bluuebunny/crossref_metadata_2025 huggingface dataset:
Enduring Positive Impact of a Virtual Communication Skills Workshop of VitalTalk Pedagogy in a Non-U.S. Setting
Authors: Uemura Takeshi , Ito Kaori , Yuasa Misuzu , Shiozawa Youkie , Ishikawa Hirono , Nakagawa Shunichi , Onishi Eriko , Ouchi Kei
Published: May 2023

Context

While in-person workshops on serious illness communication skills using VitalTalk pedagogy have been shown to have a long-lasting impact, whether changing the format into virtual would maintain its enduring impact is unknown. Objectives. To examine long-term impacts of a virtual VitalTalk communication workshop.

Methods

Physicians in Japan who participated in our virtual VitalTalk workshop were asked to complete a self-assessment survey at 3 time points: before, immediately after, and 2 months after the workshop. We examined self-reported preparedness in 11 communication skills on a 5-point Likert scale at 3 time points, as well as self-reported frequency of practice on 5 communication skills at the pre- and 2-month time points.

Results

Between January 2021 and June 2022, 117 physicians from 73 institutions across Japan completed our workshop. Seventy-four participants returned the survey at all the 3 time points. Their skill preparedness significantly improved upon the completion of the workshop in all 11 skills (P < .001 for all items). The improvement remained at the same level at 2 months in 7 skills. In 4 of the 11 skills, there was further improvement at the 2-month point. The frequency of self-directed skill practice also increased significantly in the 2-month survey for all 5 skills.

Conclusion

A virtual workshop of VitalTalk pedagogy improved self-reported preparedness of communication skills, and the impact was long-lasting in a non-U.S. setting as it likely induced self-practice of skills. Our findings encourage the use of a virtual format in any geographical location considering its enduring impact and easy accessibility.
Theoretical shear damage characterization of intact rock under compressive-shear stress considering energy dissipation
Authors: Luo Song , Gong Fengqiang , Peng Kang
Published: May 2023

Investigation into rock damage is of great significance for evaluating and predicting the stability of underground rock applications, such as deep mining or tunneling structures. Considering the energy dissipation properties during rock deformation, this paper proposes a novel theoretical characterization of the damage induced by compressive-shear stress and its evolution in intact rocks. The linear energy dissipation (LED) law is derived from shear stress and deformation data of rocks resulting from the preset angle shear experiment. Based on the LED law, two damage variables are separately constructed from the theoretical and experimental aspects. Several sets of experimental data are subsequently utilized to validate the two constructed damage variables. Results show that both damage variables grow first slowly and then rapidly with shear displacement or shear stress in nonlinear relations. By comparison, however, it is found that the theoretical damage variable outperforms the experimental damage variable, which can accurately reflect the stress and deformation data during progressive rock damage with favorable continuity. This study contributes to a novel theoretical approach to quantifying the pre-peak damage in intact rocks subject to compressive-shear stress.
Fault diagnosis of rolling bearing based on BP neural network with fractional order gradient descent
Authors: Jiao Rui , Li Sai , Ding Zhixia , Yang Le , Wang Guan
Published: May 2023

The health of rolling bearing is of great importance for the normal operation of rotating machinery. The fault diagnosis process can be roughly summarized as signal processing, feature extraction, and fault classification. In this paper, a novel feature extraction and fault diagnosis method with fractional order back-propagation neural network is put forward. The new sine cosine algorithm optimized variational mode decomposition is performed on vibration signals, and the fault feature vectors are selected and built by singular value decomposition. Inspired by the fractional order calculus, a fractional order back-propagation neural network is employed to realize fault classification. The capability of the developed fault diagnosis algorithm is comprehensively evaluated via benchmark bearing data. The experimental results demonstrate that the designed method substantially extracts bearing defect features, increases classification accuracy and efficiency, and also outperforms existing algorithms.
Male Sexual Dysfunction and the Perpetration of Intimate Partner Violence
Authors: Hill Terrence D. , Garcia-Alexander Ginny , Sileo Katelyn , Fahmy Chantal , Testa Alexander , Luttinen Rebecca , Schroeder Ryan
Published: May 2023

We contribute to our understanding of the social epidemiology of intimate partner violence (IPV) by developing a mediation model that frames IPV as an outcome of male sexual dysfunction (performance anxiety and erectile dysfunction) and the mechanisms of masculine discrepancy stress (the perceived failure to conform to internalized normative expectations of masculinity) and anger. Our mediation analyses of recently collected data from the 2021 Crime, Health, and Politics Survey (CHAPS), a national probability sample of 792 men, confirmed that sexual dysfunction was indirectly associated with the perpetration of any IPV, physical IPV, and sexual IPV through the compound path of masculine discrepancy stress and anger.
Estimating macroscopic conductivity of randomly elliptic inclusion model with imperfect interfaces
Authors: Nguyen Van-Luat
Published: May 2023

The paper introduces some solutions for computing the effective conductivity of randomly elliptic inclusion with imperfect interfaces in two-dimensional space. Based on the coated-ellipse inclusion model and the polarization approximation, one can determine the effective conductivity of the ellipse inclusions with the approximation for lowly conducting imperfect interface (ALI) and the approximation for highly conducting imperfect interface (AHI). Some solutions, including the equivalent inclusion approximations (ALI and AHI), differential approximations (DAs), Hamilton–Crosser approximations (HAs), and fast Fourier transformation (FFT) method will be applied to determine the effective conductivity of the randomly ellipse model with AHI and ALI in two-dimensional space. The ALI and AHI results agree well with DA, HA, and FFT results showing the effectiveness of the methods.
Pediatric Oral Pathology: Odontogenic Cysts
Authors: Summersgill Kurt F.
Published: May 2023

Cysts encountered in the head and neck typically arise from epithelium that would normally be programmed to form teeth or tooth-supporting structures (odontogenic epithelium). These cysts come with a confusing array of similar-sounding names and histopathologic features that are sometimes shared between conditions. Here we describe and contrast the relatively-common lesions: hyperplastic dental follicle, dentigerous cyst, radicular cyst, buccal bifurcation cyst, odontogenic keratocyst, glandular odontogenic cyst, and the less-common gingival cyst of the new-born and thyroglossal duct cyst. The goal of this review is to help clarify and simplify these lesions for the general pathologist, pediatric pathologist, and surgeon.
Patient and limb outcomes 10 years after endovascular revascularization of the superficial femoral artery for peripheral artery disease: The Boston Femoral Artery Endovascular Revascularization Outcomes (Boston FAROUT) study
Authors: Kinlay Scott , Sobieszczyk Piotr , Eisenhauer Andrew C , Ostrowski Simon , Todoran Thomas M
Published: May 2023

Background:

We aimed to describe patient and limb outcomes in the decade after endovascular revascularization for chronic lower-extremity peripheral artery disease (PAD).

Methods:

We assessed outcomes in patients having endovascular revascularization of the superficial femoral artery in two centers between 2003 and 2011 and followed for a median 9.3 (25–75%: 6.8, 11.1) years. Outcomes included death, myocardial infarction, stroke, repeat limb revascularizations, and amputations. We used competing risks analysis with clustering by patient to determine the hazard ratios (HR) and 95% CI for patients, and procedural characteristics for cause of death, cardiovascular events, and major adverse limb events (MALE).

Results:

There were 253 index limb revascularizations in 202 patients followed for a median 9.3 years. Patients had intensive medical treatment with 90% on statins and 80% on beta-blockers. During follow up there were 57 (28%) cardiovascular deaths and 62 (31%) noncardiovascular deaths. Of the 253 limbs, 227 (90%) were free of MALE over follow up and 93 (37%) had MALE or minor repeat revascularization. In multivariable models, cardiovascular death significantly associated with critical limb ischemia (HR = 3.21, 95% CI = 1.84, 5.61) and noncardiovascular death with chronic kidney disease (HR = 2.69, 95% CI = 1.68, 4.30), and smoking (HR = 2.75, 95% CI = 1.01, 7.52). MALE or minor repeat revascularization associated with critical limb ischemia (HR = 1.43, 95% CI = 0.84, 2.43), smoking (HR = 2.49, 95% CI = 1.26, 4.90), and lesion length > 200 mm (HR = 1.51, 95% CI = 0.98, 2.33).

Conclusions:

Among patients with intensive medical therapy, the risk of noncardiovascular death was high and similar to cardiovascular death. Endovascular intervention can have acceptable long-term results. Future studies should evaluate strategies to reduce both cardiovascular and noncardiovascular deaths.
Efficient segmentation of water leakage in shield tunnel lining with convolutional neural network
Authors: Wang Wenjun , Su Chao , Han Guohui , Dong Yijia
Published: May 2023

Water leakage is a critical factor reflecting the structural safety of shield tunnels. Computer vision provides new opportunities to overcome the shortcomings of manual visual inspection and realize automatic detection of water leakage regions. In this study, we propose a leakage segmentation model with an encoder–decoder structure. The encoder adopts multi-branch convolutional attention for feature fusion, and the decoder adopts a lightweight design that only contains multi-layer perceptron. Standard convolution in multi-branch is decomposed to two depth-wise strip convolutions to realize lightweight design and extract strip-like features. Extensive ablation and comparative studies were conducted to test model performance. Test results show that our model achieves robust detection of water leakage under strong noise background, reaching an intersection over union of 90.75% with performance-computation trade-off. Consequently, the proposed method can be an effective alternative to the current visual inspection technologies, and provide a nearly automated inspection platform for shield tunnels.
Watch Out for GATORs: Fasting, Seizures, and Nutrient Sensing
Authors: Metcalf Cameron S.
Published: May 2023

[Box: see text]
Ganglion Cysts Arising From the Proximal Tibiofibular Joint: Treatment Approach and Associated Outcomes—A Systematic Review
Authors: Gonzalez Marcos R. , Castillo-Flores Samy , Portmann-Baracco Arianna , Pretell-Mazzini Juan
Published: May 2023

Background: Proximal tibiofibular joint (PTFJ) ganglion cyst is a rare condition with a high rate of recurrence. Optimal treatment has not yet been determined. Purpose: We aimed to answer the following questions: (1) What are the most common treatments for PTFJ cysts and their associated recurrence rates? (2) What are the risk factors for failure to completely recover from symptoms? (3) What are the risk factors for cyst recurrence? Methods: A systematic review was performed using PubMed and EMBASE databases. Studies were assessed for inclusion and exclusion criteria, and quality analysis following the PRISMA guidelines. Information on demographic, clinical, and treatment characteristics was retrieved from articles. Results: The most common surgical treatment was cyst excision (75.3%). Patients with PTFJ arthrodesis and PTFJ resection had the lowest recurrence rates at 0% and 4.4%, respectively. Complete recovery from symptoms was more common in PTFJ resection (70.8%) than in PTFJ arthrodesis (42.9%). Risk factors for failure to achieve complete recovery from symptoms included intraneural compromise (odds ratio [OR] = 3.93), cyst recurrence (OR = 6.04), and being a contact sports athlete (OR = 9.85). Ligation of the articular branch of the peroneal nerve (PN) was a protective factor (OR = 0.29). A history of knee arthritis was the most important risk factor for cyst recurrence (OR = 20.01); PTFJ arthrodesis was a protective factor (OR = 0.04). Conclusion: This systematic review of level-IV studies found PTFJ resection or arthrodesis to be the most effective treatment options. Intraneural compromise of the common peroneal nerve, cyst recurrence, and participation in contact sports are risk factors for incomplete symptom recovery, and ligation of the articular branch of the PN is a protective factor. Knee arthritis is a risk factor for cyst recurrence. More rigorous study is needed.
Spontaneous intracranial hypotension due to CSF–venous fistula: Evaluation of renal accumulation of contrast following decubitus myelography and maintained decubitus CT to improve fistula localization
Authors: Farb Richard I , O’Reilly Sean T , Hendriks Everardus J , Peng Philip W , Massicotte Eric M , Hoydonckx Yasmine , Nicholson Patrick J
Published: May 2023

Purpose

Presented here is a strategy of sequential lateral decubitus digital subtraction myelography (LDDSM) followed closely by lateral decubitus CT (LDCT) to facilitate cerebrospinal fluid (CSF)–venous fistula (CVF) localization.

Materials and Methods

This is a retrospective analysis of patients referred to our institution for evaluation of CSF leak. Patients with Type 1 and Type 2 leaks, and those not displaying MR brain stigmata of intracranial hypotension were excluded. All patients underwent consecutive LDDSM and LDCT. If the CVF was not localized on the first LDDSM–LDCT pair the patient returned for contralateral examinations. Images were reviewed for CVF and for accumulation of contrast within the renal pelvises expressed as a renal pelvis contrast score (RPCS) in Hounsfield units (HU).

Results

Twenty-two patients were included in this study. In 21 of 22 patients (95%) a CVF was identified yielding an RPCS for the LDDSM–LDCT pair ipsilateral to the CVF ranging from 71 to 423 with an average of 146 HU. An RPCS of the negative side LDDSM–LDCT pair contralateral to a CVF was available in 8 patients and averaged 51 HU. In 4 patients the initial bilateral LDDSM–LDCT pairs did not reveal the location of the CVF however in 3 of these 4 cases the CVF was revealed on a third LDDSM repeated ipsilateral to the higher RPCS.

Conclusion

The strategy of sequential LDDSM–LDCT coupled with evaluation of renal accumulation of contrast agent appears to improve the rate of CVF localization and warrants further evaluation.
Spelling monosyllabic English words
Authors: Khanna Maya M , Cortese Michael J , Hughes Kylie , Anderson Kayley
Published: May 2023

We conducted a megastudy to examine the spelling of American English monosyllables with typewritten responses. We related both sublexical and lexical/semantic factors to spelling accuracy and reaction time (RT) for the first keypress and response duration for spelling 1,856 monophonic monosyllables. We found that (a) each of 13 predictor variables was significantly related to performance for at least one measure, (b) orthographic length was unrelated to the first key RT, but did relate to accuracy and response duration, (c) sound-spelling and spelling-sound consistency was related to performance, and in particular, onset consistency related to accuracy and first key RT, but was unrelated to response duration, (d) contextual diversity was consistently related to performance across all measures, and (e) age of acquisition (AoA) was related to all measures, but was related more to the first key RT than response duration. The results indicate that people begin the spelling process once they identify the first letter, and they continue to process the spelling pattern as the response unfolds. These results are best explained by a parallel-distributed-processing framework.
COVID-19 vaccination in adults with inflammatory bowel disease
Authors: Lutz Megan , Lazarus Sarah , Caldera Freddy
Published: May 2023

Patients with inflammatory bowel disease (IBD) are not at increased risk of SARS-CoV-2 infection compared to the general population, and most are not at increased risk for severe disease. COVID-19 is nonetheless common, and vaccination is critical. Four safe and efficacious vaccines are now available for the prevention of COVID-19, with most data available for mRNA vaccines. Patients with IBD have a robust humoral response to vaccination with rates of seroconversion exceeding 95% following a two-dose mRNA vaccine series and 99% following a three-dose mRNA series, although those on certain therapies including anti-tumor necrosis factor α agents may have lower antibody concentrations and waning of antibodies over time. Additionally, rates of cell-mediated immune response, even in those patients with IBD who did not have evidence of humoral immunity, are high. Vaccines are safe and have not been associated with flares in disease activity. Gastroenterology providers should take an active role in ensuring patients with IBD are appropriately vaccinated against COVID-19.
Changes in height, weight, and body mass index after posterior spinal fusion in juvenile and adolescent idiopathic scoliosis
Authors: Johnson Mitchell A , Cirrincione Peter M , Zucker Colson P , Blanco John S , Widmann Roger F , Heyer Jessica H
Published: May 2023

Purpose:

Posterior spinal fusion for idiopathic scoliosis is known to increase spinal height, but the impacts on weight and resulting body mass index are unknown. This study assesses body mass index, weight, and height percentile changes over time after posterior spinal fusion for idiopathic scoliosis.

Methods:

Body mass index, weight, and height age- and sex-adjusted percentiles for patients with idiopathic scoliosis undergoing posterior spinal fusion between January 2016 and August 2022 were calculated based on growth charts from the Centers for Disease Control for Disease Control and compared to preoperative values at 2 weeks, 3 months, 6 months, 1 year, and 2 years. The data were analyzed for normality with a Shapiro–Wilk test, and percentiles were compared with the Wilcoxon signed-rank tests.

Results:

On average, 12.1 ± 2.3 levels were fused in 269 patients 14.4 ± 1.9 years, and percentiles for body mass index, weight, and height preoperatively were 55.5 ± 29.4%, 57.5 ± 28.9%, and 54.6 ± 30.4%, respectively. Body mass index and weight percentiles decreased at 2 weeks (−10.7%, p < 0.001; −4.6%, p < 0.001, respectively) and 3 months (−6.9%, p < 0.001; −3.2%, p < 0.001, respectively) postoperatively. Postoperative weight loss at 2 weeks averaged 2.25 ± 3.09% of body weight (0.98 ± 4.5 kg), normalizing by 3 months. Body mass index percentile normalized at 1 year, but height percentile was increased at 2 weeks (2.42 ± 1.72 cm, p < 0.001) and through 2 years.

Conclusion:

Despite initial height increase due to deformity correction, acute postoperative weight and body mass index percentile decreases postoperatively normalize by 1-year body mass index percentile. Physicians may benefit from utilizing this information when discussing the postoperative course of posterior spinal fusion with idiopathic scoliosis.

Level of evidence:

4, Retrospective Case Series.
Serious neurological adverse events following immunization against SARS-CoV-2: a narrative review of the literature
Authors: Eslait-Olaciregui Sara , Llinás-Caballero Kevin , Patiño-Manjarrés David , Urbina-Ariza Thomas , Cediel-Becerra Juan Fernando , Domínguez-Domínguez Camilo Alberto
Published: May 2023

Amid the coronavirus disease 2019 (COVID-19) pandemic, massive immunization campaigns became the most promising public health measure. During clinical trials, certain neurological adverse effects following immunization (AEFIs) were observed; however, acceptable safety profiles lead to emergency authorization for the distribution and use of the vaccines. To contribute to pharmacovigilance and lessen the potential negative impact that vaccine hesitancy would have on immunization programs, we conducted a review of the scientific literature concerning the epidemiological data, clinical presentation, and potential mechanisms of these neurological AEFIs. There is some epidemiological evidence linking COVID-19 vaccines to cerebral venous sinus thrombosis, arterial ischemic stroke, convulsive disorder, Guillain–Barré syndrome, facial nerve palsy, and other neurological conditions. Cerebral venous sinus thrombosis has been associated with a thrombotic thrombocytopenia induced by the vaccine, similar to that induced by heparin, which suggests similar pathogenic mechanisms (likely involving antibodies against platelet factor 4, a chemokine released from activated platelets). Arterial ischemic stroke is another thrombotic condition observed among some COVID-19 vaccine recipients. Vaccine-induced convulsive disorder might be the result of structural abnormalities potentially caused by the vaccine or autoimmune mechanisms. Guillain–Barré syndrome and facial nerve palsy may also be linked to the immunization event, possibly due to immune mechanisms such as uncontrolled cytokine release, autoantibody production, or bystander effect. However, these events are mostly uncommon and the evidence for the association with the vaccine is not conclusive. Furthermore, the potential pathophysiological mechanisms remain largely unknown. Nevertheless, neurological AEFIs can be serious, life-threatening or even fatal. In sum, COVID-19 vaccines are generally safe and the risk of neurological AEFIs does not outweigh the benefits of immunization. However, early diagnosis and treatment of neurological AEFIs are of utmost importance, and both health professionals and the public should be aware of these conditions.
Donepezil-associated survival benefits among Alzheimer’s disease patients are retained but not enhanced during COVID-19 infections
Authors: Edmiston Elizabeth A. , Bej Taissa A. , Wilson Brigid , Jump Robin L. P. , Phillips Joy A.
Published: May 2023

Background and Aim:

Donepezil is a front-line treatment for Alzheimer’s disease. Donepezil treatment is associated with decreased risk of all-cause mortality. Specific protection is observed in pneumonia and cardiovascular disease. We hypothesized that donepezil treatment would improve mortality among Alzheimer’s patients following infection with COVID-19. The objective of this study is to assess the influence of ongoing donepezil treatment on survival in Alzheimer’s disease patients after polymerase chain reaction (PCR)-confirmed COVID-19 infection.

Methods:

This is a retrospective cohort study. We conducted a national survey of Veterans with Alzheimer’s disease to assess the influence of ongoing donepezil treatment on survival in Alzheimer’s disease patients after PCR-confirmed COVID-19 infection. We assessed all-cause 30-day mortality stratified by COVID-19 infection and donepezil use, estimating odds ratios using multivariate logistic regression.

Results:

Among people with Alzheimer’s disease and COVID-19, all-cause 30-day mortality was 29% (47/163) for people taking donepezil compared with 38% (159/419) for those who were not. Among people with Alzheimer’s disease without COVID-19, all-cause 30-day mortality was 5% (189/4189) for people taking donepezil compared with 7% (712/10,241) for those who were not. Adjusting for covariates, the decrease in mortality associated with donepezil did not differ between people with and without COVID-19 (interaction p = 0.710)

Conclusion:

The known survival benefits of donepezil were retained but not found to be specific to COVID-19 among people with Alzheimer’s disease.
Put Some Music on: The Effects of pre-Task Music Tempo on Arousal, Affective State, Perceived Exertion, and Anaerobic Performance
Authors: Pusey Christopher Garry , Haugen Tommy , Høigaard Rune , Ivarsson Andreas , Røshol Andreas Waaler , Laxdal Aron
Published: May 2023

Research on the ergogenic effects of music on athletic performance usually includes multiple antecedents simultaneously. Consequently, this study set out to isolate a single antecedent using a highly controlled experiment. More specifically, the aim of the study was to investigate the effect of pre-task, slow- and fast-tempo music on arousal, affective state, perceived exertion, and anaerobic rowing performance by isolating music tempo as the sole intrinsic musical factor. Forty young adults (male = 23, female = 17) participated in three trials where they all were exposed to no-music, slow-tempo, and fast-tempo music conditions in a randomized order. The music was exclusively composed for this study and equally novel for all participants. It was based on the same electronic track with a techno-orientation rendered to both 110 (slow-tempo) and 140 (fast-tempo) BPM. Following music exposure, the participants were momentarily asked to report levels of felt arousal and affective state before being instructed to perform a 30-s maximal rowing test on an ergometer. Upon completion of each rowing test, subjects were then asked to report their perceived exertion. Both fast- and slow-tempo pre-task music exposure led to increased arousal and positive affective state when compared to no music. Fast-tempo music led to a significantly higher mean power output than slow-tempo music. No significant differences were found for peak watt output or rating of perceived exertion when comparing all conditions. These findings suggest that exposure to pre-task music may offer positive psychological benefits prior to commencing anaerobic sporting tasks. Results also suggest that fast-tempo music may have an ergogenic effect on anaerobic performance.
Characterization of the COVID-19 Vaccine Uptake in Patients With Chronic Diseases in a Large University-based Family Medicine Clinical Practice
Authors: Khanna Niharika , Klyushnenkova Elena , Zhan Min , Jeong Dae Hyoun , Kernan Colleen , Stewart David
Published: May 2023

Purpose:

To characterize COVID-19 vaccine uptake in patients with chronic conditions at the large university-based Family Medicine practice serving a population with low COVID-19 vaccine acceptance.

Methods:

A rolling panel of patients attributed to the practice was submitted monthly to the Chesapeake Regional Health Information Exchange (CRISP) to monitor patients’ vaccination status. Chronic conditions were identified using the CMS Chronic Disease Warehouse. An outreach strategy deploying Care Managers was developed and implemented. Associations between vaccination status and patients’ characteristics were examined using a multivariable Cox’s proportional hazard regression modeling.

Results:

Among 8469 empaneled adult (18+) patients, 6404 (75.6%) received at least 1 dose of COVID-19 vaccine in December 2020 to March 2022. Patients were relatively young (83.4% <65 years old), predominantly female (72.3%), and non-Hispanic Black (83.0%). Among chronic conditions, hypertension had the highest prevalence (35.7%), followed by diabetes (17.0%). Associations between vaccine status and the presence of chronic conditions varied by age and race. Older patients (45+ years old) with diabetes and/or hypertension showed a statistically significant delay in receiving COVID-19 vaccine, while young Black adults (18-44 years old) with diabetes complicated by hypertension were more likely to be vaccinated compared to patients of the same age and race with no chronic conditions (Hazard ratio 1.45; 95% CI 1.19,1.77; P = .0003).

Conclusions:

The practice-specific COVID-19 vaccine CRISP dashboard helped to identify and address delays in receiving COVID-19 vaccine in the most vulnerable, underserved populations. Reasons for age and race-specific delays in patients with diabetes and hypertension should be explored further.
Effect of Symptom Duration on Injury Severity and Recovery in Patients With Achilles Tendinopathy
Authors: Hanlon Shawn L. , Scattone Silva Rodrigo , Honick Brian J. , Silbernagel Karin Grävare
Published: May 2023

Background:

Achilles tendinopathy is a common overuse condition. Distinguishing between early- and late-stage tendinopathy may have implications on treatment decisions and recovery expectations.

Purpose:

To compare the effects of time and baseline measures of tendon health on outcomes among patients with varying symptom durations after 16 weeks of comprehensive exercise treatment.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Participants (N = 127) were categorized into 4 groups based on the number of months since symptom onset: ≤3 months (n = 24); between >3 and ≤6 months (n = 25); between >6 and ≤12 months (n = 18); or >12 months (n = 60). All participants received 16 weeks of standardized exercise therapy and pain-guided activity modification. Outcomes representing symptoms, lower extremity function, tendon structure, mechanical properties, psychological factors, and patient-related factors were assessed at baseline and at 8 and 16 weeks after the initiation of exercise therapy. Chi-square tests and 1-way analysis of variance were used to compare baseline measures between groups.Time, group, and interaction effects were evaluated using linear mixed models.

Results:

The mean age of the participants was 47.8 ± 12.6 years, 62 participants were women, and symptoms ranged from 2 weeks to 274 months. No significant differences were found among symptom duration groups at baseline for any measure of tendon health. At 16 weeks, all groups demonstrated improvements in symptoms, psychological factors, lower extremity function, and tendon structure, with no significant differences among the groups ( P > .05)

Conclusion:

Symptom duration did not influence baseline measures of tendon health. Additionally, no differences were observed among the different symptom duration groups in response to 16 weeks of exercise therapy and pain-guided activity modification.
Towards care-ful distraction: Digital well-being and a politics of care during pandemic lockdowns in the U.S.
Authors: Saindon Jacob
Published: May 2023

This paper conceptualizes digital well-being during July of 2020 as an emergent, situated experience which was particularly influenced by the spatiotemporal conditions of lockdown and the affordances of digital platforms and technology. I take up two key heuristics of lockdown digital well-being—attention and intimacy—and draw upon feminist political geography to examine the alignments between attentional and intimate practices by means of digital technology during lockdown. Through four in-depth interviews conducted during this time, I focus on the connections between participants’ political intimacies, emotional geographies, and (self-)care practices. The paper identifies a disconnect between experiences of unwell-being and practices of (self-)care emerging from popular conceptions of digital well-being, specifically regarding practices of ‘doomscrolling.’ Drawing upon Sarah Atkinson’s (2011) work on the discontinuities between scales of care and responsibility, I argue for a reworking of discourses and practices of digital well-being through care-ful distraction: the unruly use of our increasingly co-constituted attentional capacities and intimate relations to practice care within, and for, the sociotechnical systems which bind us together.
A Quasi-Experimental Evaluation of Single Trough-Based Area Under the Curve Guided Dosing on the Incidence of Vancomycin Associated Nephrotoxicity in Veteran Patients
Authors: Patil Tanvi , Zysk Stacey N. , Akridge Meghan E. , McCraven Rebecca W. , Vasudeva Shikha S.
Published: May 2023

Background: Two common dosing strategies for vancomycin are trough-based and area under the curve (AUC)-based dosing. Objective: To compare the incidence of nephrotoxicity in trough-based dosing group with the single trough-based AUC dosing at the Salem VA Medical Center. Methods: This retrospective study included patients who received trough-based dosing of vancomycin between January 1, 2017, and January 1, 2019 (preimplementation group) and AUC-based dosing (postimplementation) between October 1, 2019, and October 1, 2021, at the Salem VA Medical Center. The primary outcome was nephrotoxicity at 96 hours, 7 days, and entire hospital length of stay (LOS). Secondary outcomes included 30-day readmission and all-cause mortality rates, cumulative doses at 24, 48, and 72 hours, and percentage of patients considered at goal (AUC 400-600 or trough between 10 and 20 mg/L). Propensity score (PS) matching was utilized to adjust for confounding. Results: After PS matching 100 patients were included in preimplementation and 95 patients in the postimplementation group. The average study patient was a 68-year-old white male. There was significant reduction in the risk of nephrotoxicity in postimplementation cohort at 96 hours (adjusted (a)HR: 0.28, 95% CI (0.12-0.66); 7 days (aHR: 0.39, 95% CI (0.18-0.85); and entire hospital LOS (aHR: 0.46, 95% CI (0.22-0.95). Secondary outcomes showed no difference between the groups except significantly higher proportion of patients were considered at therapeutic goal in the postimplementation cohort compared with pre-implementation cohort. Conclusion: This hypothesis generating study shows that AUC-based dosing calculated using single trough concentration may result in reduced rate of nephrotoxicity than trough-based dosing.
Dimethyl fumarate treatment in relapsed and refractory cutaneous T-cell lymphoma: a multicenter phase 2 study
Authors: Nicolay Jan P. , Melchers Susanne , Albrecht Jana D. , Assaf Chalid , Dippel Edgar , Stadler Rudolf , Wehkamp Ulrike , Wobser Marion , Zhao Jing , Burghaus Ina , Schneider Sven , Gülow Karsten , Goerdt Sergij , Schürch Christian M. , Utikal Jochen S. , Krammer Peter H.
Published: May 2023

Targeted therapies for cutaneous T-cell lymphoma (CTCL) are limited and curative approaches are lacking. Furthermore, relapses and drug induced side effects are major challenges in the therapeutic management of patients with CTCL, creating an urgent need for new and effective therapies. Pathologic constitutive NF-κB activity leads to apoptosis resistance in CTCL cells and, thus, represents a promising therapeutic target in CTCL. In a preclinical study we showed the potential of dimethyl fumarate (DMF) to block NF-κB and, specifically, kill CTCL cells. To translate these findings to applications in a clinical setting, we performed a multicentric phase 2 study evaluating oral DMF therapy in 25 patients with CTCL stages Ib to IV over 24 weeks (EudraCT number 2014-000924-11/NCT number NCT02546440). End points were safety and efficacy. We evaluated skin involvement (using a modified severity weighted assessment tool [mSWAT]), pruritus, quality of life, and blood involvement, if applicable, as well as translational data. Upon skin analysis, 7 of 23 (30.4%) patients showed a response with >50% reduction in the mSWAT score. Patients with high tumor burden in the skin and blood responded best to DMF therapy. Although not generally significant, DMF also improved pruritus in several patients. Response in the blood was mixed, but we confirmed the NF-κB–inhibiting mechanism of DMF in the blood. The overall tolerability of the DMF therapy was very favorable, with mostly mild side effects. In conclusion, our study presents DMF as an effective and excellently tolerable therapeutic option in CTCL to be further evaluated in a phase 3 study or real-life patient care as well as in combination therapies. This trial was registered at www.clinicaltrials.gov as #NCT02546440.
The genomic landscape of acute lymphoblastic leukemia with intrachromosomal amplification of chromosome 21
Authors: Gao Qingsong , Ryan Sarra L. , Iacobucci Ilaria , Ghate Pankaj S. , Cranston Ruth E. , Schwab Claire , Elsayed Abdelrahman H. , Shi Lei , Pounds Stanley , Lei Shaohua , Baviskar Pradyuamna , Pei Deqing , Cheng Cheng , Bashton Matthew , Sinclair Paul , Bentley David R. , Ross Mark T. , Kingsbury Zoya , James Terena , Roberts Kathryn G. , Devidas Meenakshi , Fan Yiping , Chen Wenan , Chang Ti-Cheng , Wu Gang , Carroll Andrew , Heerema Nyla , Valentine Virginia , Valentine Marcus , Yang Wenjian , Yang Jun J. , Moorman Anthony V. , Harrison Christine J. , Mullighan Charles G.
Published: May 2023

Intrachromosomal amplification of chromosome 21 defines a subtype of high-risk childhood acute lymphoblastic leukemia (iAMP21-ALL) characterized by copy number changes and complex rearrangements of chromosome 21. The genomic basis of iAMP21-ALL and the pathogenic role of the region of amplification of chromosome 21 to leukemogenesis remains incompletely understood. In this study, using integrated whole genome and transcriptome sequencing of 124 patients with iAMP21-ALL, including rare cases arising in the context of constitutional chromosomal aberrations, we identified subgroups of iAMP21-ALL based on the patterns of copy number alteration and structural variation. This large data set enabled formal delineation of a 7.8 Mb common region of amplification harboring 71 genes, 43 of which were differentially expressed compared with non-iAMP21–ALL ones, including multiple genes implicated in the pathogenesis of acute leukemia (CHAF1B, DYRK1A, ERG, HMGN1, and RUNX1). Using multimodal single-cell genomic profiling, including single-cell whole genome sequencing of 2 cases, we documented clonal heterogeneity and genomic evolution, demonstrating that the acquisition of the iAMP21 chromosome is an early event that may undergo progressive amplification during disease ontogeny. We show that UV-mutational signatures and high mutation load are characteristic secondary genetic features. Although the genomic alterations of chromosome 21 are variable, these integrated genomic analyses and demonstration of an extended common minimal region of amplification broaden the definition of iAMP21-ALL for more precise diagnosis using cytogenetic or genomic methods to inform clinical management.
Prioritized polycystic kidney disease drug targets and repurposing candidates from pre-cystic and cystic mouse Pkd2 model gene expression reversion
Authors: Wilk Elizabeth J. , Howton Timothy C. , Fisher Jennifer L. , Oza Vishal H. , Brownlee Ryan T. , McPherson Kasi C. , Cleary Hannah L. , Yoder Bradley K. , George James F. , Mrug Michal , Lasseigne Brittany N.
Published: May 2023

Background

Autosomal dominant polycystic kidney disease (ADPKD) is one of the most prevalent monogenic human diseases. It is mostly caused by pathogenic variants in PKD1 or PKD2 genes that encode interacting transmembrane proteins polycystin-1 (PC1) and polycystin-2 (PC2). Among many pathogenic processes described in ADPKD, those associated with cAMP signaling, inflammation, and metabolic reprogramming appear to regulate the disease manifestations. Tolvaptan, a vasopressin receptor-2 antagonist that regulates cAMP pathway, is the only FDA-approved ADPKD therapeutic. Tolvaptan reduces renal cyst growth and kidney function loss, but it is not tolerated by many patients and is associated with idiosyncratic liver toxicity. Therefore, additional therapeutic options for ADPKD treatment are needed.

Methods

As drug repurposing of FDA-approved drug candidates can significantly decrease the time and cost associated with traditional drug discovery, we used the computational approach signature reversion to detect inversely related drug response gene expression signatures from the Library of Integrated Network-Based Cellular Signatures (LINCS) database and identified compounds predicted to reverse disease-associated transcriptomic signatures in three publicly available Pkd2 kidney transcriptomic data sets of mouse ADPKD models. We focused on a pre-cystic model for signature reversion, as it was less impacted by confounding secondary disease mechanisms in ADPKD, and then compared the resulting candidates’ target differential expression in the two cystic mouse models. We further prioritized these drug candidates based on their known mechanism of action, FDA status, targets, and by functional enrichment analysis.

Results

With this in-silico approach, we prioritized 29 unique drug targets differentially expressed in Pkd2 ADPKD cystic models and 16 prioritized drug repurposing candidates that target them, including bromocriptine and mirtazapine, which can be further tested in-vitro and in-vivo.

Conclusion

Collectively, these results indicate drug targets and repurposing candidates that may effectively treat pre-cystic as well as cystic ADPKD.

Graphical Abstract
Verification of a clinical decision support system for the diagnosis of headache disorders based on patient–computer interactions: a multi-center study
Authors: Han Xun , Wan Dongjun , Zhang Shuhua , Yin Ziming , Huang Siyang , Xie Fengbo , Guo Junhong , Qu Hongli , Yao Yuanrong , Xu Huifang , Li Dongfang , Chen Sufen , Wang Faming , Wang Hebo , Chen Chunfu , He Qiu , Dong Ming , Wan Qi , Xu Yanmei , Chen Min , Yan Fanhong , Wang Xiaolin , Wang Rongfei , Zhang Mingjie , Ran Ye , Jia Zhihua , Liu Yinglu , Chen Xiaoyan , Hou Lei , Zhao Dengfa , Dong Zhao , Yu Shengyuan
Published: May 2023

Background

Although headache disorders are common, the current diagnostic approach is unsatisfactory. Previously, we designed a guideline-based clinical decision support system (CDSS 1.0) for diagnosing headache disorders. However, the system requires doctors to enter electronic information, which may limit widespread use.

Methods

In this study, we developed the updated CDSS 2.0, which handles clinical information acquisition via human–computer conversations conducted on personal mobile devices in an outpatient setting. We tested CDSS 2.0 at headache clinics in 16 hospitals in 14 provinces of China.

Results

Of the 653 patients recruited, 18.68% (122/652) were suspected by specialists to have secondary headaches. According to “red-flag” responses, all these participants were warned of potential secondary risks by CDSS 2.0. For the remaining 531 patients, we compared the diagnostic accuracy of assessments made using only electronic data firstly. In Comparison A, the system correctly recognized 115/129 (89.15%) cases of migraine without aura (MO), 32/32 (100%) cases of migraine with aura (MA), 10/10 (100%) cases of chronic migraine (CM), 77/95 (81.05%) cases of probable migraine (PM), 11/11 (100%) cases of infrequent episodic tension-type headache (iETTH), 36/45 (80.00%) cases of frequent episodic tension-type headache (fETTH), 23/25 (92.00%) cases of chronic tension-type headache (CTTH), 53/60 (88.33%) cases of probable tension-type headache (PTTH), 8/9 (88.89%) cases of cluster headache (CH), 5/5 (100%) cases of new daily persistent headache (NDPH), and 28/29 (96.55%) cases of medication overuse headache (MOH). In Comparison B, after combining outpatient medical records, the correct recognition rates of MO (76.03%), MA (96.15%), CM (90%), PM (75.29%), iETTH (88.89%), fETTH (72.73%), CTTH (95.65%), PTTH (79.66%), CH (77.78%), NDPH (80%), and MOH (84.85%) were still satisfactory. A patient satisfaction survey indicated that the conversational questionnaire was very well accepted, with high levels of satisfaction reported by 852 patients.

Conclusions

The CDSS 2.0 achieved high diagnostic accuracy for most primary and some secondary headaches. Human–computer conversation data were well integrated into the diagnostic process, and the system was well accepted by patients. The follow-up process and doctor–client interactions will be future areas of research for the development of CDSS for headaches.
Current management of classic bladder exstrophy in the modern era
Authors: Morrill Christian C. , Haffar Ahmad , Harris Thomas G. W. , Crigger Chad , Gearhart John P.
Published: May 2023

Background

Classic bladder exstrophy is a complex, multi-system congenital malformation affecting formation of the genitourinary system, pelvis, and abdominal wall.

Main body

Historically children with this abnormality were consigned to poor outcomes and quality of life. Modern advancements in the diagnosis and management of this disorder have resulted in low mortality rates and shifted clinical focus toward optimizing quality of life.

Conclusion

Modern techniques in addition to recent discoveries in the diagnosis and delayed management of this disorder have enabled high rates of urinary continence, genital cosmesis, and an improved quality of life. This is an updated overview of the pathology, diagnosis, and management of this rare disorder.
A comparative evaluation of the safety performance of bus priority route configurations
Authors: Gitelman Victoria , Doveh Etti
Published: May 2023

One way to promote public transport use in cities lies in establishing bus priority routes (BPRs) on main traffic arterials, to reduce bus travel times. But, BPRs require infrastructure changes in road layouts, creating more complex traffic settings that may have safety implications. Previous research indicated that design features affect BPRs' safety, but findings regarding the impacts of various BPR configurations are scarce. In this study, we examined the safety performance of three BPR configurations: barrier-separated central, open centre-lane and curbside BPRs, in Israel. Multivariate regression models were fitted to identify design features affecting accident occurrences on urban arterials with BPRs, using a database on all BPRs in operation. The comparative evaluations showed that barrier-separated BPRs were characterised by lower accident rates on road sections but by substantially higher accident numbers at junctions, relative to other BPR types, and particularly when bus-overtaking was possible. Hence, the use of barrier-separated bus routes should be reduced and bus-overtaking settings should be avoided, when implementing BPRs. In the comparison of curbside and center-lane BPRs none of them demonstrated a superior safety performance: the centre-lane BPRs were safer on sections while at junctions both types had advantages for certain accident types, thus, both forms are applicable in future BPR designs.
Whole genome sequencing and analysis of Armillaria gallica Jzi34 symbiotic with Gastrodia elata
Authors: Cai Jinlong , Muhammad Ikram , Chen Bilian , Xu Peng , Li Yiguo , Xu Huini , Li Kunzhi
Published: May 2023

Background

Armillaria species are plant pathogens, but a few Armillaria species can establish a symbiotic relationship with Gastrodia elata, a rootless and leafless orchid, that is used as a Chinese herbal medicine. Armillaria is a nutrient source for the growth of G. elata. However, there are few reports on the molecular mechanism of symbiosis between Armillaria species and G. elata. The genome sequencing and analysis of Armillaria symbiotic with G. elata would provide genomic information for further studying the molecular mechanism of symbiosis.

Results

The de novo genome assembly was performed with the PacBio Sequel platform and Illumina NovaSeq PE150 for the A. gallica Jzi34 strain, which was symbiotic with G. elata. Its genome assembly contained ~ 79.9 Mbp and consisted of 60 contigs with an N50 of 2,535,910 bp. There were only 4.1% repetitive sequences in the genome assembly. Functional annotation analysis revealed a total of 16,280 protein coding genes. Compared with the other five genomes of Armillaria, the carbohydrate enzyme gene family of the genome was significantly contracted, while it had the largest set of glycosyl transferase (GT) genes. It also had an expansion of auxiliary activity enzymes AA3-2 gene subfamily and cytochrome P450 genes. The synteny analysis result of P450 genes reveals that the evolutionary relationship of P450 proteins between A. gallica Jzi34 and other four Armillaria was complex.

Conclusions

These characteristics may be beneficial for establishing a symbiotic relationship with G. elata. These results explore the characteristics of A. gallica Jzi34 from a genomic perspective and provide an important genomic resource for further detailed study of Armillaria. This will help to further study the symbiotic mechanism between A. gallica and G. elata.