bluuebunny/crossref_metadata_2025 huggingface dataset:
The Risk of Prior Opioid Exposure on Future Opioid Use and Comorbidities in Individuals With Non-Acute Musculoskeletal Knee Pain
Authors: Rhon Daniel I. , Snodgrass Suzanne J. , Cleland Joshua A. , Cook Chad E.
Published: September 2020

Objectives

Due to their potentially deleterious effects, minimizing the use of opioids for musculoskeletal pain is a priority for healthcare systems. The objective of this study was to examine the risk of future opioid prescription use based on prior opioid use within a non-surgical cohort with musculoskeletal knee pain. We also examined the risk of pre-existing comorbidities on future opioid use, and the risk of prior opioid use on future comorbidities (sleep, mental health, cardiometabolic disorders).

Methods

Data came from the Military Health System Data Repository for 80 290 consecutive beneficiaries with an initial episode of care for patellofemoral pain from January 1, 2010 through December 31, 2011. Risk was calculated using 2 × 2 tables based on pre- and post-opioid utilization and comorbid diagnosis. Risk ratios, relative and absolute risk increases, and numbers needed to harm were calculated, all with 95% confidence intervals.

Results

Prior opioid use resulted in a risk ratio of 18.0 (95 CI 17.1, 19.0) and an absolute risk increase of 61.6% for future opioid use (numbers needed to harm = 2). The presence of all comorbidities (except cardiometabolic syndrome) were associated with a significant relative risk for future opioid use (RR range 1.2-1.5), but the absolute risk increase was trivial (range 0.7%-2.2%). The relative risk for a chronic pain diagnosis, traumatic brain injury/concussion, insomnia, depression, and PTSD were all significantly higher in those with prior opioid use (1.3-1.6), but absolute risk increase was minimal (1.1%-6.5%).

Discussion

Prior opioid use was a strong risk factor for future opioid use in non-surgical patients with knee pain. These findings show that history of prior opioid use is important when assessing the risk of future opioid use, whereas prior comorbidities may not be as important. Opioid history assessment should be standard practice for all patients with patellofemoral pain in whom an opioid prescription is considered.
Development of a Clinical-Academic-Community Collaboration to Improve Health Literacy
Authors: Friedman Daniela B. , Arent Michelle A. , Yelton Brooks , Sakhuja Mayank , Haynes Venice E. , Noblet Samuel , Brandt Heather M. , Isenhower William D. , Wandersman Abraham , Zona Diana , New Cyndi , Fedrick Delores , Scaccia Jonathan , Bruner Larisa
Published: September 2020

Limited health literacy is associated with poor patient health outcomes and increased hospitalization rates. Patient-provider communication plays an important role in patient health literacy and the understanding of medical terminology. This study demonstrates how a collaboration between clinical, academic, and community partners was instrumental in the design and implementation of a clinic readiness assessment and a clinic-based pilot intervention to encourage patient-provider communication and improve patient health literacy. A state hospital association, academic research team, and community adult literacy center director collaborated to develop a 60-item clinic readiness assessment and an evidence-informed pilot intervention. The clinic readiness assessment captured clinics’ motivation and capacity for pilot implementation and providers’ current communication strategies. The intervention centered around AskMe3™ educational materials and involved 2 patient visits (initial and follow-up visits). Data collection instruments for the intervention were administered verbally and included questions about patient demographics and communication needs, and a single-item health literacy measure. Descriptive statistics (frequencies/percentages) were used to analyze results from the clinic readiness assessment and pilot intervention. Establishment of the partnership, and collaborative, iterative development of the clinic readiness assessment and pilot intervention are described. This pilot project resulted in important lessons learned which led to critical modifications that will inform future expansion of the intervention. Collaboration between healthcare leaders, researchers, and community partners is recommended for developing clinic-based health literacy initiatives.
Primary Care-Led Transition Clinics Hold Promise in Improving Care Transitions for Cancer Patients Facing Social Disparities: A Commentary
Authors: Malebranche Mary , Sarivalasis Apostolos , Peters Solange , Mathevet Patrice , Cornuz Jacques , Bodenmann Patrick
Published: September 2020

Transitions in care are key junctions during which care coordination, communication, and individualized support are required to ensure optimal health outcomes for patients. This is particularly true for patients who face social disparities, such as poverty, limited health literacy, or belonging to a racial or ethnic minority, who are particularly at risk for experiencing poor care transitions. Interdisciplinary primary care-led transition clinics are an intervention that have shown promise in improving care transitions for diverse patient populations, including those that face social disparities, but their role in improving transitions in cancer care remains largely untapped. In this commentary we highlight why the time-limited support of an interdisciplinary primary care-led transition clinic that targets socially vulnerable cancer patients holds the promise of achieving more equitable healthcare access, healthcare quality, and ultimately more equitable health outcomes for cancer patients.
Pediatric COVID-19 and Pericarditis Presenting With Acute Pericardial Tamponade
Authors: Raymond Tia T. , Das Ashima , Manzuri Shai , Ehrett Stuart , Guleserian Kristine , Brenes Javier
Published: September 2020

We describe a seven-year-old female with acute pericarditis presenting with pericardial tamponade, who screened positive for coronavirus disease 2019 (COVID-19 [SARS-CoV-2]) in the setting of cough, chest pain, and orthopnea. She required emergent pericardiocentesis. Due to continued chest pain and orthopnea, rising inflammatory markers, and worsening pericardial inflammation, she underwent surgical pericardial decortication and pericardiectomy. Her symptoms and pericardial effusion resolved, and she was discharged to home 3 days later on ibuprofen and colchicine with instruction to quarantine at home for 14 days from the date of her positive testing for COVID-19.
Impact of Early Intervertebral Osseous Union After Posterior Lumbar Interbody Fusion on Health-Related Quality of Life
Authors: Ushirozako Hiroki , Hasegawa Tomohiko , Ebata Shigeto , Ohba Tetsuro , Oba Hiroki , Mukaiyama Keijiro , Shimizu Satoshi , Yamato Yu , Ide Koichiro , Shibata Yosuke , Ojima Toshiyuki , Takahashi Jun , Haro Hirotaka , Matsuyama Yukihiro
Published: September 2020

Study Design:

Retrospective cohort study.

Objectives:

Nonunion after posterior lumbar interbody fusion (PLIF) is associated with poor improvements in health-related quality of life (HRQOL). We aimed to investigate the influence of early osseous union after PLIF on HRQOL.

Methods:

We reviewed 138 patients with 1-level PLIF (mean age 67 years, follow-up period ≥1 year). Postoperative lumbar computed tomography was performed to assess screw loosening and intervertebral union. HRQOL was assessed using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire.

Results:

Thirty-nine patients (28%) showed complete union at 6 months postoperatively (early union group). Twenty-eight patients (20%) showed complete union at 6 to 12 months postoperatively (delayed union group), while 71 patients demonstrated noncomplete union. Effective improvement of lumbar spine dysfunction and psychological disorders was achieved in 19 (63.3%) and 17 (50.0%) patients in the early union group, in 9 (42.9%) and 14 (53.8%) patients in the delayed union group, and in 22 (34.9%) and 19 (29.2%) patients in the nonunion group, respectively ( P = .036 and P = .036, respectively). The nonunion group had a significantly higher proportion of cases with screw loosening at 6 and 12 months postoperatively than the complete union group ( P = .033 and P = .022).

Conclusions:

Lumbar spine dysfunction and psychological disorders improved in cases with early complete union compared to those with nonunion. Screw loosening occurred in cases with nonunion predominantly from 6 months postoperatively. Therefore, the achievement of early complete union might be helpful for better HRQOL and lower incidence of postoperative complications.
Comparing Plastic Surgeon Versus Orthopedic Surgeon Outcomes Following Distal Upper Extremity Amputations: A Study of the National Surgical Quality Improvement Program (NSQIP) Database
Authors: Du Jerry Y. , Wang Joanne H. , Coquillard Cristin L. , Kumar Anand R. , Malone Kevin J.
Published: September 2020

Background:

Both plastic and orthopedic surgeons manage care for urgent/emergent hand conditions. It is unclear if surgeon specialty affects patient outcomes of these cases. The purpose of this study was to evaluate differences in 30-day perioperative outcomes between plastic and orthopedic surgeons following distal upper extremity amputations.

Methods:

Patients who underwent distal upper extremity amputations between 2005 and 2016 were identified within the National Surgical Quality Improvement Program (NSQIP) database using Current Procedural Terminology ( CPT) codes. Differences in operative procedures, patient demographics, patient comorbidities, and 30-day perioperative complications were compared between orthopedic and plastic surgeons by univariate analysis. A Bonferroni correction was applied to account for multiple comparisons of complications.

Results:

A total of 1583 cases met inclusion criteria. Orthopedic surgeons performed 981 cases (62.0%) and plastic surgeons performed 602 cases (38.0%). Finger amputations comprised the majority of procedures for both orthopedic and plastic surgeons (95.5% and 94.4%, respectively). Orthopedic surgeons had a lower operative time (41.7 ± 36.2 minutes vs 47.1 ± 40.9 minutes, P = .008). There were no differences in proportion of emergency surgery, inpatients, or wound class. There were no differences in age, gender, or body mass index. The most common indications for amputation were trauma, gangrene, and osteomyelitis. There were no differences between surgical specialties in 18 30-day perioperative complications assessed, including death, reoperation, surgical site infection, or wound dehiscence.

Conclusions:

Plastic and orthopedic surgeons achieved equivalent outcomes comparing 30-day perioperative complications following upper extremity amputations. These results support that both orthopedic and plastic surgeons provide similar quality distal upper extremity amputation care.
Competitive Dynamics Between Multinational Companies and Local Rivals in Emerging Markets
Authors: Al-Kwifi Osama Sam , Farha Allam K. Abu , Zaraket Wael S.
Published: September 2020

Multinational Companies from Emerging Economies (EMNCs) have become key players in the global economy. EMNCs have started to operate in highly dynamic, competitive environments where they are faced with competition from multinational companies (MNCs) from developed economies. This study applied Mutlu et al.’s (2015) awareness–motivation–capability (AMC) framework to the airline industry to investigate how EMNCs outperform MNCs. The development of each round of Mutlu et al.’s framework was tested using secondary data sources that cover 16 years, from 2001 to 2016. A fourth round, relating to the determination of ‘who will be the market leader’, was added to the framework and tested. The findings demonstrate that firms’ awareness and capabilities evolve in each round to develop the competitive advantages required to enhance their market position. The complex nature of competition requires firms to analyse information constantly to define key influential factors and to build essential capabilities and resources to initiate an action strategy quickly. From a managerial perspective, it is important for managers to build a comprehensive view of the competition and understand how this competition is evolving over time, to develop capabilities, pursue new opportunities and predict competitors’ responses.
The Future Is Circular: A Case Study on MUD Jeans
Authors: Thatta Sowdamini , Polisetty Aruna
Published: September 2020

This case discusses the sustainable business model adopted by the MUD Jeans Company in the context of the Circular Economy (CE). The clothing industry evolved from clothing to apparel and eventually to fashion. The clothing economy shifted from the traditional linear to a sustainable circular model. Established in 2012, MUD Jeans introduced an innovative concept called "Lease a Jeans," thereby attempting to save precious natural resource. The fashion industry is the second largest polluter. Keeping in mind the UN Sustainable Development Goals, the company embarked on a nine-step action plan called MUD Method - simple but essential recycling concept. Increased awareness and urgency to shift to sustainable practices will only make the future of jean manufacturing and fashion industry practices to be circular. However, the company has to face challenges – more so when following the sustainability approach. This case followed the qualitative research method and case study methodology. The case appraises management students on the concept of business interests and sustainability practices.
Book review H. H. D. N. P. Opatha, Sustainable Human Resource Management: Expanding Horizons of HRM
Authors: Iddagoda Y. Anuradha , Dewasiri N. J.
Published: September 2020

H. H. D. N. P. Opatha, Sustainable Human Resource Management: Expanding Horizons of HRM. University of Sri Jayewardenepura, 2019, 464 pp. (Paperback), ISBN: 978-955-52907-1-5.
Using Photovoice to Improve Healthy Eating for Children Participating in an Obesity Prevention Program
Authors: Nabors Laura , Murphy J. Meredith , Lusky Catherine , Young Courtney-Jo , Sanger Kayley
Published: September 2020

Background: Children have benefited from participation in obesity prevention programs. Aims: The objectives of this study were to evaluate the impact of a healthy eating intervention for children in after-school programs and to use photovoice to document change in eating behavior. Methods: Forty-two children in three after-school programs participated. Children participated in lessons from an existing program to learn about healthy eating. A mixed methods study was conducted, using surveys to assess parent and child perceptions, and photovoice to capture children’s perceptions of how they and their family changed eating habits. Member-checking was used to verify themes in the data. Twenty parents completed surveys evaluating the program. Results: Findings indicated that children learned program information, were interested in eating healthier (more fruits and vegetables), and quantitative data revealed there was a pre-post trend for eating more fruits at home. They reported that using the photovoice method helped them to monitor their behavior and helped them improve personal and family eating habits. Member checking confirmed themes. A majority of parents were satisfied with the program and reported that their children were discussing what they learned at home. Conclusions: Findings suggested that the photovoice methodology helped children to change in a positive way, increasing their agency in improving their own health and that of their family. Assessing longitudinal change in attitudes about healthy eating and eating behaviors will provide information about whether children maintain gains in knowledge and healthy eating over time.
The Relationship Between Estimated Median Household Income and Critical Care Length of Stay in Children With Diabetic Ketoacidosis
Authors: Broberg Meredith C. G. , Rose Jerri A. , Slain Katherine N.
Published: September 2020

Diabetic ketoacidosis (DKA) is an important diagnosis in the pediatric intensive care unit (PICU) and is associated with significant morbidity. We hypothesized children with DKA living in poorer communities would have unfavorable outcomes while critically ill. This single-center retrospective study included children with DKA admitted to a PICU over a 27-month period. Patients were classified as low-income if they lived in a ZIP code where the median household income was estimated to be less than 200% of the federal poverty threshold, or $48 016 for a family of 4. In this study, living in a low-income ZIP code was not associated with increased severity of illness, longer PICU length of stay (LOS), or readmission.
Finding the roots of neo-traditionalist populism in Poland: ‘Cultural displacement’ and European integration
Authors: Melito Francesco
Published: September 2020

This article investigates the roots of populism in Poland in its current traditionalist-conservative fashion. In contrast with the liberal hegemony and, more specifically, with its ‘true European values’, right-wing populists in Poland claim to speak in the name of those people who refuse this external system of values and who experienced a ‘cultural displacement’. The article examines whether the consensual process of European Union (EU) integration has created room for a populist moment. Particular emphasis is given to the importance of culture in the construction of an alternative neo-traditionalist project. While the post-structuralist literature on populism has mostly focused on Western Europe and socio-economic demands, the concept of neo-traditionalism reveals the confrontation between two different blocs also in Central-Eastern Europe. The author analyses the neo-traditionalist discourse in Poland, most notably produced by the conservative party Prawo i Sprawiedliwość (PiS), as a counter-hegemonic project. Opposing mainstream EU values, PiS appealed to ‘ordinary Poles’ and adopted a traditionalist-conservative narrative. The article will show how the neglect of a neo-traditionalist world view by the European elite and the threat to identity posed by liberal and individualistic values have been exploited by right-wing populists to forge a new common sense.
Keeping Families Together in a Rural Border District of Thailand
Authors: Lillicrap Andy
Published: September 2020

Throughout Thailand, hundreds of private children’s homes have become established largely under the radar of the government ( Sawatzky, 2018 , A hidden crisis: The proliferation of private children’s homes in Thailand). This report will look at One Sky Foundation’s experience over six years to establish holistic child and family support services as a viable alternative to the long-established reliance on private children’s homes in the rural border district of Sangkhlaburi. The report will look at the challenges, successes and learnings in the journey to keep families together.
Modernisation of Childcare Workforce in India: A Way to Deinstitutionalisation
Authors: Raneesh C. , Mohan A. K.
Published: September 2020

The enactment of new legislations and policies and establishment of proper implementation agencies are considered the fundamental elements of modernisation. Likewise, in India, the child welfare sector is witnessing a paradigm shift after the implementation of juvenile justice acts and the establishment of Integrated Child Protection Scheme (ICPS). The policy documents suggest that institutionalisation of a child must be the last resort; hence, the ideal situation is deinstitutionalising children from institutions to other care facilities. Childcare staff have to intervene effectively with the stakeholders to find out a more suitable option than institutionalisation. This process demands professionals with proper skills and a scientific understanding of the multifaceted issues of vulnerable children. The process would yield the desired benefits only under this circumstance. Thus, the role of childcare staff is crucial in the deinstitutionalisation process.

In this study on childcare staff in children’s homes of Kasaragod district of Kerala, the researcher adopted a descriptive design and selected all registered children’s homes for the study purpose. The data was collected from childcare staff through an interview schedule and Kuppuswami’s socio-economic scale.

The major finding of the study is that the childcare staff in these institutions are not meeting the prescribed standards envisioned by the government. This under-skilled and non-professional workforce needs a transformation to achieve the desired output.
Development of a Communications Program to Support Care of Critically Ill Coronavirus Disease 2019 (COVID-19) Patients
Authors: Wendel Pamela K , Stack Roberta J , Chisholm Mary F , Kelly Mary J , Elogoodin Bella , Liguori Gregory A , Green Douglas S T , Kalsi Mandip Singh , Soffin Ellen M
Published: September 2020

A significant role of intensive care unit (ICU) workforce is ongoing communication with and support for families of critically ill patients. The COVID-19 pandemic has created unanticipated challenges to this essential function. Restrictions on visitors to hospitals and unprecedented clinical demands hamper traditional communication between ICU staff and patient families. In response to this challenge, we created a dedicated communications service to provide comprehensive support to families of COVID-19 patients, and to create capacity for our ICU teams to focus on patient care. In this brief report, we describe the development, implementation, and preliminary experience with the service.
Suffering Depression: Illness Perception of Informal Primary Caregivers of Medical Students With Major Depressive Disorder
Authors: Robelo-Zarza Olga , Vargas-Huicochea Ingrid , Kelsall Nora , Rodríguez-Machain Ana
Published: September 2020

When a family member has depression at a level that generates disability in various functional spheres, the informal primary caregiver (IPC) is the individual who provides the majority of emotional and basic needs of the patient. This person is usually a relative and is extremely important in the health-disease-care process. This phenomenological qualitative study aimed to analyze the illness perception, in IPCs of undergraduate medical students previously diagnosed with mild depression. It was found that IPCs generate perceptions about depression based on a lack of knowledge of the disorder, which leads to feelings of sorrow, anger, frustration, and fear, that could interfere with the evolution of patients. Psychiatric disorders, such as depression, strongly impact both patients and people around them. For mental health professionals, in order to provide a more complete clinical approach, it is important to understand the illness perceptions not only of patients but of family IPCs as well.
The Validation of Geriatric Cases for Interprofessional Education: A Consensus Method
Authors: Teuwen Carolyn CJ , Kusurkar Rashmi RA , Schreurs Hermien WH , Daelmans Hester HEM , Peerdeman Saskia SM
Published: September 2020

Background:

Case-based Interprofessional Education (IPE) can help students practise their roles and responsibilities. To construct these cases, input from experts in clinical practice is essential. Consensus between these experts can be facilitated using consensus methods. In this study, a geriatric focus for the cases was chosen because of the interprofessional nature of geriatrics and the ageing population in healthcare facilities.

Methods:

By combining the 3 most commonly used consensus methods, we developed a 6-step approach to validate cases for IPE. The 6 steps include 3 expert rounds (Steps 1, 3 and 5) and 2 rounds in which discussion points were formulated by the researcher (Steps 2 and 4). The cases were piloted with students as Step 6. Four facets of a case were included: the patient description, the complemented treatment plan, the difficulty of the case and the scoring of the treatment plan. Our educational setting required constructing 4 cases with increasing difficulty. Results: Step 1: 5 typical geriatric cases were assembled. Step 2: Similar characteristics were defined; 5 cases were merged into 4. The 4 cases showed increasing difficulty levels. Step 3: The constructed cases were validated for patient description authenticity, treatment plan adequacy, difficulty and scoring of the treatment plan. Step 4: The items for further discussion were defined. Step 5: Consensus was reached for all 4 cases through a face-to-face discussion. Step 6: The student pilot for Case 1 showed no significant adjustments.

Conclusion:

We developed a 6-step consensus method to validate cases for IPE, and we constructed 4 geriatric cases based on this method. While consensus about the patient descriptions and difficulty levels was reached easily, consensus on the treatment plans was more difficult to achieve. Validation of the scoring of the treatment plan was unsuccessful. Further research on this will be conducted.
Requirements for systemic sclerosis expert centres in the Netherlands: A Delphi consensus study
Authors: Spierings Julia , Schriemer Rita , Dittmar Sonja , de Pundert Lian , de Vries-Bouwstra Jeska , van den Ende Els , Vonk Madelon
Published: September 2020

Introduction:

Systemic sclerosis is a rare and complex disease. Optimal management of patients requires knowledge and experience and, importantly, intensive collaboration between hospitals and multidisciplinary teams. Definition and recognition of expert centres in systemic sclerosis is currently lacking, which complicates collaboration between centres and leaves patients poorly informed. The aim of this study was to develop a set of requirements for two types of systemic sclerosis centres in order to establish a nationwide structure for an optimal and transparent organization of care.

Methods:

A three-round Delphi study was conducted among a panel of rheumatologists working at university or regional hospitals across the Netherlands. Prior to the final consensus round, a session with a patient panel (N = 22) was held. The results of this meeting were described in the last round for rheumatologists. Criteria were divided into five categories: (1) medical care, (2) case load, (3) collaboration, (4) research, (5) training of staff, and (6) other. In the first round, criteria derived from literature were proposed and participants could add criteria that were missing. For every item, participants could indicate if they thought the item should be included for two types of systemic sclerosis centres: (1) systemic sclerosis expert centre or (2) systemic sclerosis treatment centres. Consensus was reached when more than 85% of the panel agreed.

Results:

In total, 47 rheumatologists participated in Delphi round 1, 35 in round 2 and 43 in round 3. Additional suggestions were added by the patient panel (n = 22). Consensus was reached for the requirements of systemic sclerosis expert centres (45 items) and systemic sclerosis treatment centres (29 items) including minimal caseloads of annual suspected systemic sclerosis cases and total patients in care.

Conclusion:

Requirements of centres for systemic sclerosis care in the Netherlands were established in this study. Feasibility of certification should be evaluated next. Our proposed list can serve as a model for other countries.
Incidence and Risk of Scleral-Fixated Akreos (AO60) Lens Opacification: A Case Series
Authors: Belin Peter J. , Kim Jang H. , Sheikh Ahmed , Winokur Jules , Rhee David , Deramo Vincent
Published: September 2020

Purpose:

Postoperative hydrophilic intraocular lens opacification can lead to decreased vision and may require intraocular lens exchange. This study aims to identify the incidence of scleral-fixated Akreos AO60’s (Bausch + Lomb) lens opacification and risk factors for this phenomenon.

Methods:

This is a retrospective case series of all patients who underwent scleral-fixated Akreos AO60 lens at our institution between January 1, 2015 and December 31, 2019. The following data were recorded: age, sex, medical history, indication for Akreos AO60 implantation, laterality, ocular history, previous ocular surgical procedures, subsequent intraocular surgical procedures after the Akreos implantation, lens opacification, visual significance of opacification, and Akreos explantation. Intraoperative and postoperative complications were recorded. Main outcome measures were the overall incidence of Akreos lens opacification as well as the incidence of these eyes undergoing subsequent intraocular surgery.

Results:

A total of 262 eyes of 257 patients underwent Akreos lens implantation. Overall, 2% (5 of 262) developed lens opacification. Two patients had Descemet stripping automated endothelial keratoplasty (DSAEK) concurrently with Akreos implantation. One patient underwent subsequent Baerveldt glaucoma implantation and DSAEK. The fourth patient had vitrectomy with sulfur hexafluoride gas followed by DSAEK. This represents a 25% (4 of 16) opacification rate among all patients who underwent DSAEK ( P ≤ .01, Fisher exact test). One patient developed opacification after undergoing 2 vitrectomies for retinal detachment in the absence of DSAEK.

Conclusions:

Akreos lens opacification can be visually significant and may occur after a retinal or corneal procedure that involves the use of intraocular gas or air.
Prevalence of Utilization Management Policies Among the Psoriatic Disease Community: Results From the 2019 National Psoriasis Foundation Advocacy Survey
Authors: Gondo George , Boles Julia , Stone Patrick , Howard Leah , Bell Stacie J.
Published: September 2020

Introduction:

Utilization management (UM) policies are becoming more common among commercial insurance policies. However, little research has been conducted to understand the prevalence of experiencing UM restrictions among patients with psoriatic disease.

Objectives:

To understand the prevalence of UM policies within the psoriatic patient community and examine their relationship with patient characteristics.

Methods:

An online survey of 1205 individuals with a psoriatic disease from the National Psoriasis Foundation’s constituent database was conducted. Data were collected from July 7 to July 31, 2019. The main outcomes of interest for the present study were frequency of experiencing UM policies (eg, prior authorization [PA] or step therapy [ST]) from their insurance company, number, and type of UM policies experienced and relationship between patient characteristics and experiencing these policies.

Results:

Survey respondents reported high rates of experiencing some form of UM restriction (80.5%). Nearly half (45.1%) of the survey respondents indicated their insurer required them to try a therapy other than the therapy originally prescribed by their physician, a practice known as ST or “fail first” and 73% of respondents reported having to receive PA from their insurer before initiating treatment.

Conclusions:

Individuals with psoriatic disease commonly encounter UM policies from their insurer when attempting to manage their disease. Statistical analyses suggest that UM policies are related to the type of treatment used by patients and the type of psoriatic disease.
Analyzing graphic structure of phono-semantic characters: A Vietnamese method of teaching and learning Chinese characters
Authors: Trần Trọng-Dương
Published: September 2020

From the perspective of graphological structure, this article examines Vietnamese methods of teaching and learning Chinese characters by analyzing their phonetic and semantic elements. The selected sample for the survey is taken from characters collected from Thiều Chửu’s Dictionary of Chinese Script with Sino-Vietnamese Reading—the most useful dictionary in Vietnam in nearly 100 years. The resulting statistics reveal that, out of the 14,950 characters in this dictionary, there are 931 phonetic elements in which 455 are strong ones, producing 10–20 phono-semantic characters. This article argues that analyzing the relationship between the characters and their phonetic elements read in Sino-Vietnamese pronunciation is a good method for Vietnamese people to teach and learn Chinese characters. The method of learning Chinese characters has been applied in teaching Chinese characters for more than 1000 monks and nuns at the Vietnam Buddhist Academy in Hanoi. The experimental results show that students were able to improve their vocabulary very quickly, and could apply this to learning and teaching Chinese characters.
Investigation of effect of uncut chip thickness to edge radius ratio on nanoscale cutting behavior of single crystal copper: MD simulation approach
Authors: Sharma A. , Ranjan P. , Balasubramaniam R.
Published: September 2020

Extremely small cutting depths in nanoscale cutting makes it very difficult to measure the thermodynamic properties and understand the underlying mechanism and behavior of workpiece material. Highly precise single-crystal Cu is popularly employed in optical and electronics industries. This study, therefore, implements the molecular dynamics technique to analyze the cutting behavior and surface and subsurface phenomenon in the nanoscale cutting of copper workpieces with a diamond tool. Molecular dynamics simulation is carried out for different ratios of uncut chip thickness ( a) to cutting edge radius ( r) to investigate material removal mechanism, cutting forces, surface and subsurface defects, material removal rate (MRR), and stresses involved during the nanoscale cutting process. Calculation of forces and amount of plowing indicate that a/ r = 0.5 is the critical ratio for which the average values of both increase to maximum. Material deformation mechanism changes from shear slip to shear zone deformation and then to plowing and elastic rubbing as the cutting depth/uncut chip thickness is reduced. The deformation during nano-cutting in terms of dislocation density changes with respect to cutting time. During the cutting process, it is observed that various subsurface defects like point defects, dislocations and dislocation loops, stacking faults, and stair-rod dislocation take place.
The Role of DNA Methylation in Transcriptional Regulation of Pro-Nociceptive Genes in Rat Trigeminal Ganglia
Authors: Bai Guang , Ross Holly , Zhang Youping , Lee KiSeok , Ro Jin Y
Published: September 2020

Epigenetic modulation by DNA methylation is associated with aberrant gene expression in sensory neurons, which consequently leads to pathological pain responses. In this study, we sought to investigate whether peripheral inflammation alters global DNA methylation in trigeminal ganglia (TG) and results in abnormal expression of pro-nociceptive genes. Our results show that peripheral inflammation remotely reduced the level of global DNA methylation in rat TG with a concurrent reduction in DNMT1 and DNMT3a expression. Using unbiased steps, we selected the following pro-nociceptive candidate genes that are potentially regulated by DNA methylation: TRPV1, TRPA1, P2X3, and PIEZO2. Inhibition of DNMT with 5-Aza-dC in dissociated TG cells produced dose-dependent upregulation of TRPV1, TRPA1, and P2X3. Systemic treatment of animals with 5-Aza-dC significantly increased the expression of TRPV1, TRPA1, and PIEZO2 in TG. Furthermore, the overexpression of DNMT3a, as delivered by a lentiviral vector, significantly downregulated TRPV1 and PIEZO2 expression and also reliably decreased TRPA1 and P2X3 transcripts. MeDIP revealed that this overexpression also significantly enhanced methylation of CGIs associated with TRPV1 and TRPA1. In addition, bisulfite sequencing data indicated that the CGI associated with TRPA1 was methylated in a pattern catalyzed by DNMT3a. Taken together, our results show that all 4 pro-nociceptive genes are subject to epigenetic modulation via DNA methylation, likely via DNMT3a under inflammatory conditions. These findings provide the first evidence for the functional importance of DNA methylation as an epigenetic factor in the transcription of pro-nociceptive genes in TG that are implicated in pathological orofacial pain responses.
Anticoagulant therapy for splanchnic vein thrombosis: a systematic review and meta-analysis
Authors: Valeriani Emanuele , Di Nisio Marcello , Riva Nicoletta , Cohen Omri , Garcia-Pagan Juan-Carlos , Magaz Marta , Porreca Ettore , Ageno Walter
Published: September 2020

Treatment of splanchnic vein thrombosis (SVT) is challenging, and evidence to guide therapeutic decisions remains scarce. The objective of this systematic review and meta-analysis was to determine the efficacy and safety of anticoagulant therapy for SVT. MEDLINE, EMBASE, and clinicaltrials.gov were searched from inception through December 2019, without language restrictions, to include observational studies and randomized controlled trials reporting radiological or clinical outcomes in patients with SVT. Pooled proportions and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated in a random-effects model. Of 4312 records identified by the search, 97 studies including 7969 patients were analyzed. In patients receiving anticoagulation, the rates of SVT recanalization, SVT progression, recurrent venous thromboembolism (VTE), major bleeding, and overall mortality were 58% (95% CI, 51-64), 5% (95% CI, 3-7), 11% (95% CI, 8-15), 9% (95% CI, 7-12), and 11% (95% CI, 9-14), respectively. The corresponding values in patients without anticoagulation were 22% (95% CI, 15-31), 15% (95% CI, 8-27), 14% (95% CI, 9-21), 16% (95% CI, 13-20), and 25% (95% CI, 20-31). Compared with no treatment, anticoagulant therapy obtained higher recanalization (RR, 2.39; 95% CI, 1.66-3.44) and lower thrombosis progression (RR, 0.24; 95% CI, 0.13-0.42), major bleeding (RR, 0.73; 95% CI, 0.58-0.92), and overall mortality (RR, 0.45; 95% CI, 0.33-0.60). These results demonstrate that anticoagulant therapy improves SVT recanalization and reduces the risk of thrombosis progression without increasing major bleeding. The incidence of recurrent VTE remained substantial in patients receiving anticoagulation, as well. Effects were consistent across the different subgroups of patients. This trial was registered on the PROPERO database at (https://www.crd.york.ac.uk/prospero//display_record.php?ID=CRD42019127870) as #CRD42019127870.
Persistent symptoms 3 months after a SARS-CoV-2 infection: the post-COVID-19 syndrome?
Authors: Goërtz Yvonne M.J. , Van Herck Maarten , Delbressine Jeannet M. , Vaes Anouk W. , Meys Roy , Machado Felipe V.C. , Houben-Wilke Sarah , Burtin Chris , Posthuma Rein , Franssen Frits M.E. , van Loon Nicole , Hajian Bita , Spies Yvonne , Vijlbrief Herman , van ’t Hul Alex J. , Janssen Daisy J.A. , Spruit Martijn A.
Published: September 2020

Background

Many patients with COVID-19 did not require hospitalisation, nor underwent COVID-19 testing. There is anecdotal evidence that patients with “mild” COVID-19 may complain about persistent symptoms, even weeks after the infection. This suggests that symptoms during the infection may not resolve spontaneously. The objective of this study was to assess whether multiple relevant symptoms recover following the onset of symptoms in hospitalised and nonhospitalised patients with COVID-19.

Methods

A total of 2113 members of two Facebook groups for coronavirus patients with persistent complaints in the Netherlands and Belgium, and from a panel of people who registered on a website of the Lung Foundation Netherlands, were assessed for demographics, pre-existing comorbidities, health status, date of symptoms onset, COVID-19 diagnosis, healthcare utilisation, and the presence of 29 symptoms at the time of the onset of symptoms (retrospectively) and at follow-up (mean±sd79±17 days after symptoms onset).

Results

Overall, 112 hospitalised patients and 2001 nonhospitalised patients (confirmed COVID-19, n=345; symptom-based COVID-19, n=882; and suspected COVID-19, n=774) were analysed. The median number of symptoms during the infection reduced significantly over time (median (interquartile range) 14 (11–17)versus6 (4–9); p<0.001). Fatigue and dyspnoea were the most prevalent symptoms during the infection and at follow-up (fatigue: 95%versus87%; dyspnoea: 90%versus71%).

Conclusion

In previously hospitalised and nonhospitalised patients with confirmed or suspected COVID-19, multiple symptoms are present about 3 months after symptoms onset. This suggests the presence of a “post-COVID-19 syndrome” and highlights the unmet healthcare needs in a subgroup of patients with “mild” or “severe” COVID-19.
Transcriptome Analysis of Early Defenses in Rice against Fusarium fujikuroi
Authors: Cheng An-Po , Chen Szu-Yu , Lai Ming-Hsin , Wu Dong-Hong , Lin Shih-Shun , Chen Chieh-Yi , Chung Chia-Lin
Published: September 2020

Background

Bakanae is a seedborne disease caused by Fusarium fujikuroi. Rice seedlings emerging from infected seeds can show diverse symptoms such as elongated and slender stem and leaves, pale coloring, a large leaf angle, stunted growth and even death. Little is known about rice defense mechanisms at early stages of disease development.

Results

This study focused on investigating early defenses against F. fujikuroi in a susceptible cultivar, Zerawchanica karatals (ZK), and a resistant cultivar, Tainung 67 (TNG67). Quantitative PCR revealed that F. fujikuroi colonizes the root and stem but not leaf tissues. Illumina sequencing was conducted to analyze the stem transcriptomes of F. fujikuroi-inoculated and mock-inoculated ZK and TNG67 plants collected at 7 days post inoculation (dpi). More differentially expressed genes (DEGs) were identified in ZK (n = 169) than TNG67 (n = 118), and gene ontology terms related to transcription factor activity and phosphorylation were specifically enriched in ZK DEGs. Among the complex phytohormone biosynthesis and signaling pathways, only DEGs involved in the jasmonic acid (JA) signaling pathway were identified. Fourteen DEGs encoding pattern-recognition receptors, transcription factors, and JA signaling pathway components were validated by performing quantitative reverse transcription PCR analysis of individual plants. Significant repression of jasmonate ZIM-domain (JAZ) genes (OsJAZ9, OsJAZ10, and OsJAZ13) at 3 dpi and 7 dpi in both cultivars, indicated the activation of JA signaling during early interactions between rice and F. fujikuroi. Differential expression was not detected for salicylic acid marker genes encoding phenylalanine ammonia-lyase 1 and non-expressor of pathogenesis-related genes 1. Moreover, while MeJA did not affect the viability of F. fujikuroi, MeJA treatment of rice seeds (prior to or after inoculation) alleviated and delayed bakanae disease development in susceptible ZK.

Conclusions

Different from previous transcriptome studies, which analyzed the leaves of infected plants, this study provides insights into defense-related gene expression patterns in F. fujikuroi–colonized rice stem tissues. Twelve out of the 14 selected DEGs were for the first time shown to be associated with disease resistance, and JA-mediated resistance was identified as a crucial component of rice defense against F. fujikuroi. Detailed mechanisms underlying the JA-mediated bakanae resistance and the novel defense-related DEGs are worthy of further investigation.
Evaluating plant residue decline data with KinGUII and TREC: results from case studies involving also non-SFO kinetic models
Authors: Ebeling Markus , Hammel Klaus
Published: September 2020

Background

Foliage residue decline data are used to refine the risk assessment for herbivorous birds and mammals foraging in fields treated with plant protection products. For evaluation, current EFSA guidance has a clear focus on single-first order (SFO) kinetic models. However, other kinetic models are well established in other areas of environmental risk evaluations (e.g., soil residue assessment), and easy-to-use calculation tools have become available now. We provide case studies with 6 fungicides how such evaluations can be conducted with two of these tools (KinGUII and TREC) that have been developed by Bayer.

Results

SFO kinetics provided the best fits only for 13 of 36 residue decline studies conducted in a standardized design under field conditions. Biphasic models (double first order in parallel, hockey stick) were often superior and sometimes more conservative for risk assessment. The additional effort is manageable when using software such as KinGUII and TREC, and appears justified by the more reliable outcome of the evaluations.

Conclusions

Further research would be useful to better assess the extent to which non-SFO better fits foliage residue decline, but our study suggests that it may be a significant proportion. Therefore, we encourage the use of biphasic models in the regulatory risk assessment for herbivorous birds and mammals, in the ongoing revision of the European Food Safety Authority (EFSA) guidance document from 2009.
A novel mouse model expressing human forms for complement receptors CR1 and CR2
Authors: Jackson Harriet M. , Foley Kate E. , O’Rourke Rita , Stearns Timothy M. , Fathalla Dina , Morgan B. Paul , Howell Gareth R.
Published: September 2020

Background

The complement cascade is increasingly implicated in development of a variety of diseases with strong immune contributions such as Alzheimer’s disease and Systemic Lupus Erythematosus. Mouse models have been used to determine function of central components of the complement cascade such as C1q and C3. However, species differences in their gene structures mean that mice do not adequately replicate human complement regulators, includingCR1andCR2. Genetic variation inCR1andCR2have been implicated in modifying disease states but the mechanisms are not known.

Results

To decipher the roles of humanCR1andCR2in health and disease, we engineered C57BL/6J (B6) mice to replace endogenous murineCr2with human complement receptors,CR1andCR2(B6.CR2CR1). CR1 has an array of allotypes in human populations and using traditional recombination methods (Flp-frtandCre-loxP) two of the most common alleles (referred to here asCR1longandCR1short) can be replicated within this mouse model, along with aCR1knockout allele (CR1KO). Transcriptional profiling of spleens and brains identified genes and pathways differentially expressed between mice homozygous for eitherCR1long, CR1shortorCR1KO. Gene set enrichment analysis predicts hematopoietic cell number and cell infiltration are modulated byCR1long,but notCR1shortorCR1KO.

Conclusion

The B6.CR2CR1mouse model provides a novel tool for determining the relationship between human-relevantCR1alleles and disease.