bluuebunny/crossref_metadata_2025 huggingface dataset:
Phase II study of liposomal doxorubicin, docetaxel and trastuzumab in combination with metformin as neoadjuvant therapy for HER2-positive breast cancer
Authors: Rocca Andrea , Cortesi Pietro , Cortesi Laura , Gianni Lorenzo , Matteucci Federica , Fantini Lorenzo , Maestri Antonio , Giunchi Donata Casadei , Cavanna Luigi , Ciani Rosa , Falcini Fabio , Bagni Antonella , Meldoli Elena , Dall’Agata Monia , Volpi Roberta , Andreis Daniele , Nanni Oriana , Curcio Annalisa , Lucchi Leonardo , Amadori Dino , Fedeli Anna
Published: February 2021

Background:

The aim of this study was to improve activity over single human epidermal growth factor receptor 2 (HER2)-blockade sequential neaodjuvant regimens for HER2-positive breast cancer, by exploiting the concomitant administration of trastuzumab, taxane and anthracycline, while restraining cardiac toxicity with use of liposomal doxorubicin, and by adding metformin, based on preliminary evidence of antitumor activity.

Patients and methods:

This multi-center, single-arm, two-stage phase II trial, assessed the safety and the activity of a new treatment regimen for HER2-positive, early or locally advanced breast cancer. Patients received six 21-day cycles of non-pegylated liposomal doxorubicin, 50 mg/m2 intravenously (i.v.) on day 1, docetaxel, 30 mg/m2 i.v. on days 2 and 9, trastuzumab, 2 mg/kg/week i.v. on days 2, 9, and 16 (with 4 mg/kg loading dose), in association with metformin 1000 mg orally twice daily. The primary endpoint was the rate of pathological complete response (pCR) in the breast and axilla (ypT0/is ypN0). A subgroup of patients performed a 3-deoxy-3-18F-fluorothymidine positron emission tomography (FLT-PET) at baseline and after one cycle.

Results:

Among 47 evaluable patients, there were 18 pCR [38.3%, 95% confidence interval (CI) 24.5–53.6%]. A negative estrogen-receptor status, high Ki67, and histological grade 3 were related with pCR, although only grade reached statistical significance. FLT-PET maximum standardized uptake value after one cycle was inversely related to pCR in the breast (odds ratio 0.29, 95% CI 0.06–1.30, p = 0.11). Toxicity included grade 3–4 neutropenia in 70% and febrile neutropenia in 4% of patients, grade 1–2 nausea/vomiting in 60%/38%, and grade 3 in 4%/2%, respectively, grade 1–2 diarrhea in 72%, and grade 3 in 6%. There were two cases of reversible grade 2 left-ventricular ejection-fraction decrease, and one case of sharp troponin-T increase.

Conclusions:

The concomitant administration of trastuzumab, liposomal doxorubicin, docetaxel, and metformin is safe and shows good activity, but does not appear to improve activity over conventional sequential regimens.
Effect of cannabis on oxaliplatin-induced peripheral neuropathy among oncology patients: a retrospective analysis
Authors: Waissengrin Barliz , Mirelman Dan , Pelles Sharon , Bukstein Felix , Blumenthal Deborah T. , Wolf Ido , Geva Ravit
Published: February 2021

Background:

Chemotherapy-induced peripheral neuropathy (CIPN) is a common and dosage-limited oxaliplatin-related toxicity. To date, there are no successful interventions for CIPN prevention or treatment. A therapeutic role for cannabis in diabetic and HIV-related peripheral neuropathy and a protective role in CIPN have been suggested. We examined the effect of cannabis on oncologic patients with CIPN.

Methods:

Medical records of 768 consecutive patients treated with oxaliplatin and 5-fluorouracil-based combinations at a tertiary medical center from October 2015 to January 2018 were reviewed. Excluded patients were those with pre-existing neuropathy or patients who received fewer than two cycles of oxaliplatin treatment. CIPN grade, oxaliplatin cumulative dose, and neuropathy-free survival were evaluated. The patients were divided based upon the exposure to cannabis: prior to oxaliplatin (cannabis-first), cannabis following the initiation of oxaliplatin treatment (oxaliplatin-first), and no exposure (control).

Results:

In total, 513 patients met the inclusion criteria, of whom 248 were treated with cannabis and 265 served as controls. The cannabis-first group included 116 (46.7%) patients and the oxaliplatin-first group included 132 (53.3%) patients. Demographic parameters were comparable between groups. There was a significant difference in CIPN grade 2–3 between cannabis-exposed patients and controls (15.3% and 27.9%, respectively, p < 0.001). The protective effect of cannabis was more pronounced among cannabis-first patients compared to oxaliplatin-first patients (75% and 46.2%, respectively, p < 0.001). The median oxaliplatin cumulative doses were higher in the cannabis-first versus the oxaliplatin-first versus the control groups (545 mg/m2, 340 mg/m2, and 425 mg/m2 respectively, p < 0.001).

Conclusion:

The rate of neuropathy was reduced among patients treated with cannabis and oxaliplatin. This reduction was more significant in patients who received cannabis prior to treatment with oxaliplatin, suggesting a protective effect. A large prospective trial is planned.
Predictors of Improvement After Fasciotomy for Treatment of Chronic Exertional Compartment Syndrome of the Lower Extremity
Authors: Mangan John J. , Rogero Ryan G. , Fuchs Daniel J. , Raikin Steven M.
Published: February 2021

Background:

Previous studies have demonstrated the effectiveness of lower extremity fasciotomies in treating chronic exertional compartment syndrome (CECS). However, not all patients have demonstrated the same level of symptom improvement.

Hypothesis:

Specific patient variables will lead to enhanced functional improvement after fasciotomy for CECS of the lower extremity.

Study Design:

Case series.

Level of Evidence:

Level 4.

Methods:

A review of patients undergoing fasciotomy of the lower extremity for treatment of CECS by a single surgeon from 2009 to 2017 was performed. Pre- and postoperative measures of Foot and Ankle Ability Measure–Sports subscale (FAAM–Sports), FAAM–Sports Single Assessment Numeric Evaluation (SANE), and visual analog scale (VAS) for pain during sporting activities were collected at a minimum of 12 months postoperatively. The primary outcomes of change in FAAM-Sports, FAAM-Sports SANE, and VAS during sporting activities were calculated by taking the difference of post- and preoperative scores. Generalized multiple linear regression analyses was performed to determine independent predictors of functional and pain improvement.

Results:

A total of 61 patients (58% response rate) who underwent 65 procedures were included in this study, with postoperative outcome measures obtained at mean duration of 57.9 months (range, 12-115 months) after surgery. Patients had a mean ± SD improvement in FAAM-Sports of 40.4 ± 22.3 points ( P < 0.001), improvement in FAAM-Sports SANE of 57.3 ± 31.6 points ( P < 0.001), and reduction of VAS pain of 56.4 ± 31.8 points ( P < 0.001). Multiple linear regression analysis revealed deep posterior compartment involvement, younger age, a history of depression, and male sex to be significant independent predictors of enhanced improvement after fasciotomy.

Conclusion:

Fasciotomy is an effective treatment of CECS, with our study identifying certain patient variables leading to greater functional improvement.

Clinical Relevance:

Male patients, younger patients, patients with depression, and patients with deep posterior compartment involvement may serve to benefit more with fasciotomies for treatment of CECS.
Urinary sodium potassium ratio is associated with clinical success after adrenalectomy in patients with unilateral primary aldosteronism
Authors: Lee Ming-Jse , Sun Chiao-Yin , Lu Ching-Chu , Chang Yuan-Shian , Pan Heng-Chih , Lin Yen-Hung , Wu Vin-Cent , Chueh Jeff S.
Published: February 2021

Background:

The urinary sodium potassium (NaK) ratio is associated with dietary sodium and potassium intake and blood pressure, and it also reflects the activity of aldosterone. Herein we evaluated the value of the urinary NaK ratio in predicting the surgical outcomes of patients with unilateral primary aldosteronism (uPA).

Methods:

This non-concurrent prospective cohort study was conducted from 2011 to 2017 and included 241 uPA patients who had undergone adrenalectomy. Predictors of successful clinical outcomes were analyzed using logistic regression.

Results:

Among the 241 uPA patients, 197 (81.7%) achieved clinical complete or partial success. A urinary sodium potassium ratio <3 (odds ratio (OR): 2.5; 95% confidence interval (CI): 1.2–5.4; p = 0.015), body mass index <25 kg/m2 (OR: 2.82; 95% CI: 1.31–6.06; p = 0.008), renin <1 ng/mL/h (OR: 2.51; 95% CI: 1.01–6.21; p = 0.047) and mean preoperative blood pressure >115 mmHg (OR: 5.02; 95% CI: 2.10–11.97; p < 0.001) could predict clinical success after adrenalectomy. Furthermore, higher pre-treatment plasma aldosterone (OR: 1.014; 95% CI 1.005–1.024; p = 0.002) or lower serum potassium (OR: 0.523; 95% CI: 0.328–0.836; p = 0.007) were correlated with lower urinary NaK ratio (<3), and log urinary NaK ratio was positively correlated with serum C-reactive protein ( β value 2.326; 95% CI 0.029–4.623; p = 0.047).

Conclusions:

uPA patients with a lower urinary NaK ratio, due to high plasma aldosterone and low serum potassium concentrations, were more likely to have clinical success after adrenalectomy. uPA patients with a higher urinary NaK ratio were associated with more severe inflammatory status, and possibly more resistant hypertension post-operatively.
Mesenchymal stem cell-based treatment in autoimmune liver diseases: underlying roles, advantages and challenges
Authors: He Chengmei , Yang Yanlei , Zheng Kunyu , Chen Yiran , Liu Suying , Li Yongzhe , Han Qin , Zhao Robert Chunhua , Wang Li , Zhang Fengchun
Published: February 2021

Autoimmune liver disease (AILD) is a series of chronic liver diseases with abnormal immune responses, including autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC). The treatment options for AILD remain limited, and the adverse side effects of the drugs that are typically used for treatment frequently lead to a low quality of life for AILD patients. Moreover, AILD patients may have a poor prognosis, especially those with an incomplete response to first-line treatment. Mesenchymal stem cells (MSCs) are pluripotent stem cells with low immunogenicity and can be conveniently harvested. MSC-based therapy is emerging as a promising approach for treating liver diseases based on their advantageous characteristics of immunomodulation, anti-fibrosis effects, and differentiation to hepatocytes, and accumulating evidence has revealed the positive effects of MSC therapy in AILD. In this review, we first summarize the mechanisms, safety, and efficacy of MSC treatment for AILD based on work in animal and clinical studies. We also discuss the challenges of MSC therapy in clinical applications. In summary, although promising data from preclinical studies are now available, MSC therapy is currently far for being applied in clinical practice, thus developing MSC therapy in AILD is still challenging and warrants further research.
A cross-sectional survey of COVID-19 preparedness in governmental hospitals of North-West Ethiopia
Authors: Tiruneh Abebe , Yetneberk Tikuneh , Eshetie Denberu , Chekol Bassazinew , Gellaw Moges
Published: February 2021

Introduction:

The novel coronavirus was first reported in December 2019, from Wuhan, China, and it has been declared as a pandemic by World Health Organization on 7 January 2020, and from that time till now the disease transmitted across the world. Hospitals need to be prepared for the overwhelming COVID-19 cases in their respective hospitals.

Objectives:

The objective of this study was to assess the level of hospital preparedness for COVID-19 in South Gondar Zone Governmental Hospitals, 2020.

Methods:

The institutionally based survey was conducted in South Gondar Zone Hospitals from 20 July to 25 July 2020. We used the World Health Organization preparedness checklist for COVID-19, and the checklist has three options for eight hospitals (not started, in progress, and started), so each hospital evaluated out of 208 points (104 items × 2) to assess each hospital their preparedness based on the checklist. Statistical Package for the Social Sciences, Version 21, is used for the analysis of the data. We used descriptive statistics and explained by using text and tables.

Results:

We evaluated all eight hospitals in these zone hospitals and only one hospital was in an acceptable level of preparation (>146 points), three hospitals were in an insufficient level of preparation (73–145 points), and the other four hospitals were grouped under the unacceptable level of preparation (<72 points) for COVID-19. And in all hospitals, there was no laboratory diagnostic method and treatment center for the COVID-19 virus.

Conclusion:

From the level of COVID-19 pandemic preparation from eight hospitals, only one hospital reaches the level of an acceptable level of preparedness. Mobilizing the community and other stakeholders to equip the hospital with resources and prioritization is recommended to mitigate the impact of COVID-19.
The cancer multiple: Producing and translating genomic big data into oncology care
Authors: Hà Tiên-Dung , Chow-White Peter A.
Published: February 2021

This article provides an ethnographic account of how Big Data biology is produced, interpreted, debated, and translated in a Big Data-driven cancer clinical trial, entitled “Personalized OncoGenomics,” in Vancouver, Canada. We delve into epistemological differences between clinical judgment, pathological assessment, and bioinformatic analysis of cancer. To unpack these epistemological differences, we analyze a set of gazes required to produce Big Data biology in cancer care: clinical gaze, molecular gaze, and informational gaze. We are concerned with the interactions of these bodily gazes and their interdependence on each other to produce Big Data biology and translate it into clinical knowledge. To that end, our central research questions ask: How do medical practitioners and data scientists interact, contest, and collaborate to produce and translate Big Data into clinical knowledge? What counts as actionable and reliable data in cancer decision-making? How does the explicability or translatability of genomic Big Data come to redefine or contradict medical practice? The article contributes to current debates on whether Big Data engenders new questions and approaches to biology, or Big Data biology is merely an extension of early modern natural history and biology. This ethnographic account will highlight how genomic Big Data, which underpins the mechanism of personalized medicine, allows oncologists to understand and diagnose cancer in a different light, but it does not revolutionize or disrupt medical oncology on an institutional level. Rather, personalized medicine is interdependent on different styles of (medical) thought, gaze, and practice to be produced and made intelligible.
Who Consumes New Media Content More Wisely? Examining Personality Factors, SNS Use, and New Media Literacy in the Era of Misinformation
Authors: Xiao Xizhu , Su Yan , Lee Danielle Ka Lai
Published: February 2021

With the emergence of new media technologies, being new media literate and able to critically analyze new media information are important to young adults, a group of individuals that are particularly active on social media. However, since the development of new media literacy, no study to date examined demographic characteristics, personality factors, and social network site (SNS) use related to it. More importantly, no research examined the relationship between new media literacy and perceptions and actions related to controversial issues. These under-explored facets deter practitioners from tailoring future new media literacy curricula and identifying the targeted audience. With a survey of 551 young adults, our study revealed that media literacy practitioners should devote more attention to (a) Caucasian males with low SNS use, (b) non-Caucasian females with low SNS use, and (c) individuals with low Need for Cognition and SNS use. Our study further showed that increasing new media literacy can help reduce misperceptions induced by misinformation that is rampant in the new media environment.
The Promoter, Celebrity, and Joker Roles in Journalists’ Social Media Performance
Authors: Mellado Claudia , Hermida Alfred
Published: February 2021

One of the main challenges of studying journalistic roles in social media practice is that the profession’s conceptual boundaries have become increasingly blurred. Social media has developed as a space used by audiences to consume, share, and discuss news and information, offering novel locations for journalists to intervene at professional and personal levels and in private and public spheres. This article takes the “journalistic ego” domain as its starting point to examine how journalists perform three specific roles on social media: the promoter, the celebrity, and the joker. To investigate these roles in journalistic performance, the article situates their emergence and operationalization in a broader epistemological context, examining how journalists engage with, contest, and/or diverge from different professional norms and practices, as well as the conflict between traditional and social media-specific roles of journalists.
Support and resources to promote and sustain health among nurses and midwives in the workplace: A qualitative study
Authors: Thapa Dip Raj , Ekström-Bergström Anette , Krettek Alexandra , Areskoug-Josefsson Kristina
Published: February 2021

Registered nurses and midwives are in short supply and have among the highest rates of sick leave in the global workforce. The aim of this study was therefore to explore and gain a deeper understanding of how nurses and midwives experience their everyday work, with a view toward promoting and sustaining their work-related health. Nine registered nurses and four registered midwives working in hospitals and community healthcare facilities in Sweden were interviewed. The interviews were analyzed using content analysis. This study is reported in accordance with COREQ. One main category emerged: ‘Quality of organizational and collegial support and opportunities to facilitate recovery, health, and patient care’. From this category, four generic categories describing the overall experiences of registered nurses and midwives could be discerned. Based on these results, it is recommended that employers adopt a systematic health-promotive approach to foster and maintain the workplace health of registered nurses and midwives.
Addressing Social Determinants of Health Identified by Systematic Screening in a Medicaid Accountable Care Organization: A Qualitative Study
Authors: Browne Julia , Mccurley Jessica L. , Fung Vicki , Levy Douglas E. , Clark Cheryl R. , Thorndike Anne N.
Published: February 2021

Introduction/Objectives:

Systematic screening for social determinants of health (SDOH), such as food and housing insecurity, is increasingly implemented in primary care, particularly in the context of Accountable Care Organizations (ACO). Despite the importance of developing effective systems for SDOH resource linkage, there is limited research examining these processes. The objective of the study was to explore facilitators and barriers to addressing SDOH identified by systematic screening in a healthcare system participating in a Medicaid ACO.

Methods:

This qualitative case study took place between January and March 2020. Semi-structured interviews were conducted with fifteen staff (8 community resource staff and 7 managers) from community health centers and hospitals affiliated with a large healthcare system. Interviews were transcribed, coded, and analyzed using the Framework Method.

Results:

Facilitators for addressing SDOH included maintaining updated resource lists, collaborating with community organizations, having leadership buy-in, and developing a trusting relationship with patients. Barriers to addressing SDOH included high caseloads, time constraints, inefficiencies in tracking, lack of community resources, and several specific patient characteristics. Further, resource staff expressed distress associated with having to communicate to patients that they were unable to address certain needs.

Conclusions:

Health system, community, and individual-level facilitators and barriers should be considered when developing programs for addressing SDOH. Specifically, the psychological burden on resource staff is an important and underappreciated factor that could impact patient care and lead to staff burnout.
IFT46 Expression in the Nasal Mucosa of Primary Ciliary Dyskinesia Patients: Preliminary Study
Authors: Mata Manuel , Zurriaga Javier , Milian Lara , Reula Ana , Armengot Miguel , Ruiz-Sauri Amparo , Carda Carmen
Published: February 2021

Background

Primary ciliary dyskinesia (PCD) is characterised by an imbalance in mucociliary clearance leading to chronic respiratory infections. Cilia length is considered to be a contributing factor in cilia movement. Recently, IFT46 protein has been related to cilia length. Therefore, this work aims to study IFT46 expression in a PCD patients cohort and analyse its relationship with cilia length and function, as it was not previously described.

Materials and methods

The expression of one intraflagellar transport ( IFT46) and two regulating ciliary architecture ( FOXJ1 and DNAI2) genes, as well as cilia length of 27 PCD patients, were measured. PCD patients were diagnosed based on clinical data, and cilia function and ultrastructure. Gene expression was estimated by real-time RT-PCR and cilia length by electron microscopy in nasal epithelium biopsies. Results and conclusions: While IFT46 expression was only diminished in patients with short cilia, FOXJ1, and DNAI2 expression were reduced in all PCD patient groups compared to controls levels. Among the PCD patients, cilia were short in 44% (5.9 ± 0.70 µm); nine of these (33% from the total) patients’ cilia also had an abnormal ultrastructure. Cilia length was normal in 33% of patients (6.4 ± 0.39 µm), and only three patients’ biopsies indicated decreased expression of dynein.
Universities as Knowledge Integrators and Cross-Industry Ecosystems: Self-Organizational Perspective
Authors: Tolstykh Tatyana , Gamidullaeva Leyla , Shmeleva Nadezhda
Published: February 2021

Universities play a vital role in innovation ecosystems. Besides, their role is being transformed and reinforced due to the interdisciplinary nature of modern innovations and inter-sectoral collaboration in the process of implementing cross-industry projects. The article’s main objective is to reveal the emerging new goals, functions, and goals of university as knowledge integrator and consolidator within cross-industry ecosystem. The article introduces the approaches to the implementation of the cross-industry ecosystem integrator functions as an “entry point” for the creation of new ideas, competencies, technological solutions, and projects for the development and testing of new technologies. The research results are useful for academics and policy makers in emerging economies to adopt and consider, so as to improve the contribution of the universities to the country’s economic and innovation development.
Impacts of ecosystem vitality on ASEAN’s agricultural exports: A System Generalized Method of Moments approach
Authors: Doanh Nguyen Khanh , Quynh Nguyen Ngoc , Heo Yoon
Published: February 2021

This study examined the impact of the Association of Southeast Asian Nations (ASEAN)’s ecosystem vitality (EV) on its agricultural exports to the rest of the world. Using a sample of the six major ASEAN countries (ASEAN-6) (including Indonesia, Malaysia, Philippines, Singapore, Thailand, and Vietnam) and their 72 trading partners for the period 2007–2016, we found robust evidence of a positive relationship between the quality of EV and the volume of agricultural exports. At the sectoral level, the quality of EV had the most substantial effects on the ASEAN’s exports of SITC-0 (food and live animals) and exerted the least impact on the ASEAN’s exports of SITC-2 (crude materials, inedible, except fuels). This empirical evidence implies that natural resource-intensive products are more sensitive to the quality of EV. At the country level, EV has the most potent effect on the ASEAN’s agricultural exports to high-income countries and the least impact on the ASEAN’s agricultural exports to low-income countries. To promote agricultural exports, especially to high-income countries, our empirical results suggest that ASEAN countries need to build specific and effective plans for conservation of environment and management of sustainable ecosystems.

JEL Classification: C33, F14, and Q56
Integration of Early Infant Diagnosis of HIV Services Into Village Health Clinics in Ntcheu, Malawi: An Exploratory Qualitative Study
Authors: Chinguwo Felix , Nyondo-Mipando Alinane Linda
Published: February 2021

Integration of Early Infant Diagnosis(EID) of HIV into Village Health Clinics (VHCs) would increase the uptake of services. This study assessed mothers and health care workers’ acceptability of integration of EID of HIV services into VHCs in Ntcheu, Malawi. We conducted an exploratory qualitative study in the phenomenological tradition among 20 mothers of either HIV exposed or non-exposed infants and 18 health care workers (HCWs) from February to July 2019. We analyzed the data using a thematic approach and guided by the theoretical framework for acceptability. There were positive perceptions of the integration of services. Acceptability is influenced by attitudes, perceived burden, intervention coherent services, and perceived effectiveness of services. The successful integration of EID of HIV into VHCs requires strengthening of the health system and community awareness. Efforts to mitigate stigma should be prioritized when integrating the services to optimize uptake of the services at a community level.
Progression of Allograft Extrusion in Both the Coronal and Sagittal Planes at Midterm Follow-up After Medial Meniscal Allograft Transplant
Authors: Kim Hanwook , Bin Seong-Il , Kim Jong-Min , Lee Bum-Sik , Sohn Dong-Wook
Published: February 2021

Background:

Although many studies have examined allograft extrusion after medial meniscal allograft transplant (MMAT), it is unclear whether allograft extrusion progresses at midterm follow-up.

Hypothesis:

After MMAT, allograft extrusion would not progress during the midterm follow-up period.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 30 patients who underwent MMAT between December 1996 and March 2016 were enrolled. Allograft extrusion was measured on magnetic resonance imaging scans obtained at 6 weeks, 1 year, and 3 to 7 years postoperatively. In the coronal plane, the absolute allograft extrusion and relative percentage of extrusion were measured. In the sagittal plane, the absolute and relative anterior cartilage meniscal distance and posterior cartilage meniscal distance were measured. The joint-space width (JSW) on radiographic Rosenberg view was measured at 3 time points. The axial alignment was measured preoperatively and at the midterm follow-up.

Results:

In the coronal plane, there were no significant differences in absolute and relative coronal extrusions between 6 weeks and 1 year postoperatively; however, the values were significantly increased at midterm follow-up compared with both of the earlier follow-up periods. Similarly, in the sagittal plane, the mean absolute and relative anterior and posterior cartilage meniscal distances were not significantly different between 6 weeks and 1 year postoperatively but showed significant increases at midterm follow-up compared with both of the earlier follow-up periods. The mean preoperative axial alignment showed a positive correlation with the delta value of relative percentage of extrusion in the coronal plane ( r = 0.378; P = .036). The mean JSW was 4.42 ± 0.88 mm preoperatively, 4.30 ± 0.83 mm at 1-year follow-up, and 3.96 ± 1.06 mm at the midterm follow-up. No significant difference was found between the preoperative and postoperative 1-year values, but the mean JSW was significantly decreased at midterm follow-up compared with both of the other time points ( P = .001 for both).

Conclusion:

Allograft extrusion did not progress until 1 year after MMAT; however, by midterm follow-up, extrusion had progressed in both the coronal and the sagittal planes. Preoperative axial alignment showed a positive correlation with allograft extrusion in the coronal plane.
Perceived Sound Quality Dimensions Influencing Frequency-Gain Shaping Preferences for Hearing Aid-Amplified Speech and Music
Authors: Vaisberg Jonathan M. , Beaulac Steve , Glista Danielle , Macpherson Ewan A. , Scollie Susan D.
Published: February 2021

Hearing aids are typically fitted using speech-based prescriptive formulae to make speech more intelligible. Individual preferences may vary from these prescriptions and may also vary with signal type. It is important to consider what motivates listener preferences and how those preferences can inform hearing aid processing so that assistive listening devices can best be tailored for hearing aid users. Therefore, this study explored preferred frequency-gain shaping relative to prescribed gain for speech and music samples. Preferred gain was determined for 22 listeners with mild sloping to moderately severe hearing loss relative to individually prescribed amplification while listening to samples of male speech, female speech, pop music, and classical music across low-, mid-, and high-frequency bands. Samples were amplified using a fast-acting compression hearing aid simulator. Preferences were determined using an adaptive paired comparison procedure. Listeners then rated speech and music samples processed using prescribed and preferred shaping across different sound quality descriptors. On average, low-frequency gain was significantly increased relative to the prescription for all stimuli and most substantially for pop and classical music. High-frequency gain was decreased significantly for pop music and male speech. Gain adjustments, particularly in the mid- and high-frequency bands, varied considerably between listeners. Music preferences were driven by changes in perceived fullness and sharpness, whereas speech preferences were driven by changes in perceived intelligibility and loudness. The results generally support the use of prescribed amplification to optimize speech intelligibility and alternative amplification for music listening for most listeners.
Public Health Nurses’ Professional Practices to Prevent, Recognize, and Respond to Suspected Child Maltreatment in Home Visiting: An Interpretive Descriptive Study
Authors: Jack Susan M. , Gonzalez Andrea , Marcellus Lenora , Tonmyr Lil , Varcoe Colleen , Van Borek Natasha , Sheehan Debbie , MacKinnon Karen , Campbell Karen , Catherine Nicole , Kurtz Landy Christine , MacMillan Harriet L. , Waddell Charlotte
Published: February 2021

The purpose of this analysis was to understand public health nurses’ experiences in preventing and addressing suspected child maltreatment within the context of home visiting. The principles of interpretive description guided study decisions and data were generated from interviews with 47 public health nurses. Data were analyzed using reflexive thematic analysis. The findings highlighted that public health nurses have an important role in the primary prevention of child maltreatment. These nurses described a six-step process for managing their duty to report suspected child maltreatment within the context of nurse-client relationships. When indicators of suspected child maltreatment were present, examination of experiential practice revealed that nurses developed reporting processes that maximized child safety, highlighted maternal strengths, and created opportunities to maintain the nurse-client relationship. Even with child protection involvement, public health nurses have a central role in continuing to work with families to develop safe and competent parenting skills.
Moving Beyond Implicit Bias Training: Policy Insights for Increasing Organizational Diversity
Authors: Onyeador Ivuoma N. , Hudson Sa-kiera T. J. , Lewis Neil A.
Published: February 2021

Many organizations are working to address diversity, equity, and inclusion. Organizations frequently use implicit bias to explain disparities and marshal implicit bias training as a solution. Implicit bias is difficult to change and trainings do not yield more diversity in organizations, so organizations should move beyond implicit bias trainings in their diversity, equity, and inclusion efforts. Organizations should (a) use trainings to educate members of their organizations about bias and about organizational efforts to address diversity, equity, and inclusion; (b) prepare for, rather than accommodate, defensive responses from dominant group members; and (c) implement structures that foster organizational responsibility for diversity, equity, and inclusion goals; opportunities for high-quality intergroup contact; affinity groups for underrepresented people; welcoming and inclusive messaging; and processes that bypass interpersonal bias. Although no simple, one-size-fits-all solutions address organizational diversity, organizational leaders have many tools they can use to design more effective diversity strategies.
Racial Inequality in Academia: Systemic Origins, Modern Challenges, and Policy Recommendations
Authors: Dupree Cydney H. , Boykin C. Malik
Published: February 2021

In an ideal world, academia serves society; it provides quality education to future leaders and informs public policy—and it does so by including a diverse array of scholars. However, research and recent protest movements show that academia is subject to race-based inequities that hamper the recruitment and retention of scholars of color, reducing scientific impact. This article provides critical systemic context for racism in academia before reviewing research on psychological, interpersonal, and structural challenges to reducing racial inequality. Policy challenges include (a) the cultivation of harmful stereotypes, (b) the education of racially ignorant future leaders, and (c) the dedication of resources to science that informs only a few, rather than many. Finally, recommendations specify critical features of hiring, retention, transparency, and incentives that can diversify academia, create a more welcoming environment to scholars of color, and maximize the potential for innovative and impactful science.
All Americans are Not Perceived as “True” Americans: Implications for Policy
Authors: Mukherjee Sahana , Perez Michael J.
Published: February 2021

The United States is a nation of immigrants with significant ethnic and racial diversity. Yet, American identity is associated with European-Americans and their cultural values, defining ethnic minorities as less American. Experiences of identity denial are associated with negative mental and physical health outcomes, as well as lower political and civic engagement. Perceptions of prototypical American-ness link to a wide range of social policy about language, affirmative action, and redistribution. A cultural psychological perspective analyzes the contexts that promote exclusive conceptions of American identity, and it focuses on individual people who make up these contexts. Policies that recognize minority-group cultures and acknowledge the historical injustices against them can promote inclusive conceptions of American identity.
A computer-game-based rehabilitation platform for individuals with fine and gross motor upper extremity deficits post-stroke (CARE fOR U) – Protocol for a randomized controlled trial
Authors: Gandhi Dorcas BC , Pandian Jeyaraj D , Szturm Tony , Kanitkar Anuprita , Kate Mahesh P , Bhanot Komal
Published: February 2021

Background & purpose

Activity-based neuroplasticity and re-organization leads to motor learning via replicating real-life movements. Increased repetition of such movements has growing evidence over last few decades. In particular, computer-game-based rehabilitation is found to be effective, feasible and acceptable for post-stroke upper limb deficits. Our study aims to evaluate the feasibility and effectiveness of 12 weeks of computer-game-based rehabilitation platform (GRP) on fine and gross motor skills post-stroke in India.

Methods

Through this trial we will study the effect of adjunctive in-hospital GRP (using a motion-sensing airmouse with off-the-shelf computer games) in 80 persons with subacute stroke, for reduction of post-stroke upper limb deficits in a single-centre prospective Randomized Open, Blinded End- point trial when compared to conventional therapy alone.

Results

We intend to evaluate between-group differences using Wolf Motor Function test, Stroke Specific Quality of Life, and GRP assessment tool. Feasibility will be assessed via recruitment rates, adherence to intervention periods, drop-out rate and qualitative findings of patient experience with the intervention.

Conclusion

The CARE FOR U trial is designed to test the feasibility and effectiveness of a computer-game based rehabilitation platform in treating upper limb deficits after stroke. In case of positive findings GRP can be widely applicable for stroke populations needing intensive and regular therapy with supervision.
Microstructure and mechanical properties of Ti-Ti2AlNb interface
Authors: Niu Tao , Jiang Bo , Zhang Ning , Wang Yaoqi
Published: February 2021

Diffusion bonding of Ti2AlNb alloy using pure titanium (Ti) foil as an interlayer was carried out on superplastic forming and diffusion bonding special equipment by gas pressure loading method. The microstructure of Ti-Ti2AlNb interface was observed using scanning electron microscope and energy-dispersive spectrometer while the mechanical properties of the joints were evaluated by shear test. The results show that the thickness of Ti foil interlayer has a great influence on the microstructure and shear strength of the interface diffusion region. When the thickness of the intermediate layer is thin (25 µm), Ti, aluminum (Al), and niobium (Nb) elements are fully diffused with uniform element distribution through the diffusion region. The diffusion layer region presents uniform, fine, and disordered lamellar α-Ti + β-Ti dual-phase structure with high shear strength. When the thickness of Ti foil interlayer is thick (50 µm), the distribution of Al elements is relatively uniform through the diffusion region due to its smaller radius and faster diffusion speed, and Ti and Nb elements present gradient distribution from the middle to both sides. The diffusion layer region presents a coarse and long strip shape α-Ti + β-Ti dual-phase structure in the middle part and a fine needle-like or irregular α-Ti + β-Ti dual-phase structure in both side parts, with slightly lower shear strength. Temperature has a great influence on the microstructure and mechanical properties of the diffusion bonding joints. The diffusion region presents a black α-Ti strip area in the middle part with the width of about 10 µm at lower temperature (910°C) with poorer property, due to the grain growth of the parent metal, the property is slightly poorer when the temperature is too high (960°C), and the optimal temperature is 930°C with a higher shear strength.
Tongue-Based Procedures in Treating Refractory Obstructive Sleep Apnea in Down Syndrome Patients: A Systematic Review and Meta-Analysis
Authors: Lee Paul B. , Chung Michael T. , Johnson Jared , Lucas Jordyn , Priest Caitlin R. , Chang Edward T. , Waxman Jonathan , Lin Ho-Sheng
Published: February 2021

Objective: There is a high prevalence of obstructive sleep apnea (OSA) in pediatric and adult Down Syndrome (DS) patients that is refractory to adenotonsillectomy and continuous positive airway pressure. Newer treatment modalities have emerged with improved outcomes. The objective is to provide an updated systematic review and meta-analysis to analyze the clinical outcomes of OSA in pediatric and adult DS patients with hypoglossal nerve stimulation using Inspire, midline posterior glossectomy plus lingual tonsillectomy (MPG + LT), and combined genioglossus advancement plus radiofrequency (GGS + RF). Methods: A comprehensive literature search of PubMed and Google Scholar was performed followed by a meta-analysis. Studies with preoperative and post-operative Apnea Hypopnea Index (AHI) values were included with patients serving as their own control. Results: Across 5 studies, 56 patients were analyzed. The mean reduction in AHI was statistically significant before vs. after procedure ( P < .001 for hypoglossal nerve stimulation using Inspire with a paired 2-tailed t-test and P = .031 for MPG + LT). Although individual patient AHI values were unavailable in the GGS + RF study, the standard difference in mean AHI was also significant for GGS + RF with P = .001. Device malfunction was the most common complication for Inspire while postoperative bleeding was observed for MPG + LT and nasopharyngeal obstruction and retropalatal collapse were observed for GGS + RF. Conclusion: This review reveals significant improvement in AHI with Inspire, MPG + LT, and GGS + RF for DS patients with refractory OSA. Further investigation is needed for comparison between these 3 therapies.
Evolution of seismic design codes of highway bridges in Chile
Authors: Wilches José , Santa Maria Hernán , Leon Roberto , Riddell Rafael , Hube Matías , Arrate Carlos
Published: February 2021

Chile, as a country with a long history of strong seismicity, has a record of both a constant upgrading of its seismic design codes and structural systems, particularly for bridges, as a result of major earthquakes. Recent earthquakes in Chile have produced extensive damage to highway bridges, such as deck collapses, large transverse residual displacements, yielding and failure of shear keys, and unseating of the main girders, demonstrating that bridges are highly vulnerable structures. Much of this damage can be attributed to construction problems and poor detailing guidelines in design codes. After the 2010 Maule earthquake, new structural design criteria were incorporated for the seismic design of bridges in Chile. The most significant change was that a site coefficient was included for the estimation of the seismic design forces in the shear keys, seismic bars, and diaphragms. This article first traces the historical development of earthquakes and construction systems in Chile to provide a context for the evolution of Chilean seismic codes. It then describes the seismic performance of highway bridges during the 2010 Maule earthquake, including the description of the main failure modes observed in bridges. Finally, this article provides a comparison of the Chilean bridge seismic code against the Japanese and United States codes, considering that these codes have a great influence on the seismic codes for Chilean bridges. The article demonstrates that bridge design and construction practices in Chile have evolved substantially in their requirements for the analysis and design of structural elements, such as in the definition of the seismic hazard to be considered, tending toward more conservative approaches in an effort to improve structural performance and reliability for Chilean bridges.
Sonographic Cardiovascular Assessment of the Aorta: Pilot of a Modified Image Grading System
Authors: Stigall-Weikle Nicole , Brady Austin N. , Yang Qian , Bloom Isaiah W. , Evans Kevin D.
Published: February 2021

Objective:

Atherosclerosis is a chronic inflammatory disease that can be undetected in middle-aged patients. Abdominal aortic calcifications (AACs) are one form of cardiovascular disease (CVD), and these can go undetected during a routine physician visit. Sonography has the potential to assess CVD progression, quantify plaque in the aorta, and help to quantify risk in asymptomatic patients.

Methodology:

This pilot study modified a current AAC grading system to create a scoring method for sonographic images among a small cohort of asymptomatic participants. A traditional portable ultrasound unit was used to image participants, and a subset underwent the same imaging with a handheld transducer and tablet.

Results:

In this cohort, six males and five females, it was possible to adequately visualize and assess plaque, utilizing both types of ultrasound equipment. The abdominal aorta was divided into segments on the sonogram for quality of grading. Ten participants were categorized with a grade II and one participant was given a grade IIIA.

Conclusion:

Replication of this modified grading system is needed to better understand the clinical utilization of sonography as a risk assessment tool. The risk assessment scoring was not dependent on the type of device used.
Alternative donor transplantation for myelodysplastic syndromes: haploidentical relative and matched unrelated donors
Authors: Grunwald Michael R. , Zhang Mei-Jie , Elmariah Hany , Johnson Mariam H. , St. Martin Andrew , Bashey Asad , Battiwalla Minoo , Bredeson Christopher N. , Copelan Edward , Cutler Corey S. , George Biju R. , Gupta Vikas , Kanakry Christopher , Mehta Rohtesh S. , Milano Filippo , Mussetti Alberto , Nakamura Ryotaro , Nishihori Taiga , Saber Wael , Solh Melhem , Weisdorf Daniel J. , Eapen Mary
Published: February 2021

We compared outcomes in 603 patients with myelodysplastic syndrome (MDS) after HLA-haploidentical relative (n = 176) and HLA-matched unrelated (n = 427) donor hematopoietic cell transplantation (HCT) from 2012 to 2017, using the Center for International Blood and Marrow Transplant Research database. All transplantations used reduced-intensity conditioning regimens. Total-body irradiation plus cyclophosphamide and fludarabine was the predominant regimen for HLA-haploidentical relative donor HCT, and graft-versus-host disease (GVHD) prophylaxis was uniformly posttransplantation cyclophosphamide, calcineurin inhibitor, and mycophenolate. Fludarabine with busulfan or melphalan was the predominant regimen for HLA-matched unrelated donor HCT, and GVHD prophylaxis was calcineurin inhibitor with mycophenolate or methotrexate. Results of multivariate analysis revealed higher relapse (hazard ratio [HR], 1.56; P = .0055; 2-year relapse rate, 48% vs 33%) and lower disease-free survival (DFS) rates after HLA-haploidentical relative donor HCT (HR, 1.29; P = .042; 2-year DFS, 29% vs 36%). However, overall survival (OS) rates did not differ between donor type (HR, 0.94; P = .65; 2-year OS, 46% for HLA-haploidentical and 44% for HLA-matched unrelated donor HCT) because of mortality associated with chronic GVHD. Acute grade 2 to 4 GVHD (HR, 0.44; P < .0001) and chronic GVHD (HR, 0.36; P < .0001) were lower after HLA-haploidentical relative donor HCT. By 2 years, probability of death resulting from chronic GVHD was lower after HLA-haploidentical relative compared with HLA-matched unrelated donor HCT (6% vs 21%), negating any potential survival advantage from better relapse control. Both donor types extend access to transplantation for patients with MDS; strategies for better relapse control are desirable for HLA-haploidentical relative donor HCT, and effective GVHD prophylaxis regimens are needed for unrelated donor HCT.