bluuebunny/crossref_metadata_2025 huggingface dataset:
Warm Dark matter constraints from the joint analysis of CMB, Ly α, and global 21 cm data
Authors: Chatterjee Atrideb , Choudhury Tirthankar Roy
Published: December 2023

With the help of our previously built MCMC (Markov chain Monte Carlo)-based parameter estimation package cosmoreionmc, we investigate in detail the potential of 21 cm global signal, when combined with cosmic microwave background (CMB) and observations related to the Quasar (QSO) absorption spectra, to constraint the mass of warm dark matter (WDM) particle. For the first time, we simultaneously vary all the free parameters (mass of WDM particle, cosmological parameters, and astrophysical parameters) in a joint analysis with CMB, observations related to the QSO absorption spectra and 21 cm global signal, to address the long-overlooked issue of the possible degeneracies between the dark matter particle mass mX and cosmological/astrophysical parameters. From the existing CMB and QSO absorption spectra data, we can rule out mX < 2.8 keV at 95 per cent confidence level. Including a mock 21 cm global signal in the redshift range z = 25−5 expected to be observed with upcoming instruments designed for global signal, the forecasted constraint is found to be much tighter mX > 7.7 keV, assuming that the true dark matter model is the usual cold dark matter. In case the mock 21 cm signal is constructed for dark matter particles having mX = 7 keV, our forecasts indicate that (mX/keV)−1 is in the range [0.1, 0.2] (95  per cent confidence level). This implies that the future 21 cm data should allow detection of the WDM particle mass if mX ∼ 7 keV.
Measuring black hole spins through X-ray reflection spectroscopy and the relativistic precession model: the case of XTE J1859+226
Authors: Mall Gitika , Liu Honghui , Bambi Cosimo , Steiner James F , García Javier A
Published: December 2023

The development of techniques to measure accurately black hole spins is crucial to study the physics and astrophysics of these objects. X-ray reflection spectroscopy is currently the most popular method to estimate the spins of accreting black holes; so far it has provided a spin measurement of about 40 stellar-mass black holes in X-ray binaries and 40 supermassive black holes in active galactic nuclei. The relativistic precession model (RPM) is another method to measure the spins of stellar-mass black holes: it requires the measurement of the frequencies of three simultaneous quasi-periodic oscillations and can potentially provide precise estimates of the black hole mass and spin. However, the two methods do not seem to provide consistent results when applied to the same sources, which questions the reliability and accuracy of these measurements. Recently, the RPM has been applied to infer the spin of the black hole in XTE J1859+226. The authors found a* = 0.149 ± 0.005 (68  per cent CL). There are no other spin measurements of this source. We looked for archived RXTE observations of XTE J1859+226 with blurred reflection features and found 23 spectra suitable for measuring the spin. We employed two different models with relxill and relxillD and obtained a higher spin value from all these fits. From simultaneous fitting of seven spectra of higher quality, we found $a_* = 0.986^{+0.001}_{-0.004}$ and a* = 0.987 ± 0.003 (90  per cent CL, statistical) with relxill and relxillD, respectively. Our results confirm the discrepancy between the spin measurements inferred from the two techniques.
Comparative Genome Microsynteny Illuminates the Fast Evolution of Nuclear Mitochondrial Segments (NUMTs) in Mammals
Authors: Uvizl Marek , Puechmaille Sebastien J , Power Sarahjane , Pippel Martin , Carthy Samuel , Haerty Wilfried , Myers Eugene W , Teeling Emma C , Huang Zixia
Published: December 2023

The escape of DNA from mitochondria into the nuclear genome (nuclear mitochondrial DNA, NUMT) is an ongoing process. Although pervasively observed in eukaryotic genomes, their evolutionary trajectories in a mammal-wide context are poorly understood. The main challenge lies in the orthology assignment of NUMTs across species due to their fast evolution and chromosomal rearrangements over the past 200 million years. To address this issue, we systematically investigated the characteristics of NUMT insertions in 45 mammalian genomes and established a novel, synteny-based method to accurately predict orthologous NUMTs and ascertain their evolution across mammals. With a series of comparative analyses across taxa, we revealed that NUMTs may originate from nonrandom regions in mtDNA, are likely found in transposon-rich and intergenic regions, and unlikely code for functional proteins. Using our synteny-based approach, we leveraged 630 pairwise comparisons of genome-wide microsynteny and predicted the NUMT orthology relationships across 36 mammals. With the phylogenetic patterns of NUMT presence-and-absence across taxa, we constructed the ancestral state of NUMTs given the mammal tree using a coalescent method. We found support on the ancestral node of Fereuungulata within Laurasiatheria, whose subordinal relationships are still controversial. This study broadens our knowledge on NUMT insertion and evolution in mammalian genomes and highlights the merit of NUMTs as alternative genetic markers in phylogenetic inference.
Reciprocity, Fairness and the Financial Burden of Undertaking COVID-19 Hotel Quarantine in Australia
Authors: Pahlman Kari , Williams Jane , Silva Diego S , Taffs Louis , Haire Bridget
Published: December 2023

In late March 2020 in response to the COVID-19 pandemic, Australia introduced mandatory 14-day supervised quarantine at hotels and other designated facilities for all international arrivals. From July 2020, most states and territories introduced a fixed charge for quarantine of up to $3220 per adult. The introduction of the fee was rationalised on the basis that Australians had been allowed sufficient time to return and there was a need to recover some of the cost associated with administering the program. Drawing on an empirical study of 58 returned Australian citizens and residents quarantined between March 2020 and January 2021, this paper aims to explore how people experienced paying for hotel quarantine, particularly with respect to fairness and relatedly, the principle of reciprocity. Reciprocity requires that the state has an obligation to assist individuals in discharging their duty to comply with public health measures and avoid disproportionate burdens accruing to populations or individuals. Though participants had varying opinions on whether they thought it fair to be charged for their quarantine, for many, the fee constituted a significant burden and source of stress. Given the undertaking of quarantine is primarily for the benefit of the public good, we argue the financial cost imposed on individuals does not meet the demands of reciprocity. It is imperative that future quarantine and isolation arrangements consider seriously the need to minimise burdens of individuals subject to such measures, and that fees do not become a new norm in public health and infectious disease control.
Strategic Foundations of Efficient Rational Expectations
Authors: Barelli Paulo , Govindan Srihari , Wilson Robert
Published: December 2023

We study an economy with traders whose payoffs are quasilinear and whose private signals are informative about an unobserved state parameter. The limit economy has infinitely many traders partitioned into a finite set of symmetry classes called types. Market mechanisms in a class that includes auctions yield the same outcome as the Walrasian rational expectations equilibrium if and only if the efficient allocation has a monotonicity property. Examples illustrate cases where they differ. Monotonicity restricts the heterogeneity among traders’ types.
Distribution of U and 210Po in groundwater of Kodagu district, Karnataka, India
Authors: Namitha S N , Lavanya B S K , Hidayath Mohamed , Pruthvi Rani K S , Karunakara Naregundi , Chandrashekara M S
Published: December 2023

Trace amounts of uranium along with its decay products are found in varying levels in natural soil, rocks, water and air. They are a matter of significant concern due to their carcinogenic nature. In the present work, the distribution of U and 210Po in groundwater of Kodagu District, Karnataka, India, was studied. The concentration of total U in groundwater samples was estimated using LASER and LED fluorimeter, and the activity of 210Po in groundwater was studied using electrochemical deposition followed by alpha counting method. The concentration of U and 210Po varied from 0.4 to 8.8 μgl−1 and 0.47 to 4.35 mBql−1, respectively. The ingestion dose due to U and 210Po in groundwater varied from 0.33 to 7.17 and 0.41 to 3.81 μSv y−1, respectively. The estimated U activity was found to be well below the standard safe limits of 30 μgl−1 in drinking water, as recommended by WHO and USEPA. The 210Po activity was low compared with the recommended 100 mBql−1 standard of WHO.
Heavy particle radioactivity of superheavy nuclei
Authors: Munishamappa Nagaraja A , Munirathnam Rajachari , Manjunatha Holaly C S , Sowmya Nagarajan , Sridhar Krishnachari N , Seenappa Lakshmaiah
Published: December 2023

We investigated different decay modes such as heavy particle radioactivity (HPR), spontaneous fission (SF), alpha decay and beta-decay in superheavy (SH) region 104 ≤ Z ≤ 126. In HPR, different emissions from Zmin = 28 to maximum heavy particle (HP) emission up to Zmax = Z − 82 were considered. In the evaluation of Q-values, mass excess Weizsäcker-Skyrme 4+radial basis function (WS4+RBF) values were taken into account. The half-lives of cluster decay determined using modified generalised liquid drop model (MGLDM) and Coulomb and proximity potential model (CPPM) were in close agreement with the experimental results. The MGLDM produce less deviation compared with CPPM. The role of asymmetry effect, relative neutron excess, pairing effect and Coulomb effect on half-lives were studied. A band of neutron numbers from 193 to 200 shows extra stability against HPR. The HPR of 86Kr, 94Zr, 91Y and 96Mo is observed in the superheavy elements Z = 118, 122−124 and 126. The dominant decay mode identified is compared with SF, alpha and beta± decay, the majority of decay chains end with the lead nuclei, which is also evident in supernova and galaxy spectrum. This study could be useful in nuclear astrophysics.
Synthesis and characterisation of Zn-doped cerium oxide nanoparticles for electromagnetic radiation shielding
Authors: Munirathnam Rajachari , Seenappa Lakshmaiah , Manjunatha Holaly Chandrashekara Shastry , Vidya Yakekadakalu Shivanna , Sridhar Krishnachari Nagarthnamma , Murugan Subramaniam Veera Rethina , Manjunatha Shivanna
Published: December 2023

CeO2-NPs (nanoparticles) exhibit a variety of properties, which have prompted researchers to explore various applications, such as gas sensing, biomedical, Electromagnetic Interference (EMI) shielding, etc. Zn-doped CeO2-NPs with concentrations ranging from 7 to 11 mol were synthesised using Aloe vera extract as a reducing agent by the solution combustion method. As obtained, NPs were characterised by standard techniques. Braggs reflections confirm the formation of a single-phase cubic structure of CeO2Zn NPs. Crystalline size is calculated using both the W-H plot and the Scherrer equation, which were found to be 12 and 9 nm, respectively. The Energy-dispersive X-ray analysis (EDAX) pattern confirmed the presence of Ce, O and Zn. The direct energy band values are found to be decreasing from 3 to 2.87 eV with an increase in the doping concentration of Zn from 7 to 11 mol. Total shielding efficiency (SET) will give the best representation of shielding properties. The SEt values of CeO2Zn NPs are compared to those of other conventional materials and NP materials, finding significant applications in EMI shielding.
An Inhibitor-Monitorable Single-Tube Duplex Quantitative Real-Time PCR Assay for the Detection of ‘Candidatus Liberibacter asiaticus’
Authors: Huang Weida , Zhong Zecheng , Lin Zhihua , Zhang Jinlian , Liu Jinhua , Chen Tingsu , Li Tingdong , Zhang Shiyin , Ge Shengxiang
Published: December 2023

Huanglongbing (HLB) is a citrus infectious disease caused by ‘Candidatus Liberibacter’ spp. Recently, it has begun to spread rapidly worldwide, causing significant losses to the citrus industry. Early diagnosis of HLB relies on quantitative real-time PCR assays. However, the PCR inhibitors found in the nucleic acid extracted from plant materials pose challenges for PCR assays because they may result in false-negative results. Internal standard (IS) can be introduced to establish a single-tube duplex PCR for monitoring the influence of the PCR inhibitor, but it also brings the risk of false-negative results because the amplification of IS may compete with the target. To solve this problem, we proposed a mutation-enhanced single-tube duplex PCR (mSTD-PCR) containing IS with mutant-type primers. By introducing the 3′-terminal mutation in the primer of IS to weaken its amplification reaction and its inhibition of ‘Candidatus Liberibacter asiaticus’ (CLas) detection, the sensitivity and quantitative accuracy of CLas detection will not be affected by IS. In evaluating the sensitivity of CLas detection using simulation samples, the mSTD-PCR showed consistent sensitivity at 25 copies per test compared with the single-plex CLas assay. The detection result of 30 leaves and 30 root samples showed that the mSTD-PCR could recognize false-negative results caused by the PCR inhibitors and reduce workload by 48% compared with the single-plex CLas assay. Generally, the proposed mSTD-PCR provides a reliable, efficient, inhibitor-monitorable, quantitative screening method for accurately controlling HLB and a universal method for establishing a PCR assay for various pathogens.
A Comparison Between Meloidogyne floridensis and M. incognita from California on Susceptible and Resistant Sweetpotato Cultivars
Authors: Ploeg Antoon T. , Stoddard C. Scott
Published: December 2023

The reproduction and ability to cause root-galling of a California isolate of the peach root-knot nematode Meloidogyne floridensis was evaluated on seven sweetpotato (Ipomea batatas) cultivars and compared with an M. incognita race 3 and an M. incognita Mi-gene resistance-breaking isolate. The susceptible tomato (Solanum lycopersicum) cultivar Daniela and the Mi-gene-carrying resistant cultivar Celebrity were included as controls. Repeated trials were done in pots in a nematode-quarantine greenhouse at the University of California, Riverside. The three Meloidogyne isolates reproduced equally well on susceptible tomato. On Mi-gene resistant tomato, the reproduction and root-galling by M. floridensis was intermediate between the avirulent M. incognita race 3 and the resistance-breaking M. incognita isolate. The sweetpotato cultivars ‘Beauregard’ and ‘Diane’ were excellent hosts for all three Meloidogyne isolates. Cultivars Bellevue, Burgundy, and Covington were resistant to these isolates. The cultivars Bonita and Murasaki-29 were hosts for the M. floridensis and the resistance-breaking M. incognita isolate, which allowed an increase in nematode levels, but they were poor hosts, resulting in a decrease in nematode levels for the M. incognita race 3 isolate. The study showed that M. floridensis can reproduce on tomato and some sweetpotato cultivars that are considered resistant to M. incognita.
Identifying victims of labor trafficking
Authors: Meredith Angela C.
Published: December 2023

Globally, more than 40 million people are victims of human trafficking, exploited as a black-market commodity generating more than $150 billion annually. These people are forced to work in various industries, including domestic work and escort services. Though studies are limited, survivor interviews have indicated that most trafficked persons presented to a healthcare provider at some point during their captivity. No single validated tool exists for screening all victims of human trafficking across all healthcare settings, but several mechanisms are available for immediate implementation, and all have the potential to pierce the veil and spare a life from further abuse.
Acute myeloid leukemia
Authors: Becker Michelle , Farina Kyle A. , Mascarenhas John
Published: December 2023

Although relatively rare, acute myeloid leukemia (AML) is the most common type of acute leukemia in adults. AML is associated with poor 5-year overall survival and prompt treatment is critical. Classifying AML based on World Health Organization criteria is important for determining prognosis and applying a risk-adapted treatment approach. Throughout therapy, patients require comprehensive supportive care measures with blood product transfusions, antimicrobial treatment, and frequent monitoring for chemotherapy-related complications. This article provides an overview of AML and its treatments. Clinicians in all specialties must be able to recognize the early signs of AML and ensure their patients seek appropriate expert medical care with a hematologist/oncologist.
Solving the Nursing Shortage
Authors: Lim Fidelindo
Published: December 2023

National work is urgently needed.
Gastrointestinal Adverse Events Associated with Popular Antiobesity Drugs
Authors: Roush Karen
Published: December 2023

Risks may be offset by cardiovascular and other benefits of weight loss.
Sanism
Authors: Poole Jennifer M.
Published: December 2023

What it is and why it matters to nursing
Improving Discharge Teaching for Adult Patients with an Ileostomy
Authors: Roeung Sophany , Lindgren Teri G. , Carley Annette
Published: December 2023

Local problem:

Discharge teaching is essential to the self-care and successful recovery of colorectal surgery patients, yet the trend toward shorter hospital stays for patients with new ileostomies limits opportunities for patient education. As a result, discharged patients at our institution are initiating calls to providers with questions that could have been addressed prior to discharge.

Purpose:

The aim of this quality improvement (QI) project was to decrease patient-initiated postdischarge inquiries using a frequently asked questions (FAQs) handout at discharge.

Methods:

A retrospective chart review of inquiries to the outpatient clinic over the six-month period between July 2020 and January 2021 revealed common concerns, among them bowel movements, home health care, medications, wound care, stoma issues, pathology reports, diet, and activity-related issues. Based on these concerns, a FAQs handout was developed to review with patients prior to discharge. Data from three postdischarge time periods (0 to 72 hours, 72 hours to 21 days, and 0 to 21 days) in the three months from June to September 2021 were analyzed to determine the impact of the intervention on the frequency and content of the patient inquiries.

Results:

Use of the FAQs handout led to a decrease in total patient-initiated postdischarge inquiries from 46 in the preintervention period to five in the postintervention period, and fewer topics of concern prompted patients' postintervention inquiries. There was also a pre-to-postintervention reduction in the proportion of patients who made calls to the outpatient clinic in each of the three postdischarge time periods, the greatest of which—from 49% to 15% of patients—was significant and occurred in the 72-hour-to-21-day period.

Conclusion:

This QI project demonstrated that a change in discharge teaching by adding a FAQs handout to the protocol could be effective.
Factors Associated with Post-Op Delirium Identified
Authors: Rosenberg Karen
Published: December 2023

According to this study:
A Journey Through Dementia
Authors: Jared Barbara
Published: December 2023

As the individual slowly faded, her distant memories and generous spirit lingered on.
Candida auris
Authors: Borton Dottie
Published: December 2023

Candida auris (C. auris) is a human pathogen that can colonize the skin and various body sites without signs or symptoms or cause serious invasive infections with high mortality. The number of cases involving drug-resistant C. auris infections have increased in the US in recent years. This article provides an overview of C. auris and important infection prevention and control measures.
Characterization of risk factors for obstructive sleep apnea and its association with absenteeism among nurses
Authors: Sadeghniiat-Haghighi Khosro , Najafi Arezu , Eftekhari Sahar , Behkar Atefeh , Tarkhan Samareh
Published: December 2023

Purpose:

To characterize risk factors associated with obstructive sleep apnea (OSA) and its relationship with nurses' absenteeism.

Methods:

A cross-sectional study was conducted from 2018 to 2020 at a 1,000-bed academic hospital complex and biomedical research facility in Tehran, Iran. Participants were selected through consecutive sampling after obtaining ethical approval and informed consent. Data on demographics, medical conditions, occupational characteristics, and absenteeism were collected through face-to-face interviews. The STOP-Bang questionnaire was utilized to assess the probability of OSA. Statistical tests included the Mann-Whitney U, t-test, Chi-square, and multivariable regression.

Results:

In this study involving 304 nurses, the majority were female (81.3%), with an average age of 35. About 27 participants (8.9%) had a high probability of OSA, with male sex, older age, higher body mass index, neck circumference, and diastolic BP identified as the main determinants of OSA. Additionally, shift work and night shifts were associated with increased absenteeism, while sex showed no significant association with absenteeism rates among nurses.

Conclusion:

Male sex, neck circumference (obesity), night shifts, and diastolic BP can predict OSA risk. However, unauthorized absence from work is not associated with a high risk for OSA (STOP-BANG ≥3) or the individual risk factors of OSA.
Clinical Implications of the Relationship Between Naltrexone Plasma Levels and the Subjective Effects of Heroin in Humans
Authors: Castillo Felipe , Harris Hannah M. , Lerman Dania , Bisaga Adam , Nunes Edward V. , Zhang Zhijun , Wall Melanie , Comer Sandra D.
Published: December 2023

Background

Extended-release naltrexone (NTX) is an opioid antagonist approved for relapse prevention after medical withdrawal. Its therapeutic effect is dependent on the NTX plasma level, and as it decreases, patients may lack protection against relapse and overdose. Therefore, identifying the minimally effective NTX level needed to block opioid-induced subjective effects has important clinical implications.

Methods

This secondary, individual-level analysis of data collected in a human laboratory study was conducted to evaluate the relationship between NTX levels and subjective effects of an intravenously administered 25-mg challenge dose of heroin in non–treatment-seeking participants with opioid use disorder (N = 12). Subjective ratings of drug liking using a 100-mm visual analog scale (VAS) and NTX levels were measured across 6 weeks after participants received a single injection of either extended-release NTX 192 mg (N = 6) or 384 mg (N = 6). Cubic spline mixed-effects models were used to provide 95% prediction intervals for individual changes in liking scores as a function of NTX levels.

Results

Naltrexone levels above 2 ng/mL blocked nearly all VAS ratings of drug liking after intravenous heroin administration. Participants with NTX levels ≥ 2 ng/mL had minimal (≤20 mm) changes from placebo in VAS ratings of drug liking based on 95% prediction intervals. In contrast, NTX levels < 2 ng/mL were associated with greater variability in individual-level subjective responses.

Conclusions

In clinical practice, a plasma level range of 1 to 2 ng/mL is considered to be therapeutic in providing heroin blockade. The current findings suggest that a higher level (>2 ng/mL) may be needed to produce a consistent blockade.
Maternal Mortality
Authors: Davidson Karina W. , Terry Mary Beth , Braveman Paula , Reis Pamela J. , Timmermans Stefan , Epling John W.
Published: December 2023

The National Institutes of Health’s (NIH) Pathways to Prevention panel on postpartum health provides a consensus statement on the evidence, research gaps, and future priorities to prevent maternal morbidity and mortality. The panel reviewed an NIH-commissioned evidence review and workshop that included epidemiologic studies, demonstration interventions, and other maternal morbidity and mortality research to create these national recommendations. The panel concludes that a maternal morbidity and mortality crisis reflects a systemic failure of current U.S. health care, research efforts, and social policies. The panel recommends improving maternal health through a “maternal morbidity and mortality prevention moonshot” that adopts a comprehensive, multilevel life course conceptual framework; strengthens the research methods used within the science of maternal health; establishes and conducts national prevention, treatment, and policy interventions; and reimburses evidence-informed clinical approaches to improve maternal health across the life course. Without a national focus on fundamentally transformative interventions and other initiatives aimed at redressing structural racism and inequities in health care, current interventions and clinical advances in maternal morbidity and mortality prevention will remain tragically insufficient.
Cardiovascular disease in spondyloarthritis: a narrative review of risk factors and the effect of treatments
Authors: Sen Rouhin , Caplan Liron , Danila Maria I.
Published: December 2023

Purpose of review

This review summarizes the recent evidence available regarding the epidemiology of cardiovascular disease in spondyloarthritis (SpA), including the effect of disease modifying drugs on cardiovascular risk.

Recent findings

People with SpA suffer from an increased risk of cardiovascular disease compared to the general population. This elevated risk is explained by the high prevalence of traditional cardiovascular risk factors and inflammation from disease activity leading to endothelial dysfunction and accelerated atherosclerosis. Consequently, the American College of Cardiology/American Heart Association and the European League Against Rheumatism recommend enhanced cardiovascular risk screening in SpA patients. There is evidence from observational studies that methotrexate and tumor necrosis factor inhibitors reduce the risk of cardiovascular events in SpA. Unlike what is observed in the general population, the use of nonsteroidal anti-inflammatory drugs does not appear to increase cardiovascular disease risk in SpA.

Cardiovascular diseases are increasingly recognized in patients suffering from SpA, especially axial SpA and psoriatic arthritis. Cardiovascular diseases can cause significant morbidity, mortality, and add to the overall disease burden. Disease modifying drugs may mitigate some of the cardiovascular risk; however, a multidisciplinary team is needed to monitor patients and improve cardiovascular health status.
Residual Paresthesia After Surgery for Degenerative Cervical Myelopathy
Authors: Tamai Koji , Terai Hidetomi , Iwamae Masayoshi , Kato Minori , Toyoda Hiromitsu , Suzuki Akinobu , Takahashi Shinji , Sawada Yuta , Okamura Yuki , Kobayashi Yuto , Nakamura Hiroaki
Published: December 2023

Study Design.

Multicenter, prospective cohort study.

Objective.

The current study aimed to identify the incidence of residual paresthesias after surgery for degenerative cervical myelopathy (DCM), and to demonstrate the impact of these symptoms on clinical outcomes and patient satisfaction.

Summary of Background Data.

Surgery for DCM aims to improve and/or prevent further deterioration of physical function and quality-of-life (QOL) in the setting of DCM. However, patients are often not satisfied with their treatment for myelopathy when they have severe residual paresthesias, even when physical function and QOL are improved after surgery.

Materials and Methods.

The authors included 187 patients who underwent laminoplasty for DCM. All patients were divided into two groups based on their visual analog scale score for paresthesia of the upper extremities at one year postoperatively (>40 vs. ≤40 mm). Preoperative factors, changes in clinical scores and radiographic factors, and satisfaction scales at one year postoperatively were compared between groups. The authors used mixed-effect linear and logistic regression modeling to adjust for confounders.

Results.

Overall, 86 of 187 patients had severe residual paresthesia at one year postoperatively. Preoperative patient-oriented pain scale scores were significantly associated with postoperative residual paresthesia (P=0.032). A mixed-effect model demonstrated that patients with severe postoperative residual paresthesia showed significantly smaller improvements in QOL (P=0.046) and myelopathy (P=0.037) than patients with no/mild residual paresthesia. Logistic regression analysis identified that residual paresthesia was significantly associated with lower treatment satisfaction, independent of improvements in myelopathy and QOL (adjusted odds ratio: 2.5, P=0.010).

Conclusion.

In total, 45% of patients with DCM demonstrated severe residual paresthesia at one year postoperatively. These patients showed significantly worse treatment satisfaction, even after accounting for improvements in myelopathy and QOL. As such, in patients who experience higher preoperative pain, multidisciplinary approaches for residual paresthesia, including medications for neuropathic pain, might lead to greater clinical satisfaction.

Level of Evidence.

3.
Concurrence of Ocular Cicatricial Pemphigoid in Chronic Ocular Graft-Versus-Host Disease
Authors: Taketani Yukako , Dehghani Shima , Sinha Shruti , Freitag Suzanne K. , Papaliodis George , Foster Stephen , Dohlman Thomas H. , Dana Reza
Published: December 2023

Purpose:

The aim of this study was to report a series of 3 patients with ocular graft-versus-host disease (oGVHD) with progressive cicatricial conjunctival changes who were diagnosed with ocular cicatricial pemphigoid (OCP) after conjunctival biopsy.

Methods:

This study was a retrospective case series.

Results:

Three patients who received hematopoietic stem cell transplantation for hematologic malignancies developed oGVHD and subsequently were diagnosed with OCP. Case 1 was a 73-year-old woman with oGVHD who developed symblepharon and showed positive IgA, IgG, and C3 staining of the basement membrane zone (BMZ) on conjunctival biopsy, consistent with OCP. She was systemically treated with tacrolimus and prednisone with resolution of conjunctival inflammation. Case 2 was a 68-year-old man with oGVHD who developed symblepharon, severe dry eye, and corneal epithelial defect. An initial conjunctival biopsy was negative, but a repeat biopsy performed 10 years later showed positive BMZ IgA and IgG staining. Healing of the epithelial defect was achieved after treatment with high-dose systemic cyclosporine. Case 3 was a 75-year-old woman with oGVHD who had a nonhealing corneal epithelial defect and symblepharon with positive IgA BMZ staining on conjunctival biopsy, consistent with OCP. The patient responded well to methotrexate with healing of the epithelial defect.

Conclusions:

Although low-grade conjunctival fibrotic changes may be observed in chronic oGVHD, development of severe and progressive cicatricial changes, including symblepharon formation, should prompt consideration of biopsy to rule out concurrent OCP, the management of which differs from that of oGVHD.
Light as a drug: prospective randomized evaluation and comparison of the effect of decreased illumination on visual recovery after cataract surgery
Authors: Rosenberg Eric D. , Shah Lopa S. , Sippel Kimberly C. , Nattis Alanna S.
Published: December 2023

Purpose:

To compare the effect of decreased illumination on the rate of postoperative visual recovery, and the incidence of cystoid macular edema (CME) with surgical visualization achieved with a traditional analog operating microscope compared with a 3D digital visualization system.

Setting:

Ambulatory surgery center, New York.

Design:

Prospective, randomized, consecutive, single-surgeon series.

Methods:

Patients undergoing routine cataract surgery were randomized into either (1) visualization through the binoculars of a standard operating microscope (“traditional group”) or (2) visualization through a 3D digital visualization system affixed to the same operating microscope (“digital group”). Note was made in each case of light intensity used, light exposure time, cumulative dissipated energy (CDE), femtosecond laser use, preoperative medical and ocular conditions, intraoperative and/or postoperative complications, and preoperative and postoperative visual acuities and optical coherence tomography confirmed CME.

Results:

The study comprised 118 eyes in the traditional group and 96 eyes in the digital group. There were no differences in preoperative visual acuity, light exposure time, CDE, or femtosecond laser use between groups, but the light intensity used in the digital group was significantly less (19.5% ± 0.5%) than in the traditional group (48.6% ± 0.6%; P < .001). Furthermore, the digital group achieved a better decimal postoperative day 1 visual acuity (0.60 ± 0.03) with less rates of CME (2.1%) when compared with that of the traditional group (0.51 ± 0.02, P = .03; and 9.2%, P = .03), respectively.

Conclusions:

Visual recovery and CME rates were significantly better in patients who underwent cataract surgery assisted by the 3D digital visualization platform without an increase in complications or surgical time.
Understanding Potentially Preventable 7-day Readmission Rates in Hospital Medicine Patients at a Comprehensive Cancer Center
Authors: Leung Cerena K. , Walton Natalie C. , Kheder Ed , Zalpour Ali , Wang Justine , Zavgorodnyaya Daria , Kondody Sonia , Zhao Christina , Lin Heather , Bruera Eduardo , Manzano Joanna-Grace M.
Published: December 2023

This study aimed to describe the potentially preventable 7-day unplanned readmission (PPR) rate in medical oncology patients. A retrospective analysis of all unplanned 7-day readmissions within Hospital Medicine at MD Anderson Cancer Center from September 1, 2020 to February 28, 2021, was performed. Readmissions were independently analyzed by 2 randomly selected individuals to determine preventability. Discordant reviews were resolved by a third reviewer to reach a consensus. Statistical analysis included 138 unplanned readmissions. The estimated PPR rate was 15.94%. The median age was 62.50 years; 52.90% were female. The most common type of cancer was noncolon GI malignancy (34.06%). Most patients had stage 4 cancer (69.57%) and were discharged home (64.93%). Premature discharge followed by missed opportunities for goals of care discussions were the most cited reasons for potential preventability. These findings highlight areas where care delivery can be improved to mitigate the risk of readmission within the medical oncology population.
The implementation and impact of an advanced practice recognition program
Authors: Bork Stephanie , LeBar Kiersten
Published: December 2023

Meaningful job recognition is a pillar for sustaining healthy work environments and proven beneficial for job satisfaction and retention. However, few dedicated award recognition programs exist for advanced practice registered nurses (APRNs), and no available literature evaluates the impact on professional practice, sense of belonging, and job retention or satisfaction. The purpose of this study was to introduce a novel award recognition program for APRNs and physician associates (PAs) in a large academic medical system and evaluate it's impact on job satisfaction, retention, and sense of belonging. Five awards were created to recognize areas of achievement for clinically practicing APRNs or PAs within an academic health system. Nomination letters were collected, deidentified, and reviewed by an award committee. Winners were announced and received a plaque. A survey was sent to employed APRNs evaluating their response to the program. The survey was sent to both APRNs (83%) and PAs (17%). Survey end points included job satisfaction, willingness to stay in role for 1 and 5 years, sense of community, something to work toward, and increasing recognition of APRNs. Results showed statistical significance in three areas. Advanced practice registered nurses or PAs who were aware of award opportunities and/or nominated for an award showed higher job satisfaction, more likely to stay in job for 1 year, and felt a greater level of recognition. Dedicated APRN award programs may have a positive impact on job satisfaction and retention. This model may be extrapolated to provide greater opportunities for meaningful recognition among clinical APRNs.
Self-Report Measures of Fatigue for People With Multiple Sclerosis: A Systematic Review
Authors: Cohen Evan T. , Matsuda Patricia Noritake , Fritz Nora E. , Allen Diane D. , Yorke Amy M. , Widener Gail L. , Jewell Sarah T. , Potter Kirsten
Published: December 2023

Background and Purpose:

The symptom of fatigue impairs function in people with multiple sclerosis (MS). Choosing appropriate measures to assess fatigue is challenging. The purpose of this article is to report the findings of a systematic review of patient-reported fatigue measures for people with MS.

Methods:

PubMed, CINAHL, and Embase databases were searched through January 2020 using terms related to fatigue and MS. Studies were included if the sample size was 30 or more or smaller samples if adequately powered, and if information about measurement characteristics (ie, test-retest reliability, content validity, responsiveness, interpretability, or generalizability) of the measure(s) could be extracted. Study quality was appraised with the 2-point COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Data about measurement characteristics, psychometrics, and clinical utility were extracted and results were synthesized.

Results:

Twenty-four articles met inclusion criteria with information about 17 patient-reported fatigue measures. No studies had critical methodologic flaws. Measurement characteristic data were not available for all measures. Clinical utility varied in time to complete and fatigue domains assessed.

Discussion and Conclusions:

Five measures had data pertaining to all properties of interest. Of these, only the Modified Fatigue Impact Scale (MFIS) and Fatigue Severity Scale (FSS) had excellent reliability, responsiveness data, no notable ceiling/floor effects, and high clinical utility. We recommend the MFIS for comprehensive measurement and the FSS for screening of subjective fatigue in people with MS.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A443).
A Mild Phenotype of Overlapping Syndrome With Myelin-Oligodendrocyte Glycoprotein and Glial Fibrillary Acidic Protein Immunoglobulin G
Authors: Pan Danmei , Gu Jina , Zeng Chengjun , Chen Lin
Published: December 2023

Introduction:

Glial fibrillary acidic protein (GFAP) astrocytopathy, an autoimmune central nervous system disorder characterized by the development of immunoglobulin G reactive with GFAP, has received growing attention in recent years. It is documented that GFAP-immunoglobulin G and other autoantibodies can be both detected in some patients. However, the coexistence of anti–myelin-oligodendrocyte glycoprotein (MOG) and GFAP antibodies is rarely reported.

Case:

A 45-year-old man presented with headache, fever, backache, dysuria, tremble of hands, numbness of lower limbs, without diplopia, decreased vision, or other manifestations of optic neuritis. He was initially diagnosed with viral meningitis. After antiviral therapy, his headache, fever, and dysuria were improved, but the tremble of his upper limbs and numbness of his lower limbs still existed. A lumbar puncture was further performed and found both anti-GFAP and anti-MOG antibodies in the cerebrospinal fluid. No evidence of other immune disorders or infectious diseases was revealed. Meanwhile, a magnetic resonance scan showed enhancement of spinal pia mater in cervical, thoracic, and lumbar segments. He was then treated with immunoglobulin (intravenous immunoglobulin) therapy (25 g for 5 d), and steroid pulse therapy (methylprednisolone, 1 g for 5 d), followed by a gradual tapering of oral prednisolone.

Conclusion:

We reported a case of overlapping anti-GFAP and anti-MOG antibody-associated syndrome. This case enriches our understanding of the clinical manifestations of overlapping syndrome and expands the spectrum of this disorder.
Venous thromboembolism in patients with liver cancer: a retrospective study
Authors: Yang Sheng-Li , Zhan Jing , Peng Miao , Hou Ling-Zhi , He Qiu-Yi , Jin Hao-Ran , Wei Bai , Hu Jian-Li
Published: December 2023

Background

Little is known about the association between venous thromboembolism (VTE) and tumors. In this study, we identified the clinical features of patients with liver cancer who presented with at least 1 VTE episode.

Methods

This was a retrospective case-control study of a single-institution database with univariate and multivariate analyses using χ
2 and Fisher exact tests. Statistical significance was set at P < 0.05.

Results

The overall incidence of VTE in the patients with liver cancer was 1.2%. More than half (53.8%) of the 13 patients with liver cancer and venous thrombosis died within 2 months. The thrombus in 12 patients (92.3%) was located within the deep veins, whereas the other patient (7.7%) was diagnosed with a pulmonary embolism. Of the 11 patients, 9 (69.2%) had swelling and/or pain symptoms. All 6 patients with peripherally inserted central catheters (PICCs) had thrombosis, accounting for 46.2% of all patients with liver cancer and venous thrombosis. Compared with the controls, liver cancer patients with PICC tubes, thrombosis-related symptoms such as swelling and pain, traumatic stimulation such as fracture, acute respiratory distress syndrome, and interventional therapy or hemostasis drugs were prone to be diagnosed with VTE (P < 0.05).

Conclusions

Liver cancer and thrombosis are rare and have poor prognoses. Liver cancer with thrombosis may be associated with PICC catheterization, traumatic stimulation, or hemostatic drugs. Patients with liver cancer and thrombosis often present with swelling and pain.
Analysis of EGFR Gene Mutations in Lung Adenocarcinoma in Karamay, Xinjiang
Authors: Ma Yuhua , Li Yuanxin , Jiang Min , Gao Jing , Lai Yining , Kulaixijiang Kamila , Zhu Min , Liang Fei
Published: December 2023

Objective

To investigate the mutation types and mutation rate of the epidermal growth factor receptor (EGFR) gene in patients with lung adenocarcinoma and the clinical features of lung adenocarcinoma with EGFR gene mutations in Karamay, Xinjiang, China.

Methods

Paraffin-embedded tissue samples of adenocarcinoma patients were collected in the Karamay Central Hospital from March 2016 to June 2019, and mutations in exon 18–21 of the EGFR gene were detected by the allele-specific amplification polymerase chain reaction (Amplification Refractory Mutation System–PCR) method. The relationships between the mutation types, mutation incidence, and clinical features were analyzed.

Results

Of the 170 patients with lung adenocarcinoma, 83 had EGFR mutations. The total mutation rate of EGFR in patients with lung adenocarcinoma was 48.8%, which included mutations in exons 18 (1.2% [2/170]), 19 (19.4% [33/170]), 20 (2.4% [4/170]), and 21 (20.6% [35/170]). Intriguingly, there was a case with 9 mutations in exons 20 and 21. The mutations in exon 19 of EGFR resulted in the deletion of codons 746 to 750. The main mutation in exon 21 was L858R (91.4% [32/35]). There was no significant difference in exons 19 and 21 mutation rates (P > 0.05). The mutation rate of EGFR in female patients was significantly higher than that in male patients (P < 0.05) but had no correlation with the age, smoking status, and clinical stage of patients with non–small cell lung cancer (P > 0.05). The EGFR mutation rate may be related to the degree of tumor differentiation.

Conclusion

Among patients with lung adenocarcinoma in Kelamayi (city in Xinjiang), EGFR mutations were more frequently detected in female patients, and the main sites of mutations were exons 19 and 21.
Nomogram for Predicting the Risk of Complications in Hospitalized Children With Peripheral Intravenous Catheters
Authors: Zhang Xin , Xu Shuhui , Sun Jing , Yang Ying , Piao Meihua , Lee Shih-Yu
Published: December 2023

Objective

The aim of the study is to identify the hospitalized children at risk of peripheral intravenous catheter (PIVC) complications by severity prediction.

Methods

The study included the data of 301 hospitalized children with PIVC complications in 2 tertiary teaching hospitals. A researcher-designed tool was used to collect risk factors associated with PIVC complications. Predictors of PIVC complications at univariate analysis and multivariable logistic regression analysis by backward stepwise. A nomogram was constructed based on the results of the final multivariable model, making it possible to estimate the probability of developing complications.

Results

A total of 182 participants (60.5%) had a moderate injury from PIVC complications. Multivariable logistic regression analysis indicated that the vascular condition, limb immobilization, needle adjustment in venipuncture, infusion length, infusion speed, and insertion site were independent predictors. The nomogram for assessing the severity of PIVC complications indicated good predictive accuracy (area under the curve = 0.79) and good discrimination (concordance index = 0.779). Decision curve analysis demonstrated that the nomogram was a good clinical value with a wide range of threshold probabilities (4%–100%).

Conclusions

The risk prediction model has good predictive performance, and the nomogram provides an easy-to-use visualization to identify the severity of PIVC complications and guide timely nursing care management.