bluuebunny/crossref_metadata_2025 huggingface dataset:
Towards a fair and transparent research participant compensation and reimbursement framework in Vietnam
Authors: Sansom Lucy J , Minh Trang Pham Nguyen , Hill Iona E , Ha Quyen Nguyen Than , Trong Thuan Dang , Vidaillac Celine , Quynh Nhu Dong , Turner Hugo C , Van Nuil Jennifer Ilo , Phuong Dung Nguyen Thi , Kestelyn Evelyne
Published: August 2020

Background

Providing compensation for participants in clinical research is well established and while international guidelines exist, defining a context-specific and fair compensation for participants in low-resource settings is challenging due to ethical concerns and the lack of practical, national compensation and reimbursement frameworks.

Methods

We reviewed Oxford University Clinical Research Unit (OUCRU) internal reimbursement documentation over a 10-y period and conducted a scoping literature review to expand our knowledge of compensation and reimbursement practices including ethical concerns. We developed a preliminary reimbursement framework that was presented to community advisory boards (CAB) and clinical investigators to assess its applicability, fairness and transparency.

Results

The main topics discussed at the workshops centered on fairness and whether the reimbursements could be perceived as financial incentives. Other decisive factors in the decision-making process were altruism and the loss of caregivers’ earnings. Investigators raised the issue of additional burdens, whereas the CAB members were focused on non-monetary elements such as the healthcare quality the patients would receive. All elements discussed were reviewed and, where possible, incorporated into the final framework.

Conclusion

Our new reimbursement framework provides a consistent, fair and transparent decision-making process and will be implemented across all future OUCRU clinical research in Vietnam.
Associations between maternal milk protein genotypes with preweaning calf growth traits in beef cattle
Authors: Hohmann Lisa G , Weimann Christina , Scheper Carsten , Erhardt Georg , König Sven
Published: August 2020

The objectives of this study were to investigate milk casein polymorphisms in dams and to determine the impacts of maternal casein genotypes on growth traits of their sucking calves. Milk samples from 433 dams of the breeds German Angus (GA) and German Simmental (GS) were typed at the milk protein loci α s1-casein (αs1-CN), β-casein (β-CN), α s2-casein (αs2-CN), and κ-casein (κ-CN) via isoelectric focusing. Associations between casein genotypes in maternal milk with growth traits of their 1,872 calves were analyzed until the age of weaning using linear mixed models, considering either genotypes of individual casein loci (model 1) or composite α s1-β-α s2-κ-CN genotypes within the casein cluster (model 2). Besides environmental effects such as sex, age of the dam, and calving year-season, genetic effects (breed group and maternal and paternal effects) were considered in statistical models. The composite casein genotype BBǀA2A2ǀAAǀAB (order of genes on bovine chromosome 6: α s1-ǀβ-ǀα s2-ǀκ-CN) was associated with greater average daily weight gains (ADG) and heavier age-adjusted weaning weights (WW) of calves (P < 0.05). The effects of composite genotypes on birth weight of calves were similar (P > 0.05; model 2). With regard to individual casein loci, greater ADG and WW were observed for calves from dams with the genotypes κ-CN BB and α s1-CN BB, respectively (P < 0.05; model 1). Age-adjusted WW was largest for calves from dams carrying the κ-CN genotype BB (215 kg) compared with calves representing the maternal AB and AA genotypes (both 204 kg). Results from the present study suggested selectable casein genotypes due to their nutritional value of milk (value in terms of offspring performances), offering new perspectives for breeding strategies in beef cattle to improve preweaning calf performance.
Escharotomy for the Face: Facial Aesthetic Subunit Principle-Based Approach
Authors: Ozkan Burak , Ertas Nilgun M , Uysal Cagri A , Haberal Mehmet
Published: August 2020

Escharotomy is the relaxation of an eschar through longitudinal or horizontal incisions in order to protect regional perfusion. In peripheral areas, such as limbs, trunk, and neck, eschar pressure poses significant issues; it causes circulatory disorder in limbs and potential limb loss, inadequate thoracic expansion in the thorax, and perfusion and oxygenation problems in the neck. To prevent complications, a basic rule of burn surgery is to perform escharotomy incisions quickly and without hesitation. However, the face is not an area in which eschar formation is commonly seen due to its robust vascular supply and patients’ protection reflex. Although descriptive drawings and guides for facial escharotomy have yet to be published, relaxation of axial arteries in terms of compression from eschar formation may be needed. Here, we present a case of escharotomy based on facial subunit principles.
Spectrum of Fungal Pathogens in Burn Wound Specimens: Data From a Tertiary Care Hospital Laboratory in Pakistan
Authors: Jabeen Kauser , Khan Muneeb , Umar Seema , Shaheen Najma , Farooqi Joveria
Published: August 2020

Burn patients are at great risk of developing fungal wound infections. Fungi are frequently cultured from burn tissue specimens alone or in combination with bacteria. However, the spectrum of fungi in burn patients from Pakistan has not been reported previously. A retrospective laboratory-based study was conducted and data on all positive cultures from burn wounds were included. During the study period, specimens were cultured on appropriate media and incubated for anaerobic and aerobic growth. Clinical and demographic information recorded during clinical reporting was also collected. Seventy tissue cultures were positive for microorganisms. Of these, 27 (39%) had growth of either filamentous mold (17 cases) or Candida species (14 cases). Two cases had growth of both mold and yeast. Aspergillus flavus was the most common mold (9) followed by Fusarium species (3). Candida tropicalis was the most common yeast (7) followed by Candida parapsilosis (4). There was concomitant bacterial growth in 19 cases, predominantly of Staphylococcus aureus (13), Pseudomonas aeruginosa (8), and other Gram-negative rods (6). Of the 35 patients in which treatment history was available, 33 were receiving broad-spectrum antibiotics. A high incidence of fungal isolation was seen in this study. Their findings are consistent with the global increase in fungal infections in burn wounds. High index of suspicion by clinicians and revision of culture protocols in burn patients may be warranted for optimal patient management.
A Comparison of Fitness-Related Traits in the Coleopteran Parasitoid Dastarcus helophoroides (Coleoptera: Bothrideridae) Reared on Two Factitious Hosts
Authors: Shi Haoni , Zhou Jiaying , Chen Yuansheng , Wang Qinzhao , Pan Youliang , Zhang Jiangtao , Liu Xingping
Published: August 2020

The coleopteran parasitoid Dastarcus helophoroides (Fairmaire) (Coleoptera: Bothrideridae) is considered an efficient preventative method against the damage caused by a large number of cerambycid pests in China and other East Asian countries. Mass rearing of this parasitoid depends on screening appropriate factitious hosts. In this paper, the fitness-related traits of this parasitic beetle were explored using pupae of the two tenebrionid beetles, Tenebrio molitor Linnaeus and Zophobas morio Fabricius (Coleoptera: Tenebrionidae) as factitious hosts. The results showed that in dual-choice trials, D. helophoroides larvae preferred to attack Z. morio pupae. In no-choice trials, D. helophoroides reared on Z. morio pupae displayed significantly higher pupation and emergence rate, longer developmental duration of larval and larval–pupal stages, larger adult body size, shorter preoviposition period, more egg masses and egg production, and higher relative expected reproduction than those reared on T. molitor pupae. These results demonstrate that Z. morio is a more suitable factitious host for mass rearing of D. helophoroides.
Early Life Adversity and Pubertal Timing: Implications for Cardiometabolic Health
Authors: Bleil Maria E , Spieker Susan J , Gregorich Steven E , Thomas Alexis S , Hiatt Robert A , Appelhans Bradley M , Roisman Glenn I , Booth-LaForce Cathryn
Published: August 2020

Objective

 To identify early life adversity (ELA) risk factors for earlier pubertal timing, itself a risk factor for poor cardiometabolic health, and to determine whether such ELA-related risk may be mediated by pre-pubertal body mass index (BMI).

Methods

 Subjects included 426 female participants in a prospective birth cohort study, the NICHD Study of Early Child Care and Youth Development. Survival analysis models were fit to examine ELA exposures, representing childhood socioeconomic status (SES), maternal sensitivity, mother–child attachment, and negative life events, along with child health indicators and covariates, in relation to pubertal timing outcomes, including age at menarche and ages at Tanner stage II for breast and pubic hair development.

Results

 Higher childhood SES emerged as an independent predictor of older age at menarche, showing each one standard deviation increase in childhood SES corresponded to a 1.3% increase in age at menarche (factor change = 1.013; 1.003–1.022; p < .01), but did not predict breast or pubic hair development (ps > .05). In mediation analyses, indirect (mediated) effects of mother–child attachment on the pubertal timing outcomes, via pre-pubertal BMI, were all statistically significant (ps < .05).

Conclusions

 Higher childhood SES predicted directly, and secure (vs. insecure) mother–child attachment predicted indirectly (via pre-pubertal BMI), later pubertal timing, suggesting these factors may protect girls from earlier pubertal development. By extension, clinical implications are that intervention strategies designed to lessen ELA- and pre-pubertal obesity-related risk may be effective in remediating life course pathways linking ELA, accelerated pubertal development, and cardiometabolic risk.
Affinity proteomic dissection of the human nuclear cap-binding complex interactome
Authors: Dou Yuhui , Kalmykova Svetlana , Pashkova Maria , Oghbaie Mehrnoosh , Jiang Hua , Molloy Kelly R , Chait Brian T , Rout Michael P , Fenyö David , Jensen Torben Heick , Altukhov Ilya , LaCava John
Published: August 2020

A 5′,7-methylguanosine cap is a quintessential feature of RNA polymerase II-transcribed RNAs, and a textbook aspect of co-transcriptional RNA processing. The cap is bound by the cap-binding complex (CBC), canonically consisting of nuclear cap-binding proteins 1 and 2 (NCBP1/2). Interest in the CBC has recently renewed due to its participation in RNA-fate decisions via interactions with RNA productive factors as well as with adapters of the degradative RNA exosome. A novel cap-binding protein, NCBP3, was recently proposed to form an alternative CBC together with NCBP1, and to interact with the canonical CBC along with the protein SRRT. The theme of post-transcriptional RNA fate, and how it relates to co-transcriptional ribonucleoprotein assembly, is abundant with complicated, ambiguous, and likely incomplete models. In an effort to clarify the compositions of NCBP1-, 2- and 3-related macromolecular assemblies, we have applied an affinity capture-based interactome screen where the experimental design and data processing have been modified to quantitatively identify interactome differences between targets under a range of experimental conditions. This study generated a comprehensive view of NCBP-protein interactions in the ribonucleoprotein context and demonstrates the potential of our approach to benefit the interpretation of complex biological pathways.
Radiotherapy, Temozolomide, and Antiprogrammed Cell Death Protein 1 Treatments Modulate the Immune Microenvironment in Experimental High-Grade Glioma
Authors: Riva Matteo , Wouters Roxanne , Sterpin Edmond , Giovannoni Roberto , Boon Louis , Himmelreich Uwe , Gsell Willy , Van Ranst Marc , Coosemans An
Published: August 2020

BACKGROUND

The lack of immune synergy with conventional chemoradiation could explain the failure of checkpoint inhibitors in current clinical trials for high-grade gliomas (HGGs).

OBJECTIVE

To analyze the impact of radiotherapy (RT), Temozolomide (TMZ) and antiprogrammed cell death protein 1 (αPD1) (as single or combined treatments) on the immune microenvironment of experimental HGGs.

METHODS

Mice harboring neurosphere /CT-2A HGGs received RT (4 Gy, single dose), TMZ (50 mg/kg, 4 doses) and αPD1 (100 μg, 3 doses) as monotherapies or combinations. The influence on survival, tumor volume, and tumor-infiltrating immune cells was analyzed.

RESULTS

RT increased total T cells (P = .0159) and cluster of differentiation (CD)8+T cells (P = .0078) compared to TMZ. Lymphocyte subpopulations resulting from TMZ or αPD1 treatment were comparable with those of controls. RT reduced M2 tumor-associated macrophages/microglia (P = .0019) and monocytic myeloid derived suppressor cells (mMDSCs,P = .0003) compared to controls. The effect on mMDSC was also seen following TMZ and αPD1 treatment, although less pronounced (P = .0439 andP = .0538, respectively). Combining RT with TMZ reduced CD8+T cells (P = .0145) compared to RT alone. Adding αPD1 partially mitigated this effect as shown by the increased CD8+T cells/Tregs ratio, even if this result failed to reach statistical significance (P = .0973). Changing the combination sequence of RT, TMZ, and αPD1 did not alter survival nor the immune effects.

CONCLUSION

RT, TMZ, and αPD1 modify the immune microenvironment of HGG. The combination of RT with TMZ induces a strong immune suppression which cannot be effectively counteracted by αPD1.
Ideal type-II Weyl points in topological circuits
Authors: Li Rujiang , Lv Bo , Tao Huibin , Shi Jinhui , Chong Yidong , Zhang Baile , Chen Hongsheng
Published: August 2020

Weyl points (WPs), nodal degenerate points in three-dimensional (3D) momentum space, are said to be ‘ideal’ if they are symmetry-related and well-separated, and reside at the same energy and far from nontopological bands. Although type-II WPs have unique spectral characteristics compared with type-I counterparts, ideal type-II WPs have not yet been reported because of a lack of an experimental platform with enough flexibility to produce strongly tilted dispersion bands. Here, we experimentally realize a topological circuit that hosts only topological bands with a minimal number of four ideal type-II WPs. By stacking two-dimensional (2D) layers of inductor-capacitor (LC) resonator dimers with the broken parity inversion symmetry (P), we achieve a strongly tilted band structure with two group velocities in the same direction, and topological surface states in an incomplete bandgap. Our results establish an ideal system for the further study of Weyl physics and other exotic topological phenomena.
Ultra-sensitive hybrid diamond nanothermometer
Authors: Liu Chu-Feng , Leong Weng-Hang , Xia Kangwei , Feng Xi , Finkler Amit , Denisenko Andrej , Wrachtrup Jörg , Li Quan , Liu Ren-Bao
Published: August 2020

Nitrogen-vacancy (NV) centers in diamond are promising quantum sensors because of their long spin coherence time under ambient conditions. However, their spin resonances are relatively insensitive to non-magnetic parameters such as temperature. A magnetic-nanoparticle-nanodiamond hybrid thermometer, where the temperature change is converted to the magnetic field variation near the Curie temperature, were demonstrated to have enhanced temperature sensitivity ($11{\rm{\,\,mK\,\,H}}{{\rm{z}}^{ - 1/2}}$) (Wang N, Liu G-Q and Leong W-H et al. Phys Rev X 2018; 8: 011042), but the sensitivity was limited by the large spectral broadening of ensemble spins in nanodiamonds. To overcome this limitation, here we show an improved design of a hybrid nanothermometer using a single NV center in a diamond nanopillar coupled with a single magnetic nanoparticle of copper-nickel alloy, and demonstrate a temperature sensitivity of $76{\rm{\,\,\mu K\,\,H}}{{\rm{z}}^{ - 1/2}}$. This hybrid design enables detection of 2 mK temperature changes with temporal resolution of 5 ms. The ultra-sensitive nanothermometer offers a new tool to investigate thermal processes in nanoscale systems.
Topological phases of quantized light
Authors: Cai Han , Wang Da-Wei
Published: August 2020

Topological photonics is an emerging research area that focuses on the topological states of classical light. Here we reveal the topological phases that are intrinsic to the quantum nature of light, i.e. solely related to the quantized Fock states and the inhomogeneous coupling strengths between them. The Hamiltonian of two cavities coupled with a two-level atom is an intrinsic one-dimensional Su-Schriefer-Heeger model of Fock states. By adding another cavity, the Fock-state lattice is extended to two dimensions with a honeycomb structure, where the strain due to the inhomogeneous coupling strengths of the annihilation operator induces a Lifshitz topological phase transition between a semimetal and three band insulators within the lattice. In the semimetallic phase, the strain is equivalent to a pseudomagnetic field, which results in the quantization of the Landau levels and the valley Hall effect. We further construct an inhomogeneous Fock-state Haldane model where the topological phases can be characterized by the topological markers. With d cavities being coupled to the atom, the lattice is extended to d − 1 dimensions without an upper limit. In this study we demonstrate a fundamental distinction between the topological phases in quantum and classical optics and provide a novel platform for studying topological physics in dimensions higher than three.
Two-dimensional characterization of three-dimensional magnetic bubbles in Fe3Sn2 nanostructures
Authors: Tang Jin , Wu Yaodong , Kong Lingyao , Wang Weiwei , Chen Yutao , Wang Yihao , Soh Y , Xiong Yimin , Tian Mingliang , Du Haifeng
Published: August 2020

We report differential phase contrast scanning transmission electron microscopy (TEM) of nanoscale magnetic objects in Kagome ferromagnet Fe3Sn2 nanostructures. This technique can directly detect the deflection angle of a focused electron beam, thus allowing clear identification of the real magnetic structures of two magnetic objects including three-ring and complex arch-shaped vortices in Fe3Sn2 by Lorentz-TEM imaging. Numerical calculations based on real material-specific parameters well reproduced the experimental results, showing that the magnetic objects can be attributed to integral magnetizations of two types of complex three-dimensional (3D) magnetic bubbles with depth-modulated spin twisting. Magnetic configurations obtained using the high-resolution TEM are generally considered as two-dimensional (2D) magnetic objects previously. Our results imply the importance of the integral magnetizations of underestimated 3D magnetic structures in 2D TEM magnetic characterizations.
Co13O8—metalloxocubes: a new class of perovskite-like neutral clusters with cubic aromaticity
Authors: Geng Lijun , Weng Mouyi , Xu Cong-Qiao , Zhang Hanyu , Cui Chaonan , Wu Haiming , Chen Xin , Hu Mingyu , Lin Hai , Sun Zhen-Dong , Wang Xi , Hu Han-Shi , Li Jun , Zheng Jiaxin , Luo Zhixun , Pan Feng , Yao Jiannian
Published: August 2020

Exploring stable clusters to understand structural evolution from atoms to macroscopic matter and to construct new materials is interesting yet challenging in chemistry. Utilizing our newly developed deep-ultraviolet laser ionization mass spectrometry technique, here we observe the reactions of neutral cobalt clusters with oxygen and find a very stable cluster species of Co13O8 that dominates the mass distribution in the presence of a large flow rate of oxygen gas. The results of global-minimum structural search reveal a unique cubic structure and distinctive stability of the neutral Co13O8 cluster that forms a new class of metal oxides that we named as ‘metalloxocubes’. Thermodynamics and kinetics calculations illustrate the structural evolution from icosahedral Co13 to the metalloxocube Co13O8 with decreased energy, enhanced stability and aromaticity. This class of neutral oxygen-passivated metal clusters may be an ideal candidate for genetic materials because of the cubic nature of the building blocks and the stability due to cubic aromaticity.
Precision spectroscopy of atomic helium
Authors: Sun Yu R , Hu Shui-Ming
Published: August 2020

Helium is a prototype three-body system and has long been a model system for developing quantum mechanics theory and computational methods. The fine-structure splitting in the 23P state of helium is considered to be the most suitable for determining the fine-structure constant α in atoms. After more than 50 years of efforts by many theorists and experimentalists, we are now working toward a determination of α with an accuracy of a few parts per billion, which can be compared to the results obtained by entirely different methods to verify the self-consistency of quantum electrodynamics. Moreover, the precision spectroscopy of helium allows determination of the nuclear charge radius, and it is expected to help resolve the ‘proton radius puzzle’. In this review, we introduce the latest developments in the precision spectroscopy of the helium atom, especially the discrepancies among theoretical and experimental results, and give an outlook on future progress.
Prescribing Patterns of Antibiotics for the Self-Treatment of Travelers’ Diarrhea in Global TravEpiNet, 2009–2018
Authors: Gandhi Aditya R , Rao Sowmya R , Chen Lin H , Nelson Michael D , Ryan Edward T , LaRocque Regina C , Hyle Emily P
Published: August 2020

Background

International travelers are often prescribed antibiotics for self-treatment of travelers’ diarrhea (TD), but the benefits and risks of antibiotics are debated. We assessed the prescribing patterns of empiric antibiotics for TD in international travelers evaluated at Global TravEpiNet (GTEN) sites (2009–2018).

Methods

We performed a prospective, multisite cross-sectional study regarding antibiotic prescriptions for the self-treatment of TD at 31 GTEN sites providing pretravel consultations to adult international travelers. We described traveler demographics, itineraries, and antibiotic(s) prescribed. We used multivariable logistic regressions to assess the association of year of consultation with antibiotic prescribing (yes/no) and class (fluoroquinolones vs azithromycin). We performed interrupted time-series analyses to examine differences in prescribing before and after the Food and Drug Administration (FDA) warning on fluoroquinolones (July 2016).

Results

Antibiotics were not prescribed in 23 096 (22.2%) of 103 843 eligible pretravel GTEN consultations; azithromycin and fluoroquinolones were most frequently prescribed. Antibiotic prescribing declined significantly each year between 2009 and 2018 (odds ratio [OR], 0.84; 95% CI, 0.79–0.89), as did fluoroquinolone prescribing, relative to azithromycin (OR, 0.77; 95% CI, 0.73–0.82). The rate of decline in fluoroquinolone prescribing was significantly greater after the FDA fluoroquinolone warning (15.3%/year) than before (1.1%/year; P < .001).

Conclusions

Empiric antibiotics for TD were prescribed in >75% of pretravel GTEN consultations, but antibiotic prescribing declined steadily between 2009 and 2018. Fluoroquinolones were less frequently prescribed than azithromycin, especially after the 2016 FDA fluoroquinolone warning. Emphasis on the risks of antibiotics may influence antibiotic prescribing by providers for empiric treatment of TD.
Low Adherence Achieves High HCV Cure Rates Among People Who Inject Drugs Treated With Direct-Acting Antiviral Agents
Authors: Norton Brianna L , Akiyama Matthew J , Agyemang Linda , Heo Moonseong , Pericot-Valverde Irene- , Litwin Alain H
Published: August 2020

We measured hepatitis C virus (HCV) adherence via electronic blister packs for 145 people who inject drugs treated on-site in a methadone program. The overall sustained virologic response (SVR) rate was 96% (95% CI, 91%–98%), and overall daily adherence was 78% (95% CI, 76%–81%). Participants who achieved at least 50% adherence had an overall SVR rate of 99%, with each 5% adherence interval >50% achieving at least 90% adherence. Suboptimal adherence may still lead to cure in the direct-acting antiviral era.
The Yield and Consistency of the Detection of SARS-CoV-2 in Multiple Respiratory Specimens
Authors: Zhang Haixia , Chen Meiling , Zhang Yanhua , Wen Jing , Wang Yajie , Wang Liming , Guo Jinjin , Liu Chen , Li Daijing , Wang Ying , Bai Jing , Gao Guiju , Wang Sa , Yang Di , Yu Fengting , Yan Liting , Wan Gang , Zhang Fujie
Published: August 2020

Background

Few studies have compared the yield of reverse transcription polymerase chain reaction (RT-PCR) assays in nasopharyngeal swabs, oropharyngeal swabs, and sputum for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection.

Methods

We conducted an observational study in Beijing Ditan Hospital, China. Specimens including nasopharyngeal swabs, oropharyngeal swabs, and sputum from confirmed coronavirus 2019 patients were collected for RT-PCR testing. Disease duration was calculated from the date of symptom onset to the date of specimen collection and divided into 3 groups: ≤14 days, 14–21 days, and >21 days. We compared positive rates across the 3 specimens collected. The kappa coefficient was used to evaluate the consistency of RT-PCR results between different specimens.

Results

A total of 291 specimens were collected and tested from 43 confirmed patients. Among specimens collected with a disease duration of ≤14 days, the positive rate was highest in sputum (79.2%); this rate was significantly higher than that in nasopharyngeal swabs (37.5%; P = .003) and oropharyngeal swabs (20.8%; P < .001). Similar findings were observed with the disease durations of 14–21 days and >21 days. The consistency of testing results between nasopharyngeal swabs and oropharyngeal swabs was low with the disease durations of ≤14 days and >21 days. The consistency between the sputum and oropharyngeal swabs and between the sputum and nasopharyngeal swabs was very low across all 3 disease durations, with statistical significance.

Conclusions

Compared with nasopharyngeal swabs and oropharyngeal swabs, sputum had the highest yield of SARS-CoV-2 detection. Nasopharyngeal swabs and oropharyngeal swabs had a similar yield. If sputum is not feasible, a nasopharyngeal swab can be recommended for the detection of SARS-CoV-2, and early testing is needed.
Assessment of Oropharyngeal Specimens for Discontinuation of Transmission-Based COVID-19 Precautions
Authors: Barocas Joshua A , Komaromy Miriam , Haidar Deeanna , Barlam Tamar F , Orr Beverley L , Miller Nancy S
Published: August 2020

We compared oropharyngeal swab test performance with nasopharyngeal testing for discontinuation of transmission-based COVID-19 precautions. We performed a retrospective review of confirmed COVID-19-positive patients who received paired nasopharyngeal and oropharyngeal SARS-CoV-2 tests for clearance from isolation from May 4, 2020, to May 26, 2020. Using nasopharyngeal swabs as the reference standard, we calculated the sensitivity, specificity, and negative predictive value of oropharyngeal swabs. We also calculated the kappa between the 2 tests. A total of 189 paired samples were collected from 74 patients. Oropharyngeal swab sensitivity was 38%, specificity was 87%, and negative predictive value was 70%. The kappa was 0.25. Our study suggests that oropharyngeal swabs are inferior to nasopharyngeal swabs for test-based clearance from COVID-19 isolation.
Inflammatory Biomarkers Do Not Differ Between Persistently Seronegative vs Seropositive People With HIV After Treatment in Early Acute HIV Infection
Authors: Cai Catherine W , Pinyakorn Suteeraporn , Kroon Eugène , de Souza Mark , Colby Donn J , Pankam Tippawan , Pattanachaiwit Supanit , Ubolyam Sasiwimol , Rupert Adam , Lallemand Perrine , Dewar Robin , Highbarger Helene C , Ananworanich Jintanat , Vasan Sandhya , Sereti Irini
Published: August 2020

Persistent viral activity may cause enduring seropositivity and inflammation in treated people with HIV (PWH). We compared inflammatory biomarkers between early treated PWH who remained seronegative or seroconverted and found similar levels of D-dimer, soluble cluster of differentiation 14, C-reactive protein, and interleukin-6, indicating that seronegativity does not affect chronic inflammation in early treated PWH.
Sequential Regular Variation: Extensions of Kendall’s Theorem
Authors: Bingham Nicholas H , Ostaszewski Adam J
Published: August 2020

Regular variation is a continuous-parameter theory; we work in a general setting, containing the existing Karamata, Bojanic–Karamata/de Haan and Beurling theories as special cases. We give sequential versions of the main theorems, that is, with sequential rather than continuous limits. This extends the main result, a theorem of Kendall’s (which builds on earlier work of Kingman and Croft), to the general setting.
Short-termism, Managerial Talent, and Firm Value
Authors: Thakor Richard T
Published: August 2020

This paper examines how the firm’s choice of investment horizon interacts with rent-seeking by privately informed, multitasking managers and the labor market. Two main results surface. First, managers prefer longer-horizon projects that permit them to extract higher rents from firms, so short-termism involves lower agency costs and is value maximizing for some firms. Second, when firms compete for managers, firms practicing short-termism attract better managerial talent when talent is unobservable, but larger firms that invest in long-horizon projects hire more talented managers when talent is revealed. (JEL D82, D86, G31, G32, J41)

Received July 25, 2019; editorial decision July 7, 2020 by Editor Uday Rajan.
Efficacy of baricitinib in patients with moderate-to-severe rheumatoid arthritis with 3 years of treatment: results from a long-term study
Authors: Smolen Josef S , Xie Li , Jia Bochao , Taylor Peter C , Burmester Gerd , Tanaka Yoshiya , Elias Ayesha , Cardoso Anabela , Ortmann Rob , Walls Chad , Dougados Maxime
Published: August 2020

Objective

To evaluate the long-term efficacy of once-daily baricitinib 4 mg in patients with active RA who were either naïve to DMARDs or who had inadequate response (IR) to MTX.

Methods

Analyses of data from two completed 52-week, phase III studies, RA-BEGIN (DMARD-naïve) and RA-BEAM (MTX-IR), and one ongoing long-term extension (LTE) study (RA-BEYOND) were performed (148 total weeks). At week 52, DMARD-naïve patients treated with MTX monotherapy or baricitinib 4 mg+MTX in RA-BEGIN were switched to open-label baricitinib 4 mg monotherapy; MTX-IR patients treated with adalimumab (+MTX) in RA-BEAM were switched to open-label baricitinib 4 mg (+MTX) in the LTE. Patients who received placebo (+MTX) were switched to baricitinib 4 mg (+MTX) at week 24. Low disease activity (LDA) [Simple Disease Activity Index (SDAI) ≤11], clinical remission (SDAI ≤ 3.3), and physical functioning [Health Assessment Questionnaire Disability Index (HAQ-DI) ≤ 0.5] were assessed. Data were assessed using a non-responder imputation.

Results

At week 148, SDAI LDA was achieved in up to 61% of DMARD-naïve patients and 59% of MTX-IR patients initially treated with baricitinib, and SDAI remission was achieved in up to 34% of DMARD-naïve patients and 24% of MTX-IR patients; HAQ-DI ≤ 0.5 was reached in up to 48% of DMARD-naïve patients and 38% of MTX-IR patients initially treated with baricitinib. Over 148 weeks, 3.6% and 10.7% of MTX-IR patients discontinued across treatment groups due to lack of efficacy or due to adverse events, respectively; discontinuation rates were similar in the DMARD-naïve population.

Conclusion

Treatment with baricitinib 4 mg demonstrated efficacy for up to 3 years and was well tolerated.
Do Psychological Interventions Work for Psychosis in Adolescents?
Authors: Daruvala Rhea , Kumar Ajit , Datta Soumitra Shankar
Published: August 2020

Background

There is emerging evidence to show that psychological interventions such as cognitive remediation therapy (CRT), psychoeducation, family therapy, and group psychotherapies may be useful for adolescents with psychosis. The current review is on the effects of various psychological interventions for adolescents with psychosis compared with treatment as usual (TAU) or other psychological interventions.

Methods

We undertook a comprehensive search for all randomized controlled trials on the topic as per predefined criteria. For binary data, a standard estimation of risk ratio, and, for continuous data, the mean difference between groups were estimated. GRADE approach was used to assess studies. “Risk of Bias” was calculated, and finally random-effects model was used for analyses.

Results

The review included 7 studies (n = 317). Two studies compared CRT and TAU with TAU alone. CRT showed improvement in short-term memory compared with those in the TAU group (relative risk 0.58, 95% CI 0.37 to 0.89, participants = 31, very low-certainty evidence). When comparing group psychosocial therapy with TAU, global state scores measured using Children’s Global Assessment Scale (CGAS) were clearly higher in the intervention arm (mean difference 5.10, 95% CI 1.35 to 8.85, participants = 56, very low-certainty evidence) as compared with the TAU group. None of the other interventions were found to be significantly effective for the treatment of psychosis in adolescents.

Conclusions

Evidence suggests that psychological interventions may have beneficial effects in the treatment of adolescents with psychosis, but the evidence is of low or very low certainty.
A partial compensation scheme for MMC-based railway cophase power supply
Authors: Sun Peiliang , Li Kang , Xing Chen
Published: August 2020

This paper presents a partial compensation scheme for V/v transformer cophase traction power supply in high-speed railway systems. The scheme compensates variable traction load current, and controls the current phase at the secondary side of the V/v transformer for power factor correction and negative sequence current reduction. To achieve this, the grid side current phase angles are optimized while satisfying the grid code on the power factor and voltage unbalance limits. The optimized phase angles are then used to design control references under varying load conditions. The compensation control action is updated regularly based on real-time measurements of the traction load, and the required currents are controlled by a 25-level single-phase back-to-back MMC power conditioner to achieve the compensation target. Static and dynamic load compensation performances are verified based on the simulation studies.
The role of PAs in providing mental health care
Authors: Mauldin Sheila G. , Morton-Rias Dawn , Barnhill Grady C. , Kozikowski Andrzej , Hooker Roderick S.
Published: August 2020

The prevalence of psychiatric and substance use disorders in the United States is rising and of growing concern. Because such behavioral conditions are widespread, one approach is to collaborate with various medical professionals to help offset this demand. To address this issue, the frequency and types of mental health conditions encountered by physician assistants (PAs) were assessed. The National Commission on the Certification of Physician Assistants Practice Analysis was examined for the types of mental health conditions encountered across the spectrum of medical and surgical practices. The findings reveal that, in 2015, at least 62% of PAs saw and evaluated mental health conditions and behavioral disorders at least weekly in their settings. These patient diagnoses were seen with variability based on the specialty of the PA. The highest percentage of cases reported by PAs were in psychiatry, followed by general internal medicine, emergency medicine, family medicine, and hospital medicine. With the profession projected to grow, recruiting, retaining, and integrating more PAs into mental health care is a suggested strategy for addressing national provider shortages.
Universal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) Testing Uptake in the Labor and Delivery Unit
Authors: Kernberg Annessa , Kelly Jeannie , Nazeer Sarah , Russell Sharman , Tuuli Methodius , Stout Molly J. , Raghuraman Nandini , Carter Ebony B.
Published: August 2020

OBJECTIVE:

To understand severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing uptake in the labor and delivery unit and rationales for declining testing, and to institute a process to increase equitable testing uptake.

METHODS:

We conducted a quality-improvement initiative from May 28–June 25, 2020, during the first 4 weeks of universal SARS-CoV-2 testing in the Barnes-Jewish Hospital labor and delivery unit. All consecutive patients presenting for delivery without coronavirus disease 2019 (COVID-19) symptoms were offered testing over four 1-week phases. Phase I documented the rate of testing uptake. Phase II recorded patients' reasons for declining testing. Phase III used phase II findings to create and implement shared decision-making tools. Phase IV offered each patient who declined nasopharyngeal testing an oropharyngeal alternative. The primary outcome was rate of SARS-CoV-2 testing uptake by phase.

RESULTS:

Of 270 patients, 223 (83%) accepted testing and 47 (17%) declined. Maternal age and mode of delivery were similar between groups, whereas testing uptake was higher among nulliparous, White, Hispanic, or privately insured patients. There was a significant increase in the primary outcome of SARS-CoV-2 testing across phases I–IV, from 68% to 76% to 94% to 95%, respectively (Somers' D 0.45; 95% CI of association 0.30–0.59). The most commonly cited reason for declining testing was concern regarding testing discomfort. In subgroup analyses by race and insurance type, there was a significant increase in testing uptake across phases I–IV for Black patients (56%, 54%, 91%, 92%; Somers' D 0.36; 95% CI of association 0.28–0.64), White patients (76%, 93%, 96%, 100%; Somers' D 0.59; 95% CI of association 0.38–0.8), those with Medicaid insurance (60%, 64%, 88%, 92%; 95%; Somers' D 0.39; CI of association 0.22 to 0.56), and those with private insurance (77%, 96%, 97%, 100%; Somers' D 0.63; 95% CI of association 0.40–0.86).

CONCLUSION:

Universal SARS-CoV-2 testing uptake significantly increased through a rapid-cycle improvement initiative. Aligning hospital policy with patient-centered approaches led to nearly universally acceptable testing.
Immunotherapy in multiple myeloma: when, where, and for who?
Authors: Verkleij Christie P.M. , Korst Charlotte L.B.M. , van de Donk Niels W.C.J.
Published: August 2020

Purpose of review

Immunotherapy is transforming treatment of multiple myeloma patients in all stages of their disease. This review will discuss recent developments in immunotherapy in multiple myeloma with a focus on antibodies, antibody–drug conjugates, and T-cell-redirection strategies.

Recent findings

CD38-targeting antibodies have single agent activity in multiple myeloma, and especially when combined with other drugs, are improving the clinical outcome of patients with newly diagnosed or relapsed/refractory multiple myeloma. Also the SLAMF7-targeting antibody, elotuzumab, improves the survival of relapsed/refractory multiple myeloma patients, when it is combined with either lenalidomide or pomalidomide. Several novel immunotherapies, such as chimeric antigen receptor T cells, antibody–drug conjugates, and bispecific antibodies, are active in patients who developed resistance to all currently available antimultiple myeloma drugs, including immunomodulatory drugs, proteasome inhibitors, and CD38 antibodies. These new immunotherapeutic agents frequently target B-cell maturation antigen, which is highly and uniformly expressed on multiple myeloma cells. However, other targets, such as GPRC5D, are also being investigated.

Immunotherapy is incorporated into first-line and relapse regimens, and is improving the survival of both newly diagnosed and relapsed/refractory multiple myeloma patients.
Adjuvant treatment of early male breast cancer
Authors: Corti Chiara , Crimini Edoardo , Criscitiello Carmen , Trapani Dario , Curigliano Giuseppe
Published: August 2020

Purpose of review

Male breast cancer (MaBC) is a rare disease, and some challenges exist in its management because current treatment recommendations are extrapolated from trials that mostly excluded men. This review will revise all available data that could improve the treatment of MaBC, with a special focus on adjuvant systemic treatments.

Recent findings

To date, men with hormone receptor-positive breast cancer, who are candidates for adjuvant endocrine therapy, should be offered tamoxifen (TAM) for five years. Additional five years are possible, according to tolerance and recurrence risk. If TAM is contraindicated, a gonadotropin-releasing hormone (GnRH) agonist or antagonist and aromatase inhibitor should be proposed. Chemotherapy and targeted therapy in the other breast cancer subtypes should be used with the same indications offered to women with breast cancer. All men with breast cancer should be offered genetic counseling and germline genetic testing of cancer predisposition genes.

For decades, men with breast cancer have been treated suboptimally and denied the participation in clinical trials. Recently, many clinical trials started enrolling both genders, as strongly endorsed by the Food and Drug Administration. Hopefully, this turnaround will help subdue the disparities in the quality of care.
Follicular Unit Excision Punches and Devices
Authors: Gupta Aditya K. , Love Robin P. , True Robert H. , Harris James A.
Published: August 2020

BACKGROUND

Follicular unit excision (FUE) is used to harvest follicular units for hair transplantation using trephine punches. The characteristics of FUE punches can impact the success of this technique; thus, many innovative punch designs and devices have been developed. With many options available, it can be difficult for the hair restoration surgeon to know which punch best suits the needs of their patients.

OBJECTIVE

To provide a comprehensive review of punch shapes and devices available.

METHODS

Search of PubMed, reference mining of relevant publications, and hand searching trade publications.

RESULTS

We examined FUE punches and devices and consolidated descriptive information for each to create textual and visual guides. No single punch shape or device may suit all cases; thus, it is important to know the best uses and limitations of each.

CONCLUSION

The surgeon should have a comprehensive knowledge base of available punch shapes and devices and understand the advantages and disadvantages of each. It is also beneficial to have an in-depth knowledge of skin properties and follicular unit structure. Ultimately, understanding the dynamics behind punch excision will enhance the FUE technique.
A Pandemic Application of Creative Destruction in Healthcare
Authors: Short Jeffrey B. , Mammen Adrin
Published: August 2020

The story of COVID-19 at Montefiore Health System is not really a story about a virus or a pandemic. It is a story about innovation—accelerating innovation. Indeed, the COVID-19 crisis has spurred innovation at healthcare organizations across the country, helping them respond to unprecedented times. The pandemic radically disrupted the entire healthcare sector as demand and supply shocks simultaneously affected established processes and supply chains. Similarly, patients’ demands for healthcare drastically changed. Nothing could be taken for granted—not even the health of employees or their ability to come to provide care. In this new reality, digital innovation is fundamental for healthcare organizations as they make their transition into recovery. The Montefiore experience exemplifies how the COVID-19 pandemic can serve as the catalyst for digital innovation.
Moving Forward to Nurture Workforce Resilience in Crisis
Authors: Owens Katie M.
Published: August 2020

As the CEO of a firm that helps organizations improve performance through culture and learning, and as someone who has spent the past 12 years coaching thousands of individual leaders, staff members, and physicians at hundreds of hospitals and health systems, I have seen both the positive effects of resilience and the negative effects of a lack of resilience. During the COVID-19 pandemic, I and my team have worked with organizations to find ways to help their distressed employees take better care of themselves and, in turn, help their patients as our collective recovery continues.
The aberrant subclavian artery: approach to management
Authors: Karangelis Dimos , Loggos Spiros , Tzifa Aphrodite , Mitropoulos Fotios A.
Published: August 2020

Purpose of review

Aberrant subclavian artery (ASCA) represents one of the most common congenital vascular anomalies of the aortic arch. The majority of ASCAs are associated with an aneurysm which occurs at their origin from the descending thoracic aorta, namely, the Kommerell's diverticulum. In this review, we discuss recent data with regards to indications of treatment and surgical management of these anatomical variants.

Recent findings

Various surgical methods have been described for the repair of ASCA and Kommerell's diverticulum. Traditionally, treatment included open surgery; however, recent studies describe a shift of conventional treatment to more hybrid or endovascular approaches. The heterogeneity in the anatomy and presentation of these clinical entities as well as patient-related factors have prevented conduction of randomized trials for the best available modality of treatment. This dearth of literature is well depicted in the current guidelines.

The optimal surgical procedure has to be tailored to every patient according to the presentation, individual anatomy, and patient's risk profile. Conventional surgery for ASCA and Kommerell's diverticulum has acceptable mortality and complication rates, whereas hybrid repairs report encouraging results. Further studies are required to provide sufficient evidence which will formulate a clear frame of treatment indications and optimal surgical methods, as well as evaluate long-term results following hybrid repair.