bluuebunny/crossref_metadata_2025 huggingface dataset:
“Those Plates That Save Me”: Experiences of Italian Patients With Implantable Cardioverter Defibrillator
Authors: Rosi Ivana Maria , Bombardieri Francesca , Steri Daniele , Sternativo Mimma , Rancati Stefania
Published: October 2020

This study aimed to investigate and understand the experiences and feelings lived by people with an ICD. Qualitative study, semi-structured interviews were conducted with a sample of 16 patients, during the annual follow-up. A hermeneutical analysis of the interviews was carried out to identify the themes. Four main themes were classified: “My heart falls asleep,” highlighting a reduced awareness of the pathology and ICD installation; “But what is this thing. . .?” underlining the lack of information and fears related to the device and its functioning; “I cannot hug the microwave” which describes the changes brought about by the surgery; “And with this one I am alright for the rest of my life”, involving hopes and life expectations. This study highlighted the patients’ need for major support from health professionals while processing their new life conditions.
Conversation Under the Sign of the Resurrection: Developing a Resurrection Lens for Pastoral Praxis
Authors: Redding Jordan
Published: October 2020

The purpose of this article is to present Eduard Thurneysen’s practical-theological reading of the Nicodemus narrative as a way to demonstrate the importance of developing a resurrection hermeneutic for the praxis of pastoral care. I will argue that Thurneysen’s kerygmatic approach to pastoral care is of enduring value for pastoral theology and practice today. Though aspects of his pastoral theology are a clear product of his own time and place, Thurneysen’s pastoral theological approach is urgently needed in the teaching of pastoral care today, which often neglects the character of pastoral conversation as an opportunity to encounter the living Lord. If pastoral conversation is eschatologically oriented, it will challenge many of the assumptions of how it is actually practiced today.
Community Health Needs Predict Population Health Partnerships Among U.S. Children’s Hospitals
Authors: Franz Berkeley , Cronin Cory E. , Wainwright Alexandra , Lai Alden Yuanhong , Pagán José A.
Published: October 2020

Cross-sector collaboration is critical to improving population health, but data on partnership activities by children’s hospitals are limited, and there is a need to identify service delivery gaps for families. The aim of this study is to use public community benefit reports for all children’s hospitals in the United States to assess the extent to which children’s hospitals partner with external organizations to address five key health needs: health care access, chronic disease, social needs, mental health, and substance abuse. Strategies that involved partnering with community organizations were most common in addressing social needs and substance abuse. When adjusted for institutional and community characteristics hospitals in a multilevel regression model, hospitals had higher odds of partnering to address chronic illness and social needs. To encourage hospital engagement with complex social and behavioral health needs and promote health equity, support should be provided to help hospitals establish local population health networks.
Capsule-related dysphagia and the use of netupitant/palonosetron (Akynzeo™) capsules – A report of two cases and a solution
Authors: Behbahany Kevin , Bubalo Joseph
Published: October 2020

Netupitant/palonestron (NEPA, Akynzeo™) is a fixed combination of netupitant 300 mg and palonosetron 0.5 mg that is indicated for the prevention of chemotherapy-induced nausea and vomiting (CINV). NEPA is supplied as a hard gelatin capsule and indicated to be administered whole with or without food. The efficacy of NEPA was maintained when administered as an oral dose of netupitant given concomitantly (in separate formulations after removal from the hard gelatin capsule) with a single oral dose of palonosetron. At our institution, two patients experienced difficulty swallowing the capsule leading to opening the capsule and individual administration of the medications. We observed that the efficacy was maintained when the opened NEPA capsule was administered as individual medications. We report the details of these two patient cases.
Predictive factors for carboplatin hypersensitivity reactions in gynecologic cancers: Effect of BRCA status
Authors: Rolfe Melanie , Gegeckas Christine , Turner Suzanne , Orr James W
Published: October 2020

Introduction

Carboplatin hypersensitivity reactions have been reported to occur in up to 16% of patients with gynecologic cancers. Several predisposing factors have been suggested including presence of BRCA1/2 mutation, however, contribution of these mutations to reaction development has not been extensively studied. The purpose of this study was to determine if there is an association between BRCA1/2 mutation status and the development of carboplatin hypersensitivity reactions. Methodology: Eligible patients were women aged 18 years or older with a diagnosis of ovarian, fallopian tube, uterine, endometrial, or primary peritoneal cancer who attempted to receive at least one dose of carboplatin. The primary outcome was the effect of BRCA1/2 status on the development of carboplatin hypersensitivity reactions with regard to: reaction frequency, timing, and severity. Secondary outcomes included identification of additional risk factors that may help identify predisposition to carboplatin hypersensitivity reaction.

Results

A total of 44 patients were included in this study. Five patients (38%) in the reaction group and 4 patients (31%) in the no reaction group had a documented mutation in one or both BRCA genes (p = 1.00). No significant differences were found in terms of reaction severity or symptoms, and timing of reaction after dose administration. Incidence of thyroid disorder was significantly higher among patients who experienced a hypersensitivity reaction (1 (4%) vs 10 (45%); p = 0.004).

Conclusion

BRCA mutation status was not associated with an increased risk of carboplatin hypersensitivity in our patient population. Further investigation into thyroid dysfunction as a risk factor for reaction development is warranted.
Analysis of the use of memes as an exponent of collective coping during COVID-19 in Puerto Rico
Authors: Flecha Ortiz José A , Santos Corrada Maria A , Lopez Evelyn , Dones Virgin
Published: October 2020

During the emergence of the novel COVID-19, a proliferation of memes related to events discussed in Spanish-speaking social media was observed. This study analysed the four stages of collective coping to determine how memes became triggered social representations that gradually monopolized the mainstream media. The research was performed through an electronic survey of 351 participants from Puerto Rico, which was subsequently analysed through partial least squares structural equation modeling (PLS-SEM). The study’s results reflected psychological implications in the use of memes in terms of how they were used to mitigate the stressful circumstances of a social event. This study is a pioneer in the application of Collective Coping Theory in the context of the effects that memes produce as a link to mitigate stressors. It also discusses how, when a culture faces a problem, memes become a decisive means to reinterpret the situation.
Can children’s play themes be assessed to inform play therapy practice?
Authors: Sarah Bridget , Parson Judi , Renshaw Kate , Stagnitti Karen
Published: October 2020

In play therapy with children, identifying play themes is key to understanding the meaning within sessions, and allows therapists to systematically track therapeutic change. This study investigated if play themes could be identified using a time limited, standardized assessment, for children aged 5–7 years. A descriptive, observational mixed methods, non-experimental study with 30 typically developing children was conducted, with participants assessed individually on one occasion using the Child-Initiated Pretend Play Assessment (ChIPPA). Play themes were able to be identified for 26 of the 30 participants. Of these 26 children, a range of primary and subthemes were observed. These findings indicate that a baseline measure of both play ability and play themes can be integrated to prescribe and align the model of play therapy with the needs of the child. Play themes were not identified for four participants which may be due to limited pretend play ability, indicating that deficits in play ability may need to be addressed in the first instance.
Health indicator construction for roller bearing based on an unsupervised deep belief network with a novel sigmoid zero local minimum point model
Authors: Xu Fan , Shu Xin , Li Xin , Tang Ruoli
Published: October 2020

Extracting bearing degradation curves with good smoothness and monotonicity as a health indicator lays a solid foundation for predicting the bearing’s remaining useful life. Traditional bearing health indicator construction methods generally have the following problems: (1) they require manual experience, such as manual labeling of data is burdensome when the amount of collected data is large, for feature extraction, selection, and fusion with other indicators and models because the methods rely on substantial expert experience and signal-processing technology; (2) deep belief networks in deep learning require engineering experts with rich experience to label the data, and because the degradation state of a bearing is constantly changing, it is difficult to rely on manual experience to distinguish and label it accurately; (3) owing to the noise in the data collected during the study, the extracted health indicator curve shows obvious oscillation and poor smoothness. In response to the above problems, this study proposes a model based on an unsupervised deep belief network and a new sigmoid zero local minimum point to eliminate health indicator curve oscillation and improve monotonicity. The main idea is that a deep belief network without a label output layer is used to extract the preliminary health indicator curve directly from the original signal, whereas the sigmoid zero local minimum point uses the average value based on a sigmoid function to reduce the weight of the current health indicator value to eliminate concussion, and then it uses the zero and local minimum points to further improve the monotonicity of the extracted health indicator without parameters. Finally, the superiority of the model proposed in this study (deep belief network–sigmoid zero local minimum point) is verified through a comparison of multiple bearing datasets and other models.
Comparison of bursting pressure on sleeve gastrectomy staple lines between stapling, buttressing, and oversewing
Authors: Tolone Salvatore , Gambardella Claudio , del Genio Gianmattia , Brusciano Luigi , Ruggiero Roberto , Lucido Francesco Saverio , Docimo Ludovico
Published: October 2020

Backgrounds. One of the major complications after laparoscopic sleeve gastrectomy (LSG) is represented by leaks along the staple line. Several reinforcement techniques have been proposed, but scarce data about the real strengthening offered are present. Thus, we aimed to evaluate if different reinforcements produced different bursting pressures after LSG, and then to verify if the clinical application of the stronger reinforcement produced a reduction in leakage rate. Methods. We prospectively enrolled all consecutive obese patients that underwent LSG. We tested 3 different types of staple lines, as follows: group 1, no reinforcement; group 2, bioabsorbable buttress reinforcement; group 3, invaginating overrunning barbed suture. A burst pressure test was applied to the gastric specimen by means of high-resolution manometric catheter. After burst pressure tests, a subsequent consecutive series of patients were treated with the most effective reinforcement, and rate of leaks was recorded. Results. We enrolled in total 110 obese patients; 20 patients for each group of staple line reinforcement and then other 50 consecutive patients underwent LSG with the higher burst pressure staple line reinforcement. Median burst pressures were similar in group 1 and group 2; group 3 showed a statistically significant pressure increase ( P < .0001) than group 1 and group 2, with a 5.2-fold value. Other consecutive 50 obese patients underwent LSG with overrunning reinforcement. In none of them a leak was detected. Conclusions. Reinforcement of the SG staple line, with overrunning suture, seems to drastically increase bursting pressures in an ex vivo model and it is promising when reproduced in vivo.
Bearing faults classification under various operation modes using time domain features, singular value decomposition, and fuzzy logic system
Authors: Gougam Fawzi , Rahmoune Chemseddine , Benazzouz Djamel , Afia Adel , Zair Mohamed
Published: October 2020

Nowadays, multi-fault diagnosis has become the most interesting topic for researchers, since it has lately attracted a substantial attention. The most published works recently have considered defects detection, identification, and classification as the toughest challenge for rotating machinery monitoring. As feature extraction requires robust techniques for online inspection with a high level of expertise to make automatic decisions on the running machine health status, a robust approach is required to adjust the misclassification of the extracted features, especially under various working conditions. In this paper, we propose the combination of two Time Domain Features (TDFs) in tandem with Singular Value Decomposition (SVD) and Fuzzy Logic System (FLS) to build an enhanced fault diagnosis technique for rolling bearing. The original vibration signal is divided first into several data samples. Thereafter, TDFs are applied on each sample to construct a feature matrix during the feature extraction step. Afterwards, SVD is performed on the obtained matrices in order to reduce their dimension and select the most stable vectors (singular values). Finally, FLS is employed as a powerful tool for automatic feature classification. Experimental results confirm that our suggested approach can enhance the ability to assess the degradation of bearing faults with a higher recognition sensitivity even under different working conditions.
Current situation of asthma–COPD overlap in Chinese patients older than 40 years with airflow limitation: a multicenter, cross-sectional, non-interventional study
Authors: Kang Jian , Zheng Jinping , Cai Baiqiang , Wen Fuqiang , Yao Wanzhen , Zhang Xiaoju , Chen Yan , Wang Guansong , Li Wen , Cao Jie
Published: October 2020

Background and aims:

Asthma–chronic obstructive pulmonary disease (COPD) overlap (ACO) is poorly recognized in China. Our study determined the distribution of ACO and its clinical characteristics among patients (aged ⩾40 years) with airflow limitation at Chinese tertiary hospitals.

Methods:

This cross-sectional, non-interventional study (NCT02600221), conducted between December 2015 and October 2016 in 20 Tier-3 Chinese hospitals, included patients aged ⩾40 years with post-bronchodilator (BD) FEV1/FVC <0.7. The primary variable was distribution of ACO in adults with post-BD forced expiratory volume /forced vital capacity (FEV1/FVC) <0.7 based on Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2015 and 2017 reports. Other variables included determination of characteristics of ACO and its clinical recognition rate.

Results:

In 2003 patients (mean age 62.30 ± 9.86 years), distribution of ACO, COPD and asthma were 37.40%, 48.50% and 14.10%, respectively. Proportions of patients with A, B, C and D grouping were 11.70%, 31.00%, 6.90% and 50.30% as per GOLD 2017, whereas they were 15.10%, 51.10%, 3.60% and 30.20% as per GOLD 2015. Similar clinical symptoms were reported in all three groups. A higher percentage of ACO patients presented with dyspnea, wheezing and chest tightness. Compared with the COPD group, a greater proportion of ACO patients reported wheezing (74.6% and 65.40%), while a lower proportion in the ACO group reported cough (79.40% versus 82.70%) and expectoration (76.50% versus 81.60%). Blood eosinophil count ⩾0.3 × 109/L was observed in 34.6% of ACO patients. The clinical recognition rate of ACO was 31.4%.

Conclusion:

Despite ACO affecting two-fifths of the study population, the initial diagnosis rate was low at 6% in China, thus warranting concerted efforts to improve ACO diagnosis.

ClinicalTrials.gov:

[ClinicalTrials.gov identifier: NCT02600221] registered 22 October 2015, https://clinicaltrials.gov/ct2/show/NCT02600221 The reviews of this paper are available via the supplemental material section.
The concept of “domino” in liver and hepatocyte transplantation
Authors: Zhou Guang-Peng , Sun Li-Ying , Zhu Zhi-Jun
Published: October 2020

Although orthotopic liver transplantation remains the only proven treatment for end-stage liver disease and inherited metabolic liver disease, its application has been limited by the scarcity of donor organs available for transplantation. Among feasible approaches developed to expand the donor organ pool, domino liver transplantation is a strategy in which explanted genetically defective livers of liver transplant recipients are used as grafts in other patients. Another promising therapeutic strategy is hepatocyte transplantation, an alternative to liver transplantation for certain groups of patients. However, the availability of primary hepatocytes is also hindered by the shortage of donor liver tissues. Against this background, domino hepatocyte transplantation, a strategy that utilizes the hepatocytes derived from the explanted livers of liver transplant recipients with noncirrhotic inherited metabolic liver diseases as the source of primary hepatocytes, may help increase the supply of liver cells available for transplantation. In this review, we focus on the status quo of domino liver transplantation and domino hepatocyte transplantation. We also describe recent innovative transplant strategies based on domino transplantation.
Four-dimensional impedance manometry derived from esophageal high-resolution impedance-manometry studies: a novel analysis paradigm
Authors: Kou Wenjun , Carlson Dustin A. , Patankar Neelesh A. , Kahrilas Peter J. , Pandolfino John E.
Published: October 2020

Background:

This study aimed to introduce a novel analysis paradigm, referred to as 4-dimensional (4D) manometry based on biophysical analysis; 4D manometry enables the visualization of luminal geometry of the esophagus and esophagogastric junction (EGJ) using high-resolution-impedance-manometry (HRIM) data.

Methods:

HRIM studies from two asymptomatic controls and one type-I achalasia patient were analyzed. Concomitant fluoroscopy images from one control subject were used to validate the calculated temporal-spatial luminal radius and time-history of intraluminal bolus volume and movement. EGJ analysis computed diameter threshold for emptying, emptying time, flow rate, and distensibility index (DI), which were compared with bolus flow time (BFT) analysis.

Results:

For normal control, calculated volumes for 5 ml swallows were 4.1 ml–6.7 ml; for 30 ml swallows 21.3 ml–21.8 ml. With type-I achalasia, >4 ml of intraesophageal bolus residual was present both pre- and post-swallow. The four phases of bolus transit were clearly illustrated on the time-history of bolus movement, correlating well with the fluoroscopic images. In the control subjects, the EGJ diameter threshold for emptying was 8 mm for 5 ml swallows and 10 mm for 30 ml swallows; emptying time was 1.2–2.2 s for 5 ml swallows (BFT was 0.3–3 s) and 3.25–3.75 s for 30 ml swallows; DI was 2.4–3.4 mm2/mmHg for 5 ml swallows and 4.2–4.6 mm2/mmHg for 30 ml swallows.

Conclusions:

The 4D manometry system facilitates a comprehensive characterization of dynamic esophageal bolus transit with concurrent luminal morphology and pressure from conventional HRIM measurements. Calculations of flow rate and wall distensibility provide novel measures of EGJ functionality.
Evaluation of Reference Metrics for Continuous Glucose Monitoring in Persons Without Diabetes and Prediabetes
Authors: Sofizadeh Sheyda , Pehrsson Anders , Ólafsdóttir Arndís F. , Lind Marcus
Published: October 2020

Background:

Recent guidelines have been developed for continuous glucose monitoring (CGM) metrics in persons with diabetes. To understand what glucose profiles should be judged as normal in clinical practice and glucose-lowering trials, we examined the glucose profile of healthy individuals using CGM.

Methods:

Persons without diabetes or prediabetes were included after passing a normal oral glucose tolerance test, two-hour value <8.9 mmol/L (160 mg/dL), fasting glucose <6.1 mmol/L (110 mg/dL), and HbA1c <6.0% (<42 mmol/mol). CGM metrics were evaluated using the Dexcom G4 Platinum.

Results:

In total, 60 persons were included, mean age was 43.0 years, 70.0% were women, mean HbA1c was 5.3% (34 mmol/mol), and mean body mass index was 25.7 kg/m2. Median and mean percent times in hypoglycemia <3.9 mmol/L (70 mg/dL) were 1.6% (IQR 0.6-3.2), and 3.2% (95% CI 2.0; 4.3), respectively. For glucose levels <3.0 mmol/L (54 mg/dL), the corresponding estimates were 0.0% (IQR 0.0-0.4) and 0.5% (95% CI 0.2; 0.8). Median and mean time-in-range (3.9-10.0 mmol/L [70-180 mg/dL]) was 97.3% (IQR 95.4-98.7) and 95.4% (95% CI 94.0; 96.8), respectively. Median and mean standard deviations were 1.04 mmol/L (IQR 0.92-1.29) and 1.15 mmol/L (95% CI 1.05; 1.24), respectively. Measures of glycemic variability (standard deviation, coefficient of variation, mean amplitude of glycemic excursions) were significantly greater during daytime compared with nighttime, whereas others did not differ.

Conclusions:

People without prediabetes or diabetes show a non-negligible % time in hypoglycemia, median 1.6% and mean 3.2%, which needs to be accounted for in clinical practice and glucose-lowering trials. Glycemic variability measures differ day and night in this population.
Characterisation of osteogenic and vascular responses of hMSCs to Ti-Co doped phosphate glass microspheres using a microfluidic perfusion platform
Authors: Peticone Carlotta , Thompson David De Silva , Dimov Nikolay , Jevans Ben , Glass Nick , Micheletti Martina , Knowles Jonathan C , Kim Hae-Won , Cooper-White Justin J , Wall Ivan B
Published: October 2020

Using microspherical scaffolds as building blocks to repair bone defects of specific size and shape has been proposed as a tissue engineering strategy. Here, phosphate glass (PG) microcarriers doped with 5 mol % TiO2 and either 0 mol % CoO (CoO 0%) or 2 mol % CoO (CoO 2%) were investigated for their ability to support osteogenic and vascular responses of human mesenchymal stem cells (hMSCs). Together with standard culture techniques, cell-material interactions were studied using a novel perfusion microfluidic bioreactor that enabled cell culture on microspheres, along with automated processing and screening of culture variables. While titanium doping was found to support hMSCs expansion and differentiation, as well as endothelial cell-derived vessel formation, additional doping with cobalt did not improve the functionality of the microspheres. Furthermore, the microfluidic bioreactor enabled screening of culture parameters for cell culture on microspheres that could be potentially translated to a scaled-up system for tissue-engineered bone manufacturing.
Ethical Issues in the Design and Conduct of Pragmatic Cluster Randomized Trials in Hemodialysis Care: An Interview Study With Key Stakeholders
Authors: Nicholls Stuart G. , Carroll Kelly , Weijer Charles , Goldstein Cory E. , Brehaut Jamie , Sood Manish M. , Al-Jaishi Ahmed , Basile Erika , Grimshaw Jeremy M. , Garg Amit X. , Taljaard Monica
Published: October 2020

Background:

Pragmatic cluster randomized trials (CRTs) offer an opportunity to improve health care by answering important questions about the comparative effectiveness of treatments using a trial design that can be embedded in routine care. There is a lack of empirical research that addresses ethical issues generated by pragmatic CRTs in hemodialysis.

Objective:

To identify stakeholder perceptions of ethical issues in pragmatic CRTs conducted in hemodialysis.

Design:

Qualitative study using semi-structured interviews.

Setting:

In-person or telephone interviews with an international group of stakeholders.

Participants:

Stakeholders (clinical investigators, methodologists, ethicists and research ethics committee members, and other knowledge users) who had been involved in the design or conduct of a pragmatic individual patient or cluster randomized trial in hemodialysis, or their role would require them to review and evaluate pragmatic CRTs in hemodialysis.

Methods:

Interviews were conducted in-person or over the telephone and were audio-recorded with consent. Recorded interviews were transcribed verbatim prior to analysis. Transcripts and field notes were analyzed using a thematic analysis approach.

Results:

Sixteen interviews were conducted with 19 individuals. Interviewees were largely drawn from North America (84%) and were predominantly clinical investigators (42%). Six themes were identified in which pragmatic CRTs in hemodialysis raise ethical issues: (1) patients treated with hemodialysis as a vulnerable population, (2) appropriate approaches to informed consent, (3) research burdens, (4) roles and responsibilities of gatekeepers, (5) inequities in access to research, and (6) advocacy for patient-centered research and outcomes.

Limitations:

Participants were largely from North America and did not include research staff, who may have differing perspectives.

Conclusions:

The six themes reflect concerns relating to individual rights, but also the need to consider population-level issues. To date, concerns regarding inequity of access to research and the need for patient-centered research have received less coverage than other, well-known, issues such as consent. Pragmatic CRTs offer a potential approach to address equity concerns and we suggest future ethical analyses and guidance for pragmatic CRTs in hemodialysis embed equity considerations within them. We further note the potential for the co-creation of health data infrastructure with patients which would aid care but also facilitate patient-centered research. These present results will inform planned future guidance in relation to the ethical design and conduct of pragmatic CRTs in hemodialysis.

Trial Registration:

Registration is not applicable as this is a qualitative study.
Effects of polyclonal activators on cell differentiation and cytokine production of cultured invasive breast carcinoma of no special type, their association with tumour histopathological parameters and lymph node metastasis
Authors: Autenshlyus Alexander , Arkhipov Sergey , Mikhailova Elena , Marinkin Igor , Varaksin Nikolay , Vavilin Valentin , Lyakhovich Vyacheslav
Published: October 2020

Currently, a number of promising strategies and approaches to cancer treatment include differentiation therapy. However, theoretical and methodological foundations of this field are not yet well developed. The objective of this study was to determine the effects of a mixture of polyclonal activators (PAs; phytohaemagglutinin, concanavalin A and lipopolysaccharide) on cytokine production by biopsy samples of invasive breast carcinoma of no special type (IBC-NST) having various differentiation abilities and metastatic potentials as well as on differentiation status of the IBC-NST biopsy samples. We used ELISAs to investigate spontaneous and PA-stimulated cytokine production in the IBC-NST biopsy samples; from these data, we calculated a cytokine production stimulation index (SIPA). The effect of PAs on tumour cell differentiation was determined via a differentiation stimulation index (DSI). DSI was found to vary within the range 1.0–5.0. After treatment with PAs, in the IBC-NST biopsy samples of group I (DSI <1.25), the production of IL-2, IL-6, IL-8, IL-17, IL-18, IL-1β, IL-1Ra, TNF-α and GM-CSF increased; in the biopsy samples of group II (DSI >1.25), the production of IL-6, IL-1β, IL-1Ra, TNF-α, G-CSF and GM-CSF significantly increased, while the production of VEGF-A decreased. Receiver operating characteristic (ROC) analysis of SIPA revealed that increased production of IL-18 in the IBC-NST biopsy samples after exposure to PAs may block the PA-driven, cytokine-mediated differentiation of moderately differentiated into highly differentiated tumour cells. The ROC analysis also uncovered an association between the responses of tumour cells to PAs and lymph node metastasis observed in the patients. The findings suggest that there is a need for research aimed at finding new drugs for differentiating cancer therapy and at searching for targeted inducers of cytokine production or specific suppressors of their induction.
The Role of Entrepreneurial Self-Efficacy in Resources Acquisition in a New Venture: The Mediating Role of Effectuation
Authors: Maitlo Qamaruddin , Pacho Frida Thomas , Liu Jia , Bhutto Tahseen Ahmed , Xuhui Wang
Published: October 2020

The present study aims to explore the role of entrepreneurial self-efficacy (ESE) concept with a combination of an effectuation concept. First, it examined the effect of ESE on resources acquisition in a new venture in an emerging country’s context. Second, it attempted to use effectuation principles, namely, affordable loss, set of means, and precommitment as mediators in a relationship between ESE and resource acquisition in a new venture. A sample of 462 agro-processing entrepreneurs is explicitly surveyed and interviewed. The hierarchical regression and structural equation model were employed to analyze the data. Results showed that an ESE has a significant positive effect on the venture’s resources acquisition ability. Moreover, results showed that the effect of ESE in resource acquisition is manifested through affordable loss, precommitment, and set of means principles. Theoretically, this study extends the knowledge on the mediating role of effectuation principles using ESE in pursuing essential venture functions such as resources acquisition.
Hysteroscopic vaginoscopy. An additional diagnostic tool for recto-vaginal deep infiltrating endometriosis
Authors: Zizolfi Brunella , Foreste Virginia , Di Spiezio Sardo Attilio , Giampaolino Pierluigi , Gencarelli Annarita , Carugno Jose , Bifulco Giuseppe
Published: October 2020

Endometriosis is the presence of endometrial tissue outside the uterine cavity. Rectovaginal infiltration is present in 5% to 25% of the patients diagnosed with endometriosis. Accurate diagnosis is imperative for adequate counseling. Hysteroscopic vaginoscopy allows the inspection of the posterior vaginal fornix, not only providing better visualization of the area due to image magnification, but also allowing to obtain biopsy providing pathologic confirmation. We report the case of a 49-year-old nulliparous patient with long history of severe dysmenorrhea, deep dyspareunia and debilitating chronic pelvic pain not responding to medical treatment. On physical exam, recto-vaginal tender nodularity was palpated. Vaginal ultrasound and magnetic resonance imaging confirmed the presence of the nodular formation extending up to the rectum. In-office vaginoscopy revealed a perforated bulge on the uterine cervix, mimicking a double cervix. A biopsy of the nodule confirmed the presence of endometrial tissue, confirming the diagnosis of endometriosis. Patient underwent total hysterectomy with excision of deep infiltrating endometriosis which required segmental bowel resection with diverting loop colostomy. The final pathology confirmed the diagnosis of deep infiltrating endometriosis.
The Association Between Health Status and Insomnia, Mental Health, and Preventive Behaviors: The Mediating Role of Fear of COVID-19
Authors: Ahorsu Daniel Kwasi , Lin Chung-Ying , Pakpour Amir H.
Published: October 2020

Objectives:

This study examined the mediation role of fear of COVID-19 in the association between perceived health status of older adults and their insomnia, mental health, and COVID-19 preventive behaviors so as to have better understanding of the factors associated with COVID-19 and its preventive measures.

Methods:

A total of 413 older adults with a mean age of 57.72 ( SD = 7.31) were recruited for this study. They responded to the measures on fear of COVID-19, insomnia, mental health, and COVID-19 preventive behaviors.

Results:

There were small-large significant interrelationships between insomnia, mental health, fear of COVID-19, and preventive behaviors. Fear of COVID-19 significantly mediated the associations between perceived health status and insomnia, mental health, and COVID-19 preventive behaviors. It was also observed that perceived health status directly influenced insomnia and mental health of older adults but not their COVID-19 preventive behaviors.

Conclusion:

Fear of COVID-19 has an important role to play in the management of the health and preventive behaviors of older adults. Health experts and communicators may capitalize on these findings to educate people on COVID-19. Future studies are needed to perfectly ascertain the extent of fear needed to stimulate or initiate better preventive behaviors and healthcare practices.
Neighborhood poverty and pediatric allogeneic hematopoietic cell transplantation outcomes: a CIBMTR analysis
Authors: Bona Kira , Brazauskas Ruta , He Naya , Lehmann Leslie , Abdel-Azim Hisham , Ahmed Ibrahim A , Al-Homsi A Samer , Aljurf Mahmoud , Arnold Staci D. , Badawy Sherif M , Battiwalla Minoo , Beattie Sara , Bhatt Neel S. , Dalal Jignesh , Dandoy Christopher E. , Diaz Miguel Angel , Frangoul Haydar A. , Freytes César O. , Ganguly Siddhartha , George Biju , Gomez-Almaguer David , Hahn Theresa , Kamble Rammurti T. , Knight Jennifer M. , LeMaistre C. Fred , Law Jason , Lazarus Hillard M. , Majhail Navneet S. , Olsson Richard F. , Preussler Jaime , Savani Bipin N. , Schears Raquel , Seo Sachiko , Sharma Akshay , Srivastava Alok , Steinberg Amir , Szwajcer David , Wirk Baldeep , Yoshimi Ayami , Khera Nandita , Wood William A. , Hashmi Shahrukh , Duncan Christine N. , Saber Wael
Published: October 2020

Social determinants of health, including poverty, contribute significantly to health outcomes in the United States; however, their impact on pediatric hematopoietic cell transplantation (HCT) outcomes is poorly understood. We aimed to identify the association between neighborhood poverty and HCT outcomes for pediatric allogeneic HCT recipients in the Center for International Blood and Marrow Transplant Research database. We assembled 2 pediatric cohorts undergoing first allogeneic HCT from 2006 to 2015 at age ≤18 years, including 2053 children with malignant disease and 1696 children with nonmalignant disease. Neighborhood poverty exposure was defined a priori per the US Census definition as living in a high-poverty ZIP code (≥20% of persons below 100% federal poverty level) and used as the primary predictor in all analyses. Our primary outcome was overall survival (OS), defined as the time from HCT until death resulting from any cause. Secondary outcomes included relapse and transplantation-related mortality (TRM) in malignant disease, acute and chronic graft-versus-host disease, and infection in the first 100 days post-HCT. Among children undergoing transplantation for nonmalignant disease, neighborhood poverty was not associated with any HCT outcome. Among children undergoing transplantation for malignant disease, neighborhood poverty conferred an increased risk of TRM but was not associated with inferior OS or any other transplantation outcome. Among children with malignant disease, a key secondary finding was that children with Medicaid insurance experienced inferior OS and increased TRM compared with those with private insurance. These data suggest opportunities for future investigation of the effects of household-level poverty exposure on HCT outcomes in pediatric malignant disease to inform care delivery interventions.
Progress in quickly finding orthologs as reciprocal best hits: comparing blast, last, diamond and MMseqs2
Authors: Hernández-Salmerón Julie E. , Moreno-Hagelsieb Gabriel
Published: October 2020

Background

Finding orthologs remains an important bottleneck in comparative genomics analyses. While the authors of software for the quick comparison of protein sequences evaluate the speed of their software and compare their results against the most usual software for the task, it is not common for them to evaluate their software for more particular uses, such as finding orthologs as reciprocal best hits (RBH). Here we compared RBH results obtained using software that runs faster than blastp. Namely, lastal, diamond, and MMseqs2.

Results

We found that lastal required the least time to produce results. However, it yielded fewer results than any other program when comparing the proteins encoded by evolutionarily distant genomes. The program producing the most similar number of RBH to blastp was diamond ran with the “ultra-sensitive” option. However, this option was diamond’s slowest, with the “very-sensitive” option offering the best balance between speed and RBH results. The speeding up of the programs was much more evident when dealing with eukaryotic genomes, which code for more numerous proteins. For example, lastal took a median of approx. 1.5% of the blastp time to run with bacterial proteomes and 0.6% with eukaryotic ones, while diamond with the very-sensitive option took 7.4% and 5.2%, respectively. Though estimated error rates were very similar among the RBH obtained with all programs, RBH obtained with MMseqs2 had the lowest error rates among the programs tested.

Conclusions

The fast algorithms for pairwise protein comparison produced results very similar to blast in a fraction of the time, with diamond offering the best compromise in speed, sensitivity and quality, as long as a sensitivity option, other than the default, was chosen.
Correction to: Analysis of the role of the human papillomavirus 16/18 E7 protein assay in screening for cervical intraepithelial neoplasia: a case control study
Authors: Kong Linghua , Xiao Xiaoping , Lou Huiping , Liu Pengfei , Song Shuhui , Liu Moudu , Xu Tao , Zhang Ying , Li Caijuan , Guan Ruoli , Li Yan , Yu Xin , Liu Haiyuan , Fan Qingbo , Shi Honghui , Zhu Lan
Published: October 2020

An amendment to this paper has been published and can be accessed via the original article.
Reproducibility and inter-observer agreement of Greulich-Pyle protocol to estimate skeletal age among female adolescent soccer players
Authors: Faustino-da-Silva Yuri V. , Martinho Diogo V. , Coelho-e-Silva Manuel J. , Valente-dos-Santos João , Conde Jorge , Oliveira Tomás G. , Ronque Enio R. V. , Agostinete Ricardo R. , Fernandes Rômulo A. , Sherar Lauren B.
Published: October 2020

Background

Skeletal age (SA) is considered the best method of assessing biological maturation. The aim of this study was to determine intra-observer (reproducibility) and inter-observer agreement of SA values obtained via the Greulich-Pyle (GP) method. In addition, the variation in calculated SAs by alternative GP protocols was examined.

Methods

The sample was composed of 100 Portuguese female soccer players aged 12.0–16.7 years. SAs were determined using the GP method by two observers (OB1: experience < 100 exams using GP; OB2: experience > 2000 exams using several methods). The radiographs were examined using alternative GP protocols: (wholeGP) the plate was matched to the atlas as an overall approach; (30-boneGP) bone-by-bone inspections of 30-bones; (GPpmb) bone-by-bone inspections of the pre-mature bones only. For the 30-boneGP and GPpmb approaches, SA was calculated via the mean (M) and the median (Md).

Results

Reproducibility ranged 82–100% and 88–100% for OB1 and OB2, respectively. Inter-observer agreement (100 participants multiplied by 30 bones) was 92.1%. For specific bones, agreement rates less than 90% were found for scaphoid (81%), medial phalange V (83%), trapezium (84%) and metacarpal V (87%). Differences in wholeGP SAs obtained by the two observers were moderate (d-cohen was 0.79). Mean differences between observers when using bone-by bone SAs were trivial (30-boneGP: d-cohen less than 0.05; GPpmb: d-cohen less than 0.10). The impact of using the mean or the median was negligible, particularly when analyses did not include bones scored as mature.

Conclusion

The GP appeared to be a reasonably reproducible method to assess SA and inter-observer agreement was acceptable. There is evidence to support a recommendation of only scoring pre-mature bones during later adolescence. Further research is required to examine whether these findings are consistent in younger girls and in boys.
Patient characteristics and healthcare utilisation among Danish patients with chronic conditions: a nationwide cohort study in general practice and hospitals
Authors: Schlünsen Anders Damgaard Møller , Christiansen David Høyrup , Fredberg Ulrich , Vedsted Peter
Published: October 2020

Background

The complexity of caring for patients with chronic conditions necessitates new models of integrated care to accommodate an increasing demand. To inform the development of integrated care models, it is essential to map patients’ use of healthcare resources. In this nationwide registry-based cohort study, we describe and compare patient characteristics and healthcare utilisation between Danish patients with chronic conditions in general practice follow-up and in hospital outpatient follow-up.

Methods

On 1 January 2016, we identified 250,402 patients registered in 2006–2015 with a hospital diagnosis of atrial fibrillation/flutter, congestive heart failure, chronic liver disease, inflammatory bowel disease or chronic obstructive pulmonary disease. By linkage to national social and health registries, patient characteristics and 12-month healthcare utilisation were extracted. Incidence rates of health care utilisation were compared between patients with chronic conditions in general practice follow-up and patients in hospital outpatient follow-up using negative binomial regression.

Results

Across all five conditions, the largest proportions of patients were in general practice follow-up (range = 59–87%). Patients in hospital outpatient follow-up had higher rates of exacerbation-related admissions (adjusted incidence rate ratio (IRR) range = 1.3 to 2.8) and total length of stay (IRR range = 1.2 to 2.2). For these five conditions, all-cause admissions and lengths of stay, general practice daytime and out-of-hours contacts, and municipal home nursing contacts were similar between follow-up groups or higher among patients in general practice follow-up. The exception was patients with chronic obstructive pulmonary disease, where patients in hospital outpatient follow-up had higher utilisation of healthcare resources.

Conclusions

Patients in general practice follow-up accounted for the largest proportion of total healthcare utilisation, but patients in hospital outpatient follow-up were characterised by high exacerbation rates. Enhanced integration of chronic care may be of most benefit if patients in general practice follow-up are targeted, but it is also likely to have an impact on exacerbation rates among patients in hospital outpatient follow-up.
Nanopolystyrene translocation and fetal deposition after acute lung exposure during late-stage pregnancy
Authors: Fournier Sara B. , D’Errico Jeanine N. , Adler Derek S. , Kollontzi Stamatina , Goedken Michael J. , Fabris Laura , Yurkow Edward J. , Stapleton Phoebe A.
Published: October 2020

Background

Plastic is everywhere. It is used in food packaging, storage containers, electronics, furniture, clothing, and common single-use disposable items. Microplastic and nanoplastic particulates are formed from bulk fragmentation and disintegration of plastic pollution. Plastic particulates have recently been detected in indoor air and remote atmospheric fallout. Due to their small size, microplastic and nanoplastic particulate in the atmosphere can be inhaled and may pose a risk for human health, specifically in susceptible populations. When inhaled, nanosized particles have been shown to translocate across pulmonary cell barriers to secondary organs, including the placenta. However, the potential for maternal-to-fetal translocation of nanosized-plastic particles and the impact of nanoplastic deposition or accumulation on fetal health remain unknown. In this study we investigated whether nanopolystyrene particles can cross the placental barrier and deposit in fetal tissues after maternal pulmonary exposure.

Results

Pregnant Sprague Dawley rats were exposed to 20 nm rhodamine-labeled nanopolystyrene beads (2.64 × 1014 particles) via intratracheal instillation on gestational day (GD) 19. Twenty-four hours later on GD 20, maternal and fetal tissues were evaluated using fluorescent optical imaging. Fetal tissues were fixed for particle visualization with hyperspectral microscopy. Using isolated placental perfusion, a known concentration of nanopolystyrene was injected into the uterine artery. Maternal and fetal effluents were collected for 180 min and assessed for polystyrene particle concentration. Twenty-four hours after maternal exposure, fetal and placental weights were significantly lower (7 and 8%, respectively) compared with controls. Nanopolystyrene particles were detected in the maternal lung, heart, and spleen. Polystyrene nanoparticles were also observed in the placenta, fetal liver, lungs, heart, kidney, and brain suggesting maternal lung-to-fetal tissue nanoparticle translocation in late stage pregnancy.

Conclusion

These studies confirm that maternal pulmonary exposure to nanopolystyrene results in the translocation of plastic particles to placental and fetal tissues and renders the fetoplacental unit vulnerable to adverse effects. These data are vital to the understanding of plastic particulate toxicology and the developmental origins of health and disease.