bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Observation and Analysis of Thyroglossal Duct Cyst Carcinoma: A Report of 5 Cases
Authors: Lei Lei , Chen Min , Pang Zongguo , Zou Jian , Ma Lin , Song NingYing , Liu Jifeng
Published: September 2023

Thyroglossal duct cyst carcinoma (TGDCCa) is a rare condition with only approximately 300 cases reported to date. There is a lack of comprehensive reporting on its clinical manifestations, ultrasound, contrast-enhanced computed tomography, magnetic resonance imaging (MRI) features, immunophenotyping, procedure, and prognosis following modified Sistrunk’s procedure. This study aimed to address these gaps by analyzing and summarizing the clinical features of 5 cases of papillary carcinoma arising in thyroglossal duct cysts (TGDC).

Five patients with papillary carcinoma in TGDC treated by modified Sistrunk’s procedure were included. Their clinical manifestation, physical examination findings, iconography, pathological findings, treatment, and outcomes were analyzed in aiding the diagnosis and treatment of TGDCCa. Immunohistochemistry was used to confirm the papillary carcinoma subtype. The BRAFV600E mutation was detected in 2 patients. No evidence of cancer recurrence, distant metastases, and malignant changes in the thyroid was found after a mean follow-up of 29.8 months.

The management of TGDCCa with papillary carcinoma in low-risk patients can be accomplished by performing a modified Sistrunk’s procedure along with a regular follow-up imaging of the thyroid and neck. Although postoperative pathological diagnosis is the gold standard for diagnosis, it is equally crucial to comprehend the clinical manifestations and auxiliary diagnostic techniques before surgical intervention.
Are Big Ponds Better? How Local Labor Markets Moderate Compensation Comparison Effects on TMT Turnover
Authors: Andrus Joel L. , Lee Jieun , Hom Peter W.
Published: September 2023

We formulate and test a theory explaining how local labor markets moderate the effects of pay comparisons on turnover among non-CEO top management team (TMT) members. Sampling S&P 1500 TMT members, we find that dense local labor markets for executives weaken the effects of social comparisons and CEO tournaments on TMT member turnover by providing more job alternatives and decreasing switching costs. We also find that pay comparisons with other TMT members in the local area are most salient in dense labor markets, increasing higher-paid TMT members’ labor market visibility (signaling their worth externally) and their subsequent turnover. Our theory and findings thus identify local labor markets as a highly relevant boundary condition for TMT turnover decisions, as TMT members more readily quit when residing in communities where jobs are plentiful and offer higher pay than their current employment.
Nationalization of State Legislative Elections: Evidence From the Minnesota State Senate
Authors: Lynch Timothy
Published: September 2023

This investigation explores the evolution of the relationship between national and local factors in Minnesota’s state legislative elections. Correlations demonstrate a growing connection between presidential and state legislative results between 1992 and 2020. Further, the findings reveal that national factors have exercised an outsized influence on State Senate election results in recent years, even when the strongest rival explanations are included in the analysis. In fact, when presidential vote and previous vote for a State Senate seat are assessed alongside incumbency and campaign spending in the 2020 election, presidential vote demonstrates the strongest influence on outcomes, while incumbency and candidate spending show negligible effects. The findings suggest that national factors thoroughly dominate state legislative elections. This has implications for policy responsiveness and raises the specter that the mismatch between a federal system and nationalized politics may prove unsustainable.
The Major Characteristics and Trends of Gifted Education Doctoral Dissertation Research From 2006 Through 2016
Authors: Lee Hyeseong , Gentry Marcia
Published: September 2023

This study features a content analysis of gifted education doctoral dissertation studies from 2006 through 2016 ( n = 683) to identify the characteristics and shifts of the field. The major topics of the studies were categorized into the National Association for Gifted Children’s 16 networks and compared with the future directions suggested by the State of the States in Gifted Education report to locate the gaps between research and practical needs. The findings of this study not only outline gifted education’s significant features and trends but also provide an understanding of the evolving nature and insights of the field such as research methods, data sources, study participants, and journal publication rates.
Working Across Boundaries: School Leaders Redefining Communities of Practice Through Twitter
Authors: Bailey Jennifer , Kaiser Forrest , Rhone Ron , Atchley Stephanie
Published: September 2023

Attrition rates among school leaders have risen in recent years, and scholars cite a lack of meaningful connections and responsive professional learning as leading reasons why they are leaving the field. School leaders are called to navigate unfamiliar and complex challenges, often working in isolation with limited opportunities for collaboration and professional growth. Social media forums, like Twitter, have potential to support a Community of Practice to facilitate learning around school leadership; however, there is a lack of scholarship exploring how school leaders use social media to support their needs. This mixed-methods study used sentiment and content analysis along with a phronetic iterative approach to explore how school leaders use Twitter to connect with others in the field. The umbrella categories of efficacy, agency, and resiliency emerged from the analysis, offering a glimpse into potential connections made through social media. The findings of this exploratory study suggest that principals are seeking connection, encouragement, and professional learning, yet further development in this area could help inform more formal practices to fill the gap in access to informal professional learning.
Anemia in female adolescents at Karanganyar regency: A cross-sectional study associated with polymorphism of duodenal cytochrome B gene and daily consumptions of fruits and vegetables
Authors: Ilmiyati Liyana , Indarto Dono , Wasita Brian
Published: September 2023

Background

The prevalence of anemia in female adolescents increases every year. A duodenal Cytochrome B ( CYBRD1) enzyme is involved in the regulation of iron metabolism. G797A gene polymorphism of the CYBRD1 reduces nonheme iron transport into the enterocytes, which was mediated by the divalent metal transporter 1 protein. Daily consumption of fruits and vegetables has been recommended for the prevention of non- communicable diseases, including anemia.

Aim

This study aimed to analyze the association of CYBRD1 polymorphism and daily consumption of fruits and vegetables with anemia in female adolescents in the Karanganyar regency.

Methods

This cross-sectional study recruited 233 female students in 6 senior and vocational high schools in Karanganyar regency, which were selected using purposive sampling. Data on fruit and vegetable consumption were collected using Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ). Polymorphism of the G797A CYBRD1 gene was determined using the amplification refractory mutation system polymerase chain reaction. All collected data were analyzed using chi-square and multiple logistic regression tests with p < 0.05.

Results

Anemia was found in 13.73% of female students. Inadequate intakes of fruits and vegetables were found in 63.09 and 51.07% of female students, respectively. The AA genotype (OR =  5.779; 95%CI: 0.974–34.289; p = 0.053), inadequate fruit consumption (OR = 1.497; 95%CI: 0.603–3.718; p = 0.133), and inadequate vegetable consumption (OR =  11.99; 95%CI: 3.457–41.586; p < 0.001) increased higher risk of anemia, compared with their counterparts.

Conclusions

G797A CYBRD1 gene polymorphism and daily consumption of vegetables increase the risk of anemia but not for daily consumption of fruits in female adolescents in the Karanganyar regency.
A constant threat? A narrative exploration of the relationship between benefit receipt, mental distress and the threat of homelessness
Authors: JORDAN UISCE , SAGE DANIEL
Published: September 2023

Resistance to housing and welfare reforms on economic, ‘practical’ grounds was shattered by the covid-19 pandemic, which demonstrated that where there is a will there is a way when it comes to providing housing. Despite a purported ‘right’ to adequate housing, many people in the UK face profound challenges accessing stable accommodation. Drawing from a biographical-narrative study, this article details experiences of men who have the right to adequate housing denied and thus experience housing insecurity. Subsequently, it explores how such insecurity exacerbates pre-existing mental health problems. The core argument of the article is that welfare reforms produced the sense of a constant threat of homelessness and destitution for the 17 male participants in the study who claimed sickness benefits. This sense of constant threat manifested itself through (a) the production of present homelessness at the time of the research and (b) and underlying anxiety, fear and threat of homelessness. The article contends that the UK social security system perpetuates the structural and emotional drivers of mental distress, creating a deleterious cycle of poverty, insecurity and ill-health, concluding that the provision of stable housing is an upstream intervention to improve mental health and reduce social exclusion.
Prevalence of burnout among perfusionists in China: A nationwide survey
Authors: Hao Xing , Hu Yao , Shao Chengcheng , Wang Xiaomeng , Li Chenglong , Wang Hong , Hei Feilong , Li Xin , Liu Bin , Zhang Xiaohua , Jin Zhenxiao , Wang Wei , Liu Yan , Wu Ting , Yang Feng
Published: September 2023

Background

Burnout has gained increasing attention worldwide as a phenomenon that affects health care professionals. However, there is a lack of relevant research about its impact on practitioners in the field of cardiovascular perfusion in China. This study investigated the prevalence of and the factors associated with the burnout affecting perfusionists in mainland China.

Methods

This national cross-sectional study included perfusionists from 31 provinces in mainland China. Participants were asked to complete a self-administered questionnaire, which included three parts: (1) demographic information, (2) work-related information, and (3) dissatisfaction with work and sources of pressure. The levels of burnout were calculated, and logistic regression was used to analyze the factors associated with burnout.

Results

The questionnaire, created by the survey program “Questionnaire Star”, was sent to 2211 perfusionists in mainland China. A final sample of 1813 perfusionists participated in the survey, with a participation rate of 82.0% (1813/2211). The prevalence of burnout and severe burnout was 86.0% (1559/1813, 95%CI: 84.3%-87.5%) and 13.3% (241/1813, 95%CI: 11.8%-15.0%), respectively. The logistic regression analysis revealed that age [20-29 years, odds ratio (OR) = 1; 30-39 years, OR = 2.009; 40-49 years, OR = 2.220], educational background (bachelor and below, OR = 1; postgraduate, OR = 1.472), and professional background (others, OR = 1; surgery, OR = 1.283; anesthesiology, OR = 2.004) were associated with burnout. We also found that age (20-29 years, OR = 1; 30-39 years, OR = 1.928), professional background (others, OR = 1; surgery, OR = 1.734; anesthesiology, OR = 2.257), annual cardiopulmonary bypass (CPB) case load in the most recent 3 years (< 50, OR = 1; 50-100, OR = 1.613; 100-300, OR = 1.702; ≥300, OR = 2.637), and income level [< 5000 (RMB/month), OR = 1; 5000-10,000, OR = 0.587; 10,000-20,000, OR = 0.366] were associated with severe burnout among perfusionists.

Conclusions

Cardiovascular perfusionists in mainland China experience high rates of burnout. Age, the professional background, annual CPB caseload in the most recent 3 years, and income level are independently associated with the burnout rates experienced by these health care professionals.
Implications of pediatric extracorporeal cardiopulmonary resuscitation simulation for intensive care team confidence and coordination: A pilot study
Authors: Akinpelu Toluwani , Shah Nikhil R. , Weaver Karen , Muller Nicole , McElroy James , Bhalala Utpal S
Published: September 2023

Introduction

Extracorporeal cardiopulmonary resuscitation (ECPR) is associated with improved outcomes in select populations, however, crisis resource management (CRM) in this setting is logistically challenging. This study evaluates the impact of ECPR simulation on self-perceived confidence and collaboration of intensive care unit team members.

Methods

This is a prospective observational study analyzing data obtained between July 2018–December 2019. This study focused on non-surgical members of critical care team consisting of pediatric intensivists, resident physicians, registered nurses, respiratory therapists. Participants were expected to perform cardiopulmonary resuscitation (CPR) during the ECPR event, participate in code-team responsibilities and provide ancillary support during cannulation. Pre- and post-simulation surveys employed the Likert scale (1 = not at all confident, 5 = highly confident) to assess self-perceived scores in specified clinical competencies.

Results

Twenty-nine providers participated in the simulation; 38% had prior ECPR experience. Compared to mean pre-study Likert scores (2.4, 2.4, 2.5), post-simulation scores increased (4.2, 4.4, 4.3) when self-evaluating: confidence in assessing patients needing ECPR, confidence in participating in ECPR workflow and confidence in performing high-quality CPR, respectively. Post-simulation values of >3 were reported by 100% of participants in all domains ( p < .0001). All participants indicated the clinical scenario and procedural environment to be realistic and appropriately reflective of situational stress. Additionally, 100% of participants reported the simulation to improve perceived team communication and teamwork skills.

Conclusion

This study demonstrated preliminary feasibility of pediatric ECPR simulation in enhancing independent provider confidence and team communication. This self-perceived improvement may establish a foundation for cohesive CRM, in preparation for a real life ECPR encounter.
Evaluation of late gadolinium enhancement cardiac MRI using deep learning reconstruction
Authors: Yang Jing , Wang Feng , Wang Zhirong , Zhang Wei , Xie Lizhi , Wang LiXin
Published: September 2023

Background

Deep learning (DL)-based methods have been used to improve the imaging quality of magnetic resonance imaging (MRI) by denoising.

Purpose

To assess the effects of DL-based MR reconstruction (DLR) method on late gadolinium enhancement (LGE) image quality.

Material and Methods

A total of 85 patients who underwent cardiovascular magnetic resonance (CMR) examination, including LGE imaging using conventional construction and DLR with varying levels of noise reduction (NR) levels, were included. Both magnitude LGE (MLGE) and phase-sensitive LGE (PSLGE) images were reviewed independently by double-blinded observers who used a 5-point Likert scale for multiple measures regarding image quality. Meanwhile, the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and edge sharpness of images were calculated and compared between conventional LGE imaging and DLR LGE imaging.

Results

Both MLGE and PSLGE with DLR at 50% and 75% noise reduction levels received significantly higher scores than conventional imaging for overall imaging quality (all P < 0.01). In addition, the SNR, CNR, and edge sharpness of all DLR LGE imaging are higher than conventional imaging (all P < 0.01). The highest subjective score and best image quality is obtained when the DLR noise reduction level is at 75%.

Conclusion

DLR reduced image noise while improving image contrast and sharpness in the cardiovascular LGE imaging.
Acute multifocal osteomyelitis with septic arthritis caused by nontyphoidal Salmonella in an immunocompetent young adult: a case report
Authors: Jiang Boyi , Xu Hong , Zhou Zongke
Published: September 2023

Nontyphoidal Salmonella (NTS) infection can lead to gastroenteritis, enteric fever, and bacteremia. However, bone and joint infections due to NTS are rarely encountered, accounting for only 0.8% of all Salmonella infections and 0.45% of all types of osteomyelitis. We herein report an extremely rare case of acute multifocal osteomyelitis (bilateral femurs and left tibia) with septic arthritis of the bilateral hips caused by Salmonella Dublin in an immunocompetent adult. We performed thorough debridement of the bilateral hips and surgical decompression of the involved bones. At 1 year of follow-up, the patient’s inflammatory biomarkers were within normal limits, and clinical and radiologic examinations showed no signs of infection. We emphasize that invasive NTS can lead to multifocal bone and joint infections in immunocompetent adults. The manifestations of Salmonella osteomyelitis may be insidious; thus, we recommend performing a simultaneous magnetic resonance imaging examination of the bone adjacent to the infected joint to avoid missed or delayed diagnosis. Thorough surgical debridement combined with a long course of sensitive antibiotic therapy is essential to eradicate the infection.
A case report of superficial siderosis of the central nervous system and literature review
Authors: Huang Jian , Xie Gaosheng , Chen Jianping , Huang Ying
Published: September 2023

Superficial siderosis of the central nervous system (SSCNS) is a rare disease characterized by iron deposition on the tissue surface of the middle axis system. We report the case of a man in his late 40 s who was admitted to the hospital with ataxia. A physical examination revealed cerebellar ataxia, sensorineural deafness, and bilateral pyramidal tract injury. Susceptibility-weighted magnetic resonance imaging showed linear hypointense signals on the surface of the cerebral hemispheres, sulcus gyrus, lateral ventricles, and cerebellum. The patient underwent treatment with deferiprone, mecobalamin, and vitamin B1, and the symptoms were not aggravated. The patient’s daily living ability was near normal after 1 year of follow-up. A literature review indicated that most SSCNS patients present diverse clinical manifestations. Clinicians may consider SSCNS in patients with hearing impairment and gait ataxia, especially for those receiving anticoagulant therapy and with a history of brain injury or accident.
Multiple organ dysfunction after mitral valve replacement in a patient with systemic lupus erythematosus complicated by Libman–Sacks endocarditis: a case report and literature review
Authors: Wu Bo Lan , Hu Yang , Luo Xiang Jun , Lei Xiang Li , Gan Yan Qing , Zhu Zi Gui , Yao Hong Yi , Zhang Yi
Published: September 2023

This case report describes a 47-year-old woman with systemic lupus erythematosus (SLE) complicated by Libman–Sacks endocarditis (LSE) who developed multiple organ dysfunction after mitral valve replacement surgery. The patient presented with a 5-day history of cough, sputum, and fever. Transthoracic echocardiography showed significant vegetations on the mitral valve. Biopsy was performed, and the pathological diagnosis was SLE complicated by LSE. After the mitral valve replacement surgery, the patient developed clinical manifestations of hepatic and renal dysfunction, cardiopulmonary failure, oliguria, and shock. The clinical symptoms significantly improved after administration of mechanical ventilation, continuous renal replacement therapy, plasma exchange, anti-inflammatory and anti-infection treatments, immunomodulatory and immunosuppressive therapies, and low-molecular-weight heparin anticoagulation. Multiple organ dysfunction after mitral valve replacement in patients with SLE complicated by LSE has rarely been reported. This report discusses the clinical manifestations, pathogenesis, and treatment of this severe complication. We hope the sharing of our experience in this case will provide a clinical basis for the treatment of severe multiple organ dysfunction after mitral valve replacement in patients with SLE complicated by LSE.
The clinical and pathological significance of increased expression of the cannabinoid receptors CB-1R and CB-2R in patients with papillary thyroid carcinomas compared to benign thyroid lesions
Authors: Doyuran Damla Zeynep , Eronat Ömer
Published: September 2023

Introduction

Papillary thyroid carcinoma is the most common malignancy of the endocrine system. Most papillary thyroid carcinoma patients enjoy excellent outcomes. However, in patients with biologically aggressive features, additional prognostic and predictive data may aid disease management. Dysregulation of the endocannabinoid system including the cannabinoid receptors 1 and 2 (CB-1R and CB-2R) during carcinogenesis has been extensively studied over the last few decades. The aim of this study was to evaluate immunohistochemically the expression levels of both receptors in patients with papillary thyroid carcinoma and benign diseases, and to compare these rates and the histopathologically and clinically prognostic features.

Methods

The pathological materials and clinical data of 100 patients with papillary thyroid carcinoma and 40 with benign diseases were retrospectively re-evaluated. All tissues were immunohistochemically stained for CB-1R and CB-2R. The expression levels of CB-1R and CB-2R in papillary thyroid carcinomas, and benign lesions were recorded and compared with the pathological and clinical features.

Results

The expression levels of both receptors were significantly higher in papillary thyroid carcinoma patients than in those with benign conditions ( P = 0.001). CB-1R expression correlated with both extrathyroidal extension ( P = 0.022) and capsular invasion ( P = 0.001). CB-2R expression was associated with the risk group of the American Thyroid Association stratification system ( P = 0.004).

Conclusion

Our study suggests that increased cannabinoid receptor expression contributes to thyroid carcinogenesis. The CB-2R expression level could provide additional information aiding risk management. Furthermore, the CB-1R and CB-2R antibodies might increase the accuracy of papillary thyroid carcinoma diagnosis when combined with the papillary thyroid carcinoma biomarkers assayed after fine-needle aspiration of neoplastic cells.
Electro-mechanical behavior of self-sensing textile-reinforced composites for in situ structural health monitoring
Authors: Singh Sudhanshu , Kamble Zunjarrao , Neje Ghanshyam
Published: September 2023

Advanced engineering materials like glass fabric-reinforced composites (GFRC) are frequently utilized in automotive components, civil structures, aviation sectors, etc. Contrary to metals, the anisotropic nature of composites makes it difficult to forecast damage and failure under real-time loads. GFRC is employed in this work to demonstrate structural health monitoring (SHM) using a reduced graphene oxide (rGO) coated glass fabric piezo-resistive sensor. The sensor was embedded in the GFRC composite to detect changes in the fractional electrical resistance under flexural strain. The developed composite specimens were subjected to three-point bending to examine the piezo-resistive performance. Throughout testing, the effect of sensor width and relative positions in the thickness direction within the composite specimen on strain and damage detection was assessed. The results of the tests revealed that these parameters were responsively associated with the piezo-resistance of the developed sensor. This study concluded that the developed piezo-resistive sensor has the potential to be used as a strain and damage detection mechanism for glass fabric-reinforced composite structures for disparate applications.
Association Between Opioid Dose Reduction Rates and Overdose Among Patients Prescribed Long-Term Opioid Therapy
Authors: Glanz Jason M. , Xu Stanley , Narwaney Komal J. , McClure David L. , Rinehart Deborah J. , Ford Morgan A. , Nguyen Anh P. , Binswanger Ingrid A.
Published: September 2023

Background:

Tapering long-term opioid therapy is an increasingly common practice, yet rapid opioid dose reductions may increase the risk of overdose. The objective of this study was to compare overdose risk following opioid dose reduction rates of ≤10%, 11% to 20%, 21% to 30%, and >30% per month to stable dosing.

Methods:

We conducted a retrospective cohort study in three health systems in Colorado and Wisconsin. Participants were patients ≥18 years of age prescribed long-term opioid therapy between January 1, 2006, and June 30, 2019. Five opioid dosing patterns and drug overdoses (fatal and nonfatal) were identified using electronic health records, pharmacy records, and the National Death Index. Cox proportional hazard regression was conducted on a propensity score-weighted cohort to estimate adjusted hazard ratios (aHRs) for follow-up periods of 1, 3, 6, 9, and 12 months after a dose reduction.

Results:

In a cohort of 17 540 patients receiving long-term opioid therapy, 42.7% of patients experienced a dose reduction. Relative to stable dosing, a dose reduction rate of >30% was associated with an increased risk of overdose and the aHR estimates decreased as the follow-up increased; the aHRs for the 1-, 6- and 12-month follow-ups were 5.33 (95% CI, 1.98-14.34), 1.81 (95% CI,1.08-3.03), and 1.49 (95% CI, 0.97-2.27), respectively. The slower tapering rates were not associated with overdose risk.

Conclusions:

Patients receiving long-term opioid therapy exposed to dose reduction rates of >30% per month had increased overdose risk relative to patients exposed to stable dosing. Results support the use of slow dose reductions to minimize the risk of overdose.
Competency Based Education Pilot in Illinois: Preliminary Findings
Authors: Blankenberger Bob , Kerr Rob , Dooley Ty
Published: September 2023

In this study we employed regression analysis and between-group matched pair design to analyze whether participation in a competency-based education pilot was associated with improved high school completion and postsecondary entry. Data were obtained for high schools participating in a CBE pilot program in Illinois. Results of the matched pair design showed that CBE participation was significantly associated with higher rates of high school graduation for seniors across all groups with differences significant overall (97.2% for CBE vs. 93.1% for non-CBE), for White students (97.2% vs. 92.7%), and for students eligible for Free and Reduced Lunch (96.3% vs. 90.3%). Graduation rate for seniors was also higher for African American students and for Hispanic-Latinx students, but the differences were not statistically significant. In the matched pair design, CBE participation was not significantly associated with entry into college within 12 months of high school.
Justice starts at home: A call for stepped-up nationally-led investigations into torture
Authors: Edwards Alice Jill
Published: September 2023

In my role as the UN's lead expert on tackling torture I see the scale and extent of torture crimes being perpetrated by – and being ignored by – States every day, and everywhere. It is my opinion that only through national prosecutions can the cycle of impunity – the antithesis of accountable government – be broken. For too long, the burden of achieving justice has been pushed onto overloaded and inherently limited international courts and tribunals, even as they play an important role (and sometimes are the only acceptable actor). In this column I make the case why national prosecutions are so important and how they can be achieved.
Alternative dolutegravir dosing strategies with concurrent rifapentine utilized for latent tuberculosis treatment
Authors: Taylor Addison , Winthrop Elizabeth , Pecora Fulco Patricia
Published: September 2023

We present a case of a 53-year-old person living with human immunodeficiency virus and a new diagnosis of latent tuberculosis. The patient had baseline suppressed HIV viral load on fixed dose combination dolutegravir/abacavir/lamivudine when once-weekly rifapentine 900 mg/isoniazid 900 mg/pyridoxine 25 mg was initiated for 12 weeks. An additional 50 mg dolutegravir dose, administered in the evenings, was added to the daily antiretroviral regimen for treatment duration secondary to rifapentine uridine diphosphate glucuronsyl transferase induction. Dolutegravir trough concentrations decreased during concurrent therapy with noted slight HIV viral load rebound. Upon completion of rifapentine use, and a return to dolutegravir 50 mg daily dose, the trough concentrations increased with a return to an undetectable viral load. We provide suggested dolutegravir dosing considerations with concomitant rifapentine use, not currently addressed in recommended guidelines.
Measuring Indoor Air Quality Does Not Prevent COVID-19
Authors: Pechter Elise , Lessin Nancy
Published: September 2023

Boston Public Schools (BPS) closed for in-person learning in March 2020 due to COVID-19 and didn't fully reopen until the 2021–2022 school year. Due to the age of schools and absent ventilation systems, coupled with decades of disinvestment in the infrastructure, BPS entered the pandemic with serious challenges impacting the health of students and staff. These challenges were magnified by an infectious airborne virus. Instead of using this opportunity to improve ventilation systems, BPS opted to invest in an air quality monitoring system. This system only confirmed what was already known—there is poor ventilation in most school buildings. It did not lead to correction of new or long-standing problems. This failure has harmed the BPS community, which includes primarily low-income Black and Brown families. This article describes Boston's school system, its track record of inadequate attention to infrastructure, and explores pitfalls of focusing on evaluation instead of correction.
Eleology‐ A Modest Proposal
Authors: Knisley Caleb , Baumrucker Steven J.
Published: September 2023

A proposal to create a new name for our specialty: Eleology.
Improving Dementia Caregiver Activation With a Brief Communication Module
Authors: Wittenberg Elaine , Sullivan Suzanne S. , Rios Melissa
Published: September 2023

Objective: Palliative care often plays a pivotal role in supporting informal caregivers of persons living with dementia who experience a lack of continuity in care. Dementia caregiver activation, the caregiver’s willingness and ability to navigate care needs, requires communication skills for developing relationships with healthcare providers. Communication activation is important because caregivers facilitate physician and patient information exchange. This study aimed to explore changes in communication outcomes (attitude, knowledge, and skills) and impact on caregiver communication activation (confidence, self-report) following completion of a brief communication module. Methods: A 15-minute asynchronous online module was developed to provide caregivers with communication skills for working with doctors and nurses. Caregivers completed pre/post module measures of communication outcomes, a vignette for applying communication strategies and were interviewed within a week of module completion to assess self-reported communication activation. Module acceptability was also evaluated. Results: Communication knowledge ( P < .01) significantly increased and nearly all participants (99%) demonstrated use of module-specific communication skills after completing the module. While not statistically significant, caregiver attitudes were in the expected direction. Caregiver self-reported communication confidence ( P < .001) significantly increased and 84% of caregivers described communication activation at post-module. Caregivers (83%) were likely to recommend the module. Conclusions: The brief communication module for dementia caregivers in this project offers an online resource with low time-burden that results in caregiver communication activation. Future testing in the clinical setting will increase understanding of its efficacy and integration and could be a viable resource for palliative care providers.
CYP3A5 Genotype-Dependent Drug-Drug Interaction Between Tacrolimus and Voriconazole in Chinese Kidney Transplant Patients
Authors: Zhang Yundi , Du Yue , Ren Shuyu , Li Yue , Zhang Xiaoming , Cao Xiaohong , Liu Fengxi , Zong Huiying , Li Yan
Published: September 2023

Background:

The effect of drug-drug interaction (DDI) between tacrolimus and voriconazole on the pharmacokinetics of tacrolimus in different CYP3A5 genotypes has not been reported in previous studies.

Objective:

The objective of this study was to investigate whether CYP3A5 genotype could influence tacrolimus-voriconazole DDI in Chinese kidney transplant patients.

Methods:

All kidney transplant patients were divided into combination and non-combination groups based on whether tacrolimus was combined with or without voriconazole. Each group was subdivided into CYP3A5 expresser ( CYP3A5*1/*1 or CYP3A5*1/*3) and CYP3A5 nonexpresser ( CYP3A5*3/*3). A retrospective analysis compared tacrolimus dose (D)-corrected trough concentrations (C0) (C0/D) between combination and non-combination groups, respectively. Tacrolimus C0/D was also compared between CYP3A5 expresser and nonexpresser in both groups.

Results:

The C0/D values of tacrolimus were significantly different between CYP3A5 expresser and nonexpresser in combination group (378.20 [219.38, 633.48] ng/mL/[mg/kg/d] vs 720.00 [595.35, 1681.50] ng/mL/[mg/kg/d], P = 0.0010). Either in C YP3A5 expresser or nonexpresser, we found a statistically significant difference in tacrolimus C0/D between combination and non-combination group ( P < 0.0001). The increase in CYP3A5 nonexpresser was 1.38 times higher than that in CYP3A5 expresser (320.93% vs 232.19%).

Conclusion and Relevance:

The median C0/D values were 90.38% higher in kidney transplant recipients with CYP3A5*3/*3 genotype than in those with CYP3A5*1/*1 or CYP3A5*1/*3 genotype when treated with both tacrolimus and voriconazole. A CYP3A5 genotype-dependent DDI was found between tacrolimus and voriconazole. Therefore, personalized therapy accounting for CYP3A5 genotype detection and therapeutic drug monitoring is necessary for kidney transplant patients when treating with tacrolimus and voriconazole.
Florida-California Cancer Research, Education and Engagement (CaRE2) Health Equity Center: Structure, Innovations, and Initial Outcomes
Authors: Reams R. Renee , Odedina Folakemi T. , Carpten John D. , Redda Kinfe , Stern Mariana C. , Krieger Janice L. , Aparicio Jose , Hensel Brooke , Askins Nissa , Abreu Andre , Adams Angela , Agyare Edward , Ali Jamel , Allen John M. , Aló Richard , Baezconde-Garbanati Lourdes , Brant Jason , Brown Clyde P. , Buxbaum Sarah G. , Cohen Pinchas , Cozen Wendy , Ezenwa Miriam O. , Falzarano Sara , Fillingim Roger B. , Flores-Rozas Hernan , Fredenburg Kristianna M. , George Thomas , Han Bo , Huang Yong , Hughes Halbert Chanita , Kiros Gebre-Egziabher , Lamango Nazarius S. , Lee Ji-Hyun , Lyon Debra E. , Mitchell Duane A. , Mochona Bereket , Nieva Jorge J. , Offringa Ite A. , Okunieff Paul , Parker Alexander , Rhie Suhn K. , Richey Joyce M. , Rogers Sherise C. , Salhia Bodour , Schmittgen Thomas D. , Segal Richard , Setiawan Veronica W. , Smith Ukamaka , Su Li-Ming , Suther Sandra , Trevino Jose , Velazquez-Villarreal Enrique I. , Webb Fern J. , Wu Anna H. , Yao Yingwei , Wilkie Diana J.
Published: September 2023

Introduction

The Florida-California Cancer Research, Education, and Engagement (CaRE2) Health Equity Center is a triad partnership committed to increasing institutional capacity for cancer disparity research, the diversity of the cancer workforce, and community empowerment. This article provides an overview of the structure, process innovations, and initial outcomes from the first 4 years of the CaRE2 triad partnership.

Methods

CaRE2 serves diverse populations in Florida and California using a “molecule to the community and back” model. We prioritize research on the complex intersection of biological, environmental, and social determinants health, working together with scientific and health disparities communities, sharing expertise across institutions, bidirectional training, and community outreach. Partnership progress and outcomes were assessed using mixed methods and four Program Steering Committee meetings.

Results

Research capacity was increased through development of a Living Repository of 81 cancer model systems from minority patients for novel cancer drug development. CaRE2 funded 15 scientific projects resulting in 38 publications. Workforce diversity entailed supporting 94 cancer trainees (92 URM) and 34 ESIs (32 URM) who coauthored 313 CaRE2-related publications and received 48 grants. Community empowerment was promoted via outreaching to more than 3000 individuals, training 145 community cancer advocates (including 28 Community Scientist Advocates), and publishing 10 community reports. CaRE2 members and trainees together have published 639 articles, received 61 grants, and 57 awards.

Conclusion

The CaRE2 partnership has achieved its initial aims. Infrastructure for translational cancer research was expanded at one partner institution, and cancer disparities research was expanded at the two cancer centers.
Victim Notification Protocols for Untested Sexual Assault Kits: Survivors’ and Advocates’ Perspectives on Law Enforcement-Led Outreach Methods
Authors: Campbell Rebecca , Gregory Katie , Goodman-Williams Rachael , Engleton Jasmine , Javorka McKenzie
Published: September 2023

Current estimates suggest there are 300,000–400,000 untested sexual assault kits (SAKs) in police department storage facilities throughout the United States. As these kits are being discovered and then submitted for forensic DNA testing, legal system personnel may recontact victims. These “victim notifications” involve informing survivors their kits were previously untested, sharing the results of new DNA testing, and asking for their engagement in reinvestigating and prosecuting the case. Typically, victim notifications are conducted by police, and survivors are connected with victim advocates soon thereafter. In this study, we interviewed survivors about their experiences of being notified by the police. We also interviewed about their work supporting survivors. Both survivors and advocates expressed strong concerns about police conducting notifications without an advocate present.
Collegiate Dancers With Chronic Ankle Instability Possess Altered Strength and saut de chat Leap Landing Mechanics
Authors: Rice Paige E. , Hill Ryan D. , Messier Stephen P.
Published: September 2023

Introduction:

Ankle sprains are among the most common injuries in dancers. Following one or more severe sprains, some individuals will experience residual mechanical and functional deficits, otherwise known as chronic ankle instability (CAI). Dancers who suffer from CAI may have weaker musculature surrounding the ankle and altered landing mechanics. The purpose of this study was to compare ankle strength and saut de chat landing mechanics between dancers with and without CAI.

Methods:

Dancers with and without CAI, defined by the Identification of Functional Ankle Instability (IdFAI), participated in the study (CAI n = 8; IdFAI = 18.75 ± 5.50 points; age = 20 ± 1.5 years; training = 15.5 ± 3.5 years) (Control n = 8; IdFAI = 7.13 ± 3.40 points; age = 19 ± 0.6 years; training = 15.9 ± 2.5 years). Strength and leap landing mechanics were measured on the affected ankle for the CAI group and on the preferred landing leg of a leap for the control group. Concentric and eccentric ankle plantar flexion, and subtalar inversion and eversion strength were determined with dynamometry set at an angular velocity of 60°•s−1. Force plates and motion capture cameras were used to calculate lower extremity kinematic and kinetic data as participants performed 3 saut de chat leaps. Independent t-tests were calculated to determine differences between groups.

Results:

Compared to dancers without CAI, dancers with CAI had lower eccentric plantar flexor strength, landed with higher vertical ground reaction forces, and absorbed greater power at the knee-joint during landing.

Conclusion:

Whether dancers who are weaker are more prone to injury or ankle-joint injury leads to muscular weakness is unknown. Dancers with CAI appear to lack control during leap landing while concomitantly shifting loads proximally away from the ankle-joint. We encourage dancers with and without CAI to engage in additional training that enhances ankle strength.
Expert consensus on the management of patients undergoing cataract surgery: A Delphi study
Authors: Orfeo Vincenzo , Aragona Pasquale , Alessio Giovanni , Drago Lorenzo , Mastropasqua Leonardo , Rossi Scipione , Vinciguerra Paolo , Ciprandi Giorgio , Tognetto Daniele
Published: September 2023

Purpose

To define the management of patients undergoing cataract surgery.

Setting

Panel of experts on cataract surgery and members of the Italian Association of Cataract and Refractive Surgery (AICCER) participated in the Delphi study.

Design

A restricted panel of experts defined the statements concerning the topic and identified a larger panel of experts who voted the statements. The statements concerned a series of practical issues concerning the management of patients undergoing cataract surgery.

Methods

An initial web round-table served to develop the statements. The larger panel was constituted by 15 experts which anonymously voted the statements, presented in a web platform, using a 5- point Likert scale. Consensus was defined as at least 80% of agreement.

Results

All participants completed the questionnaire. Globally, the total percentage of agreement of all statements was 90.4%. The total mean score was 4.5. Score 4 and score 5 accounted for the 27% and the 68% of the total votes, respectively.

Conclusions

The participants felt they could largely agree with and approve the statements proposed by the board. In addition, the Delphi study identified some points that are highly shared and endorsed. In particular, a new model approach can be based on a seven-day course using a fixed high-potency corticosteroid combination with a broad-spectrum antibiotic. At the end of this cycle, the patient should be re-evaluated in some way to continue any treatment in the most appropriate and personalized way possible.
Clinical outcomes for femoral tunneled-cuffed hemodialysis catheters with different tip positions: A single-center retrospective study
Authors: Wu Sudan , Zhang Lifeng , Wang Qiqi , Wei Haijun , Zheng Siwei , Huang Dan , Ni Jie , Liu Yang
Published: September 2023

Background:

Tunneled-cuffed catheter (TCC) reaching the mid-atrium has been demonstrated to be associated with improved catheter survival. However, whether similar conclusions can be made for femoral TCC reaching the inferior vena cava (IVC) remains unknown.

Methods:

Data from 47 patients with end-stage renal disease receiving right femoral TCC were retrospectively collected and analyzed. The primary patency, catheter dysfunction, and TCC-associated infection rate were compared between patients with TCC tip at the IVC and those with TCC tip at non-IVC.

Results:

TCC tips were located at the IVC in 26 patients and non-IVC in 21 patients. The technical success rates for both groups were 100%. The primary patency of the former group were significantly higher than those of the latter group at 3 months (92.3% vs 61.9%, p = 0.011), 6 months (80.8% vs 52.4%, p = 0.017), and 12 months (50.0% vs 28.5%, p = 0.024) follow-up, respectively. Kaplan-Meier curve analysis demonstrated significantly different catheter dysfunction-free survival between the two groups (log-rank p = 0.017). The overall TCC-associated infection rate was similar between the two groups (7.7% vs 9.5%, p = 0.82).

Conclusion:

Femoral TCC with tips at IVC was associated with higher primary patency, lower catheter dysfunction but similar TCC-associated infection rate as compared with those at non-IVC.
GM-CSF is a marker of compartmentalised intrathecal inflammation in multiple sclerosis
Authors: Martin S-J , Brand-Arzamendi K , Saab G , Muccilli A , Oh J , Schneider R
Published: September 2023

Background:

Granulocyte-macrophage colony stimulating factor (GM-CSF) is a pro-inflammatory cytokine secreted by various immune cells. Several studies have demonstrated an expansion of GM-CSF producing T cells in the blood or CSF of people with MS (pwMS). However, whether this equates to greater concentrations of circulating cytokine remains unknown as quantification is difficult with traditional assays.

Objective:

To determine whether GM-CSF can be quantified and whether GM-CSF levels are elevated in pwMS.

Methods:

We employed Single Molecule Array (Simoa) to measure GM-CSF in both CSF and blood. We then investigated relationships between GM-CSF levels and measures of blood–CSF-barrier integrity.

Results:

GM-CSF was quantifiable in all samples and was significantly higher in the CSF of pwMS compared with controls. No association was found between CSF GM-CSF levels and Q-Albumin – a measure of blood–CSF-barrier integrity. CSF GM-CSF correlated with measures of intrathecal inflammation, and these relationships were greater in primary progressive MS compared with relapsing-remitting MS.

Conclusion:

GM-CSF levels are elevated specifically in the CSF of pwMS. Our results suggest that elevated cytokine levels may reflect (at least partial) intrathecal production, as opposed to simple diffusion across a dysfunctional blood–CSF-barrier.
‘Void’ democrats? The populist notion of ‘democracy’ in action
Authors: Schwörer Jakob , Koß Michael
Published: September 2023

Populism is often seen as a threat to liberal democracy because of its rejection of constitutional constraints and emphasis on popular sovereignty. Others argue that populism is a corrective to mainstream politics and not necessarily anti-democratic. While the relationship between populism and democracy is widely debated in theory and empirically assessed by estimating the effect of populist rule, we analyse discursive references to democracy in election manifestos and tweets of populist radical right (PRRP) and populist radical left (PRLP) parties in seven Western European countries. By mapping populists’ discourses on democracy across electoral, liberal, participatory, deliberative and egalitarian dimensions, we find that PRLP elaborate a more coherent understanding of democracy (especially its participatory and egalitarian dimensions) and do not reject any dimension. PRRP hardly elaborate on any dimension except participation. PRRP appear as ‘void’ democrats with ambivalent and incoherent credentials, which at times reject and instrumentalise democracy.