bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of Complications Occurrence Associated With Emergency Surgical Tracheotomy
Authors: Jotic Ana D. , Milovanovic Jovica P. , Trivic Aleksandar S. , Folic Miljan M. , Krejovic‐Trivic Sanja B. , Radin Zorana Z. , Buta Marko N. , Milicic Biljana R.
Published: August 2020

Objective

In emergency airway management, the occurrence of surgical tracheotomy complications is increased and may be fatal for the patient. However, the factors that play a role in complication occurrence and lead to lethal outcome are not known. The objective of this study was to determine predictors associated with the occurrence of complications and mortality after emergency surgical tracheostomy.

Study Design

Retrospective study with a systematic review of the literature.

Setting

Tertiary medical academic center.

Subjects and Methods

We included 402 adult patients who underwent emergency surgical tracheostomy under local anesthesia due to upper airway obstruction. Demographic, clinical, complication occurrence, and mortality data were collected. For statistical analysis, univariable and multivariable logistic regression methods were used.

Results

In multivariable analysis, significant positive predictors of complication occurrence were previously performed tracheotomy (odds ratio [OR] 3.67, 95% confidence interval [CI], 0.75–17.88), neck pathology (OR 2.05, 95% CI 1.1–1.77), and tracheotomy performed outside the operating room (OR 5.88, 95% CI, 1.58–20). General in‐hospital mortality was 4%, but lethal outcome as a direct result of tracheotomy complications occurred in only 4 patients (1%) because of intraoperative and postoperative complications.

Conclusion

The existence of neck pathology and situations in which tracheotomy was performed outside the operating room in uncontrolled conditions were significant prognostic factors for complication occurrence. Tracheotomy‐related mortality was greater in patients with intraoperative and early postoperative complications. Clinicians should be aware of the increased risk in specific cases, to prepare, prevent, or manage unwanted outcomes in further treatment and care.
External Beam Radiotherapy for Medullary Thyroid Cancer Following Total or Near‐Total Thyroidectomy
Authors: Jin Michael , Megwalu Uchechukwu C. , Noel Julia E.
Published: August 2020

Objectives

Medullary thyroid carcinoma (MTC) often presents with advanced disease and takes an aggressive course as compared with more well‐differentiated thyroid cancers. The role of adjuvant therapy, specifically external beam radiotherapy (EBRT), remains disputed. This study investigated the impact of EBRT on survival in MTC.

Study Design

Cross‐sectional analysis of a national database.

Setting

Patients with MTC were identified from the SEER program (Surveillance, Epidemiology, and End Results).

Methods

Collected variables included age, sex, race, T and N stages, lymph node yield, and use of EBRT. Propensity score matching was performed to determine the association of EBRT with overall and disease‐specific survival.

Results

A total of 2046 patients with locoregional MTC were identified. Of these, 152 received EBRT. Patients receiving EBRT were older and had more advanced disease. EBRT was not associated with differences in overall survival (hazard ratio, 1.12; 95% CI, 0.76‐1.65) or disease‐specific survival (1.66; 0.93‐2.95), as well as in subset analysis of age and disease extent. Long‐term overall survival was similar, with 77.3% (95% CI, 70.1%‐85.3%) and 58.3% (48.2%‐70.5%) of patients without EBRT alive at 5 and 10 years, respectively (vs 70.7% [63.2%‐79.1%] and 52.3% [43.3%‐63.2%] of patients with EBRT). There were no differences in 5‐ and 10‐year disease‐specific survival.

Conclusion

EBRT was not associated with improved overall or disease‐specific survival in patients with MTC. Decisions regarding EBRT must be made with consideration of morbidity relative to benefit for individual patients.
Caregivers' Experiences of Aggressive Persons with Schizophrenia
Authors: Neha A.  , Gandhi Sailaxmi , Manjula M.  , Padmavathi N.
Published: August 2020

Background:

Understanding the caregivers’ experiences of aggressive persons with mental disorders is very important from the public health point of view. Only a few Indian studies have focused on this. No Indian studies could be found that explored the caregivers’ experiences of aggressive persons with schizophrenia. This study was conducted to explore the same.

Methods:

A qualitative phenomenological study was conducted in the outpatient and inpatient settings at a tertiary care mental health institute at Bengaluru, Karnataka. Ten participants meeting the eligibility criteria were selected using purposive sampling. Data collection was done by individual, in-depth, face-to-face, semi-structured interviews using topic guide along with subjective observation and field notes. Each interview was audio-recorded, transcribed, translated, and coded. A total of five master themes and 22 subthemes were derived from the codes by using the qualitative research software ATLAS-Ti.

Results:

The themes derived based on the experiences of caregivers living with their aggressive persons with schizophrenia were the aggressive behaviors of the patients, reasons for the aggression of the patients, dealing with the aggression of the patients, the impact of aggression on the caregivers, and the coping methods of the caregivers.

Conclusion:

This study explored the experiences of the caregivers living with the aggressive patients. The results show the need for care and support to the caregivers. The themes can guide mental health professionals while developing culture-specific tools and interventions for future research as well as suggest them standard operating procedures for prevention and management of aggressive patients in the psychiatric hospitals.
Foaming behavior of 1-vinyl-2-pyrrolidone–methyl methacrylate copolymers under ScCO2
Authors: Trigo-López Miriam , Reglero Ruiz José A , Vallejos Saúl , Ramos Cipriano , Beltrán Sagrario , García Félix C , García José M
Published: August 2020

We report on the preparation, characterization, and foaming behavior of cellular polymers based on 1-vinyl-2-pyrrolidone (VP) and methyl methacrylate (MMA). Samples with different feed ratios proportions of VP and MMA were prepared following the bulk radical copolymerization procedure, using commercially available monomers and testing two different initiators (photochemical and thermal), obtaining solid samples of around 1.5 mm thick. To evaluate the polymerization process, the chemical structure of VP/MMA copolymers was determined by proton nuclear magnetic resonance measurements. In a second step, single-batch supercritical carbon dioxide (CO2) foaming tests were carried out at different temperatures to evaluate the influence of the VP to MMA feed ratios and the foaming temperature in the density, the presence of solid outer skin, the CO2 sorption–desorption process, and the cellular morphology of the foamed polymers.
Improving interactions of transition-age peers with visual impairment and intellectual disability
Authors: Bruce Susan , Stutzman Brent , Nannemann Allison , Lewitus Amanda , McDonald Colleen , Mango Talia
Published: August 2020

This collaborative action research study addressed the interaction skills of two young adults with visual impairments and intellectual disability in the context of a board game. The intervention involved the use of an adapted board game, four social stories, and rehearsal of game play skills in the context of individual and group therapy sessions. Instructional strategies included clear within and between activity routines, least to most prompting system, sufficient wait time, and modeling of game play behaviors. Both young men improved their initiation skills, terminated interactions appropriately with fewer prompts, and learned some of the elements of board game play. Self-stimulation and anxiety over changes in their daily lives impacted progress. More research is needed to investigate the potential benefit of social stories for students with visual impairments and additional disabilities.
SOLAR: The Science of Language and Reading
Authors: Snow Pamela C.
Published: August 2020

Reading ability is profoundly important, for individuals and for the societies of which they are a part. Research indicates that we should be successfully teaching 95% of children to read, yet, in reality, high rates of reading failure are common in western, industrialized nations. In large part, this reflects a failure to translate into practice knowledge derived from the scientific study of reading and reading instruction and, indeed, to the rejection in some circles of the notion that there is a science of reading, in the same way that there is a science of memory, learning, and cognition. In this article, I suggest the Science of Language and Reading (SOLAR) framework as a way of positioning oral language as a central driver of reading acquisition. The SOLAR framework is illustrated via the Language House schema, which considers the social-emotional contexts for language acquisition and reading instruction, alongside the ongoing development of prosocial interpersonal skills and mastery of sufficient language and reading skills by early adulthood to be able to function as part of the social and economic mainstream. I argue that speech-language therapy has much to offer to the promotion of evidence-based early reading and writing instruction and support, given the linguistic nature of reading and the high comorbidity between language and reading difficulties and social-emotional disturbances in childhood and adolescence.
Geographies of sexuality I: Making room for lesbianism
Authors: Browne Kath
Published: August 2020

Despite three decades of this vibrant sub-discipline, this is the first progress report on lesbian geographies. They are crucial to contemporary sexualities focusing on female-identified same-sex lives, relationships, desires, practices and discriminations. Lesbian placemaking explores intersections of sexualities and gender, and race, class and age that are central to the mutual reconstitution of people and place. Overall, this report demonstrates both the vibrancy of lesbian geographies and the importance of exploring the intersections of gender and sexualities in engaging with the underpinning premise of human geography, namely the mutual constitution of people and place.
A case series of topiramate-induced angle closure crisis – an ophthalmic emergency
Authors: Gopalakrishna Megha , Odayappan Annamalai , Srinivasan Kavitha , Rengaraj Venkatesh
Published: August 2020

Background

Topiramate is a drug commonly used by physicians. However, it has various systemic and ocular adverse effects. Bilateral angle closure crisis is a potentially blinding adverse reaction that is seldom reported in non-ophthalmic journals.

Objective

This article aims to report a case series of topiramate-induced angle closure crisis in the eyes.

Methods and material

Most patients presented to us with blurred vision and high intra-ocular pressure within days of starting topiramate tablet for headache. However, the attack resolved in those who presented early with prompt treatment, which included stopping topiramate.

Conclusions

Physicians prescribing topiramate must be well aware of this potentially blinding adverse effect. Educating the patient about this possible side effect is important. Timely referral and treatment can prevent blindness in these individuals.
Undergraduate Radiology Education During the COVID-19 Pandemic: A Review of Teaching and Learning Strategies
Authors: Darras Kathryn E. , Spouge Rebecca J. , de Bruin Anique B. H. , Sedlic Anto , Hague Cameron , Forster Bruce B.
Published: August 2020

The Coronavirus disease 2019 (COVID-19) pandemic has altered how medical education is delivered, worldwide. Didactic sessions have transitioned to electronic/online platforms and clinical teaching opportunities are limited. These changes will affect how radiology is taught to medical students at both the pre-clerkship (ie, year 1 and 2) and clinical (ie, year 3 and 4) levels. In the pre-clerkship learning environment, medical students are typically exposed to radiology through didactic lectures, integrated anatomy laboratories, case-based learning, and ultrasound clinical skills sessions. In the clinical learning environment, medical students primarily shadow radiologists and radiology residents and attend radiology resident teaching sessions. These formats of radiology education, which have been the tenets of the specialty, pose significant challenges during the pandemic. This article reviews how undergraduate radiology education is affected by COVID-19 and explores solutions for teaching and learning based on e-learning and blended learning theory.
Photosensitive properties, synergistic antibacterial abilities of intelligent response-type self-assembled nanoparticle TiO2@V2O5
Authors: Liu Yanan , Liu Jiawei , Guo Xiaoping , Lin Ange , Wen Yayu , Chen Xu , Zhu Xufeng , Liu Jie , Luo Zhaohui
Published: August 2020

Representative pathogenic bacteria such as Escherichia coli ( E. coli) and Staphylococcus aureus ( S. aureus) are widespread in nature and pose a threat to human health. To control the propagation of these pathogens from the source, the key is to design broad-spectrum antibacterial materials to reduce the serious damage of pathogenic bacteria. At present, more and more nanoparticles are widely researched and applied due to their multi-pathway antibacterial properties, such as regulating physiology, biochemistry and physical chemistry. In this work, we synthesized a uniformly dispersed and stable spherical nanoparticle (TiO2@V2O5) synthesized by self-assembly of tianium dioxide and vanadium pentoxide. Based on its excellent photosensitive properties, TiO2@V2O5 nanoparticles have showed excellent antibacterial properties under the light irradiation due to the production of hydroxyl radicals in antibacterial and mechanism tests. In addtion, related cell and plant experiments have showed that TiO2@V2O5 nanoparticles are excellent biocompatible materials, it could be widely used in environmental pollution control, limiting the serious damage caused by pathogens.
The Elites of Solidarity: Prosopography of Delegates for the First National Congress of Solidarity
Authors: Osęka Piotr
Published: August 2020

The article aims at contributing to the social history of the Solidarity movement by tracing the collective biography of its elected representatives. It will focus on the life trajectories of the 900 delegates to the First National Congress of Delegates. The convention, held in Autumn 1981, is commonly perceived as a focal moment in the history of Solidarity and plays a crucial role in almost every academic narrative on the anti-communist opposition. Often seen as a first genuine Polish parliament since pre-war times, its main task was to forge the political and economic programme thus furthering the revolution. The projected research will draw on genuine methodology, combining prosopographical and oral history approach. The research will address mainly the following issues: what social strata the elites came from, what was their cultural and educational background, what motives/causes/expectations drove them to engage with Solidarity, to what generations did they belong, how did they embrace the character of political transformation of 1989, and to what extent and how did they get involved in the political, economic, and social life of post-communist Poland. In general, the paper seeks to shed a new light on our understanding of Solidarity’s social roots—for instead examining to what extent the contesting, revolutionary elites were a product of the Stalinist social advancement. It also tries to depict the level of continuity between the elites of 1981 and post-1989—thus testing the common theories whether the Third Republic is (or is not) rooted in the legacy of Solidarity.
Impact of hybrid nanosilica and nanoclay on the properties of palm rachis-reinforced recycled linear low-density polyethylene composites
Authors: Sadik Wagih Abdel Alim , El Demerdash Abdel Ghaffar Maghraby , Abbas Rafik , Bedir Alaa
Published: August 2020

The main goal of this work was to assess the technical feasibility of palm rachis (PR) as a reinforcing agent in the production of wood–plastic composites. Recycled linear low-density polyethylene/PR fiber composites were prepared at constant content (3 phc (per hundred compounds)) of maleic anhydride-grafted polyethylene as compatibilizer by melt blending method utilizing a two-roll mill and compression molding. The effect of nanosilica (NS), nanoclay (NC), and hybrid nanoparticles (NSNC) at different concentrations (2, 4, and 6 phc) on mechanical, physical, thermal, and morphological properties was investigated. The results of mechanical properties measurements demonstrated that when 6 phc NS, 4 phc NC, and 4 phc NSNC were added, tensile, modulus strength, and hardness reached their optimum values. At a high level of NC loading (6 phc), the increased populace of NC layers led to agglomeration and stress transfer gets restricted. Elongation at break and Izod impact strength were decreased by the incorporation of different nanoparticles. Water absorption and thickness swelling of prepared composites were found to decrease on the incorporation of NS and NC. In addition, the thermal stability showed slightly improved by the addition of nanoparticles, but there are no perceptible changes in the values of melting temperature by increasing the content of NS and NC or NSNC. Scanning electron microscopy study approved the good interaction of the PR fibers with the polymer matrix as well as the effectiveness of NS and NC in the improvement of the interaction. The finding indicated that wood–plastic composite treated by NS had the highest properties than other composites.
Passion for Work and Well-Being of Working Adults
Authors: Yukhymenko-Lescroart Mariya A. , Sharma Gitima
Published: August 2020

The purpose of the present study was to extend a study by Yukhymenko-Lescroart and Sharma (2019,“The Relationship Between Faculty Members’ Passion for Work and Well-Being”) to test the relationship between passion for work and well-being using a completely independent and much more heterogeneous sample of full-time working adults representing a wide variety of professions. Participants, who were recruited through the Amazon’s Mechanical Turk website, completed several scales ( N = 297, 55.2% female, median age = 34 years), and the data were analyzed using structural equation modeling. In line with our hypotheses, results showed that harmonious passion for work contributed positively to life satisfaction, subjective happiness, awareness of purpose, altruistic purpose, and awakening to the purpose. Additionally, obsessive passion for work contributed positively to altruistic purpose and awakening to the purpose. However, the results did not support the hypothesis that obsessive passion for work contributed to the awareness of purpose.
Natural History of Social Participation in the Very Old: Findings from the Newcastle 85+ Study
Authors: Rantakokko Merja , Duncan Rachel , Robinson Louise , Wilkie Ross
Published: August 2020

Objective: To describe the natural history of social participation in people aged 85 years and over. Methods: Prospective cohort study; Newcastle 85+ study. Data were collected at baseline ( n = 850) and at 18-, 36- and 60-month follow-ups ( n = 344). Participation in 19 social activities (e.g. playing bingo, doing volunteer work and watching television) was measured at each time point. Results: The mean number of activities reported at baseline was 8.7 ( SD 2.6). The number of activities was higher in those with higher educational attainment and intact walking ability (both p < .001). Social participation decreased significantly over time ( p < .001) and at a similar rate in both sexes and for those with/without limited walking ability but at a higher rate in those with higher than lower educational attainment ( p = .019). Discussion: Social participation seems to decrease significantly between ages 85 and 90 years; ways of encouraging social participation in this age group are needed.
Multiobjective optimization of a tubular pump to improve the applicable operating head and hydraulic performance
Authors: Zhao Wenlong , Zhang Jian , Yu Xiaodong , Zhou Daqing , Calamak Melih
Published: August 2020

Tubular pumps are widely used in irrigation and water conveyance projects. However, the operating head of most of these pumps is low, and only a few studies have focused on the design of an efficient tubular pump with a head more than 5 m, which is common in long-distance water supply projects. This work aims to improve the operating head and efficiency of tubular pumps while maintaining a low shaft power. The multi-objective orthogonal optimization method was used to determine the critical parameters of the tubular pump, i.e., blade number, airfoil, blade thickness and guide vane distance, and nine design schemes were selected. Next, by using computational fluid dynamics (CFD), a 3D model of the tubular pumps under different schemes was established, and the results were compared. Subsequently, the range method and weighted matrix method were utilized to find the optimized scheme. In addition, an experimental investigation was performed to verify the simulation and the performance of the designed tubular pump. The results indicated that the optimized scheme improved the operating head to 6.9 m with higher efficiency of 84.2% and a lower shaft power of 27.7 kW. The modeling results were in agreement with the experimental measurements, and the designed tubular pump had a wide range of high-efficiency zones.
Haemodynamic mechanism of formation and distribution of coronary atherosclerosis: A lesion-specific model
Authors: Feng Jiling , Wang Nannan , Wang Yiliang , Tang Xiaoxian , Yuan Jie
Published: August 2020

Coronary arterial disease, as the most devastated cardiovascular disease, is caused by the atherosclerosis in the coronary arteries, which blocks the blood flow to the heart, resulting in the deficient supply of oxygen and nutrition to the heart, and eventually leading to heart failure. To date, haemodynamic mechanisms for atherosclerosis development are not fully understood although it is believed that the haemodynamic disturbance at the region of the arterial bifurcation, particular, bifurcation angle, plays an important role in the atherosclerosis development. In this study, two types of computational fluid dynamics models, lesion-specific and idealized models, combined with the computer tomography imaging techniques, are used to explore the mechanism of formation and distribution of the atherosclerosis around the bifurcation of left coronary artery and its association with the bifurcation angle. The lesion-specific model is used to characterize the effect of personalized features on the haemodynamic performance, while the idealized model is focusing on the effect of single factor, bifurcation angle, on the haemodynamic performance. The simulated results from both types of the models, combined with the clinical observation, revealed that the three key areas around the bifurcations are prone to formation of the atherosclerosis. Unlike the idealized models, lesion-specific modelling results did not show the significant correlation between the wall shear stress and bifurcation angle, although the mean value of the wall shear stress in smaller bifurcation angles (less than 90°) is higher than that with larger bifurcation angles (greater than 90°). In conclusion, lesion-specific computational fluid dynamics modelling is an efficient and convenient way to predict the haemodynamic performance around the bifurcation region, allowing the comprehensive information for the clinicians to predict the atherosclerosis development. The idealized models, which only focus on single parameter, may not provide the sufficient and reliable information for the clinical application. A novel multi-parameters modelling technique, therefore, is suggested to be developed in future, allowing the effects of many parameters on the haemodynamic performance to be evaluated.
Variable selection for ultra-high dimensional quantile regression with missing data and measurement error
Authors: Bai Yongxin , Tian Maozai , Tang Man-Lai , Lee Wing-Yan
Published: August 2020

In this paper, we consider variable selection for ultra-high dimensional quantile regression model with missing data and measurement errors in covariates. Specifically, we correct the bias in the loss function caused by measurement error by applying the orthogonal quantile regression approach and remove the bias caused by missing data using the inverse probability weighting. A nonconvex Atan penalized estimation method is proposed for simultaneous variable selection and estimation. With the proper choice of the regularization parameter and under some relaxed conditions, we show that the proposed estimate enjoys the oracle properties. The choice of smoothing parameters is also discussed. The performance of the proposed variable selection procedure is assessed by Monte Carlo simulation studies. We further demonstrate the proposed procedure with a breast cancer data set.
Engineering of Primary Pancreatic Islet Cell Spheroids for Three-dimensional Culture or Transplantation: A Methodological Comparative Study
Authors: Wassmer Charles-Henri , Bellofatto Kevin , Perez Lisa , Lavallard Vanessa , Cottet-Dumoulin David , Ljubicic Sanda , Parnaud Géraldine , Bosco Domenico , Berishvili Ekaterine , Lebreton Fanny
Published: August 2020

Three-dimensional (3D) cell culture by engineering spheroids has gained increasing attention in recent years because of the potential advantages of such systems over conventional two-dimensional (2D) tissue culture. Benefits include the ability of 3D to provide a more physiologically relevant environment, for the generation of uniform, size-controlled spheroids with organ-like microarchitecture and morphology. In recent years, different techniques have been described for the generation of cellular spheroids. Here, we have compared the efficiency of four different methods of islet cell aggregation. Rat pancreatic islets were dissociated into single cells before reaggregation. Spheroids were generated either by (i) self-aggregation in nonadherent petri dishes, (ii) in 3D hanging drop culture, (iii) in agarose microwell plates or (iv) using the Sphericalplate 5D™. Generated spheroids consisted of 250 cells, except for the self-aggregation method, where the number of cells per spheroid cannot be controlled. Cell function and morphology were assessed by glucose stimulated insulin secretion (GSIS) test and histology, respectively. The quantity of material, labor intensity, and time necessary for spheroid production were compared between the different techniques. Results were also compared with native islets. Native islets and self-aggregated spheroids showed an important heterogeneity in terms of size and shape and were larger than spheroids generated with the other methods. Spheroids generated in hanging drops, in the Sphericalplate 5D™, and in agarose microwell plates were homogeneous, with well-defined round shape and a mean diameter of 90 µm. GSIS results showed improved insulin secretion in response to glucose in comparison with native islets and self-aggregated spheroids. Spheroids can be generated using different techniques and each of them present advantages and inconveniences. For islet cell aggregation, we recommend, based on our results, to use the hanging drop technique, the agarose microwell plates, or the Sphericalplate 5D™ depending on the experiments, the latter being the only option available for large-scale spheroids production.
The Combination of Astragalus membranaceus and Ligustrazine Protects Against Thrombolysis-Induced Hemorrhagic Transformation Through PKCδ/Marcks Pathway in Cerebral Ischemia Rats
Authors: Pan Ruihuan , Tang Xialin , Wang Huajun , Huang Yan , Huang Kai , Ling Shanshan , Zhou Mingchao , Cai Jun , Chen Hongxia , Huang Yan
Published: August 2020

Astragalus membranaceus (Ast) and ligustrazine (Lig) have a protective effect on lower hemorrhagic transformation induced by pharmaceutical thrombolysis. The cerebral ischemia rat model was induced with autologous blood clot injections. A combination of Ast and Lig, or a protein kinase C delta (PKCδ) inhibitor—rottlerin, or a combination of Ast, Lig, and rottlerin was administered immediately after recombinant tissue plasminogen activator injection. The cerebral infarct area, neurological deficits, cerebral hemorrhage status, neuronal damage and tight junctions’ changes in cerebral vessels, and the messenger RNA and protein levels of PKCδ, myristoylated alanine-rich C kinase substrate (Marcks), and matrix metallopeptidase 9 (MMP9) were determined after 3 h and 24 h of thrombolysis. The ultrastructure of the neuronal damage and tight junctions was examined under a transmission electron microscope. The expression levels of PKCδ, Marcks, and MMP9 were assessed by immunohistochemistry, western blot, and quantitative real-time polymerase chain reaction . Administration of Ast and Lig not only significantly decreased neurological deficit scores, infarct volumes, and cerebral hemorrhage but also inhibited the disruption due to neuronal dysfunction and the tight junction integrity in the cerebral vessel. Treatment with a combination of Ast and Lig effectively protected ischemia-induced microhemorrhage transformation through PKCδ/Marcks pathway suppression.
“It’s Hard to Talk When Your Child Has a Life Threatening Illness”: A Qualitative Study of Couples Whose Child Is Diagnosed With Cancer
Authors: Hooghe An , Rosenblatt Paul C. , Vercruysse Trui , Cosyns Veerle , Lambrecht Karolien , Rober Peter
Published: August 2020

When parents are confronted with something as fundamental as a cancer diagnosis for their child, it is generally assumed that sharing the emotional impact of it, in the form of talking about it with the partner, is helpful and necessary to cope as an individual and a couple. However, couple communication in the context of childhood oncology is often challenging. In this qualitative research, we aimed for a better understanding of how partners experience their couple communication during treatment of their child. Thematic coding was done on in-depth interviews with 16 parents (7 couples interviewed together and 2 mothers). We found that the circumstances of the treatment period affected couple communication. In the interviews, parents provided three main meanings to their limited talking: (a) because of the hospital and treatment context; (b) for self-care/self-protection related to the value of blocking emotions; and (c) because of each other. These findings invite us to rethink emotional closeness being equated with frequent or intense emotional communication in couples with a child who has cancer. This research, framed in a dialectic approach, emphasizes the value of both talking and not talking in the tense and challenging couple situation of dealing with a child’s cancer diagnosis and treatment. Rather than advocating for the general promotion of open communication, our study suggests the value of hesitations to talk at certain points in the process, while also taking into account the degree of marital difficulties in offering interventions aimed at improving couple communication.
Preparing to Implement Evidence-Based Literacy Practices in the Co-taught Classroom
Authors: Wexler Jade , Kearns Devin M. , Hogan Erin K. , Clancy Erin , Shelton Alexandra
Published: August 2020

It is essential that middle school content-area and special education co-teachers adopt evidence-based literacy practices that they can integrate into their content-area instruction to address the needs of all of the students in their classes. This article provides co-teachers with four planning tips to improve implementation of the practices they adopt. The planning tips are organized using the acronym FIRST: (a) monitor Fidelity of implementation of the adopted practices, (b) Integrate the practices into daily content-area instruction and across the year, (c) determine the Roles of each co-teacher when planning for and implementing instruction in the adopted practices, and (d) consider specific guidelines to Select Texts for each literacy-focused lesson. The planning tips are illustrated using examples related to the content-area literacy instruction (CALI) instructional framework, which is a set of evidence-based literacy practices and procedures designed to improve the literacy instruction middle school coteachers implement in their content-area classes.
Evaluation of the Microbiological Profile of Alveolar Residual Screws and Cleft-Adjacent Teeth in Individuals With Complete Unilateral Fissures
Authors: Iurovschi Ronaldo , Joaquim Claudia Regina , de Faveri Marcelo , de Miranda Tamires Szeremeske , Feres Magda , de Figueiredo Luciene Cristina
Published: August 2020

Objective:

To evaluate the microbiota profile of residual alveolar slits and teeth adjacent to the cleft in fissured individuals.

Designs:

This study used a cross-sectional design.

Participants:

Twenty individuals, aged 14 to 24 years, who had a residual fissure in the maxillary alveolar ridge region were selected.

Main outcome measures:

Three sites per individual were selected for microbiological collection (the site of the residual cleft and the 2 nearest teeth). The samples were analyzed using the Checkerboard DNA–DNA hybridization technique for 73 species of bacteria.

Results:

All the species analyzed were found in the 2 niches (slits and teeth). The bacterial species present in the largest number in the residual cracks were Prevotella melaninogenica, Prevotella nigrescens, and Streptococcus mitis. With regard to the bacterial profiles in the mesial and distal faces, the most prevalent species were P nigrescens, Veillonella parvula, and Fusobacterium nucleatum sp vicentii. The analysis of all the collected samples demonstrated very similar profiles for the mesial and distal faces, with these 2 sites even presenting the same species in greater frequencies. Higher counts of 20 bacterial species (Wilcoxon test) were observed in the dental niche, in relation to the fissure, particularly, P nigrescens, V parvula, F nucleatum sp vicentii, and Neisseria mucosa.

Conclusion:

Some species were significantly more prevalent in the residual alveolar fissures and in adjacent teeth. The comparison between the profiles of the 2 niches demonstrated large differences in the most frequent species in the teeth, and no qualitative differences with regard to specific pathogens.
Prescribing Practices of Valproic Acid for Agitation and Delirium in the Intensive Care Unit
Authors: Quinn Nicholas J. , Hohlfelder Benjamin , Wanek Matthew R. , Duggal Abhijit , Torbic Heather
Published: August 2020

Background

Analgesics, sedatives, and antipsychotics are commonly prescribed for agitation and delirium in the intensive care unit (ICU), but their use is limited by adverse effects and lack of efficacy. Valproic acid is an alternative treatment option.

Objective

The primary objective of this study was to describe valproic acid prescribing in our institution’s ICUs when used for agitation or delirium. Measures of effectiveness and safety were also assessed.

Methods

This was a single-center, retrospective, institutional review board–approved cohort study of adult inpatients admitted to the ICU between January 2018 and August 2018. Patients who received valproic acid for the treatment of agitation or delirium for ≥24 hours were included. Prescribing practices were evaluated for dose, frequency, and route of administration. Effectiveness was assessed via agitation and delirium assessment tools and quantity of adjunctive agents used.

Results

A total of 80 patients were included, with 35 receiving valproic acid alone and 45 in conjunction with antipsychotics. The most common valproic acid regimen was 250 mg orally 3 times daily. Delirium resolution occurred in 55% of patients: 24 in the valproic acid monotherapy group and 20 in the valproic acid plus antipsychotic group (69% vs 44%; P = 0.03). The incidence of delirium decreased from valproic acid day 0 to day 3 (93% vs 68%; P < 0.01), with no change in agitation (64% vs 63%; P = 0.28).

Conclusion and Relevance

Valproic acid is frequently prescribed in agitated, delirious patients at our institution and may have a role in the management of ICU delirium.
No Crystal Stair: Predictors of Pessimism Among Black Men
Authors: Palmer Gordon J. M. , Cole-Lewis Yasmin C. , Goodwill Janelle R. , Mattis Jacqueline S.
Published: August 2020

Social scientists have paid scant attention to factors relating to pessimism among Black American men. Drawing from Fankl’s existentialist framework, this study explored the association between life stress, everyday racism, existential well-being (EWB), religiosity and self-reported pessimism among a community sample of Black men ( n = 147). Regression analysis revealed that life stress was positively associated with pessimism, while EWB was negatively associated with pessimism. Relative weights analysis indicated that EWB had the greatest explanatory power in the model. Findings suggest that future studies of pessimism among Black American men should account for men’s sense of purpose and life stress, while also considering the potentially moderating effects of chronic and acute life stress on men’s future orientation.
Overall Health and the Influence of Physical Therapy on Physical Function Following Total Ankle Arthroplasty
Authors: DiLiberto Frank E. , Aslan Daniel H. , Houck Jeff R. , Ho Bryant S. , Vora Anand M. , Haddad Steven L.
Published: August 2020

Background:

The overall health and the importance of physical therapy for people following total ankle arthroplasty (TAA) have been understudied. Our purpose was to characterize the overall health of patients following TAA, and explore the frequency, influence, and patient-perceived value of physical therapy.

Methods:

People who received a TAA participated in this retrospective cohort online survey study. The survey included medical history questions and items from the Patient-Reported Outcomes Measurement Information System (PROMIS) Short Forms. Seven PROMIS domains, reflecting the biopsychosocial model of care (physical, mental, social), were included to examine participant overall health status in comparison to the general population. Items regarding physical therapy participation (yes/no), number of visits, and perceived value (scale 0-10; 10 = extremely helpful) were also included. Descriptive statistics were generated for participant characteristics, PROMIS domain T scores, and physical therapy questions. The influence of participant characteristics or physical therapy visits on PROMIS domain T scores that scored below the population mean were examined with multiple linear regression or ordinal regression.

Results:

The response rate was 61% (n=95). Average postoperative time was approximately 3 years (mean [SD]: 40.0 [35.3] months). Physical function and ability to participate in social roles and activities domain T scores were at least 1 SD below the population mean. Most patients received physical therapy (86%; 17.1 [11.0] visits) and found it helpful (7.2 [3.0]). Participant characteristics were minimally predictive of physical function and social participation T scores. Number of physical therapy visits predicted physical function T scores ( P = .03).

Conclusions:

Most health domain scores approached the population mean. Physical therapy was perceived to have a high value, and greater visits were related to greater physical function. However, lower physical function and social participation scores suggest that postoperative care directed toward these domains could improve the value of TAA and promote overall health.

Level of Evidence:

Level III, retrospective comparative study.
A Multilevel Modeling Approach to Examine Incongruent Illness Appraisals in Family Care Dyads Over Time
Authors: Lyons Karen S. , Lee Christopher S.
Published: August 2020

Over the past two decades, there has been movement toward a dyadic perspective of the illness experience. Although multilevel models have led to great insights into how dyads are affected by illness as family units, these models are still underutilized for understanding incongruent illness appraisals. Such incongruent appraisals can have implications for how the dyad collaborates to manage illness, the health of the dyad, and clinical outcomes. The focus of this article is to describe and promote the application of multilevel models to longitudinal dyadic data to understand incongruent illness appraisals over time. In particular, we present a data exemplar so researchers can apply these models to their own data and clinical questions to understand the ways care dyads converge and diverge in their appraisals and determine factors associated with such variability. We comment on the implications and extensions of these models for family nursing research and practice.
Intergenerational Transmission of Abusive Parenting: Role of Prospective Maternal Distress and Family Violence
Authors: Morelli Nicholas M. , Duong Jacqueline , Evans Meghan C. , Hong Kajung , Garcia Jackelyne , Ogbonnaya Ijeoma N. , Villodas Miguel T.
Published: August 2020

Parents who were abused as children are at increased risk for perpetuating maladaptive parenting practices, yet the mechanisms underlying this relationship remain unclear. This study prospectively examined maternal distress (a latent variable consisting of depressive symptoms and daily stress) and family violence as potential mediators in the intergenerational transmission of abusive (i.e., psychologically aggressive and physically assaultive) parenting. Participants included ( N = 768) mother-child dyads identified as being at-risk for family violence and maltreatment prior to children’s age four. More maternal childhood abuse was associated with more distress and increased risk for family violence exposure in adulthood. However, only maternal distress mediated the association between mothers’ history of abuse and their use of abusive parenting strategies. This study provides critical information about ecological mechanisms underlying the intergenerational transmission of abusive parenting and suggests the importance of targeting depression and stress management among mothers with abuse histories to curtail the cycle of violence.
“911 What’s Your Emergency?”: Deception in 911 Homicide and Homicide Staged as Suicide Calls
Authors: Miller Michelle L. , Merola Melissa A. , Opanashuk Leonard , Robins Cari J. , Chancellor Arthur S. , Craun Sarah W.
Published: August 2020

Emergency 911 calls are often the first indication a homicide occurred and serve as initial witness statements in an investigation. The current study explores deception among homicide and homicide staged as suicide 911 calls. One hundred suicides, 18 homicide staged as suicide calls, 31 homicides with uninvolved callers, and 26 homicide offender calls were compared. Little overlap was found in deception indicators between the current findings and previous studies. Caution is warranted when extrapolating from studies using only 911 homicide calls to equivocal death cases, where investigators consider if the manner of death is a suicide or a staged homicide.
IL-6 and Soluble Receptors in Overweight and Obese African American Women With and Without Breast Cancer
Authors: Griffith K. A. , Ryan A. S.
Published: August 2020

Interleukin 6 (IL-6) and its receptors are expressed in approximately half of breast cancer (BC) tissues, and high serum IL-6 levels are associated with poor prognosis. African American (AA) patients with BC have higher serum IL-6 levels compared to Caucasians, suggesting additional risk of disease-related complications in AAs. The purpose of this study was to compare IL-6 complex biomarkers in AA women with and without a history of BC. We conducted a secondary analysis of phenotypic data from two studies of weight loss in AA women with and without a history of BC who had similar age and adiposity. Biomarkers analyzed included tumor necrosis factor alpha (TNF-α), IL-6, IL-6 soluble receptor (IL6sr), and soluble glycoprotein 130 (GP130); IL6sr and GP130 were newly analyzed for this study. TNF-α levels were 1.86 times higher in the BC group (N = 7) compared to those without BC (N = 10; p < 0.001) despite similar age, weight, and body mass index. GP130 levels tended to be higher in women with BC; IL-6 and Il-6 sr were not different between groups. There was a strong correlation between GP130 and TNF-α (r = .638; p = .006) in the group overall. High TNF-α levels in the BC group and a strong correlation between GP130 and TNF-α in the overall group suggest the presence of IL-6 complex initiated TNF-α production. Further study is needed to evaluate IL-6 reduction through a variety of approaches, including weight loss and anti-IL-6 therapies, which may ultimately implicate the reduction of IL-6 complex associated BC-specific recurrence and mortality.
Endocrine Therapy Plus Anti-HER2 Therapy as Adjuvant Systemic Therapy for Luminal HER2-Positive Breast Cancer: An Analysis of the National Cancer Database
Authors: Nahleh Zeina A , Elimimian Elizabeth B , Elson Leah C , Hobbs Brian , Wei Wei , Blake Cassann N
Published: August 2020

Background:

Guidelines regarding the usage of adjuvant systemic therapy in patients with small human epidermal growth factor receptor 2 (HER2)-positive and estrogen receptor/progesterone receptor–positive (luminal HER2 positive) tumors are nonspecific. Outcomes of chemotherapy followed by endocrine therapy (ET), with or without anti-HER2 therapy, vs ET alone (no chemotherapy) have not been widely studied in this disease subtype. We sought to examine the usage and outcomes of adjuvant systemic therapy (ET vs chemotherapy with or without trastuzumab) in stage I luminal HER2-positive breast cancer (BC), based on the large National Cancer Database.

Methods:

We conducted a retrospective analysis of patients with luminal HER2-positive stage I BC, diagnosed between 2010 and 2015, in the United States, using univariable and multivariable logistic regression analyses. The Kaplan-Meier method estimated overall survival (OS).

Results:

A total of 37 777 patients were included in the analysis; of these, n = 32 594 (86%) received adjuvant ET and n = 5183 (14%) received chemotherapy. Around 40% of all patients received anti-HER2 therapy (trastuzumab). Patients who received trastuzumab had a better 5-year OS (93.4% vs 92.0%, P = .0002) compared with those who did not. Patients who received anti-HER2 therapy plus ET had the best OS rate at 5 years (93.5%, confidence interval [CI]: 89.2%-98%, P < .0001) compared with those receiving anti-HER2 therapy plus chemotherapy (92.7%, CI: 89.4%-96.1%, P < .0001).

Conclusions:

Most patients in the United States, with stage I luminal HER2 positive BC, received ET, not chemotherapy but most of them do not receive anti-HER2 therapy resulting in inferior outcome. Future trials exploring the de-escalation of systemic adjuvant therapy for early-stage luminal HER2-positive BC to ET plus anti-HER2 therapy would be desirable.