bluuebunny/crossref_metadata_2025 huggingface dataset:
When Is a Harm a Harm? Discordance between Patient and Medical Experts’ Evaluation of Lung Cancer Screening Attributes
Authors: Schapira Marilyn M. , Rodriguez Keri L. , Chhatre Sumedha , Fraenkel Liana , Bastian Lori A. , Kravetz Jeffrey D. , Asan Onur , Akers Scott , Vachani Anil , Prigge Jason M. , Meline Jessica , Ibarra Jennifer V. , Corn Barbara , Kaminstein Dana
Published: February 2021

Background

A shared decision-making (SDM) process for lung cancer screening (LCS) includes a discussion between clinicians and patients about benefits and potential harms. Expert-driven taxonomies consider mortality reduction a benefit and consider false-positives, incidental findings, overdiagnosis, overtreatment, radiation exposure, and direct and indirect costs of LCS as potential harms.

Objective

To explore whether patients conceptualize the attributes of LCS differently from expert-driven taxonomies.

Design

Cross-sectional study with semistructured interviews and a card-sort activity.

Participants

Twenty-three Veterans receiving primary care at a Veterans Affairs Medical Center, 55 to 73 y of age with 30 or more pack-years of smoking. Sixty-one percent were non-Hispanic African American or Black, 35% were non-Hispanic White, 4% were Hispanic, and 9% were female.

Approach

Semistructured interviews with thematic coding.

Main Measures

The proportion of participants categorizing each attribute as a benefit or harm and emergent themes that informed this categorization.

Key Results

In addition to categorizing reduced lung cancer deaths as a benefit (22/23), most also categorized the following as benefits: routine annual screening (8/9), significant incidental findings (20/23), follow-up in a nodule clinic (20/23), and invasive procedures (16/23). Four attributes were classified by most participants as a harm: false-positive (13/22), overdiagnosis (13/23), overtreatment (6/9), and radiation exposure (20/22). Themes regarding the evaluation of LCS outcomes were 1) the value of knowledge about body and health, 2) anticipated positive and negative emotions, 3) lack of clarity in terminology, 4) underlying beliefs about cancer, and 5) risk assessment and tolerance for uncertainty.

Conclusions

Anticipating discordance between patient- and expert-driven taxonomies of the benefits and harms of LCS can inform the development and interpretation of value elicitation and SDM discussions.
Fear of Crime among Female North Korean Defectors in South Korea
Authors: Choi Jaeyong , Hack Tay , Lee Julak
Published: February 2021

Although some studies have focused on immigrants’ fear of crime in the United States, it is important to point out that the number of North Korean defectors to South Korea has rapidly increased since the 1990s. Therefore, understanding factors associated with fear of crime for North Korean immigrants, especially female defectors, is important for ensuring their successful transitions into South Korean culture. The present study used existing survey data from a sample of female North Korean defectors to explore factors related to fear of crime. Results indicate that the number of North Korean friends, language proficiency, and patriarchal attitudes toward gender were significant predictors of fear of crime for the North Korean female defectors. Findings are described and discussed as a potential source for policymaking to reduce North Korean immigrants’ acculturative stress and fear of crime and to encourage smooth transitions into new cultures.
A Validated, Automated, 3-Dimensional Method to Reliably Measure Tibial Torsion
Authors: Stephen Joanna M. , Teitge Robert A. , Williams Andy , Calder James D.F. , El Daou Hadi
Published: February 2021

Background:

Tibial torsion is a twist in the tibia measured as an angle between a proximal axis line and a distal axis line. Abnormal torsion has been associated with a variety of painful clinical syndromes of the lower limb. Measurements of normal tibial torsion reported by different authors vary by 100% (ranging from 20° to 42°), making it impossible to determine normal and pathological levels.

Purpose:

To address the problem of unreliable measurements, this study was conducted to define an automated, validated computer method to calculate tibial torsion. Reliability was compared with current clinical methods. The difference between measurements of torsion generated from computed tomography (CT) and magnetic resonance imaging (MRI) scans of the same bone, and between males and females, was assessed.

Study Design:

Controlled laboratory study.

Methods:

Previous methods of analyzing tibial torsion were reviewed, and limitations were identified. An automated measurement method to address these limitations was defined. A total of 56 cadaveric and patient tibiae (mean ± SD age, 37 ± 15 years; range, 17-71 years; 28 female) underwent CT scanning, and 3 blinded assessors made torsion measurements by applying 2 current clinical methods and the automated method defined in the present article. Intraclass correlation coefficient (ICC) values were calculated. Further, 12 cadaveric tibiae were scanned by MRI, stripped of tissue, and measured using a structured light (SL) scanner. Differences between torsion values obtained from CT, SL, and MRI scans, and between males and females, were compared using t tests. SPSS was used for all statistical analysis.

Results:

When the automated method was used, the tibiae had a mean external torsion of 29°± 11° (range, 9°-65). Automated torsion assessment had excellent reliability (ICC, 1), whereas current methods had good reliability (ICC, 0.78-0.81). No significant difference was found between the torsion values calculated from SL and CT ( P = .802), SL and MRI ( P = .708), or MRI and CT scans ( P = .826).

Conclusion:

The use of software to automatically perform measurements ensures consistency, time efficiency, validity, and accuracy not possible with manual measurements, which are dependent on assessor experience.

Clinical Relevance:

We recommend that this method be adopted in clinical practice to establish databases of normal and pathological tibial torsion reference values and ultimately guide management of related conditions.
Bridge-Enhanced Anterior Cruciate Ligament Repair Leads to Greater Limb Asymmetry and Less Cartilage Damage Than Untreated ACL Transection or ACL Reconstruction in the Porcine Model
Authors: Karamchedu Naga Padmini , Murray Martha M. , Sieker Jakob T. , Proffen Benedikt L. , Portilla Gabriela , Costa Meggin Q. , Molino Janine , Fleming Braden C.
Published: February 2021

Background:

The extent of posttraumatic osteoarthritis (PTOA) in the porcine anterior cruciate ligament (ACL) transection model is dependent on the surgical treatment selected. In a previous study, animals treated with bridge-enhanced ACL repair using a tissue-engineered implant developed less PTOA than those treated with ACL reconstruction (ACLR). Alterations in gait, including asymmetric weightbearing and shorter stance times, have been noted in clinical studies of subjects with osteoarthritis.

Hypothesis:

Animals receiving a surgical treatment that results in less PTOA (ie, bridge-enhanced ACL repair) would exhibit fewer longitudinal postoperative gait asymmetries over a 1-year period when compared with treatments that result in greater PTOA (ie, ACLR and ACL transection).

Study Design:

Controlled laboratory study.

Methods:

Thirty-six Yucatan minipigs underwent ACL transection and were randomized to receive (1) no further treatment, (2) ACLR, or (3) bridge-enhanced ACL repair. Gait analyses were performed preoperatively, and at 4, 12, 26, and 52 weeks postoperatively. Macroscopic cartilage assessments were performed at 52 weeks.

Results:

Knees treated with bridge-enhanced ACL repair had less macroscopic damage in the medial tibial plateau than those treated with ACLR or ACL transection (adjusted P = .03 for both comparisons). The knees treated with bridge-enhanced ACL repair had greater asymmetry in hindlimb maximum force and impulse loading at 52 weeks than the knees treated with ACL transection (adjusted P < .05 for both comparisons). Although not significant, there was a trend that knees treated with bridge-enhanced ACL repair had greater asymmetry in hindlimb maximum force and impulse loading (adjusted P < .10 for both comparisons) compared with ACLR.

Conclusion:

Contrary to our hypothesis, the surgical treatment resulting in less macroscopic cartilage damage (ie, bridge-enhanced ACL repair) exhibited greater asymmetry in load-related gait parameters than the other surgical groups. This finding suggests that increased offloading of the surgical knee may be associated with a slower rate of PTOA development.

Clinical Relevance:

Less cartilage damage at 52 weeks was found in the surgical group that continued to protect the limb from full body weight during gait. This finding suggests that protection of the knee from maximum stresses may be important in minimizing the development of PTOA in the ACL-injured knee within 1 year.
The 25 Best Books of All Time for Health Promotion Professionals
Authors: Terry Paul E.
Published: February 2021

Best books lists are the ultimate opinion pieces. In this editorial, this journal’s editorial team go out on a big science limb together and proclaim the 25 books relating to the health promotion profession that we consider “must reads.” While several of our selections are standard bearer textbooks that have informed the training of graduates from Schools of Public Health for several decades, many of our best books finalists are best-selling books that have garnered tremendous accolades in the popular press. This best books list for health promotion professionals has been published on publicly accessible blog sites and I invite readers to visit those sites and weigh in with their reactions and recommendations for books that they believe should be included in future lists.
Human Colostrum and Derived Extracellular Vesicles Prevent Infection by Human Rotavirus and Respiratory Syncytial Virus in Vitro
Authors: Civra Andrea , Francese Rachele , Donalisio Manuela , Tonetto Paola , Coscia Alessandra , Sottemano Stefano , Balestrini Raffaella , Faccio Antonella , Cavallarin Laura , Moro Guido E. , Bertino Enrico , Lembo David
Published: February 2021

Background

It is known that breastfeeding protects the infant from enteric and respiratory infections; however, the antiviral properties of human milk against enteric and respiratory viruses are largely unexplored.

Research aims

To explore the antiviral activity of human preterm colostrum against rotavirus and respiratory syncytial virus and to assess whether the derived extracellular vesicle contribute to this activity.

Methods

We used a cross-sectional, prospective two-group non-experimental design. Colostra were collected from mothers of preterm newborns ( N = 10) and extracellular vesicles were purified and characterized. The antiviral activity of colostra and derived extracellular vesicles were tested in vitro against rotavirus and respiratory syncytial virus and the step of viral replication inhibited by extracellular vesicles was investigated.

Results

Each sample of colostrum and colostrum-derived extracellular vesicles had significant antiviral activity with a wide interpersonal variability. Mechanism of action studies demonstrated that extracellular vesicles acted by interfering with the early steps of the viral replicative cycle.

Conclusion

We demonstrated the intrinsic antiviral activity of human colostrum against rotavirus and respiratory syncytial virus and we showed that extracellular vesicles substantially contribute to the overall protective effect. Our results contribute to unravelling novel mechanisms underlying the functional role of human milk as a protective and therapeutic agent in preterm infants.
Negotiating Social Diversity in Residential Care for Older Persons
Authors: Kilaberia Tina R.
Published: February 2021

Studies have long noted challenges of diversity in the workplace. Growing evidence suggests that both the aging population and the workforce needed for health and social care will be more diverse than in previous decades. The confluence of older person and care worker diversity can result in suboptimal care. Drawing on 44 interviews, observations of 62 meetings, and a five-year immersion, this organizational ethnography examines the impact of social diversity at a large, urban, multi-level, residential care organization for older persons. The impact of diversity is delineated on three levels such as among care workers, between care workers and residents, and in terms of personal and organizational responsibility for diversity work. Strengths of diversity are mainly with regard to connectivity between care workers and residents. Diversity challenges include implications for care processes, care workers’ identities, and organizational health.
Autonomous Versus Controlled Motivation on Career Indecision: The Mediating Effect of Career Exploration
Authors: Paixão Olímpio , Gamboa Vítor
Published: February 2021

Effective career decision-making outcomes may depend on the type of motivation underlying career development. The purpose of this study was to analyze how autonomous and controlled motivation predict exploration behaviors and career indecision and in which degree the effect of motivation on indecision is mediated by career exploration (environmental exploration, self-exploration, intended-systematic exploration and amount of information), among a group of high-school students (10th, 11th, and 12th grades, N = 523, M = 16.40). An integrative model was tested using path analysis to test direct and indirect effects and model fit (AMOS 20.0). The final model showed good fit to the data. Three indirect effects were found significant, being self-exploration, and amount of information presented as mediators. Our results highlight the importance to design career interventions not only focusing on promoting exploration behaviors but also on creating purposeful planning, based on students’ reasons underlying their involvement in the career decision-making process.
Schistosomiasis is associated with rectal mucosal inflammation among Kenyan men who have sex with men
Authors: Mehta Supriya D , Okal Duncan , Otieno Fredrick , Green Stefan J , Nordgren Rachel K , Huibner Sanja , Bailey Robert C , Bhaumik Dulal K , Landay Alan , Kaul Rupert
Published: February 2021

Background: Schistosoma mansoni infection is hyperendemic in Lake Victoria communities and associated with cervicovaginal immune alterations and HIV acquisition. We assessed the hypothesis that schistosomiasis correlates with greater rectal inflammation in men who have sex with men (MSM) in Kisumu, Kenya. Methods: In this cross-sectional study of 38 HIV-negative MSM aged 18–35 years, schistosomiasis was diagnosed by urine circulating cathodic antigen (CCA). Microbiome was assessed in rectal swabs by 16S rRNA gene amplicon sequencing, and rectal inflammation by quartile normalized summative score of inflammatory cytokines (IL-1α, IL-1β, IL-8, and TNF-α). Elastic net (EN) regression identified taxa associated with inflammation. Multivariable linear regression estimated the association between inflammation score and schistosomiasis and bacteria identified in EN. Results: Most men were CCA positive (24/38; 63%), and median rectal inflammation score was significantly higher in these participants (11 vs. 8, p = 0.04). In multivariable regression, CCA-positive men had 2.85-point greater inflammation score ( p = 0.009). The relative abundance of Succinivibrio (coefficient = −1.13, p = 0.002) and Pseudomonas (coefficient = −1.04, p = 0.001) were negatively associated with inflammation. Discussion: CCA positivity was associated with rectal mucosal inflammation, controlling for rectal microbiome composition. Given its high prevalence and contribution to inflammation, schistosomiasis may have important implications for HIV transmission in this vulnerable population.
Women and men in the United Nations: A corpus analysis of General Debate addresses
Authors: Brun-Mercer Nicole
Published: February 2021

The United Nations (UN) has demonstrated a commitment to women’s empowerment over seven decades of work. Yet gender inequality pervades in countries around the world and even within the UN. This corpus analysis investigated collocates of woman(’s), women(’s), man(’s) and men(’s) in 193 UN General Assembly General Debate addresses in fall 2015 to examine gender representation by international decision-makers. The analysis revealed that the plural women occurred more frequently than men and primarily in discussions on gender equality and violence. In contrast, the singular man was identified more frequently than woman, in generic use (e.g. mankind) and in references to eminent male leaders. Despite UN dedication to gender equality and linguistic guidelines promoting gender-inclusive language, these General Debate addresses do not conceptualise women and men equally, more frequently referring to women as a group in need of protection and support and to men as political figures and other distinguished individuals.
Fearing the worst yet to come: Derrida and health anxiety
Authors: Kelly Molly
Published: February 2021

Building from the works of Jacques Derrida, this article explores health anxiety’s aporetic relationship with medicine through a deconstructive approach. I argue that attention to Derrida’s writings (and in particular, his readings of pharmakon and autoimmunity) may prove useful in explaining the cyclical character of health anxiety and its ambivalent response to medical reassurance. What’s more, I demonstrate how structuralist interpretations of health anxiety as a signifier without referent prove insufficient within a Derridean account. Such a reading emphasizes the need for interdisciplinary medical humanities as well as critical reflections on the possible limitations of Western medical semiotics.
Bioinformatic analysis of key biomarkers and immune filtration of skin biopsy in discoid lupus erythematosus
Authors: Xiang Mengmeng , Chen Qian , Feng Yang , Wang Yilun , Wang Jie , Liang Jun , Xu Jinhua
Published: February 2021

Objective

Discoid lupus erythematosus (DLE) is the most common category of chronic cutaneous lupus erythematosus, where the pathological process is proved to be closely associated with immunity. This bioinformatic analysis sought to identify key biomarkers and to perform immune infiltration analysis in the skin biopsy samples of DLE.

Methods

GSE120809, GSE100093, GSE72535, GSE81071 were used as the data source of gene expression profiles, altogether containing 79 DLE samples and 47 normal controls (NC). Limma package was applied to identify differentially expressed genes (DEGs) and additional Gene Ontology (GO) together with The Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were done. Protein-protein interaction network (PPI) was constructed using STRING and Cytoscape. Hub genes were selected by CytoHubba. Finally, immune filtration analysis was finished by the CIBERSORT algorithm, and comparisons between the two groups were accomplished.

Results

A total of 391 DEGs were identified, which were composed of 57 up-regulated genes and 334 down-regulated genes. GO and KEGG enrichment analyses revealed that DEGs were closely related with different steps in the immune response. Top 10 hub genes included GBP2, HLA-F, IFIT2, RSAD2, ISG15, IFIT1, IFIT3, MX1, XAF1 and IFI6. Immune filtration analysis from CIBERSORT had found that compared with NC, DLE samples had higher percentages of CD8+ T cells, T cells CD4 memory activated, T cells gamma delta, macrophages M1 and lower percentages of T cells regulatory, macrophages M2, dendritic cells resting, mast cells resting, mast cells activated.

Conclusion

This bioinformatic study selected key biomarkers from the contrast between DLE and NC skin samples and is the first research to analyze immune cell filtration in DLE.
Implications of COVID-19 Pandemic for Health Financing System in Ghana
Authors: Abor Patience Aseweh , Abor Joshua Yindenaba
Published: February 2021

This article examined the impact of the COVID-19 pandemic on the health financing system in Ghana. The COVID-19 pandemic presents two different crises—a health crisis and an economic crisis, and these have implications for the health financing system in Ghana. The pandemic is likely to have adverse effects on the various sources of healthcare financing, including government support, donor support, national health insurance scheme (NHIS) and out-of-pocket payments, which will impact the general delivery of healthcare in the country. Government support to the health sector in general is likely to be rechannelled into fighting the pandemic considering the declining tax and other non-tax revenues as well as huge expenditure commitment. Donor support is also likely to be scaled down and existing funds redirected into dealing with the COVID-19 pandemic. The NHIS will be affected, as many subscribers are not likely to renew their health insurance policies because of the fear of contracting the coronavirus when they visit health facilities. Also, the non-attendance at health facilities by health consumers will impact out-of-pocket payments and the hospitals’ ability to generate sufficient internal resources for their operations. A number of useful recommendations are proffered with the aim of improving health financing system in Ghana during and post-COVID-19 pandemic.
Can Kosovo be considered as a ‘third country’ in the meaning of EU law? Case note to Spain v. Commission
Authors: Challet Celia , Bachelier Pierre
Published: February 2021

The question of the recognition of the independence of Kosovo has been a dividing factor among Member States for more than a decade. Never before, however, had it led to an action for annulment before European courts. In Spain v. Commission, the Kingdom of Spain challenged the validity of a Commission decision providing for the participation of Kosovo’s national regulation authority in the Body of European Regulators for Electronic Communications (BEREC). The General Court ruled that the Commission could consider Kosovo as a third country in order to provide for the participation of its national regulation authority in BEREC. The Commission could also rely on the Stabilisation and Association Agreement concluded between the EU and Kosovo in order to enhance such cooperation. This judgment is of particular importance in terms of both EU-Kosovo relations and participation of third countries in EU agencies.
Trailing Wives and Constrained Agency Among Women Migrant Entrepreneurs: An Intersectional Perspective
Authors: Lassalle Paul , Shaw Eleanor
Published: February 2021

This article applies an intersectional lens to analyze the lived experience of 11 women migrant entrepreneurs based in the UK. We adopt structuration as our ontology to analyze intersectionality in entrepreneurship at the interplay of macro-level structures and micro-level agency, addressing tensions between determinism and subjectivism. Findings show that women migrant entrepreneurs are trailing wives who experience constrained agency which influences their entrepreneurial activities. By highlighting the specific issues faced by entrepreneurs situated at the intersection of the oppressive structures of patriarchy and outsidership, we advance the intersectional agenda in entrepreneurship research and policymaking.
Leaving the Shining City on a Hill: A Plea for Rediscovering Comparative Criminal Justice Policy in the United States
Authors: Corda Alessandro , Hester Rhys
Published: February 2021

Over the past several decades, American penal exceptionalism—the tendency for U.S. penal policies and practices to proudly diverge from those of other Western countries—has severely limited the development of comparative criminal justice research from a U.S. perspective. However, in recent years, a growing consensus that America’s criminal justice policies and practices are too expensive, ineffective, excessively punitive, and often inhumane has laid the ground for a new phase of soul-searching. This article argues for an explicit rediscovering of comparative criminal justice policy in America, which would prove extremely helpful in providing bold yet practicable solutions in the current commendable but unimaginative era of criminal justice reform. We first contend that American exceptionalism is not as embedded in U.S. penal policy and culture as the past few decades might seem to suggest. Second, we discuss the main causes of the gradual demise of the comparative criminal justice enterprise in America. Finally, we discuss two areas of U.S. criminal justice reform suggesting mechanisms of comparative criminal justice policy that should be nurtured: (1) new prison reform initiatives pointing to renewed openness to comparative insights and (2) the growing chorus calling for prosecutorial reform, showing how many of the reform ideas proffered tap into characteristics found in continental systems.
Women Who Have Experienced Pregnancy Loss: Implications for Counseling
Authors: Randolph Amber L. , Swanson Renae , Smith Allyson , Ojeda Katherine
Published: February 2021

The purpose of this research was to explore women’s experiences of pregnancy loss. The following five themes were identified: (a) grief and new emotions, (b) social aspects, (c) meaning making, (d) subsequent pregnancies, and (e) what was and would have been helpful. The results indicate that counselors can be instrumental in the healing of women who have experienced pregnancy loss. Specifically, counselors can help clients communicate effectively with their families, partners, and social networks post-loss.
Role of Adaptive Immune and Impacts of Risk Factors on Adaptive Immune in Alzheimer’s Disease: Are Immunotherapies Effective or Off-Target?
Authors: Shi Mingchao , Chu Fengna , Tian Xiaoping , Aerqin Qiaolifan , Zhu Feiqi , Zhu Jie
Published: February 2021

The pathogenesis of Alzheimer’s disease (AD) is complex. Still it remains unclear, which resulted in all efforts for AD treatments with targeting the pathogenic factors unsuccessful over past decades. It has been evidenced that the innate immune is strongly implicated in the pathogenesis of AD. However, the role of adaptive immune in AD remains mostly unknown and the results obtained were controversial. In the review, we summarized recent studies and showed that the molecular and cellular alterations in AD patients and its animal models involving T cells and B cells as well as immune mediators of adaptive immune occur not only in the peripheral blood but also in the brain and the cerebrospinal fluid. The risk factors that cause AD contribute to AD progress by affecting the adaptive immune, indicating that adaptive immunity proposes a pivotal role in this disease. It may provide a possible basis for applying immunotherapy in AD and further investigates whether the immunotherapies are effective or off-target?
Safety and Effectiveness of an Accelerated Intravenous Iron Administration Protocol in Hospitalized Patients With Heart Failure
Authors: Eche Ifeoma Mary , Owen Kathryn L. , Eche Ijeoma Julie , Patel Parth , Sabe Marwa
Published: February 2021

Background:

The ACC/AHA heart failure (HF) guidelines include a class IIb recommendation for intravenous (IV) iron replacement in patients with iron deficiency and New York Heart Association class II or III to improve functional status and quality of life. Several studies have addressed the use of IV iron formulations such as ferric carboxymaltose or iron sucrose in HF population; however, few studies focused on sodium ferric gluconate complex (SFGC).

Objectives:

To assess the safety and effectiveness of an IV SFGC administration protocol in patients hospitalized with HF.

Methods:

A retrospective cohort study was conducted. We included patients admitted to the HF service from September 2017 to March 2018. The primary outcome was the frequency of adverse reactions. The secondary outcome was the odds of HF readmissions between the 2 groups (IV SFGC vs. control).

Results:

Of the 123 patients, 70 received IV iron (SFGC group) and 53 did not receive IV iron (control group). Five (7%) patients of the 70 in the SFGC group experienced adverse events, which included hypotension (n = 2, 2.8%), fever (n = 2, 2.8%) and myalgia (n = 2, 2.8%). Nine (12.8%) and 18 (25.7%) were readmitted within 30 days and 6 months respectively. In the control arm, 5 (9.4%) and 14 (26.4%) were admitted within 30 days and 6 months respectively. The odds of HF readmission at 30 days [OR 1.4 (95% CI: 0.45, 4.5)] and at 6 months [OR 0.96 (95% CI: 0.43, 2.2)] were similar in those who did not receive IV iron compared to those who received IV iron.

Conclusions:

Sodium ferric gluconate complex given at an accelerated dosing schedule appears to provide a more efficient means to prescribe IV iron in the inpatient setting and is safe with a low frequency of hypotension, fevers, and myalgias.
Family Dynamics and the Alzheimer’s Disease Experience
Authors: Esandi Nuria , Nolan Mike , Canga-Armayor Navidad , Pardavila-Belio M. Idoia , Canga-Armayor Ana
Published: February 2021

Using constructivist grounded theory, this study explored how family groups respond to Alzheimer’s disease in its early stages. Seven family units ( N = 22) participated in a series of 26 longitudinal interviews and 14 other family caregivers took part in three focus groups at a later stage for refinement and verification of the findings. Data analysis revealed four types of family dynamics: close dynamics at the start that were maintained throughout the experience, close dynamics at the start which became conflicting, conflicting dynamics at the start which remained problematic, and conflicting dynamic at the start which became closer over time. Factors such as prior relationships and family history, motivation to care, family organization, communication, and the family vision for future shaped the development of these dynamics. This theory of family dynamics in Alzheimer’s disease has the potential to inform the development of more adequate early interventions for families living with the illness.
Rationale for the Role of Heparin and Related GAG Antithrombotics in COVID-19 Infection
Authors: Magnani Harry N.
Published: February 2021

The SARS-CoV-2 pandemic has focused attention on prevention, restriction and treatment methods that are acceptable worldwide. This means that they should be simple and inexpensive. This review examines the possible role of glycosaminoglycan (GAG) antithrombotics in the treatment of COVID-19. The pathophysiology of this disease reveals a complex interplay between the hemostatic and immune systems that can be readily disrupted by SARS-CoV-2. Some of the GAG antithrombotics also possess immune-modulatory actions and since they are relatively inexpensive they could play an important role in the management of COVID-19 and its complications.
Parameters optimization of series–parallel inerter system with negative stiffness in controlling a single–degree–of–freedom system under base excitation
Authors: Baduidana Marcial , Wang Xiaoran , Kenfack-Jiotsa Aurelien
Published: February 2021

This study proposes a series–parallel inerter system with negative stiffness for the passive vibration control of an undamped single–degree–of–freedom system under base excitation. The necessary and sufficient conditions for stability of series-parallel inerter system with negative stiffness are established by Routh–Hurwitz criterion, and the stability boundary is obtained. The tuning parameters of the series-parallel inerter system with negative stiffness are determined through fixed point theory, and a comparison between the vibration mitigation performance of series-parallel inerter system with negative stiffness, series–parallel inerter system (without negative stiffness), and tuned mass damper is presented considering both harmonic excitation, transient excitation, and random (white noise) excitation. The results of this study demonstrate that under base harmonic excitation, series-parallel inerter system with negative stiffness outperforms the series–parallel inerter system and tuned mass damper in terms of suppression bandwidth and reducing the peak vibration amplitude of the primary mass. In the case of base acceleration–excited primary structure, more than 49.84% and 67.53% improvement can be obtained from series-parallel inerter system with negative stiffness as compared with tuned mass damper in terms of suppression bandwidth and reducing the peak vibration amplitude, respectively. Whereas in the case of base displacement–excited primary structure, more than 78% and 80% improvement can be obtained from series-parallel inerter system with negative stiffness, respectively, following the same criteria. A slightly lower improvement has been obtained from series-parallel inerter system with negative stiffness as compared with series–parallel inerter system, which justified the superiority of series–parallel inerter system compared to tuned mass damper. The transient response investigation showed that series-parallel inerter system with negative stiffness outperforms the series–parallel inerter system and tuned mass damper in terms of much shorter stabilization times and lower peak amplitude of the primary mass. Finally, the further comparison among these devices (series-parallel inerter system with negative stiffness, series–parallel inerter system, and tuned mass damper) under white noise excitation also shows that series-parallel inerter system with negative stiffness is superior to series–parallel inerter system and tuned mass damper for a small inertance mass ratio. This result could provide a theoretical basis for the design of inerter-based isolators with negative stiffness.
Inaccessible rolling bearing diagnosis using a novel criterion for Morlet wavelet optimization
Authors: Behzad Mehdi , Kiakojouri Amirmasoud , Arghand Hesam Addin , Davoodabadi Ali
Published: February 2021

The objective of this research is to diagnose an inaccessible rolling bearing by indirect vibration measurement. In this study, a shaft supported with several bearings is considered. It is assumed that the vibration for at least one bearing is not recordable. The purpose is to diagnose inaccessible bearing by the recorded data from the sensors located on the other bearings. To achieve this goal, the continuous wavelet transform is used to detect weak signatures in the available vibration signals. A new criterion for adjusting the scale parameter of continuous wavelet transform is proposed based on the amplitude of the bearing characteristic frequencies. In this criterion, the optimal scale is selected to maximize the amplitude of bearing characteristic frequencies in comparison with the amplitude of the other frequencies. The results of the proposed method are compared with a popular method, energy-to-entropy ratio criterion, using two different sets of run-to-failure experimental data. Results indicate that the proposed method in this article is more effective and efficient for extracting the weak signatures and diagnosing inaccessible bearings from the recorded vibration signals.
Pre-Existing Inequality: The Impact of COVID-19 on Medicare Home Health Beneficiaries
Authors: Cabin William
Published: February 2021

There is significant data on the adverse impact of COVID-19 on persons who were poor, minorities, had compromised physical or mental health, or other vulnerabilities prior to the COVID-19 pandemic. A significant portion of the overall Medicare population has such vulnerabilities. The Medicare home health beneficiary population is even more vulnerable than the overall Medicare population based on gender, race, income level, living alone status, and number of chronic conditions. A literature review indicates there is only 1 study on the impact of COVID-19 in Medicare home health on home care workers and none on the impact on home health beneficiaries. The current study is a qualitative study based on interviews of a convenience sample of 48 home care nurses from 9 different home health agencies in New York City between April 1 and August 31, 2020. Six major themes emerged: need for social service supports increased; loneliness and depression increased among patients; physical and mental health conditions became exacerbated; substance use and abuse increased; evidence of domestic violence against patients increased; and there was a limited amount of staff and equipment to care for patients.
Bilateral Nephroblastic Tumors and a Complex Renal Vascular Anomaly in a Patient With a Mosaic RASopathy: Novel Histopathologic Features and Molecular Insights
Authors: Slack Jonathan C , Bründler Marie-Anne , Chang Caitlin A , Perrier Renee , Lafay-Cousin Lucie , Kurek Kyle C
Published: February 2021

Mosaic RASopathies are an emerging group of disorders characterized by mosaic or post-zygotic activating mutations in genes of the RAS/MAPKinase signaling pathway. The phenotype is highly variable, ranging from limited or localized forms to cases with a syndromic presentation with extensive or multiorgan involvement, and also overlaps with other mosaic disorders. While there are several reports of malignancies in patients with mosaic RASopathies, specifically rhabdomyosarcoma and transitional urothelial carcinoma, the lifetime risk and molecular mechanisms that lead to the development of malignancies remain unclear. We report a 22-month-old boy with a somatic RASopathy due to an underlying KRAS p.G12D mutation who presented with a large unilateral epidermal nevus, asymmetric lower limb overgrowth with lytic and sclerotic bone lesions, capillary malformation, bilateral nephrogenic rests and Wilms tumors, and a novel complex renal vascular anomaly that resembles Fibro-Adipose Vascular Anomaly (FAVA). This report further expands the phenotypic spectrum of somatic RASopathies, and discusses the potential phenotypic and pathogenetic overlap with PIK3CA-related overgrowth disorders, specifically CLOVES. The occurrence of a secondary cancer hotspot mutation ( FBXW7 p.R479G ) in the Wilms tumor, but not the associated nephrogenic rest, moreover suggests that additional driver mutations are involved in the development of Wilms tumor in somatic overgrowth disorders.
Increased insulin-like growth factor 1 concentrations in a retrospective population of non-diabetic cats diagnosed with hypertrophic cardiomyopathy
Authors: Steele Matthew ME , Borgeat Kieran , Payne Jessie R , Coss Peter , Navarro-Cubas Xavier , Church David B , Niessen Stijn JM , Connolly David J
Published: February 2021

Objectives

The aim of the study was to document whether a proportion of non-diabetic cats with left ventricular hypertrophy (LVH) previously diagnosed with hypertrophic cardiomyopathy (HCM) have elevated circulating insulin-like growth factor 1 (IGF-1) concentrations.

Methods

A retrospective analysis of residual blood samples obtained at the time of echocardiographic diagnosis of HCM from a population of 60 non-diabetic cats were analysed for circulating IGF-1 concentrations using a validated radioimmunoassay and compared with a control group of 16 apparently healthy cats without LVH. Clinical and echocardiographic data for cats with an IGF-1 level >1000 ng/ml were compared with those with an IGF-1 level <800 ng/ml.

Results

In total, 6.7% (95% confidence interval 1.8–16.2%) of cats with HCM had an IGF-1 level >1000 ng/ml. The prevalence of an IGF-1 level >1000 ng/ml in the control group was zero.

Conclusions and relevance

A small proportion of non-diabetic cats previously diagnosed with HCM had an IGF-1 concentration at a level that has been associated with feline hypersomatotropism (fHS) in the diabetic cat population. Further prospective research is required to confirm or refute the presence of fHS in non-diabetic cats with LVH and increased IGF-1.
Serum haptoglobin concentrations in feline inflammatory bowel disease and small-cell alimentary lymphoma: a potential biomarker for feline chronic enteropathies
Authors: Love Edwina K , Leibman Nicole F , Ringold Randy , Lamb Kenneth
Published: February 2021

Objectives

The aim of this study was to evaluate serum haptoglobin as a biomarker to differentiate between small-cell alimentary lymphoma and inflammatory bowel disease in cats.

Methods

Client-owned domestic cats with and without chronic gastrointestinal signs were enrolled in the study. Serum was collected from each patient and serum haptoglobin levels were measured using ELISA. In cats with gastrointestinal signs, histopathologic evaluation of endoscopic biopsies harvested from the intestinal tract was used to separate them into inflammatory bowel disease and small-cell lymphoma cohorts. Serum haptoglobin levels were statistically analyzed and compared among the three groups: healthy cats; cats with inflammatory bowel disease; and cats with small-cell alimentary lymphoma.

Results

Sixty-two cats were enrolled in the study, including 20 clinically normal cats, 14 cats with small-cell alimentary lymphoma and 28 cats with inflammatory bowel disease. The mean ± SD serum haptoglobin was 73.2 ± 39.1 mg/dl in normal cats, 115.3 ± 72.8 mg/dl in cats with inflammatory bowel disease and 133.1 ± 86.1 mg/dl in cats with small-cell alimentary lymphoma. Cats with inflammatory bowel disease and lymphoma had significantly higher serum haptoglobin than controls, with P values of 0.0382 and 0.0138, respectively. There was no statistical difference between the inflammatory bowel disease and lymphoma cohorts ( P = 0.4235). For every one unit increase in serum haptoglobin, the odds of gastrointestinal inflammatory disease (inflammatory bowel disease or small-cell alimentary lymphoma) increased by 1.41% ( P = 0.0165).

Conclusions and relevance

Serum haptoglobin is a useful biomarker for distinguishing between normal cats and those with gastrointestinal inflammatory disease, but it could not significantly differentiate between inflammatory bowel disease and lymphoma. Additional studies may be beneficial in determining the prognostic significance of serum haptoglobin as it may relate to the severity of gastrointestinal inflammation.
Experience in managing glaucoma filtration surgery complications with oral doxycycline: A case series
Authors: Yong Geng-Yi , Mohamed-Noor Jelinar , Ong Poh-Yan , Suliman Nurull Bahya , Lim Ching-Wei , Zahari Mimiwati
Published: February 2021

Purpose:

To report the clinical profile and effectiveness of oral doxycycline as a non-invasive treatment for glaucoma filtering surgery complications.

Method:

Prospective case series.

Results:

Doxycycline is widely used in treating corneal melts, ocular surface diseases, meibomian gland disease, recurrent epithelial cell erosion, rosacea, and keratitis sicca. This prospective case series highlights the successful treatment of five patients with leaking blebs and conjunctiva erosion from glaucoma filtration surgery with the use of oral doxycycline. There was no adverse event reported in our cases.

Conclusions:

This study suggests that oral doxycycline may be a feasible non-surgical treatment modality due to its ability to inhibit collagenolysis, restore the Meibomian gland function, thereby stopping breakdown and promote conjunctival tissue healing.
The impact of a notched peripheral intravenous catheter on the first attempt success rate in hospitalized adults: Block-randomized trial
Authors: van Loon Fredericus HJ , Timmerman Ricky , den Brok Geert PH , Korsten Erik HM , Dierick-van Daele Angelique TM , Bouwman Arthur RA
Published: February 2021

Introduction:

Peripheral intravenous cannulation is the preferred method to obtain vascular access, but not always successful on the first attempt. Evidence on the impact of the intravenous catheter itself on the success rate is lacking. Faster visualization of blood flashback into the catheter, as a result of a notched needle, is thought to increase first attempt success rate. The current study aimed to assess if inserting a notched peripheral intravenous catheter will increase first attempt cannulation success up to 90%, when compared to inserting a catheter without a notched needle.

Design:

In this block-randomized trial, adult patients in the intervention group got a notched peripheral intravenous catheter inserted, patients in the control group received a traditional non-notched catheter. The primary objective was the first attempt success rate of peripheral intravenous cannulation. Intravenous cannulation was performed according to practice guidelines and hospital policy.

Results:

About 328 patients were included in the intervention group and 330 patients in the control group. First attempt success was 85% and 79% for the intervention and control group respectively. First attempt success was remarkably higher in the intervention group regarding patients with a high risk for failed cannulation (29%), when compared to the control group (10%).

Conclusion:

This study was unable to reach a first attempt success of 90%, although first attempt cannulation success was higher in patients who got a notched needle inserted when compared to those who got a non-notched needle inserted, unless a patients individual risk profile for a difficult intravenous access.
Forty-One-Year-Old Man with Pulmonary Embolism 5 Months After COVID-19
Authors: Taha Muhanad , Nguyen Paul , Sharma Aditi , Taha Mazen , Samavati Lobelia
Published: February 2021

Background:

Hypercoagulation is one of the striking features of COVID-19. Patients hospitalized with COVID-19 are at high risk for venous thromboembolism. However, it is unknown if the risk for venous thromboembolism persists after discharge.

Case Summary:

We report a case with pulmonary embolism 5 months after COVID-19. No risk factors for venous thrombosis have been identified.

Conclusion:

In COVID-19 related hospitalization, large studies are needed to identify the risk of venous thromboembolism after discharge.
Eculizumab-Associated Moraxella lacunata Bacteremia and Systemic Inflammatory Response Syndrome in a Toddler with Atypical Hemolytic Uremic Syndrome
Authors: Bicoll Paige S , Goyal Ashima , Blatt Neal B , Freij Bishara J
Published: February 2021

Moraxella lacunata, a low-virulence Gram-negative coccobacillus, is classically associated with conjunctivitis and upper respiratory tract infections; systemic infections such as sepsis have rarely been reported, especially in children. We describe a 28-month-old girl with atypical hemolytic uremic syndrome and stage II chronic kidney disease on long-term eculizumab therapy who presented with systemic inflammatory response syndrome and was found to have Moraxella lacunata bloodstream infection. Eculizumab, a humanized monoclonal anti-C5 antibody, has been associated with susceptibility to infections with encapsulated bacteria, especially Neisseria meningitidis. This is the first report of an invasive bacterial infection with Moraxella lacunata in a pediatric eculizumab recipient.
The life of the parties: Party activists and the 2016 presidential election
Authors: Cooperman Rosalyn , Shufeldt Gregory , Conger Kimberly
Published: February 2021

Hillary Clinton and Donald Trump secured their respective party’s 2016 nominations only after raucous, spirited debates among delegates at the start of each party convention. Groups and their preferred candidates behaved consistently with the policy demanders view of parties, which identifies parties as comprised of coalitions of groups with strong policy preferences that negotiate with one another for influence in the party decision-making and policy process. Using the 2016 Convention Delegate Study, the longest standing survey of Democratic and Republican Party activists, we examine intra-party groups as new delegates are folded into the framework along with returning delegates. We assess how the theory of parties as comprised of policy-demander groups works in a context of high external party polarization. The competition between these groups to recast their party in its preferred image in the absence of a standard party bearer for either party holds important implications for Democrats and Republicans in future presidential and congressional elections.