bluuebunny/crossref_metadata_2025 huggingface dataset:
Tapered and non-tapered prosthetic grafts in upper extremity dialysis access: A systematic review and meta-analysis
Authors: Jasty Venkata Sai , Haddad David , Mohan Babu , Zhou Wei , Siracuse Jeffrey J , Tan Tze-Woei
Published: November 2020

Objective:

It is unclear whether tapered arteriovenous grafts (AVGs) are superior to non-tapered AVGs when it comes to preventing upper extremity ischemic steal syndrome. We aimed to evaluate the outcomes of tapered and non-tapered AVGs using systematic review and meta-analysis.

Methods:

A literature search was systemically performed to identify all English publications from 1999 to 2019 that directly compared the outcomes of upper extremity tapered and non-tapered AVGs. Outcomes evaluated were the primary patency at 1-year (number of studies ( n) = 4), secondary patency at 1-year ( n = 3), and risk of ischemic steal ( n = 5) and infection ( n = 4). Effect sizes of individual studies were pooled using random-effects model, and between-study variability was assessed using the I2 statistic.

Results:

Of 5808 studies screened, five studies involving 4397 patients have met the inclusion criteria and included in the analysis. Meta-analyses revealed no significant difference for the risk of ischemic steal syndrome (pooled odds ratio (OR) 0.92, 95% Confidence Incidence (CI) 0.29–2.91, p = 0.89, I2 = 48%) between the tapered and non-tapered upper extremity AVG. The primary patency (OR 1.33, 95% CI 0.93–1.90, p = 0.12, I2 = 10%) and secondary patency at 1-year (OR 1.49, 95% CI 0.84–2.63, p = 0.17, I2 = 13%), and rate of infection (OR 0.62, 95% CI 0.30–1.27, p = 0.19, I2 = 29%) were also similar between the tapered and non-tapered AVG.

Conclusions:

The risk of ischemic steal syndrome and patency rate are comparable for upper extremity tapered and non-tapered AVGs. This meta-analysis does not support the routine use of tapered graft over non-tapered graft to prevent ischemic steal syndrome in upper extremity dialysis access. However, due to small number of studies and sample sizes as well as limited stratification of outcomes based on risk factors, future studies should take such limitations into account while designing more robust protocols to elucidate this issue.
Nonlinear energy sink applied for low-frequency noise control inside acoustic cavities: A review
Authors: Shao Jianwang , Yang Jinmeng , Wu Xian , Zeng Tao
Published: November 2020

In recent years, the research of nonlinear energy sink on low-frequency noise control has become a hotspot. By adding a nonlinear energy sink into one primary system, it is possible to obtain the significant target energy transfer characteristics. The target energy transfer can be defined for which the vibration energy of the primary structure is irreversibly transferred to the nonlinear energy sink, quickly concentrated in the nonlinear energy sink and dissipated by the nonlinear energy sink damping. This method has significant advantages to control the broadband low-frequency noise inside the transportations (such as cars, trains, airplanes, etc.). Compared with traditional noise reduction methods such as adding the damping and acoustical materials, the nonlinear energy sink has a simple and lightweight structure. The paper reviews the nonlinear characteristics of the nonlinear energy sink, the main theoretical research methods and the applications of vibration and noise control, and discusses the application of the nonlinear energy sink for the control of low-frequency noise inside the three-dimensional acoustic cavities, which provides the reference and guidance for the low-frequency noise control inside the acoustic cavities of the mean of transportation.
Cardiovascular safety of Glimepiride: An indirect comparison from CAROLINA and CARMELINA
Authors: Ghosh Sujoy , Mukhopadhyay Pradip , Pandey Prabhakar , Chatterjee Purushottam , Pandit Kaushik
Published: November 2020

Background:

Despite having unquestionable glucose lowering efficacy, current guidelines no more favour the uses of sulphonylureas for CV safety concern, except when cost is an issue. However, formal cardiovascular outcome trial (CVOT) is not available.

Materials and methods:

We performed an indirect treatment comparison to find the hazard ratio for 3-point MACE, all-cause death, CV death and non-CV death between glimepiride and placebo based on two large CVOTs which established the CV safety of linagliptin (CARMELINA and CAROLINA).

Results:

Glimepiride was shown to have a non-inferior risk compared to placebo for 3-point MACE (HR 1.04, 95% CI 0.850, 1.274), all-cause mortality (HR 1.08, 95% CI 0.880, 1.317), CV death (HR 0.96, 95% CI 0.732, 1.259), and non-CV death (HR 1.24, 95% CI 0.893, 1.733).

Conclusion:

Cardiovascular safety of glimepiride is re-assuring and may help patients with type 2 diabetes world-over to avail the benefit of this affordable efficacious medication.
Deep-Seated Interictal Epileptiform Activity: Another Reason to Lose Sleep
Authors: King-Stephens David
Published: November 2020

[Box: see text]
Recanalization and Stenting of the Celiac and the Superior Mesenteric Artery Supported by Use of a Steerable Introducer Sheath: Report on 2 Years’ Experience
Authors: Pedersoli Federico , Hitpass Lea , Isfort Peter , Zimmermann Markus , Schulze-Hagen Maximilian , Gombert Alexander , Kuhl Christiane K. , Bruners Philipp , Keil Sebastian
Published: November 2020

Purpose:

To compare technical parameters and success of recanalization of celiac (CA) or superior mesenteric artery (SMA) with usage of steerable vs not steerable introducer sheaths.

Methods:

A retrospective analysis was performed on all consecutive patients who underwent recanalization with stent implantation of CA or SMA between 2015 and 2019. Data regarding technical success (successful stent placement with restoration of sufficient blood flow by the first attempt without changing kind of introducer sheath or access site), indication for treatment, vascular access, kind of introducer sheath, fluoroscopy time and radiation dose were collected. Preinterventional CT were analyzed to classify the difficulty of catheterization of target vessels. Technical parameters were compared with independent t-test (p ≤ 0.05).

Results:

66 patients underwent recanalization of CA or SMA. Usage of steerable introducer sheaths was associated with higher technical success compared to not steerable introducer sheaths with transfemoral approach respectively of 8/8 vs 15/19 for the CA and 11/11 vs 17/20 for the SMA. Steerable introducer sheaths were used in recanalization considered more technically difficult compared to not steerable introducer sheaths (58% vs 33%). Usage of steerable introducer sheath showed a statistically significant reduction of radiation dose in the recanalization of the SMA (respectively 32035 ± 15716 cGy cm2 vs 60102 ± 28432 cGy cm2; p = 0.005).

Conclusion:

Even if used in more difficult interventions, steerable introducer sheaths showed a higher technical success compared to not steerable introducer sheaths with transfemoral access.
Development of energy control system for parallel hybrid power system using dynamic equations and fuzzy theory
Authors: Chen Po-Tuan , Yang Cheng-Jung , Huang K David
Published: November 2020

A fuzzy control strategy is developed in this study to manage the parallel hybrid power system of internal combustion engine (ICE) and electric motor (EM) for hybrid vehicles. The rules established for the fuzzy logic are based on the conditions of vehicle pedal position, vehicle velocity, and the state of charge to control the throttle position of the ICE and the switch position of EM in low-, mid-, and high-power cruising. The optimization of the control strategy can make vehicles achieving ECE 40 driving pattern. In addition, the ICE can work in an optimal operation range, thus reducing carbon emission. The EM may provide power according to the demand, such that the torque output of the output shaft of the power split device is twice of the input of the two power sources separately.
Quantifying jump-specific loads in beach volleyball by an inertial measurement device
Authors: Schmidt Marcus , Meyer Eike , Jaitner Thomas
Published: November 2020

The ability to complete a large volume of high intensity jumps represents an important performance indicator in beach volleyball. Inertial measurement units are suitable tools to monitor those jump-specific loads but the applicability in beach volleyball lacks research. This study evaluates the accuracy of a commercially available inertial measurement device in beach volleyball for (i) jump count during match-play and (ii) jump height measurement under laboratory conditions. Jump count measures were compared to retrospective video analysis to determine precision and recall. Jump heights were referenced to three-dimensional motion analysis to determine typical errors of estimate, correlations and Bland-Altman statistics. Match-play analysis results in excellent precision (0.975) for a total of 439 jumps and recall values between 0.836–1.000 depending on jump type. Jump heights revealed good to excellent correlations for block (r = 0.81) and spike jumps (r = 0.90), with a mean bias of 2.61 and 7.69 cm, respectively. The device demonstrates good validity for measuring jump count as well as vertical displacement. Due to its potential for nearly real time feedback with constraints of limited resources, we assume that this device will have considerable benefits for quantifying jump-specific load in beach volleyball.
Does tackle height influence offload success in rugby union? Analysis from the 2019 Rugby World Cup
Authors: Amayo Joshua , Tierney Gregory J
Published: November 2020

Offloads are an effective way of breaking through a defensive line in rugby union. Higher tackle heights are considered an effective strategy to defend against offloads. However, in a bid to reduce head injuries, there is a cultural shift within the rules of the game to tackle lower down on the body. This study used match video analysis of ten games from the 2019 Rugby World Cup to investigate whether tackle height influences offload success for the ball carrier. Each legal tackle was categorised based on tackle height (e.g. shoulder), player body position (e.g. upright), tackle type (e.g. shoulder tackle), tackle direction (e.g. front on) and player position (e.g. tight forwards). For each characteristic, the Odds Ratio (OR) and 95% Confidence Interval (CI) were calculated based on offload success outcome. Tackles at the hip (OR = 1.81, 95% CI 1.10 to 2.96, p = 0.018) and upper leg (OR = 1.94, 95% CI 1.30 to 2.90, p = 0.001) had a greater propensity to result in offload success while tackles at shoulder height reduced offload success (OR = 0.09, 95% CI 0.04 to 0.22, p < 0.001). A bent at the waist tackler against an upright ball carrier had a greater propensity to result in offload success (OR = 1.74, 95% CI 1.19 to 2.54, p = 0.004). Tackling lower increased the chances of offload success for the ball carrier. The cultural shift towards lower tackle heights is likely to result in an increased number of offloads and it is up to players, coaches and defensive systems to be able to adapt to this.
Genetic risk factors predict disease progression in Crohn’s disease patients of the Swiss inflammatory bowel disease cohort
Authors: Ditrich Felicitas , Blümel Sena , Biedermann Luc , Fournier Nicolas , Rossel Jean-Benoit , Ellinghaus David , Franke Andre , Stange Eduard F. , Rogler Gerhard , Scharl Michael ,   on behalf of the Swiss IBD Cohort Study Group
Published: November 2020

Background:

Crohn’s disease (CD) may progress from an inflammatory to a stricturing or penetrating disease phenotype. The aim of our study was to identify single nucleotide polymorphisms (SNPs) that predict disease progression in patients of the Swiss IBD Cohort Study (SIBDCS).

Methods:

We applied a multi-state Markov model for progression behavior of CD with three behavioral states according to the Montreal classification. The model considered transition from B1 to B2/B3 or from B2 to B3 stage. Model dynamics were summarized with transition intensities by including the effect of SNPs and calculating transition intensities for each SNP.

Results:

We included 1276 CD patients [669 (52.4%) B1, 248 (19.4%) B2, 359 (28.1%) B3 patients] with a median follow-up of 6.8 (interquartile range = 3.6–9.1; range 0–11.6) years. Probability for a B1 patient to develop a stenosis (B1 to B2, q = 0.033) was twice as much as compared to developing a penetrating complication (B3) during the disease course. In contrast, the probability of entering B3 stage was similar regardless of whether antecedent stricture was present (B2 to B3, q = 0.016) or not (B1 to B3, q = 0.016). We identified SNPs within the gene loci encoding ZMIZ1, LOC105373831 and KSR1 as carrying the highest risk for progression to B3, while the presence of SNPs within gene loci TNFSF15 and CEBPB-PTPN1 protected from progression to B2 or B3.

Conclusion:

We identified new genetic risk factors that can predict disease course in CD patients. A closer understanding on the functional impact of these genetic variations might improve our treatment options finally to prevent disease progression in CD patients.
Shortening Scarf Osteotomy for Macrodactyly and Valgus of the Hallux in Acrodysostosis Lesser Toes Brachydactyly
Authors: Mansur Henrique , Maranho Daniel Augusto
Published: November 2020

Acrodysostosis is a rare syndrome of peripheral dysostosis, neurodevelopment delay, and skeletal abnormalities. The most common bone changes are peripheral dysostosis with severe brachydactyly of the lesser toes. The first ray of the feet is often not affected or may present hyperplasia resulting in an unbalanced transverse arch of the forefoot, with potential negative effects on function. Additionally, the insufficiency of the lesser toes may be associated with complex congenital hallux valgus deformities. Surgical approaches include growth plate epiphysiodesis, bulk reduction procedures, bone shortening, osteotomies, or amputation. Here, we report a case of a 14-year-old girl with acrodysostosis and severe discrepancy of the first ray and hallux valgus deformity simultaneously treated by a modified scarf osteotomy.

Levels of Evidence

Level V: Case report
Immediate Unrestricted Weightbearing With Simple Stirrup Brace Following Single Anchor Lateral Ankle Ligament Stabilization
Authors: Lundeen Gregory A. , Diefenbach Christopher , Moles Laura Hemker , White Larissa Lee , Barousse Patrick
Published: November 2020

Objective

To report on a series of patients treated with immediate unrestricted weightbearing with limited protection following single anchor lateral ligament stabilization.

Methods

Patients with chronic lateral ankle ligament instability who underwent modified Broström-Gould lateral ligament reconstruction with a single double-loaded anchor were identified. Immediate unrestricted full weightbearing in a stirrup brace was allowed the first postoperative day and accelerated physical therapy was initiated from 2 weeks. Subsequent assessment was performed at a minimum of 1-year follow-up.

Results

Thirteen patients with a mean age at final follow-up of 49 years (range 21-70 years). Average follow-up was 21 months (16 to 26). American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score and visual analogue scale (VAS) score improved significantly (P < .05) from preoperative to postoperative, respectively (57 to 91, 5.7 to 1.5). Average postoperative Foot and Ankle Outcome Score (FAOS) was 82 (range 52-100). Short Form–12 (SF-12) scores averaged 55 and 49 on mental component and physical components, respectively, consistent with US age-matched averages. No measurable differences in range of motion, ligamentous stability, or Star Excursion Balance Test in the anterior, posterolateral, or posteromedial planes compared to the contralateral side (P > .05) were observed. No recurrence was reported.

Conclusion

Immediate unrestricted weightbearing in a stirrup brace following single anchor lateral ligament reconstruction is a successful protocol for the treatment of chronic lateral ankle instability.

Levels of Evidence

Therapeutic, Level IV: Case series
Environmental Regulation and Development Transformation in the Tropical and Subtropical Cities of China: A Big Data Analysis
Authors: Deng Zhituan , Kang Jiaojiao , Fan Haobin
Published: November 2020

This paper studies the effects of Key Control Areas (KCA) policy implemented by the Chinese government in 2012 on city development transformation, in which strict environmental regulations were imposed in KCA cities in both tropical and subtropical zone. Based on the panel data of 155 tropical and subtropical cities in China from 2000 to 2017, we use a simple Differences-in-Differences approach to estimate the effects. Results show that more draconian environmental regulation has significant positive effects on city transformation. Furthermore, the designation of key areas leads to a screening effect on firms, that is, some of them increase technology investment in green production, while other firms are not capable to shoulder the rising cost and choose to reduce production or even shut their business, which ultimately promotes the city transformation. Meanwhile, with the expansion of the service industry, the relative proportion of manufacturing has declined, which brings about the upgrading of the industrial structure, and in turn promotes the city transformation.
Assessment of Reye’s syndrome profile with data from the US Food and Drug Administration Adverse Event Reporting System and the Japanese Adverse Drug Event Report databases using the disproportionality analysis
Authors: Matsumoto Kiyoka , Hasegawa Shiori , Nakao Satoshi , Shimada Kazuyo , Mukai Ririka , Tanaka Mizuki , Satake Riko , Yoshida Yu , Goto Fumiya , Inoue Misaki , Ikesue Hiroaki , Iguchi Kazuhiro , Hashida Tohru , Nakamura Mitsuhiro
Published: November 2020

Objectives:

Reye’s syndrome is a rare and potentially fatal illness that is defined as encephalopathy accompanied by liver failure. The aim of this study was to assess Reye’s syndrome profiles by analyzing data from the spontaneous reporting system database.

Methods:

We analyzed reports of Reye’s syndrome using the US Food and Drug Administration Adverse Event Reporting System and the Japanese Adverse Drug Event Report databases. The reporting odds ratio and proportional reporting rate were used to detect the pharmacovigilance signal.

Results:

The US Food and Drug Administration Adverse Event Reporting System contains 12,201,620 reports from January 2004 to June 2020, of which 186 are on Reye’s syndrome. The Japanese Adverse Drug Event Report contains 646,779 reports from April 2004 to September 2020, of which 30 are on Reye’s syndrome. In the US Food and Drug Administration Adverse Event Reporting System database, the reporting odds ratios (95% confidence interval, number of cases) of aspirin, diclofenac, ibuprofen, acetaminophen, and valproate sodium were 404.6 (302.6–541.0, n = 80), 15.1 (6.7–34.1, n = 6), 26.2 (16.1–42.6, n = 18), 10.7 (5.5–20.9, n = 9), and 47.1 (26.2–84.6, n = 12), respectively. In the Japanese Adverse Drug Event Report database, the reporting odds ratios (95% confidence interval, number of cases) of aspirin, diclofenac, ibuprofen, loxoprofen, acetaminophen, and valproate sodium were 14.1 (5.4–36.8, n = 5), 51.7 (22.2–120.5, n = 7), 135.0 (40.8–446.2, n = 3), 17.6 (6.7–46.0, n = 5), 24.0 (9.2–62.6, n = 5), and 13.8 (3.3–57.9, n = 2), respectively. The reported number of female patients aged 30–39 years was the highest in the Japanese Adverse Drug Event Report.

Conclusion:

Although the frequency of the occurrence of Reye’s syndrome is low, the possible risk of the disease occurring in adult females should be considered.
Prevalent, uncontrolled, and undiagnosed diabetes mellitus among urban adults in Dire Dawa, Eastern Ethiopia: A population-based cross-sectional study
Authors: Ayele Behailu Hawulte , Roba Hirbo Shore , Beyene Addisu Shunu , Mengesha Melkamu Merid
Published: November 2020

Objective:

Globally, 8.8% of adults were estimated to have diabetes mellitus, with the low-and middle-income countries sharing the largest burden. However, the research evidence for targeted interventions is lacking in sub-Saharan Africa, particularly in Ethiopia. Therefore, this study aimed to assess the prevalence of diabetes mellitus, disaggregated by the epidemiology of diabetes mellitus morbidity and associated factors among adults in Dire Dawa town, Eastern Ethiopia.

Methods:

Data from a total of 872 randomly sampled adults aged 25–64 years were obtained for analysis using the World Health Organization STEPwise approach to non-communicable disease risk factors surveillance instruments. We estimated the prevalence of diabetes mellitus disaggregated by the previous diabetes mellitus diagnosis status and by the current blood sugar level control status. The bivariable and multivariable binary logistic regression model was used to identify correlates of diabetes mellitus, along with STATA version 14.2 for data management and analysis. All statistical tests were declared significant at p-value < 0.05.

Results:

14.9% (95% confidence interval: 12.1, 17.4) of adults aged 25–64 years had diabetes mellitus in the study sample with 58.5% (95% confidence interval: 49.7, 66.7) on diabetes mellitus medication. Among adults currently taking diabetes mellitus medications, 30.3% (95% confidence interval: 19.8, 45.6) had uncontrolled diabetes mellitus. The magnitude of previously undiagnosed diabetes mellitus was 6.2% (95% confidence interval: 4.8, 8.0) in the study sample and 41.5% (95% confidence interval: 33.3, 50.3) among the diabetics. The odds of diabetes mellitus were higher among adults over the age of 55 years (adjusted odds ratio = 2.1, 95% confidence interval: 1.2, 3.6), currently married adults (adjusted odds ratio = 2.3, 95% confidence interval: 1.2, 4.4), and overweight adults (adjusted odds ratio = 1.6, 95% confidence interval: 1.1, 2.1). Adults with primary education (adjusted odds ratio = 0.4, 95% confidence interval: 0.2, 0.8) and no formal education (adjusted odds ratio = 0.5, 95% confidence interval: 0.2, 0.9) had lower odds of diabetes mellitus.

Conclusion:

The prevalence of diabetes mellitus among adults was high in Dire Dawa, with a third of the diabetics having poor control of their blood sugar levels and, nearly four in ten were previously undiagnosed. Adults who were overweight, currently married, and those over 55 years need to be targeted for regular diabetes health checkups and community-based screening. Also, a mechanism should be instituted to track a patient’s adherence to medications and promote diabetes self-care management.
Derationalizing Delusions
Authors: Bell Vaughan , Raihani Nichola , Wilkinson Sam
Published: November 2020

Because of the traditional conceptualization of delusion as “irrational belief,” cognitive models of delusions largely focus on impairments to domain-general reasoning. Nevertheless, current rationality-impairment models do not account for the fact that (a) equivalently irrational beliefs can be induced through adaptive social cognitive processes, reflecting social integration rather than impairment; (b) delusions are overwhelmingly socially themed; and (c) delusions show a reduced sensitivity to social context both in terms of how they are shaped and how they are communicated. Consequently, we argue that models of delusions need to include alteration to coalitional cognition—processes involved in affiliation, group perception, and the strategic management of relationships. This approach has the advantage of better accounting for both content (social themes) and form (fixity) of delusion. It is also supported by the established role of mesolimbic dopamine in both delusions and social organization and the ongoing reconceptualization of belief as serving a social organizational function.
Platelet-Rich Plasma Augmentation for Isolated Arthroscopic Meniscal Repairs Leads to Significantly Lower Failure Rates: A Systematic Review of Comparative Studies
Authors: Sochacki Kyle R. , Safran Marc R. , Abrams Geoffrey D. , Donahue Joseph , Chu Constance , Sherman Seth L.
Published: November 2020

Background:

Studies have reported relatively high failure rates of isolated meniscal repairs. Platelet-rich plasma (PRP) has been suggested as a way to increase growth factors that enhance healing.

Purpose:

To compare (1) meniscal repair failures and (2) patient-reported outcomes after isolated arthroscopic meniscal repair augmented with and without PRP.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

A systematic review was performed using the PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines. Multiple databases were searched for studies that compared outcomes of isolated arthroscopic meniscal repair augmented with PRP versus without PRP in human patients. Failures and patient-reported outcome scores were reported for each study and compared between groups. Study heterogeneity was assessed using I 2 for each outcome measure before meta-analysis. Study methodological quality was analyzed. Continuous variable data were reported as mean and standard deviation from the mean. Categorical variable data were reported as frequency with percentage. All P values were reported with significance set at P < .05.

Results:

Five articles were analyzed (274 patients [110 with PRP and 164 without PRP]; 65.8% male; mean age, 29.1 ± 4.6 years; mean follow-up, 29.2 ± 22.1 months). The risk of meniscal repair failure ranged from 4.4% to 26.7% for PRP-augmented repairs and 13.3% to 50.0% for repairs without PRP. Meniscal repairs augmented with PRP had significantly lower failure rates than repairs without PRP (odds ratio, 0.32; 95% CI, 0.12-0.90; P = .03). One of the 5 studies reported significantly higher outcomes in the PRP-augmented group versus the no-PRP group for the International Knee Documentation Committee (IKDC), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee injury and Osteoarthritis Outcome Score (KOOS) ( P < .05 for all). The remaining 4 studies reported no significant difference between groups with regard to outcomes for the IKDC, Lysholm knee scale, visual analog scale for pain, or Tegner activity level.

Conclusion:

Although the studies were of mostly of low quality, isolated arthroscopic meniscal repairs augmented with PRP led to significantly lower failure rates (10.8% vs 27.0%; odds ratio, 0.32; P = .03) as compared with repairs without PRP. However, most studies reported no significant differences in patient-reported outcomes.
Autoethnography as a Strategy for Engaging in Reflexivity
Authors: Koopman Wilma J. , Watling Christopher J. , LaDonna Kori A.
Published: November 2020

Reflexivity is a key feature in qualitative research, essential for ensuring rigor. As a nurse practitioner with decades of experience with individuals who have chronic diseases, now embarking on a PhD, I am confronted with the question “how will my clinical experiences shape my research?” Since there are few guidelines to help researchers engage in reflexivity in a robust way, deeply buried aspects that may affect the research may be overlooked. The purpose of this paper is to consider the affordances of combining autoethnography (AE) with visual methods to facilitate richer reflexivity. Reflexive activities such as free writing of an autobiographical narrative, drawings of clinical vignettes, and interviews conducted by an experienced qualitative researcher were analyzed to probe and make visible perspectives that may impact knowledge production. Two key themes reflecting my values—fostering advocacy and favoring independence and autonomy were uncovered with this strategy.
Predictive Value of the BSID-II and the Bayley-III for Early School Age Cognitive Function in Very Preterm Infants
Authors: Flynn Rachel S. , Huber Matthew D. , DeMauro Sara B.
Published: November 2020

Objective:

To compare the predictive validity of the Bayley Scales of Infant Development, Second Edition (BSID-II) and the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) for cognitive function at early school age in very preterm infants.

Methods:

Seventy-seven former preterm infants (born <32 weeks gestation and ≤2000 g) completed both the BSID-II and the Bayley-III at 2 years corrected age. Children enrolled at hospitals that perform follow-up beyond 2 years had cognitive assessments with the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI-IV). Associations between Bayley and WPPSI scores were assessed using correlation coefficients, linear regression, and Bland-Altman plots.

Results:

Thirty-one of 45 eligible children were tested with the WPPSI-IV at 47 ± 11 months. Average BSID-II Mental Development Index (MDI) was 86 ± 19, Bayley-III Cognitive composite score was 101 ± 12 and WPPSI Full Scale IQ (FSIQ) was 96 ± 12. Correlation between MDI and FSIQ was 0.54 ( P < .001); correlation between Bayley-III cognitive composite score and FSIQ was 0.31 ( P = .03). Bayley-III language composite had a modestly stronger correlation with FSIQ than cognitive composite (correlation coefficient 0.39; P = .005). Linear regression models also demonstrated that BSID-II was more closely correlated with FSIQ than Bayley-III. This bias was consistent across the full range of scores.

Conclusion:

The BSID-II underestimated FSIQ and the Bayley-III overestimated FSIQ. Children at risk for impairment might be missed with the Bayley-III. As the Bayley-4 is introduced, clinicians and researchers should be cautious about interpretation of scores until performance of this new measure is fully understood.
The role of ultrasound in systemic sclerosis: On the cutting edge to foster clinical and research advancement
Authors: Hughes Michael , Bruni Cosimo , Cuomo Giovanna , Delle Sedie Andrea , Gargani Luna , Gutierrez Marwin , Lepri Gemma , Ruaro Barbara , Santiago Tania , Suliman Yossra , Watanabe Shinji , Iagnocco Annamaria , Furst Daniel , Bellando-Randone Silvia
Published: November 2020

Ultrasound has been widely explored in systemic sclerosis in the clinical and research settings. Ultrasound allows a non-invasive and ionising radiation-free ‘window’ into this complex disease and is well-suited to repeated examinations. Ultrasound provides novel insights into the pathogenesis and measurement of disease in systemic sclerosis, including early (preclinical) internal organ involvement. The purpose of this review is to describe the role of ultrasound to foster clinical and research advancements in systemic sclerosis relating to (1) musculoskeletal, (2) digital ulcer, (3) lung disease and (4) skin disease. We also highlight unmet needs which much be addressed for ultrasound to assume a central role in systemic sclerosis clinical care and research.
Response spectral matching of horizontal ground motion components to an orientation-independent spectrum (RotDnn)
Authors: Montejo Luis A
Published: November 2020

This article presents a methodology to spectrally match two horizontal ground motion components to an orientation-independent target spectrum (RotDnn). The algorithm is based on the continuous wavelet transform decomposition and iterative manipulation of the two horizontal components of a seed record. The numerical examples presented follow current ASCE/SEI 7 specifications and therefore maximum-direction spectra (RotD100) are used as target for the match. However, the proposed methodology can be used to match other RotDnn spectra, like the median spectrum (RotD50). It is shown that with the proposed methodology the resulting RotDnn from the modified horizontal components closely match the smooth target RotDnn spectrum, while the response spectrum for each horizontal component continue to exhibit a realistic jagged behavior. The response spectra variability at the component level within suites of spectrally matched motions was found to be of the same order than the variability measured in suites composed of amplitude scaled records. Moreover, the spectrally matched records generated preserved most of the characteristics of the seed records, including the nonlinear characteristics of the time history traces and the period-dependent major axis orientations.
Secondary lanthanide phosphate mineralisation in weathering profiles of I-, S- and A-type granites
Authors: Voutsinos Marcos Y. , Banfield Jillian F. , Moreau John W.
Published: November 2020

Rare earth elements (REEs, ‘lanthanides’) constitute a vital commodity for technological applications. Although these elements occur at trace levels in many minerals, they can comprise major constituents of low abundance phosphate, carbonate, silicate and oxide minerals, some of which form during granite weathering. REE-phosphate phases can be a source of phosphorus for essential biomolecules and certain REEs are required by some bacterial enzymes involved in the oxidation of methanol, an important compound in the global biogeochemical carbon cycle. The mechanisms that promote the dissolution of lanthanide phosphate minerals are largely unknown, but probably vary with the lanthanide phosphate mineralogy of weathered rock and soil. Here, we studied weathering of five I-type, three S-type and one A-type granite to determine the extent of weathering of primary REE- and/or P-bearing minerals apatite, allanite and monazite, and the formation of secondary REE/P-bearing minerals. We found evidence for greater mobilisation of REE and P in weathered I-type and A-type granites than in S-types, reflecting the higher solubility of apatite and allanite relative to monazite. Although monazite persisted in highly weathered S-type granites, some alteration was detected. Secondary REE/P-bearing minerals were not detected in two S-type profiles, while spherical secondary REE/P-bearing mineral aggregates were abundant throughout the third S-type profile. Secondary euhedral REE/P-bearing crystals were abundant even in the slightly weathered I-type and A-type granite material, yet they were not detected in the highly weathered material, indicating that these minerals had dissolved. Our findings indicate that mineralogy constrains substantially, but does not control completely, lanthanide availability as a function of degree of weathering. These results have implications for predicting REE and phosphate bioavailability in soils derived from granitic rock types and suggest that highly weathered I-type granites may provide inocula for bioleaching experiments.
Obinutuzumab vs rituximab for advanced DLBCL: a PET-guided and randomized phase 3 study by LYSA
Authors: Le Gouill Steven , Ghesquières Hervé , Oberic Lucie , Morschhauser Franck , Tilly Hervé , Ribrag Vincent , Lamy Thierry , Thieblemont Catherine , Maisonneuve Hervé , Gressin Rémy , Bouhabdallah Krimo , Haioun Corinne , Damaj Gandhi , Fornecker Luc , Bouhabdallah Réda , Feugier Pierre , Sibon David , Cartron Guillaume , Bonnet Christophe , André Marc , Chartier Loic , Ruminy Philippe , Kraeber-Bodéré Françoise , Bodet-Milin Caroline , Berriolo-Riedinger Alina , Brière Josette , Jais Jean-Philippe , Molina Thierry Jo , Itti Emmanuel , Casasnovas René-Olivier
Published: November 2020

Rituximab plus polychemotherapy is the standard of care in diffuse large B-cell lymphoma (DLBCL). GAINED, a randomized phase 3 trial, compared obinutuzumab to rituximab. Transplant-eligible patients (18-60 years) with an untreated age-adjusted International Prognostic Index (aaIPI) score ≥1 DLBCL were randomized (1:1) between obinutuzumab or rituximab and stratified by aaIPI (1; 2-3) and chemotherapy regimen (doxorubicin, cyclophosphamide, prednisone plus vindesine, bleomycin [ACVBP] or vincristine [CHOP]). Consolidation treatment was determined according to response to interim positron emission tomography (PET). Responders after cycle 2 and 4 (PET2−/PET4−) received immunochemotherapy. Responders after only cycle 4 (PET2+/4−) received transplantation. The primary objective was an 8% improvement (hazard ratio [HR] = 0.73; 80% power; α risk, 2.5%; 1-sided) in 2-year event-free survival (EFS) in the obinutuzumab arm. From September 2012, 670 patients were enrolled (obinutuzumab, n = 336; rituximab, n = 334). A total of 383 (57.2%) were aaIPI 2-3, 339 (50.6%) received CHOP. Median follow-up was 38.7 months. The 2-year EFS was similar in both groups (59.8% vs 56.6%; P = .123; HR = 0.88). The 2-year PFS in the whole cohort was 83.1% (95% confidence interval, 80% to 85.8%). PET2−/4− and PET2+/4− had similar 2-year progression-free survival (PFS) and overall survival (OS): 89.9% vs 83.9% and 94.8% vs 92.8%. The 2-year PFS and OS for PET4+ patients were 62% and 83.1%. Grade 3-5 infections were more frequent in the obinutuzumab arm (21% vs 12%). Obinutuzumab is not superior to rituximab in aaIPI ≥1 DLBCL transplant-eligible patients. This trial was registered at www.clinicaltrials.gov as #NCT01659099.
Crossed cerebellar diaschisis after stroke detected noninvasively by arterial spin-labeling MR imaging
Authors: Wang Juan , Pan Li-Jun , Zhou Bin , Zu Jin-Yan , Zhao Yi-Xu , Li Yang , Zhu Wan-Qiu , Li Lei , Xu Jian-Rong , Chen Zeng-Ai
Published: November 2020

Background

As a noninvasive perfusion-weighted MRI technique, arterial spin-labeling (ASL) was becoming increasingly used to evaluate cerebral hemodynamics in many studies. The relation between ASL-MRI and crossed cerebellar diaschisis (CCD) was rarely discussed. In this study, the aim of our study was to assess the performance of ASL-MRI in the detection of crossed cerebellar diaschisis after stroke in compared with single-photon emission CT (SPECT).

Results

17 of 51(33.3%) patients revealed CCD phenomenon by the SPECT method. In CCD-positive group, CBFASL of ipsilateral cerebellar were significantly increased compared with contralateral cerebellar (p < 0.0001) while no significant differences (p = 0.063, > 0.001) in the CCD-negative group. Positive correlation was detected between admission National institute of health stroke scale (NIHSS) and asymmetry index of SPECT (AISPECT) (r = 0.351, p = 0.011), AIASL (r = 0.372, p = 0.007); infract volume and AISPECT (r = 0.443, p = 0.001), AIASL (r = 0.426, p = 0.002). Significant correlation was also found between cerebral blood flow of SPECT (CBFSPECT) and CBFASL, AISPECT and AIASL (r = 0.204, p = 0.04; r = 0.467, p = 0.001, respectively). Furthermore, the area under the receiver operating characteristic (ROC) curve value of AIASL was 0.829.

Conclusions

CBF derived from ASL-MRI could be valuable for assessment of CCD in supratentorial stroke patients. Additionally, CCD was significantly associated with larger ischemic volume and higher initial NIHSS score.
Fertility preservation with successful pregnancy outcome in a patient with transplanted heart and non-Hodgkin’s lymphoma – a case report
Authors: Pais Ana Sofia , Guerra Nuno , Couto Daniela , Sousa Ana Paula , Almeida-Santos Teresa
Published: November 2020

Background: Fertility preservation must be discussed with reproductive age women before cancer treatment. Heart transplantation raises complex issues in pregnancy. Pregnancy in a heart transplant woman after pelvic irradiation involves close multidisciplinary follow-up to avoid complications in the mother and the foetus. We report the first live birth in a heart transplant woman after pelvic irradiation, chemotherapy and fertility preservation.

Case presentation: A 36-year-old heart transplant woman with pelvic non-Hodgkin lymphoma spared her fertility, with cryopreservation of oocytes and embryos, before chemotherapy and pelvic irradiation. After multidisciplinary discussion and pre-conception evaluation, pregnancy was achieved. A close follow-up by a multidisciplinary team allowed a normal pregnancy without maternal or foetal complications and the delivery of a healthy infant.

Conclusions

Achieving pregnancy in heart transplant women with iatrogenic ovarian failure after oncologic treatment including pelvic irradiation is possible and can be successful. Careful and close surveillance by a multidisciplinary team is mandatory due to increased risk of maternal and foetal complications.
Correction to: The efficacy of etanercept as anti-breast cancer treatment is attenuated by residing macrophages
Authors: Shirmohammadi Elnaz , Ebrahimi Seyed-Esmaeil Sadat , Farshchi Amir , Salimi Mona
Published: November 2020

An amendment to this paper has been published and can be accessed via the original article.
Correction to: A pilot study of improved psychological distress with art therapy in patients with cancer undergoing chemotherapy
Authors: Elimimian E. B. , Elson L. , Stone E. , Butler R. S. , Doll M. , Roshon S. , Kondaki C. , Padgett A. , Nahleh Z. A.
Published: November 2020

An amendment to this paper has been published and can be accessed via the original article.
C-reactive protein- and clinical symptoms-guided strategy in term neonates with early-onset sepsis reduced antibiotic use and hospital stay: a quality improvement initiative
Authors: Gyllensvärd Johan , Ingemansson Fredrik , Hentz Elisabet , Studahl Marie , Elfvin Anders
Published: November 2020

Background

Early-onset sepsis (EOS) is a potentially life-threatening complication of birth. Clinical symptoms are often unspecific and biomarkers have low predictive values for EOS. Therefore, clinical suspicion often leads to antibiotic therapy in neonates with a negative blood culture. In the study we evaluated if a quality improvement initiative could reduce unwarranted antibiotic use in a safe way in term neonates with culture-negative sepsis.

Methods

The quality improvement initiative included new treatment guidelines and were introduced on 11 June 2018. The guidelines included C-reactive protein- and clinical symptoms-guided decision-making and shorter intravenous antibiotic therapy. All term neonates treated for EOS at Ryhov Hospital, Jönköping, Sweden were studied before (period 1: 2016–2017) and after the introduction of the new guidelines (period 2: 11 June 2018 to 30 Sept 2019).

Laboratory and clinical data were analysed.

Results

There were 7618 term neonates in period 1 and 5005 term neonates in period 2. We identified 140 (1.8%) EOS in period 1 and 97 (1.9%) EOS in period 2. During period 1 and 2, there were 61 (61/140, 44%) and 59 (59/97, 61%) EOS neonates, respectively, who met the criteria for shorter antibiotic treatment. The number of positive blood cultures were seven (0.92/1000 live births) and five (1.0/1000 live births) in period 1 and 2. The median C-reactive protein were 52 mg/L (37–62) in period 1 and 42 mg/L (31–56) in period 2 in the group who met the criteria of the guidelines. The duration of antibiotic therapy (Median: seven vs. five days, p < 0.001) and hospital stay (Median: seven vs. five days, p < 0.001) as well as healthcare costs (decreased by €122,000/year) was reduced in the group who met the criteria after the introduction of the guidelines.

Conclusion

C-reactive protein- and clinical symptoms-guided decision-making for EOS significantly decreased the duration of antibiotic therapy and hospital stay, and hence reduced healthcare costs, with no reinfection in a cohort of term infants.

Trial registration

Trial registration number: ISRCTN29535824. Date of registration: 28 May 2020. Retrospectively registered.
Sleep in disorders of consciousness: behavioral and polysomnographic recording
Authors: Mertel Isabella , Pavlov Yuri G. , Barner Christine , Müller Friedemann , Diekelmann Susanne , Kotchoubey Boris
Published: November 2020

Background

Sleep-wakefulness cycles are an essential diagnostic criterion for disorders of consciousness (DOC), differentiating prolonged DOC from coma. Specific sleep features, like the presence of sleep spindles, are an important marker for the prognosis of recovery from DOC. Based on increasing evidence for a link between sleep and neuronal plasticity, understanding sleep in DOC might facilitate the development of novel methods for rehabilitation. Yet, well-controlled studies of sleep in DOC are lacking. Here, we aimed to quantify, on a reliable evaluation basis, the distribution of behavioral and neurophysiological sleep patterns in DOC over a 24-h period while controlling for environmental factors (by recruiting a group of conscious tetraplegic patients who resided in the same hospital).

Methods

We evaluated the distribution of sleep and wakefulness by means of polysomnography (EEG, EOG, EMG) and video recordings in 32 DOC patients (16 unresponsive wakefulness syndrome [UWS], 16 minimally conscious state [MCS]), and 10 clinical control patients with severe tetraplegia. Three independent raters scored the patients’ polysomnographic recordings.

Results

All but one patient (UWS) showed behavioral and electrophysiological signs of sleep. Control and MCS patients spent significantly more time in sleep during the night than during daytime, a pattern that was not evident in UWS. DOC patients (particularly UWS) exhibited less REM sleep than control patients. Forty-four percent of UWS patients and 12% of MCS patients did not have any REM sleep, while all control patients (100%) showed signs of all sleep stages and sleep spindles. Furthermore, no sleep spindles were found in 62% of UWS patients and 21% of MCS patients. In the remaining DOC patients who had spindles, their number and amplitude were significantly lower than in controls.

Conclusions

The distribution of sleep signs in DOC over 24 h differs significantly from the normal sleep-wakefulness pattern. These abnormalities of sleep in DOC are independent of external factors such as severe immobility and hospital environment.
Neutrophil to lymphocyte ratio and cancer prognosis: an umbrella review of systematic reviews and meta-analyses of observational studies
Authors: Cupp Meghan A. , Cariolou Margarita , Tzoulaki Ioanna , Aune Dagfinn , Evangelou Evangelos , Berlanga-Taylor Antonio J.
Published: November 2020

Background

Although neutrophils have been linked to the progression of cancer, uncertainty exists around their association with cancer outcomes, depending on the site, outcome and treatments considered. We aimed to evaluate the strength and validity of evidence on the association between either the neutrophil to lymphocyte ratio (NLR) or tumour-associated neutrophils (TAN) and cancer prognosis.

Methods

We searched MEDLINE, Embase and Cochrane Database of Systematic Reviews from inception to 29 May 2020 for systematic reviews and meta-analyses of observational studies on neutrophil counts (here NLR or TAN) and specific cancer outcomes related to disease progression or survival. The available evidence was graded as strong, highly suggestive, suggestive, weak or uncertain through the application of pre-set GRADE criteria.

Results

A total of 204 meta-analyses from 86 studies investigating the association between either NLR or TAN and cancer outcomes met the criteria for inclusion. All but one meta-analyses found a hazard ratio (HR) which increased risk (HR > 1). We did not find sufficient meta-analyses to evaluate TAN and cancer outcomes (N = 9). When assessed for magnitude of effect, significance and bias related to heterogeneity and small study effects, 18 (9%) associations between NLR and outcomes in composite cancer endpoints (combined analysis), cancers treated with immunotherapy and some site specific cancers (urinary, nasopharyngeal, gastric, breast, endometrial, soft tissue sarcoma and hepatocellular cancers) were supported by strong evidence.

Conclusion

In total, 60 (29%) meta-analyses presented strong or highly suggestive evidence. Although the NLR and TAN hold clinical promise in their association with poor cancer prognosis, further research is required to provide robust evidence, assess causality and test clinical utility.

Trial registration

PROSPERO CRD42017069131.