bluuebunny/crossref_metadata_2025 huggingface dataset:
Phosphaturic Mesenchymal Tumors of the Sinonasal Area and Skull Base: Experience at a Single Institution
Authors: Argersinger Davis P. , Haring Catherine T. , Hanks John E. , Kovatch Kevin J. , Ali S. Ahmed , McHugh Jonathan B. , Pynnonen Melissa A. , McKean Erin L.
Published: August 2021

Objectives:

Phosphaturic mesenchymal tumor (PMT) is a rare, polymorphous neoplasm with a highly variable presentation and natural history and unpredictable clinical course. The primary objective was to describe our clinical experience with and management of 4 markedly different cases of sinonasal and skull base PMT.

Methods:

A retrospective case series with chart review, and relevant literature review, was performed at a tertiary academic medical center between 1998 and 2020. Adult patients treated for PMTs of the sinonasal area and skull base were included. Our main outcome measures included postoperative laboratory findings and radiological evidence of disease remission.

Results:

Four patients (2 Males, 2 Females; Mean Age: 63.5 years) with PMTs of the skull base have been managed at our institution since 1998. Patient presentations varied, ranging from severe phosphorus wasting and osteoporosis to symptoms secondary to mass effect, including nasal obstruction and rhinorrhea. All 4 patients were eventually found to have elevated levels of fibroblast growth factor 23. Tumors were located in the sinonasal area (right frontal sinus, right ethmoid sinus, and right nasal cavity, respectively) in 3 patients and in the lateral skull base (right jugular foramen) in 1 patient. All 4 patients underwent complete surgical resection of their tumors. PMT tissue pathology was confirmed in all cases. Gross total resection was achieved in all patients. There was no chemical or radiological evidence of disease recurrence in any patients at follow-up.

Conclusions:

The presentation of skull base PMT is variable, and it may mimic other mass pathologies of the head and neck. Complete surgical resection with negative margins is potentially curative.
A Comparison of Three Capstones: Survey Results from Sociology Alumni
Authors: Love Hannah Beth , MacIlroy Kelsea
Published: August 2021

Undergraduate capstone courses in sociology are designed to integrate students’ knowledge in the discipline and to culminate the classroom experience with field application. Are capstones achieving these goals in a durable way? Although the short-term outcomes of capstone courses have been researched, fewer studies have documented the long-term outcomes of capstone courses. We conducted a survey of sociology capstone alumni to understand the long-term outcomes of the sociology capstone by asking sociology alumni about their capstone experience. Our research revealed that all capstones produced long-term outcomes as measured in the alumni survey. Second, alumni of the community-based research capstone experienced a more profound and longer reaching effect than those who participated in the internship or traditional capstone seminar format. Alumni reported the development of professional skills, application of sociological concepts and research skills, and a sense of being part of a community.
Revisiting Israel’s Mixed Cities Trope
Authors: Karlinsky Nahum
Published: August 2021

This article offers a critical examination of the term mixed cities, concentrating mainly on its usage in Zionist and Israeli discourse. It posits that the term is uniquely reserved to denote Israel’s Jewish Arab urban spaces. Presented as bureaucratic and value-free, the term sharply contrasts with the anti-Arab reality of Israel’s mixed cities. The article traces the origin of the term to pre-State, Zionist discourse, which denounced Arab Jewish “mixing,” situating it between “pure” Zionist and “foreign” Palestinian Arab spaces. The article identifies four general forms of urban (anti-)mixing: pluralistic, racial, sovereign, and colonial. It locates Israel’s mixed cities within the latter two categories. Abandoning this ideologically charged trope and replacing it with Urban Studies concepts are proposed. The advantages of this perspective are demonstrated with a test-case analysis of Arab-Jewish cities in British Palestine (1918-1948) through the lens of Scott Bollens’s model for the study of ethno-national contested cities.
Phonological awareness intervention using a standard treatment protocol for individuals with Down syndrome
Authors: Hessling Prahl Alison , Jones Ragan , Melanie Schuele C , Camarata Stephen
Published: August 2021

This multiple baseline across-participants single case desgin study examined the effect of small group, phonological awareness intervention on the phonological awareness skills of three school-age children with Down syndrome. Each child with Down syndrome was paired with a typical peer to participate in small group intervention, three sessions per week for seven weeks. Lessons from a single unit in the Intensive Phonological Awareness Program were adapted to incorporate repeated exposure to the curriculum and increased opportunities for practice. A functional relation between the intervention and improved phonological awareness skills was not established based on visual analysis of the probe data across the three participants. However, an increasing therapeutic trend following delayed treatment effects as well as an increase in phase means from baseline to intervention was observed for each participant. This investigation provides preliminary guidance for adapting phonological awareness standard treatment protocols for children with Down syndrome by providing repeated opportunities for practice and including peers in small group intervention.
Plexiform fibromyxoma: a clinicopathological and immunohistochemical analysis of two cases with a literature review
Authors: Ma Shaofei , Wang Jing , Lu Zhanjun , Shi Chaoying , Yang Daohua , Lin Jun
Published: August 2021

Objective

This article aimed to study the clinicopathological features, immunophenotypes, and differential diagnoses of plexiform fibromyxoma (PF).

Methods

We searched clinical and pathology databases of our hospital for patients with histologically confirmed PF from 2007 to 2020 and reviewed the relevant English and Chinese language literature.

Results

Two cases of PF were identified, a 67-year-old woman and a 23-year-old man. Both patients presented with melena and anemia and underwent partial gastrectomy. Histologically, the tumors exhibited a plexiform growth pattern in the gastric submucosa and the presence of bland-looking spindle cells in the fibromyxoid stroma with the formation of small blood vessels. Immunohistochemically, the two cases were strongly positive for vimentin, smooth muscle actin, and muscle-specific actin and negative for CD117, discovered on gastrointestinal stromal tumors protein 1, CD34, CD10, S100, desmin, H-caldesmon, estrogen receptor, progesterone receptor, β-catenin, and cytokeratin.

Conclusions

PF is a rare mesenchymal tumor of the stomach that can be distinguished from other gastrointestinal mesenchymal tumors based on its distinctive morphology and immunophenotype.
Disseminated peritoneal leiomyomatosis: a case report and review of the literature
Authors: Liu Xu , Hu Yuchang , Chen Lu , Zhou Quan
Published: August 2021

Disseminated peritoneal leiomyomatosis (DPL), also known as leiomyomatosis peritonealis disseminata, is a rare disease characterized by multiple benign smooth muscle tumors proliferating along the peritoneal surfaces. The cause of the disease is unclear, and possible factors include iatrogenic and hormonal stimulation. The patient was a 41-year-old Chinese woman with a history of laparoscopic myomectomy and subsequent pregnancy. Multiple abdominal masses were identified and required surgical intervention. The patient had no tenderness or other discomfort. The clinical and imaging diagnosis was gastrointestinal stromal tumor, but DPL was confirmed by postoperative pathological examination. The patient had a good prognosis, and no recurrence was observed during follow-up. Iatrogenic and hormonal stimulation leading to DPL is very rare, and we believe that multiple factors led to DPL in this case. Clinicians should be aware of such potential patients.
Incremental peritoneal dialysis in incident end-stage kidney disease patients
Authors: Yan Hao , Abreu Zita , Bargman Joanne M
Published: August 2021

Background:

This retrospective cohort study investigated the characteristics and outcomes of the end-stage kidney disease (ESKD) patients treated with incremental peritoneal dialysis (PD) at a large academic centre.

Methods:

ESKD patients initiating PD with a dialysate volume ≤6 L/day were analysed.

Results:

One hundred and seventy-five patients were included and were followed up for 352.6 patient-years. The baseline residual kidney function (RKF) was 8.3 ± 3.4 mL/min/1.73 m2. The unadjusted 1- to 5-year patient survival rate was 89.6%, 80.4%, 65.4%, 62.7% and 48.8%, respectively, and the corresponding time on PD therapy rate was 95.1%, 89.1%, 89.1%, 82.4% and 77.6%. Greater initial PD dose (hazard ratio = 1.608, 95% confidence interval 1.089–2.375) was associated with death after adjusting for age, Charlson comorbidity index (CCI), haemodialysis prior to PD, assisted PD and baseline RKF, likely as a result of residual confounding. There was no association with PD discontinuation. The average peritonitis rate and hospitalisation rate were 0.122 and 0.645 episodes per patient-year, respectively. The dialysate volume increased from 4.5 (4.3–5.7) L/day to 8.0 (6.0–9.8) L/day at 5 years. Fifty-seven (32.6%) patients graduated to full-dose PD at a median time of 10.3 (6.2, 15.7) months. Male sex, greater body mass index and lower baseline serum albumin were risk factors for increasing PD dose to over 6 L/day within 1 year.

Conclusions:

Incremental PD is a safe approach to initiate dialysis, and it offers satisfactory outcomes. Close monitoring, comprehensive evaluation of clinical responses and prompt adjustment of the prescription as needed play a crucial role in this patient-centred treatment.
Mental observation wards: an alternative provision for emergency psychiatric care in England in the first half of the twentieth century
Authors: Cowan Colin
Published: August 2021

In England in the early twentieth century, mental observation wards in workhouses developed as a parallel service to the asylums for emergency mental health admissions under the 1890 Lunacy Act, particularly in urban areas and especially London on account of local policy. The purpose of the wards was initial patient assessment and early discharge or certification, and there was controversy between their medical supporters and the Board of Control about any extension of their remit which might usurp the role of the mental hospitals. Their significance declined with changing policy in the NHS era, as more emergency admissions went to mental hospitals, and local treatment units emerged. This article explores the history of these services in the context of the changing legal and policy frameworks.
Performance of the wall implanted with heat pipes on indoor thermal environment
Authors: Zhang Zhigang , Wu Ming , Yao Wanxiang
Published: August 2021

In order to improve the utilization of solar energy absorbed by the building wall, a passive building technology, that is the wall implanted with heat pipes, had been proposed. In the present study, two rooms with the same environmental conditions were built, and the one with a wall implanted with heat pipes installed was taken as a test room and the other as a control. The dynamic heat transfer characteristics of a wall implanted with heat pipes in transition season and its impact on indoor thermal environment were studied experimentally. The results showed that the application of a wall implanted with heat pipes could increase the indoor temperature by about 0.5 °C and would assert a positive influence on the vertical distribution of temperature. The PMV-PPD values of two rooms were calculated to compare and evaluate the improvement in thermal comfort, and the results indicated that the wall implanted with heat pipes reduced the dissatisfaction rate by more than one seventh in comparison to the indoor thermal environment. Also, it enhanced the PMV value. Therefore, wall implanted with heat pipes as an auxiliary heat source has a good effect on the indoor thermal environment during the transition season.
Circulating LIPCAR is a potential biomarker of heart failure in patients post-acute myocardial infarction
Authors: Yan Li , Zhang Yu , Wang Mei , Wang Lu , Zhang Wei , Ge Zhi-Ru
Published: August 2021

In heart failure (HF) patients with reduced ejection fraction, LIPCAR, a long noncoding RNA is elevated and is associated with left ventricular remodeling and poor prognosis. We studied the role of LIPCAR in patients with HF post-acute myocardial infarction (AMI) to find biomarkers for early detection of HF. We conducted a study of 127 patients with AMI, of which 59 were patients with HF post-AMI. LIPCAR levels were higher in HF patients post-AMI than patients without HF, and LIPCAR had a high predictive value for diagnosis of HF, which was estimated by receiver operating characteristic curves (AUC: 0.985). The results indicate that LIPCAR may be a marker of early HF after AMI.
Non-probabilistic models for in-plane elastic properties of cellular hexagonal honeycomb cores involving imprecise parameters
Authors: Alazwari Mashhour A
Published: August 2021

Inherent imprecisions present in the basic parameters of cellular honeycomb cores, such as the cell angle, the material properties, and the geometric parameters, need to be considered in the analysis and design to meet the high-performance requirements. In this paper, imprecisions associated with the basic parameters of honeycomb cores are considered. Non-probabilistic models for the in-plane elastic properties of hexagonal honeycomb cores are developed in which the imprecisely defined input and response parameters are represented by only their mean values and variations without the requirement of knowing the probability density distributions of the imprecise parameters as is required for probabilistic methods. Thus, the proposed models predict not only the nominal values of the in-plane elastic properties but also their variations from the respective mean values. The applicability of the proposed models is demonstrated by considering the analysis of the in-plane elastic properties of a honeycomb core made of aluminum 5052-H-32 in which the core material properties are defined by their mean values and variations. The results show that realistic variations of the in-plane elastic properties are obtained using the proposed non-probabilistic models. The sensitivity of the in-plane elastic properties to the imprecisions present in each basic parameter is also investigated.
Parameters and properties for the preparation of Cu nanocolloids containing polyvinyl alcohol using the electrical spark discharge method
Authors: Tseng Kuo-Hsiung , Ke Han-Chiao , Ku Hsueh-Chien
Published: August 2021

Through the use of an electric discharge machine, this study performed the electrical spark discharge method in deionised water under normal temperature and pressure for Cu nanocolloid (CuNC) preparation. The CuNCs had a zeta potential of 12.3 mV, indicating poor suspension stability. The suspension stability was effectively increased (zeta potential 32.5 mV) through the addition of polyvinyl alcohol (PVA) to form PVA-containing CuNCs PVA/CuNCs. Next, the following pulse-width modulation (Ton:Toff) parameters were tested to determine the optimal setting for PVA/CuNC preparation: 10:10, 30:30, 50:50, 70:70 and 90:90 µs. The optimal preparation parameter was then determined according to the absorbance, zeta potential and size distribution results. Finally, the surface properties and crystal structure of the PVA/CuNCs were characterised through transmission electron microscopy (TEM) and X-ray diffraction (XRD). When the Ton:Toff was set to 30:30 µs, preparation efficiency was optimal, as was suspension stability, as indicated by the absorbance value (0.534), zeta potential (32.5 mV) and size distribution (85.47 nm). Transmission electron microscopy revealed that Cu nanoparticles that were more dispersed in the PVA/CuNCs had a diameter smaller than 10 nm and a crystal line width of 0.2028 nm. X-ray diffraction showed that the PVA/CuNCs contained intact Cu crystal structures.
Male Allies at Work: Gender-Equality Supportive Men Reduce Negative Underrepresentation Effects Among Women
Authors: Moser Charlotte E. , Branscombe Nyla R.
Published: August 2021

Does commitment to allyship from a dominant group member cue identity-safety for women in male-dominated environments? We examine this question by assessing women’s perceptions of workplaces that included the presence (vs. absence) of a male ally (Studies 1–3) or a female ally (Study 3), and determine the impact of Black versus White allies for Black and White women. Across three studies ( N = 1,032) and an integrative data analysis, we demonstrate that an equality-supportive male ally reduces anticipated isolation and workplace hostility and increases anticipated support, respect, and gender-equality norms for women in general populations (Studies 1 and 2) and women in science, technology, and math (Study 3). These results represent a possible strategy to help retain women in male-dominated fields.
The penetration and ricochet of ogive-nosed rigid projectiles obliquely impacting metallic targets
Authors: Vayig Yaniv , Rosenberg Zvi
Published: August 2021

A large number of 3D numerical simulations were performed in order to follow the trajectory changes of rigid CRH3 ogive-nosed projectiles, impacting semi-infinite metallic targets at various obliquities. These trajectory changes are shown to be related to the threshold ricochet angles of the projectile/target pairs. These threshold angles are the impact obliquities where the projectiles end up moving in a path parallel to the target’s face. They were found to depend on a non-dimensional entity which is equal to the ratio between the target’s resistance to penetration and the dynamic pressure exerted by the projectile upon impact. Good agreement was obtained by comparing simulation results for these trajectory changes with experimental data from several published works. In addition, numerically-based relations were derived for the penetration depths of these ogive-nosed projectiles at oblique impacts, which are shown to agree with the simulation results.
Affordances and challenges of teaching language skills by virtual reality: A systematic review (2010–2020)
Authors: Bahari Akbar
Published: August 2021

The emergence of newer educational technologies provides opportunities for computer-assisted language learning practitioners and software developers to capitalize on the affordances for the second language (L2) learning purposes. This article explored and brought together the reported affordances and challenges of virtual reality to teach the L2 receptive and productive skills by reviewing seventy-five peer-reviewed articles published from 2010 to 2020. The results revealed an imbalanced trend of research on language skills learning by virtual reality tools and affordances in favor of listening and speaking skills compared to reading and writing skills. The obtained data were tabularized in terms of language skills. The results were visualized by hierarchical database formats. Pedagogical implications of the study inform teachers about affordances available to teach L2 skills in educational virtual reality environments toward a more digitally enhanced L2 pedagogy. Theoretical implications of the study inform researchers about the challenges that need to be addressed.
Issues in Estimating Interpretable Lower Order Factors in Second-Order Hierarchical Models: Commentary on Clark et al. (2021)
Authors: Moore Tyler M. , Lahey Benjamin B.
Published: August 2021

In a previous issue of Clinical Psychological Science, Clark and colleagues asserted that lower order factors in second-order models are comparable with specific factors in bifactor models when residualized on the general factor. Modeling simulated data demonstrated that residualized lower order factors are correlated with bifactor-specific factors only to the extent that factor loadings are proportional. Modeling actual data with violations of proportionality showed that specific and residualized lower order factors are not always highly correlated and have differential correlations with criterion variables even when both models fit acceptably. Because proportionality constraints limit only second-order models, bifactor models should be the first option for hierarchical modeling.
Activating Joy and Hope in Critical Literacies Instruction: Responding Pedagogically to Youth Skepticism in a YPAR Project
Authors: Hendrix-Soto Aimee
Published: August 2021

In the face of persistent racial injustice, critical literacy approaches to instruction frequently involve investigating and altering unjust racialized power structures through critical action. However, what happens when youth have become understandably skeptical of action for change? This analysis uses healing frameworks to explore the critical literacies of Black and Latinx youth in a youth participatory action research project that took place in the early days of the Trump administration, as well as the pedagogies employed. The salience and persistence of racial injustice in national politics and the local school district operated against youth’s reserves of hope and belief in change work, introducing tension into a project focused on transformation. As a pedagogical response, the project’s two White coteachers facilitated new pathways for critical literacies that involved joy, care, and new audiences. This response focused on joy in critical work and prompted some, though notably not all, youth to reengage with critical action and articulate hope for justice in their local worlds.
Readability of Online Materials Related to Vocal Cord Leukoplakia
Authors: Shneyderman Matthew , Snow Grace E. , Davis Ruth , Best Simon , Akst Lee M.
Published: August 2021

Objectives

To assess readability and understandability of online materials for vocal cord leukoplakia.

Study Design

Review of online materials.

Setting

Academic medical center.

Methods

A Google search of “vocal cord leukoplakia” was performed, and the first 50 websites were considered for analysis. Readability was measured by the Flesch Reading Ease Score (FRES), Flesch‐Kincaid Grade Level (FKGL), and Simple Measure of Gobbledygook (SMOG). Understandability and actionability were assessed by 2 independent reviewers with the PEMAT‐P (Patient Education Materials Assessment Tool for Printable Materials). Unpaired t tests compared scores between sites aimed at physicians and those at patients, and a Cohen’s kappa was calculated to measure interrater reliability.

Results

Twenty‐two websites (17 patient oriented, 5 physician oriented) met inclusion criteria. For the entire cohort, FRES, FKGL, and SMOG scores (mean ± SD) were 36.90 ± 20.65, 12.96 ± 3.28, and 15.65 ± 3.57, respectively, indicating that materials were difficult to read at a >12th‐grade level. PEMAT‐P understandability and actionability scores were 73.65% ± 7.05% and 13.63% ± 22.47%. Statistically, patient‐oriented sites were more easily read than physician‐oriented sites (P <. 02 for each of the FRES, FKGL, and SMOG comparisons); there were no differences in understandability or actionability scores between these categories of sites.

Conclusion

Online materials for vocal cord leukoplakia are written at a level more advanced than what is recommended for patient education materials. Awareness of the current ways that these online materials are failing our patients may lead to improved education materials in the future.
‘Leadership’ as a Project: Neoliberalism and the Proliferation of ‘Leaders’
Authors: Learmonth Mark , Morrell Kevin
Published: August 2021

It is increasingly common for anyone with formal, hierarchical status at work to be called a ‘leader’. Though widespread, this relatively recent change in day-to-day discourse is largely passing by unnoticed. We argue that using ‘leader’ in this way is not simply fashion or empty rhetoric; rather it can be understood in relation to neoliberalism. We argue that the language of ‘leadership’ represents a particularly subtle but powerful opportunity for the pursuit of individual elite interests to be disguised so that it looks as if it is for the benefit of all. This opportunity has arisen because using ‘leader’ has tangible effects that reinforce implied values and assumptions about human relationships at work. In terms of implied values, the label ‘leader’ is celebratory and predisposes us to see elites in overly positive ways. In terms of implied assumptions, referring to executives as ‘leaders’ draws a veil over the structured antagonism at the heart of the employment relationship and wider sources of inequality by celebrating market values. Making ‘leadership’ recognizable as a political project is not intended primarily to suggest intentionality, but to help challenge representational practices that are becoming dominant. ‘Project-ing’ leadership also helps us to emphasize the risks inherent in taking this label for granted; which, we argue, is an important contribution because the language of leadership is increasingly used but is hardly questioned within much contemporary organizational life as well as organization theory.
Graft-versus-host disease: a disorder of tissue regeneration and repair
Authors: Chakraverty Ronjon , Teshima Takanori
Published: August 2021

Regenerative failure at barrier surfaces and maladaptive repair leading to fibrosis are hallmarks of graft-versus-host disease (GVHD). Although immunosuppressive treatment can control inflammation, impaired tissue homeostasis leads to prolonged organ damage and impaired quality of life. In this Blood Spotlight, we review recent research that addresses the critical failures in tissue regeneration and repair that underpin treatment-resistant GVHD. We highlight current interventions designed to overcome these defects and provide our assessment of the future therapeutic landscape.
CoSTA: unsupervised convolutional neural network learning for spatial transcriptomics analysis
Authors: Xu Yang , McCord Rachel Patton
Published: August 2021

Background

The rise of spatial transcriptomics technologies is leading to new insights about how gene regulation happens in a spatial context. Determining which genes are expressed in similar spatial patterns can reveal gene regulatory relationships across cell types in a tissue. However, many current analysis methods do not take full advantage of the spatial organization of the data, instead treating pixels as independent features. Here, we present CoSTA: a novel approach to learn spatial similarities between gene expression matrices via convolutional neural network (ConvNet) clustering.

Results

By analyzing simulated and previously published spatial transcriptomics data, we demonstrate that CoSTA learns spatial relationships between genes in a way that emphasizes broader spatial patterns rather than pixel-level correlation. CoSTA provides a quantitative measure of expression pattern similarity between each pair of genes rather than only classifying genes into categories. We find that CoSTA identifies narrower, but biologically relevant, sets of significantly related genes as compared to other approaches.

Conclusions

The deep learning CoSTA approach provides a different angle to spatial transcriptomics analysis by focusing on the shape of expression patterns, using more information about the positions of neighboring pixels than would an overlap or pixel correlation approach. CoSTA can be applied to any spatial transcriptomics data represented in matrix form and may have future applications to datasets such as histology in which images of different genes are from similar but not identical biological sections.
A common gene drive language eases regulatory process and eco-evolutionary extensions
Authors: Verma Prateek , Reeves R. Guy , Gokhale Chaitanya S.
Published: August 2021

Background

Synthetic gene drive technologies aim to spread transgenic constructs into wild populations even when they impose organismal fitness disadvantages. The extraordinary diversity of plausible drive mechanisms and the range of selective parameters they may encounter makes it very difficult to convey their relative predicted properties, particularly where multiple approaches are combined. The sheer number of published manuscripts in this field, experimental and theoretical, the numerous techniques resulting in an explosion in the gene drive vocabulary hinder the regulators’ point of view. We address this concern by defining a simplified parameter based language of synthetic drives.

Results

Employing the classical population dynamics approach, we show that different drive construct (replacement) mechanisms can be condensed and evaluated on an equal footing even where they incorporate multiple replacement drives approaches. Using a common language, it is then possible to compare various model properties, a task desired by regulators and policymakers. The generalization allows us to extend the study of the invasion dynamics of replacement drives analytically and, in a spatial setting, the resilience of the released drive constructs. The derived framework is available as a standalone tool.

Conclusion

Besides comparing available drive constructs, our tool is also useful for educational purpose. Users can also explore the evolutionary dynamics of future hypothetical combination drive scenarios. Thus, our results appraise the properties and robustness of drives and provide an intuitive and objective way for risk assessment, informing policies, and enhancing public engagement with proposed and future gene drive approaches.
Non-specific pain and 30-day readmission in acute coronary syndromes: findings from the TRACE-CORE prospective cohort
Authors: Chen Jinying , Kiefe Catarina I. , Gagnier Marc , Lessard Darleen , McManus David , Wang Bo , Houston Thomas K.
Published: August 2021

Background

Patients with acute coronary syndromes often experience non-specific (generic) pain after hospital discharge. However, evidence about the association between post-discharge non-specific pain and rehospitalization remains limited.

Methods

We analyzed data from the Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education (TRACE-CORE) prospective cohort. TRACE-CORE followed patients with acute coronary syndromes for 24 months post-discharge from the index hospitalization, collected patient-reported generic pain (using SF-36) and chest pain (using the Seattle Angina Questionnaire) and rehospitalization events. We assessed the association between generic pain and 30-day rehospitalization using multivariable logistic regression (N = 787). We also examined the associations among patient-reported pain, pain documentation identified by natural language processing (NLP) from electronic health record (EHR) notes, and the outcome.

Results

Patients were 62 years old (SD = 11.4), with 5.1% Black or Hispanic individuals and 29.9% women. Within 30 days post-discharge, 87 (11.1%) patients were re-hospitalized. Patient-reported mild-to-moderate pain, without EHR documentation, was associated with 30-day rehospitalization (odds ratio [OR]: 2.03, 95% confidence interval [CI]: 1.14–3.62, reference: no pain) after adjusting for baseline characteristics; while patient-reported mild-to-moderate pain with EHR documentation (presumably addressed) was not (OR: 1.23, 95% CI: 0.52–2.90). Severe pain was also associated with 30-day rehospitalization (OR: 3.16, 95% CI: 1.32–7.54), even after further adjusting for chest pain (OR: 2.59, 95% CI: 1.06–6.35).

Conclusions

Patient-reported post-discharge generic pain was positively associated with 30-day rehospitalization. Future studies should further disentangle the impact of cardiac and non-cardiac pain on rehospitalization and develop strategies to support the timely management of post-discharge pain by healthcare providers.
Developing and evaluating online COVID-centric advance care planning training and information resources for nursing staff and family members in nursing homes: the necessary discussions study protocol
Authors: Harding Andrew , Preston Nancy , Doherty Julie , Cousins Emily , Varey Sandra , McCann Adrienne , Dening Karen Harrison , Finucane Anne , Carter Gillian , Mitchell Gary , Brazil Kevin
Published: August 2021

Background

Nursing home residents are typically older adults with high levels of chronic illness and impairment. As such, they are particularly susceptible to severe complications and mortality from COVID-19. Since all nursing home residents are at increased risk, nursing home care staff need to know what residents would want to happen should they become infected with COVID-19. This study aims to develop and evaluate advance care planning (ACP) COVID-centric online training and information resources for nursing home staff and family members of residents, to improve care at the end of life during a COVID-19 outbreak. Based on the findings we will develop implementation guidelines for nursing homes to ensure wider impact and application during the pandemic and beyond.

Methods

The content of the training and information resources will be based on a rapid review of literature and guidance on ACP in the context of COVID-19 and consultation with the study expert reference group. An integrated communications company will then work alongside the research team to design the online training and information resources. To evaluate the resources, we will employ a multiple case study design where a nursing home (defined as an institutional setting in which nursing care is provided to older adults on-site 24 h a day) will be the unit of analysis or ‘case’. The RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework will guide the evaluation of implementation of the training and information resources. We will recruit and interview staff and family members from between 6 and 9 nursing homes across Northern Ireland, England and Scotland and gather quantitative data from a feedback survey included in the training and information resources.

Discussion

The Necessary Discussions study is very timely given the challenging experiences of nursing homes, their staff, residents and their family members during the COVID-19 pandemic. It meets a key need and addresses an important gap in research and practice. The training and information resources will be ‘COVID-centric’, but they will also have a longstanding relevance for future ACP practice in UK care homes.

Trial registration

ISRCTN registry (ID 18003630) on 19.05.21
Case report: pulmonary nocardiosis caused by Nocardia exalbida in an immunocompetent patient
Authors: Abe Seitaro , Tanabe Yoshinari , Ota Takeshi , Fujimori Fumio , Youkou Akira , Makino Masato
Published: August 2021

Background

Nocardiosis is known as an opportunistic infection in immunocompromised hosts, but it occasionally has been reported in immunocompetent patient. The Nocardia exalbida is first-reported in 2006 from Japan, and a few cases of have been reported in only immunocompromised host, and the characteristic is still unclear. We herein describe the first case of pulmonary nocardiosis caused by N. exalbida in an immunocompetent patient.

Case presentation

A77 -year-old Japanese man was admitted to our hospital on November 2, 2018. He was a lifelong non-smoker with no childhood history of respiratory disease. He had a medical history of dyslipidemia. One month before this admission fevers, sputum, mild cough were developed and he was evaluated in a clinic near our hospital. His diagnosis was community acquired pneumonia within his right middle lobe. He was treated with ceftriaxone 1 g/day intravenously for a week, however his symptoms relapsed a few days later. So, the physician retried ceftriaxone for another 3 days, but his symptoms did not improve. He was referred to our hospital. He was treated with sitafloxacin as an outpatient for a week, however his symptoms got worse. The chest CT showed consolidation and atelectasis in his right middle lobe. Low density area was scattered in consolidation, and right pleural effusion was observed.

The patient was diagnosed with pulmonary abscess and he was admitted. Administration of piperacillin/tazobactam improved his condition. We switched antibiotics to amoxicillin/clavulanate, and he was discharged. After 2 weeks, he relapsed and was admitted again. After administration of piperacillin/tazobactam for 3 weeks, we perform bronchoscopy and Nocardia species were cultured from samples of the bronchial wash. The isolates were identified as N. exalbida using 16S rRNA gene sequencing. We prescribed Trimethoprim / Sulfamethoxazole (TMP/SMX) for 4 months. Then we switched to minocycline for renal dysfunction caused from TMP-SMX for 1 more month. After 5 months therapy, Consolidation on CT disappeared, and Nocardiosis was cured.

Conclusion

we reported the first case of pulmonary nocardiosis caused by N. exalbida in an immunocompetent patient. N. exalbida infection might be associated with a good response to treatment.
Clinical and virological outcomes with baloxavir compared with oseltamivir in pediatric patients aged 6 to < 12 years with influenza: an open-label, randomized, active-controlled trial protocol
Authors: Ishiguro Nobuhisa , Morioka Ichiro , Nakano Takashi , Furukawa Masashi , Tanaka Shintaro , Kinoshita Masahiro , Manabe Atsushi
Published: August 2021

Background

Children with influenza virus infections are prone to complications and are common sources of influenza transmission. Baloxavir marboxil inhibits cap-dependent endonuclease and was approved for influenza treatment in adolescent, adult, and pediatric patients in Japan. The miniSTONE-2 study included pediatric patients with influenza (1 to < 12 years) and demonstrated similar median times to alleviation of signs and symptoms of influenza with a single dose of baloxavir granules (weight < 20 kg: 2 mg/kg, ≥ 20 kg: 40 mg) and oseltamivir. Although the baloxavir dose in miniSTONE-2 was higher than the Japanese-approved dose, baloxavir exposure in miniSTONE-2 was similar to Japanese pediatric patients who receive the Japanese-approved dose. This study will be the first randomized active-controlled study in pediatric patients with influenza using the Japanese-approved dose of baloxavir.

Methods

This is a multicenter, open-label, randomized, active-controlled trial in which 200 Japanese subjects aged 6 to < 12 years with influenza virus infection are randomly allocated (2:1) to a single dose of baloxavir at the approved dose in Japan (weight ≥ 10 to < 20 kg: 10 mg, ≥ 20 to  < 40 kg: 20 mg, ≥ 40 kg: 40 mg) or oseltamivir twice daily for 5 days. The primary clinical endpoint is the time to illness alleviation of influenza, from administration of baloxavir or oseltamivir until the following criteria were met and sustained for at least 21.5 h (24 h—10%): cough and nasal discharge/nasal congestion rated as absent or mild axillary body temperature < 37.5 °C. The primary analysis population is the intention-to-treat infected population, which includes all pediatric subjects who receive at least one dose of study drug and have confirmed influenza virus infection by reverse transcription-polymerase chain reaction. The safety population includes all subjects who receive at least one dose of study drug.

Discussion

No comparative studies have been conducted to confirm the efficacy and safety of baloxavir versus a comparator in pediatric patients with influenza infection in Japan. The outcomes from this trial will provide evidence on the efficacy and safety of baloxavir as an antiviral treatment option for Japanese pediatric patients with influenza infection. Trial registration Japan Registry of Clinical Trials: jRCTs011200011. Registered November 2020. (https://rctportal.niph.go.jp/en/).
Sero-epidemiology and associated factors of HIV, HBV, HCV and syphilis among blood donors in Ethiopia: a systematic review and meta-analysis
Authors: Melku Mulugeta , Ambachew Sintayehu , Enawgaw Bamlaku , Abebe Molla , Abebe Zegeye , Deressa Tekalign , Damtie Debasu , Biadgo Belete , Tessema Belay , Geremew Demeke , Kebede Asemarie , Woldu Berhanu , Teklu Takele , Shiferaw Elias
Published: August 2021

Background

Transfusion transmissible infections (TTIs) remain a major public health problem in developing countries including Ethiopia. In Ethiopia, comprehensive information about sero-epidemiology of major TTIs is lacking at the national level. Therefore, this systematic review and meta-analysis was aimed at providing the pooled estimate of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis among blood donors in Ethiopia.

Methods

Relevant studies published until May 31, 2019 were searched through PubMed/Medline, EMBASE, SCOPUS, HINARI, Cochrane database library, Web of Science, Google Scholar and Google. The methodological quality of articles was assessed using Joanna Brigg’s Institute critical appraisal checklist for prevalence and analytical studies. The pooled sero-epidemiology of HIV, HBV, HCV and syphilis were determined using the random-effects model. Heterogeneity between the studies was assessed using the I2 statistics. Publication bias was assessed by visual inspection of the funnel plot and Egger's statistics.

Results

A total of 7921 articles were retrieved, and 7798 were screened for eligibility after duplicates removed. Forty-nine full-text articles were assessed for eligibility; of which 45 were eligible for qualitative and quantitative synthesis: categorized as 36, 34, 31 and 23 studies for estimations of HBV, HIV, HCV and syphilis, respectively. In the random-effects model, the pooled sero-epidemiology of HBV, HIV, HCV and syphilis was 5.20, 2.83, 0.93 and 1.50%, respectively. Moreover, being a male blood donor was significantly associated with HBV and syphilis infection, whereas being a replacement blood donor was significantly associated with a high burden of HIV, HBV and HCV infections.

Conclusion

The pooled sero-epidemiology of major TTIs among blood donors was high. Therefore, there is a need to design prevention and control strategies in a comprehensive approach to reduce the burden.
A vein-viewing application enabled detecting abdominal wall varices related to the presence of non-treated gastroesophageal varices: a cross-sectional study
Authors: Hoshino Yoshiki , Sugihara Takaaki , Ikeda Suguru , Matsuki Yukako , Nagahara Takakazu , Okano Jun-ichi , Isomoto Hajime
Published: August 2021

Background

Gastroesophageal varices (GOV) are a life-threatening complication in chronic liver disease. A method for non-invasively predicting GOV is crucial for management. This study aimed to determine whether a vein-viewing application can detect abdominal wall varices (AWV) and elucidate the relationship between AWV and GOV.

Methods

One-hundred patients with chronic liver diseases were prospectively enrolled. All the patients underwent esophagogastroduodenoscopy within three months of the enrollment. Unmanipulated images (UI) and vein-weighted images (VWI) were taken for assessing AWV by a vein-viewing application on iPhone. Two doctors independently evaluated both image types. We defined the grading of both UI and AWV as grade 0 (non-detectable), grade 1 (slightly detectable), and grade 2 (distinct).

Results

The causes of liver diseases among the 71 men and 29 women (median age, 70.5 yr) included Hepatitis B (n = 19), Hepatitis C (n = 21), alcoholism (n = 33), primary biliary cholangitis (n = 3), autoimmune hepatitis (n = 4) and others (n = 20). GOV was indicated in ﻿60﻿ patients, and half of them had not been treated previously (non-treated). VWI could significantly visualize AWV than UI (72% vs. 24%, p = 0.0005). The presence of cirrhosis (chronic hepatitis vs. cirrhosis = 64.6% vs. 91.4%, p = 0.004) and GOV (52.3% vs. 74.3%, p = 0.032) were significantly higher in the VWI-AWV grade 2 group. Multivariate analysis demonstrated that VWI-AWV grade 2 was an independent factor related to the presence of non-treated GOV [OR = 3.05 (1.24–7.53), p = 0.016].

Conclusions

The vein-viewing application non-invasively detected AWV related to the presence of cirrhosis and GOV, and VWI-AWV grade 2 was an independent factor related to the presence of non-treated GOV.
Borderline personality disorder and adolescent suicide attempt: the mediating role of emotional dysregulation
Authors: Mirkovic Bojan , Delvenne Véronique , Robin Marion , Pham-Scottez Alexandra , Corcos Maurice , Speranza Mario
Published: August 2021

Background

Emotional dysregulation seems to be a core feature of Borderline Personality Disorders (BPD). In addition, recent research in the adolescent population has shown that suicidal behaviours have been associated with maladaptive strategies of emotion regulation.

Methods

This study examined the relative contributions of emotional dysregulation to suicide attempt history in a clinical sample of borderline adolescents. Data were analyzed from 85 participants of the Collaborative European Research Network on Borderline Personality Disorder. Participants completed measures of BPD traits and symptoms, suicide behaviours, emotional dysregulation, attachment styles and lifetime depressive disorders.

Results

In an SEM model, lifetime depressive disorders and insecure attachment styles have a significant direct effect on lifetime suicide attempt, but only lifetime depressive disorders have an indirect effect through emotion dysregulation. The results suggest that emotional dysregulation has a mediating role in suicide attempts among BPD adolescents.

Conclusions

These findings call for the development of interventions targeting the role of emotion dysregulation in effectively predicting and preventing suicidality in borderline adolescents.