development approaches for instructors are generally associated with improved learning outcomes for participants, and also improved teaching ability and self‐confidence of the instructors. It is encouraged that local organizations implement faculty development programs for their teaching staff of their accredited resuscitation courses. Further studies should explore the best ways to strengthen and maintain instructor competency, and define the cost‐effectiveness of various different faculty development strategies.
Ottoman Raiders (Akıncıs) as a Driving Force of Early Ottoman Conquest of the Balkans and the Slavery-Based Economy
Authors: Schmitt Oliver Jens , Kiprovska Mariya
Published: June 2022

The paper examines the akıncıs’ actions and hence the motivation for their raids as essential constituents within the process of Ottoman conquest of the Balkans in the late Middle Ages. Focusing on the raiders and their plundering activities, it asserts that the akıncıs played a crucial key role in the early Ottoman slave economy, as slave hunting was arguably the main economic driving force behind the Ottoman conquest. It hence argues that an analysis of the akıncıs allows for new insights into the nature of the early Ottoman Empire, but also advances the idea that their actions fall within a particular phase of the conquest period. To that end, the authors re-periodize the Ottoman conquest of the Balkans into the akıncı phase, which spanned eight to thirteen decades, depending on the region, and was characterized by continuous slave hunting and destruction of economic infrastructure, and the phase of administrative integration into the Ottoman Empire, which latter process was pursued by other actors, namely imperial elites from the center, and is usually characterized by at least partial repopulation of demographically weakened areas.
Identification of Mediterranean marine gobies (Actinopterygii: Gobiidae) of the continental shelf from photographs of in situ individuals
Authors: KOVAČIĆ MARCELO , RENOULT JULIEN P. , PILLON ROBERTO , SVENSEN RUDOLF , BOGORODSKY SERGEY V. , ENGIN SEMIH , LOUISY PATRICK
Published: June 2022

Numerous photographs of live fishes posted by anglers and divers on social media and citizen science databases are important sources of information for ichthyological research. However, validating records that extend the known ecology and bathymetric or geographic distribution of species should rely on a rigorous identification process. The family Gobiidae, with their small size, superficial resemblance among species and high species richness are particularly difficult to identify. Therefore, the identification from photographs of live individuals of Mediterranean marine gobies from the continental shelf was studied. A dichotomous identification key is provided based on photographs of live individuals, allowing positive identification of 41 out of the 66 species reviewed in this publication. Then, for all 66 species we provide a brief description of important characters, which can be used for provisional identification for those species that could not be positively identified using the key. Pending further progress in identification of live individuals, we suggest that records extending the known geographic and ecological species distribution be taken into account only if they could be validated using the dichotomous identification key.
Xorides xylotrechi sp. n. (Hymenoptera: Ichneumonidae: Xoridinae) parasitizing Xylotrechus stebbingi (Gahan, 1906) (Coleoptera: Cerambycidae) in India
Authors: MAQBOOL IQRA , VARGA OLEKSANDR , MAQBOOL AMIR , WACHKOO AIJAZ AHMAD , BANU A. NAJITHA , RATHER SUMI ULAH
Published: June 2022

New xoridine species, Xorides xylotrechi sp. n., from India is described and illustrated. The parasitoid was reared from the larvae of the xylophagous beetle, Xylotrechus stebbingi (Gahan, 1906), infesting Juglans regia L. Notes on parasitoid behaviour and biology are also provided with a brief description of female reproductive system and venom apparatus.
Ocean Reference Stations: Long-Term, Open-Ocean Observations of Surface Meteorology and Air–Sea Fluxes Are Essential Benchmarks
Authors: Weller Robert A. , Lukas Roger , Potemra James , Plueddemann Albert J. , Fairall Chris , Bigorre Sebastien
Published: June 2022

There is great interest in improving our understanding of the respective roles of the ocean and atmosphere in variability and change in weather and climate. Due to the sparsity of sustained observing sites in the open ocean, information about the air–sea exchanges of heat, freshwater, and momentum is often drawn from models. In this paper observations from three long-term surface moorings deployed in the trade wind regions of the Pacific and Atlantic Oceans are used to compare observed means and low-passed air–sea fluxes from the moorings with coincident records from three atmospheric reanalyses (ERA5, NCEP-2, and MERRA-2) and from CMIP6 coupled models. To set the stage for the comparison, the methodologies of maintaining the long-term surface moorings, known as ocean reference stations (ORS), and assessing the accuracies of their air–sea fluxes are described first. Biases in the reanalyses’ means and low-passed wind stresses and net air–sea heat fluxes are significantly larger than the observational uncertainties and in some case show variability in time. These reanalyses and most CMIP6 models fail to provide as much heat into the ocean as observed. In the discussion and conclusions section, long-term observing sites in the open ocean are seen as essential, independent benchmarks not only to document the coupling between the atmosphere and ocean but also to promote collaborative efforts to assess and improve the ability of models to simulate air–sea fluxes.
Extreme Heat Impacts on the Viability of Alternative Transportation for Reducing Ozone Pollution: A Case Study from Maricopa County, Arizona
Authors: Braun Rachel A. , Fraser Matthew P.
Published: June 2022

One commonly proposed strategy for reducing urban air pollution is transitioning from single-occupancy vehicle (SOV) travel to alternative transportation (AT) modes, such as walking, biking, and using public transportation. While many studies have addressed the benefits of switching from SOV to AT, fewer studies have examined the potential for negative outcomes due to increased exposure to heat when using AT modes. This work uses Maricopa County, Arizona, home to the metropolitan Phoenix area, as a test case to examine the potential impacts of heat on commuters who utilize AT. First, regions of the county with the most candidates for switching from SOV to AT were identified and used to develop an AT candidate index. This index was based on both the current rates of AT use and the number of SOV commuters with the shortest commuting times in the dataset (<10 min). Next, typical weather conditions during warnings for high ozone (O3) pollution were examined. From 2017 to 2020, over one-quarter of all days with an O3 warning also were subject to an excessive heat warning. Last, land surface temperature data were used to determine the potential for increased heat exposure during AT commuting at both the ZIP code and AT infrastructure (public transit stops and bikeways) scales. Although this work focuses on Maricopa County, the issues presented here are increasingly relevant for cities across the world that are subject to poor air quality, hotter temperatures, and heat waves.
Single-Cell Transcriptomic Atlas of Gingival Mucosa in Type 2 Diabetes
Authors: Wang Q. , Lin W. , Zhou X. , Lei K. , Xu R. , Zhang X. , Xiong Q. , Sheng R. , Song W. , Liu W. , Wang Q. , Yuan Q.
Published: June 2022

The oral gingival barrier is a constantly stimulated and dynamic environment where homeostasis is often disrupted, resulting in inflammatory periodontal diseases. Type 2 diabetes (T2D) has been reported to be associated with gingival barrier dysfunction, but the effect and underlying mechanism are inconclusive. Herein, we performed single-cell RNA sequencing (scRNA-seq) of gingiva from leptin receptor-deficient mice ( db/db) to examine the gingival heterogeneity in the context of T2D. Periodontal health of control mice is characterized by populations of Krt14+-expressing epithelial cells and Col1a1+-fibroblasts mediating immune homeostasis primarily through the enrichment of innate lymphoid cells. The db/db gingiva exhibited decreased epithelial/stromal ratio and dysfunctional barrier. We further observed stromal, particularly fibroblast immune hyperresponsiveness, linked to the recruitment of myeloid-derived cells at the db/db gingiva. Both scRNA-seq and histological analysis suggested the inflammatory signaling between fibroblasts and neutrophils as a potential driver of diabetes-induced periodontal damage. Notably, the “immune-like” stromal cells were wired toward the induction of gingival IL-17A hyperresponsiveness in db/db mice. Our work reveals that the “immune-like” fibroblasts with transcriptional diversity are involved in the innate immune homeostasis at the diabetic gingiva. It highlights a potentially significant role of these cell types in its pathogenesis.
Prospective case series of neuropathic cancer pain in patients treated with an EGFR-inhibitor
Authors: Cameron Marte Grønlie , Kersten Christian
Published: June 2022

Background:

Novel treatments of neuropathic pain are urgently needed. Rapid relief of neuropathic cancer pain in patients treated with epidermal growth factor receptor (EGFR) inhibitors have been reported. Experiments in rodent models confirm the pain relief and reveal novel mechanisms critically involving the EGFR. Clinical pain research is complicated and patients with advanced cancer are heterogeneous, often with complex, deteriorating clinical pictures, hampering feasibility of drug-trial procedures.

Actual case:

Prospective case series exploring the EGFR inhibition/neuropathic cancer pain association in order to inform planning clinical trials.

Possible courses of action:

Symptom assessment method was tailored to what was ethical, feasible, and clinically relevant for each patient.

Formulation of a plan:

Patients with neuropathic cancer pain treated off-label with the monoclonal antibody panitumumab were studied to assess feasibility of different measurement tools.

Outcome:

Fourteen of 20 patients (70%) experienced clinically significant pain relief. There was good concordance in patient and physician-reported outcomes.

Lessons:

Results support panitumumab’s potential to be of significant benefit to patients with refractory neuropathic cancer pain. Findings also reinforce the difficulty of using conventional drug trial endpoints and designs in this population.

View:

Innovative research methods must be considered for much needed pivotal trials.
Brain and pituitary-adrenal lesions of Trypanosoma brucei brucei and Trypanosoma congolense infections in the West African Dwarf rams: Is trypanotolerance overrated?
Authors: Anyogu Davinson C. , Shoyinka Shodeinde V. O. , Ihedioha John I.
Published: June 2022

Trypanosomosis of the West African Dwarf (WAD) sheep is often neglected due to emphasis on trypanotolerance. Nevertheless, significant pathological changes may occur in tissues of infected WAD sheep. The purpose of this study was to evaluate the brain, pituitary, and adrenal lesions of Trypanosoma brucei brucei (Tbb) and Trypanosoma congolense (Tc) infections in WAD rams. Fifteen WAD rams were infected intraperitoneally with Tbb or Tc (106 trypanosomes/animal) or were uninfected controls (5 rams per group). Adrenocorticotrophic hormone (ACTH) and cortisol were assayed in serum by enzyme immunoassay technique. The brain, pituitary, and adrenal glands were processed for histopathology. Serum ACTH levels of infected rams were significantly ( P < .05) higher than that of controls on days 14 and 70 post infection (PI). Serum cortisol levels of infected rams were significantly ( P < .05) higher than that of controls only on day 14 PI. Mortality was 60% in Tbb- and 40% in Tc-infected rams. The brain of the infected groups showed chromatolysis of cortical neurons and Purkinje cells with severe encephalitis. Degenerative, necrotic, and inflammatory changes were seen in the pituitary and adrenal glands of the infected rams. Adrenal corticomedullary ratio was significantly ( P < .05) higher in Tc-infected rams than controls. Based on the high mortality levels, likely due to severe encephalitis, the WAD sheep may not be regarded as trypanotolerant.
Predicting anxiety, depression, and wellbeing in professional and nonprofessional musicians
Authors: Loveday Catherine , Musgrave George , Gross Sally-Anne
Published: June 2022

People working in the music industry report significantly higher levels of anxiety and depression than the general population, but to date, studies have not explored the differences between professional musicians and those who perform music primarily for recreation. In this study, 254 musicians from 13 countries completed measures of anxiety, depression, and wellbeing as well as answering questions about their professional status, level of success, and income. Across the whole sample, we found that over half had high levels of anxiety, and a third were experiencing depression. We showed that musicians who viewed music as their main career were more likely to have poor mental wellbeing and had significantly higher levels of clinical depression. Status as a solo or lead artist and perceived level of success also significantly predicted higher levels of anxiety and depression, and lower levels of positive wellbeing. We conclude that low mental wellbeing in musicians is the result of working as a professional musician, as opposed to being an inherent trait. Future work should explore underlying beliefs and perceptions of career musicians alongside other key factors, such as health behaviors and social support, with the aim of making specific recommendations to the music industries and educators.
Performance Dashboard Tool to Visualize Adaptive Resilience Maturity of Transportation Agencies
Authors: Singh Prerna , Amekudzi-Kennedy Adjo , Kassa Habte
Published: June 2022

Incorporating adaptive resilience as a core value of transportation systems will equip transportation agencies to better address the increasing pace of future changes—both in climate and transportation system performance demands. Quantifiable measures are instrumental in incorporating adaptive resilience in agency organizational frameworks. This paper presents a dashboard tool that evaluates the maturity of adaptive resilience capabilities of a transportation agency, using an Adaptive Resilience (AR) Capability Maturity Model. A demonstrative example is presented to show the potential application of the dashboard tool and its implications for transportation system resilience planning. The example shows how the tool can facilitate identification of adaptive resilience capabilities that are at low maturity and thus may need prioritization for future resilience investments, and capabilities that are at a high maturity level and thus can be leveraged to enhance the lower-level capabilities. The AR performance dashboard tool may be used by transportation agencies to communicate their adaptive resilience efforts and maturity to stakeholders. It can also be used by practitioners to streamline and prioritize process improvements in adaptive resilience efforts.
Safety Analysis for Micromobility: Recommendations on Risk Metrics and Data Collection
Authors: Karpinski Elizabeth , Bayles Eleanor , Sanders Tracy
Published: June 2022

Existing measures of road safety were primarily designed to evaluate motor vehicle crashes. Consequently, they are not well-suited for alternate or emerging modes of micromobile transportation, particularly the e-scooter, whose popularity has surged without a corresponding body of research on their safety. Effective safety analysis depends on complete, high-quality data capable of accounting for the relevant mode-specific dangers. The established criteria for measuring consequences and hazard exposure in risk metrics used for motor vehicles do not apply. Most road safety data sources and schemas have a similar motor vehicle-centric bias. This framing presents challenges when it comes to selecting and interpreting data about alternate modes of transportation like micromobility. This paper discusses a basic theory of risk metric selection and the purpose of transportation safety measures. It applies these ideas to the emerging mode of micromobility transportation and recommends appropriate criteria and limitations for each component of a metric. This paper also evaluates existing data sources and schemas to provide examples of bias and estimate the relative size of each issue. These considerations may serve as useful guidelines for further research in the area and help inform the requirements of data collection necessary to better answer questions of safety.
Reimagining Perinatal Palliative Care: A Broader Role for Support in the Face of Uncertainty
Authors: Lord Sarah , Williams Rebecca , Pollard Lindsay , Ives-Baine Lori , Wilson Carolyn , Goodman Kira , Rapoport Adam
Published: June 2022

Perinatal medicine is confronted by a growing number of complex fetal conditions that can be diagnosed prenatally. The evolution of potentially life-prolonging interventions for the baby before and after birth contributes to prognostic uncertainty. For clinicians who counsel families in these circumstances, determining which ones might benefit from early palliative care referral can be challenging. We assert that all women carrying a fetus diagnosed with a life-threatening condition for which comfort-focused care at birth is one ethically reasonable option ought to be offered palliative care support prenatally, regardless of the chosen plan of care. Early palliative care support can contribute to informed decision making, enhance psychological and grief support, and provide opportunities for care planning that includes ways to respect and honor the life of the fetus or baby, however long it may be.
A Multicenter Study of Adherence to Best Practices and Application of Epilepsy Quality Metrics in a Pediatric Telemedicine Encounter
Authors: Joshi Charuta N. , Miller Joseph S. , Silveira Lori J. , Nelson Julie A. , Walleigh Diana J. , Joshi Sucheta M. , Patel Anup D.
Published: June 2022

Objective: To assess Epilepsy Quality Metrics (EQM) and guideline implementation in new pediatric patients seen in telemedicine. Methods: Multicenter, cross sectional, retrospective analysis. Results: Patients were similar across 3 centers for age, gender, and insurance type. Eighty-one percent presented for spells. One hundred sixty patients with epilepsy formed the EQM cohort. Results: Seizures described: 95%; frequency: 67%, last seizure documented: 81%, epilepsy syndrome documented: 67%; epilepsy diagnosis: 77%, medications reviewed: 56%, adverse events discussed: 73%. Quality of life discussed: 3%. Anticipatory guidance was described as follows: seizure safety, 57%; driving, 47%; SUDEP, 11%; vitamin D discussion, 19%; pregnancy and folic acid counseling, 4% and 10%. Epileptologists were 4 times as likely as generalists in discussing driving safety (odds ratio 3.93, 95% confidence interval 1.7-8.9; P = .001) for all ages. Significance: Performance on EQM and guideline implementation in pediatric epilepsy telemedicine encounters can be improved.
Women’s Solidarity, Communicative Space, the Gig Economy’s Social Reproduction and Labour Process: The Case of Female Platform Drivers in China
Authors: Kwan Haley
Published: June 2022

This article draws on a study conducted over a period of 17 months, including chatnography and semi-structured interviews with 30 female platform drivers working in China’s hail-riding industry, and makes three important contributions to the labour process and the social reproduction process scholarship. First, it fills a gap in the burgeoning literature on the gendered experience of gig work and of work–family flexibility in an on-demand economy. Women’s surplus production, as a means of subsistence for oneself and the family, is contradictory to childcare commitments in the labour process. Second, it theorises that the communicative space is a space for social reproduction in which labour-power is replenished outside the household. Labour productivity is not solely determined by algorithmic logic and platform control, but rather is organised by the social reproduction process. Third, it discusses how female platform workers negotiate technological insecurity and resist the platform’s control over and sexual exploitation in the communicative space. This sheds light on how the social reproduction process creates a potential for women’s solidarity. Women fight against sexual harassment and gender-based violence by utilising communication technologies, such as WeChat and TikTok. The social reproduction process organises labour resistance in a time of individual and collective crisis.
Kinematic and mechanical error analysis of serial spherical linkages using a modular approach
Authors: Hsu Kuan-Lun , Lai Pai-Yu
Published: June 2022

Although spherical mechanisms have been widely implemented in medical and industrial fields, there still lacks a simple and systematic approach for analyzing their kinematics and mechanical errors. Therefore, the purpose of this paper is to provide a modular approach for kinematic and mechanical error analysis of serial spherical mechanisms that can be decomposed into predefined modules. Firstly, the forward and inverse kinematics, described by rotation matrices, of the spherical serial manipulator are derived. Besides, the error propagations of the spherical serial manipulator are formulated based on the derived kinematic equations. The derived algorithms are programed into subroutines to analyze the kinematics and mechanical error of a serial spherical linkage by analyzing each of its substructures as the illustrative examples have shown. Until now, the presented module in this paper is applicable to a variety of serial spherical mechanisms, and the feasibility of this method adopting high-class modules will be explored in the future.
Robust attitude estimation for an unmanned aerial vehicle using multiple GPS receivers
Authors: DHAHBANE Djamel , NEMRA Abdelkrim , SAKHI Samir
Published: June 2022

Estimation of the system state is an important task in the field of control, localization, and navigation. Many sensors are used to extract the attitude information. GPS (Global Positioning System) is widely used to provide position and velocity for ground and aerial vehicles. However, only a few research works have addressed the problem of attitude estimation using multiple GPS receivers. The main contribution of this paper consists on proposing a robust algorithm for attitude estimation of an unmanned aerial vehicle using INS/3GPS integration. First, we propose two alternative methods for attitude determination with three GPS receivers: Direct Computing Method (DCM) and Least Square Method (LSM) based on Singular Value Decomposition (SVD). Second, the attitude given by GPS receivers is fused with the measurement of a three-axis gyroscope using a robust Smooth Variable Structure Filter (SVSF). The optimal geometric configuration of GPS antennas is determined based on a deep performance analysis of the proposed system. Then, robustness analysis is assessed against measurement noise and parameters uncertainties. Simulation results are presented to demonstrate the robustness of the proposed approach. A more realistic evaluation of the proposed solution is obtained using an aerial vehicle type “Helicopter” from the Virtual Robot Experimentation Platform (VREP simulator). The proposed filter is compared with an Extended Kalman Filter (EKF). The obtained results have confirmed how much the SVSF is robust for attitude estimation in presence of the considered disturbances.
Public library events with spaces and collections: Case analysis of the Helsinki Central Library Oodi
Authors: Igarashi Tomoya , Watanabe Momoka , Tomita Yumi , Sugeno Yuki , Yamagishi Motoko , Koizumi Masanori
Published: June 2022

In recent years, programmes and events have become one of the major services of public libraries. This study aimed to provide a comprehensive and detailed investigation of the types of programmes and events that occur in modern public libraries that provide new services, in addition to traditional services such as book lending. The Helsinki Central Library Oodi (Finland) was used as a case study and data posted on their webpage was collected for analysis. In Finland, as per the Library Act of 2017, public libraries are encouraged to hold programmes and events. Accordingly, various programmes and events are held at Oodi. A total of 1,330 events (excluding duplicates) took place between 13 August 2019 and 31 October 2020 and were coded using the open coding method and grouped into categories. Oodi provided users with many types of learning and experience opportunities through programmes and events, aiming to eliminate social disparities and ensure equality among citizens. Many programmes and events were held to provide citizens with a place for social interaction and dialogue, creating connections among them. The library’s traditional resource, that is, its collection, was central to many programmes and events. Even during the COVID-19 pandemic, the library has been contributing to the community by holding programmes and events online. This study is the first to comprehensively elucidate the contents of programmes and events held in a modern public library, which is expected to contribute to the further dissemination and development of these types of programmes and events. Furthermore, this study promotes research on specific programmes and events and encourage discussion regarding the linkages between events.
How Corporate Social Responsibility Is Described in Keywords: An Analysis of 144 CSR Definitions Across Seven Decades
Authors: Homer Stephen Thomas , Gill Colin Mathew Hugues D.
Published: June 2022

This article reports a longitudinal analysis of corporate social responsibility (CSR) keywords drawing on an extensive sample of 144 CSR definitions across seven decades. There are clear differences in the keywords used in various time periods to describe the person or entity providing CSR, the CSR activity provided, and the intended recipients or targets of any CSR activities. There has been a trend away from individuals such as managers or specific groups such as employees being identified as providers or recipients of CSR towards keywords describing CSR as an organizational responsibility that is provided to large and inclusive groups such as communities or abstract entities such as stakeholders or the environment. Since the millennium, there has been considerable convergence in CSR keywords that appears to be driven by the availability of CSR information via the internet. The changes in CSR keywords appear to parallel changes in societal expectations, regulation and legislation, and the wider business environment. This suggests that corporations deploy CSR defensively to express alignment with prevailing public priorities, stress compliance with government directives and emphasise conformity with corporate contemporaries. The implications of these findings are discussed and possible lines for future research are proposed.
Reducing False Alarms and Alarm Fatigue from Pulse Oximeters in a Neonatal Care Unit: A Quality Improvement Study
Authors: Patel Nawaz Z. , Patel Dipen Vasudev , Phatak Ajay Gajanan , Patel Vinit G. , Nimbalkar Somashekhar Marutirao
Published: June 2022

Background:

Pulse oximeters play a vital role in monitoring sick newborns, but majority of the times, their alarms are of little clinical significance. False alarms from pulse oximeters were frequent in our neonatal intensive care unit, causing desensitization of staff and inattention to clinically important alarms.

Objectives:

The objective of the study was to reduce the burden of false alarms and alarm fatigue.

Methods:

This was a quality improvement (QI) study. During the baseline phase, alarms for heart rate and SPO2 (percentage of oxygenated blood) were evaluated. Response to them within 30 s was checked. Major causes of false alarms were the movement of the newborns, inappropriate alarm limits, and loose probe. Fishbone chart was prepared, and Plan-Do-Study-Act (PDSA) model was designed using point of care quality improvement (POCQI) principles. During the first PDSA (implementation phase), the staff was trained to adjust alarm limits using the reference chart. A lecture on noise hazards, emphasis on muting the alarms, and advice to change probe site at beginning of their duty was given. In the second PDSA (sustenance phase), components of the first PDSA were strengthened by supportive supervision and guidance and the training of new staff.

Results:

Total 494, 329, and 162 alarms were observed during baseline, implementation, and sustenance phases, respectively. In the baseline phase majority, 364 (73.7%) were false alarms, which occurred at a frequency of 0.39 alarms/patient/h. More than one-third of the alarms were not responded timely. After QI, false alarms reduced to 214 (65%; 0.22 alarms/patient/h) and 100 (61.7%; 0.16 alarms/patient/h) in implementation and sustenance phases, respectively. Response to true alarms improved from 101 (77.7%) to 104 (90.4%) to 62 (100%) during the 3 phases consecutively.

Conclusion:

Frequent false alarms lead to desensitization of health care workers. POCQI principles can be a practical approach for reducing false alarms and improving alarm safety.
Prevalence of antinuclear antibodies and rheumatoid factor titers in dogs with arthritis secondary to leishmaniosis (Leishmania infantum)
Authors: Tsouloufi Theodora K. , Theodorou Konstantina , Day Michael J. , Oikonomidis Ioannis L. , Kasabalis Dimitrios , Mylonakis Mathios E. , Saridomichelakis Manolis N. , Kritsepi-Konstantinou Maria , Soubasis Nectarios
Published: June 2022

Dogs with infectious arthritis may occasionally exhibit positive serum antinuclear antibody (ANA) and rheumatoid factor (RF) titers; however, relevant data are sparse for arthritis secondary to canine leishmaniosis (CanL) caused by Leishmania infantum. We determined the prevalence of positive serum ANA and RF titers in dogs with arthritis secondary to CanL. Blood samples from adult, client-owned dogs with purulent arthritis secondary to CanL, without any comorbidities, were collected for diagnostic purposes. Serum ANA titers were measured by immunoperoxidase test and RF titers by the Rose–Waaler latex test. Twelve of 23 dogs enrolled prospectively in our study had clinical arthritis, and 11 of 23 had subclinical arthritis. Based on LeishVet clinical staging, 7 dogs had clinical stage II disease, 11 had clinical stage III disease, and 5 had stage IV. None of the 23 dogs was seropositive for ANA; 3 of 23 were positive for RF. ANA and/or RF seropositivity, in dogs with CanL-associated arthritis, appears to be weak, if present at all. Based on our results, positive serum ANA and RF titers should not be expected in dogs with arthritis secondary to CanL.