bluuebunny/crossref_metadata_2025 huggingface dataset:
Telemedicine in Geriatric Psychiatry: Relevance in India
Authors: Kalaivanan Rakesh Chander , Rahul Patley , Manjunatha Narayana , Kumar Channaveerachari Naveen , Sivakumar Palanimuthu Thangaraju , Math Suresh Bada
Published: September 2021

Telemedicine has evolved as a novel tool in delivering health care in the modern world. With the advancement in video conferencing technology at an affordable price and innovative digital medical instruments, it has grown from guiding paramedics in managing patients to aiding physicians in providing direct consultation. Delivering care for older adults has always been challenging due to comorbidities that may warrant a multidisciplinary approach leading to frequent visits across specialties. As per the preliminary reports of the Longitudinal Aging Study in India, 55% of this population suffers from any chronic illness, of which 40% have some form of disability and 20% deal with mental health issues. Over the years, telepsychiatry care for older adults has received increasing acceptability. Videoconferencing with improved connectivity and transmission rates has aided in evaluating, assessing, and providing mental health interventions at ease. The recent regulation of telemedicine practice in the country by rolling out the Telemedicine Practice Guidelines 2020 and Telepsychiatry Operational Guidelines 2020 has fast-tracked its utility during the COVID-19 pandemic. Concerns of physical examination, psychological satisfaction of consulting physician in person, confidentiality, and security of information shared are points that need better addressing in the future. However, Telemedicine is recommended to be used judiciously, taking the risk and benefit of older adults on a case basis as it can significantly bring down the financial and emotional burden.
An analysis of inspection in probation and its impact on practitioners, practice and providers
Authors: Phillips Jake
Published: September 2021

This article analyses the impact of Her Majesty's Inspectorate of Probation on practice, providers and practitioners. Since 1936 HMI Probation has aimed to improve practice through independently inspecting probation services. However, no research has looked at its impact on those it inspects. This is important not only because the evidence on whether inspection improves delivery in other sectors is weak but also because oversight has the potential to create accountability overload. Following a brief overview of the history, aims and policy context for probation inspection the article presents data from interviews with 77 participants from across the field of probation. Overall, participants were positive about inspection and the Inspectorate. However, the data suggest that inspection places a considerable operational burden on staff and organisations and has real emotional consequences for practitioners. Staff experience case interviews as places for reflection and validation but there is less evidence of the direct impact of inspection on practice. Ultimately, the article argues that inspection can monitor practice whilst also contributing to improving practice and providing staff with a way to reflect on their work, yet this balance is difficult strike. Finally, the article considers the implications of these findings for the Inspectorate and the probation service.
Digital Discipleship: A Study of How Churches in New York Used Technology for Adult Discipleship During the COVID-19 Pandemic
Authors: Dunlow Jacob
Published: September 2021

The COVID-19 Pandemic brought unexpected and unparalleled challenges to bear on the adult discipleship ministries of local churches. These challenges were felt sharply early on in New York, the location of the most severe outbreak in the East Coast during the first half of 2020. This paper explores how Evangelical churches in the New York regions of Metro NYC and Eastern New York adapted to these challenges and turned to technology to continue serving their churches. Through the use of qualitative surveys, 21 churches in New York shared how they shifted to continue to minister to their congregation. The research demonstrated that over 95% of churches surveyed engaged in digital discipleship, with half finding it to be effective for their congregation.
Impact of COVID-19 on Latinos: A Social Determinants of Health Model and Scoping Review of the Literature
Authors: Salgado de Snyder Velia Nelly , McDaniel Marisol , Padilla Amado M. , Parra-Medina Deborah
Published: September 2021

The purpose of this scoping review of the literature was to analyze the impact of the COVID-19 pandemic on the living conditions of Latinos (Hispanics) in the U.S. from a social determinants of health perspective. We developed a conceptual model based on the social determinants of health framework to guide the search, extraction, analysis, and interpretation of the bibliographic material. A systematic review of peer reviewed literature published in 2020 in scientific journals in the social, health, and behavioral sciences was conducted. A total of 37 articles met the selection criteria, 12 were original investigations with primary data collection, and 25 were studies reporting results of secondary data analysis using public or private databases. The representation of Latinos in the study samples ranged from 5% to 40%. The results of our review are compelling in terms of the overrepresentation of Latinos in SARSCoV-2 positivity and COVID-19 morbidity and mortality rates. The risk factors identified include working in a job considered essential, living in a geographic area with a high population density of Latinos and blacks, overcrowded living conditions in the household, limited English proficiency, and being unable to systematically carry out preventive behaviors known to be effective for infection avoidance. Existing national surveys and registries suffer from assumptions and omissions regarding variables relevant to Latinos. New studies must be guided by inquiries on the usual social determinants of health, but also those relevant for Latinos, such as national group, generational status, and language, among others.
Surveillance for hepatocellular carcinoma in people of African ancestry with HIV and Hepatitis B
Authors: Patel Nisha , Post Frank A
Published: September 2021

Current guidelines recommend six-monthly ultrasound surveillance for hepatocellular carcinoma (HCC) in high risk, non-cirrhotic people with HIV and hepatitis B co-infection (HBV). African or Asian ethnicity is considered a risk factor for the development of HCC. Risk stratification scores for HCC have been generated in HBV mono-infected Caucasian and Asian populations, however they not been validated in people with HIV or those of African ancestry. We undertook an audit of HCC surveillance in HIV/HBV co-infected individuals of African ancestry who participated in the GEN-AFRICA study. Electronic patient records were reviewed for liver disease characteristics. REACH-B and PAGE-B scores were calculated to ascertain whether individuals at greatest risk of developing HCC were being targeted for ultrasound surveillance. 76 individuals (median age 51 years, 96% HIV RNA < 200 copies/mL, 87% HBV DNA <20 IU/mL) were included. 7% of participants had undergone six-monthly HCC surveillance by liver ultrasound (5% of those at low risk; 9% at intermediate or high risk). Adherence to HCC surveillance was poor and not targeted to those at highest risk. Lack of an evidence base for intensive HCC screening of non-cirrhotic, HIV/HBV co-infected individuals of African ancestry may have contributed to the poor uptake of biannual HCC ultrasound surveillance.
Idiosyncratic Tower of Babel: Individual Differences in Word-Meaning Representation Increase as Word Abstractness Increases
Authors: Wang Xiaosha , Bi Yanchao
Published: September 2021

Humans primarily rely on language to communicate, on the basis of a shared understanding of the basic building blocks of communication: words. Do we mean the same things when we use the same words? Although cognitive neural research on semantics has revealed the common principles of word-meaning representation, the factors underlying the potential individual variations in word meanings are unknown. Here, we empirically characterized the intersubject consistency of 90 words across 20 adult subjects (10 female) using both behavioral measures (rating-based semantic-relationship patterns) and neuroimaging measures (word-evoked brain activity patterns). Across both the behavioral and neuroimaging experiments, we showed that the magnitude of individual disagreements on word meanings could be modeled on the basis of how much language or sensory experience is associated with a word and that this variation increases with word abstractness. Uncovering the cognitive and neural origins of word-meaning disagreements across individuals has implications for potential mechanisms to modulate such disagreements.
At-Tahur’s IPO: Creating Pakistan’s First Public Company in Pasteurized Dairy Segment
Authors: Tauseef Sana
Published: September 2021

This case examines the initial public offering (IPO) decision made by At-Tahur Limited during 2017. The outstanding performance of the equity market led the company to decide in favour of stock issuance to finance its required expansion. However, soon after the company started its IPO process till the month when the shares were floated in the market, Pakistan Stock Exchange experienced its worst decline since the financial crisis, with the index dropping by 17% over the one year from July 2017 to July 2018.

The IPO was oversubscribed, and the company was able to sell its shares at PKR 21 per share, higher than the floor price of PKR 20. The strong demand for the company’s shares and a successfully completed stock offering transaction during one of the most difficult periods in capital market history left the IPO management team confused about whether PKR 21 was an appropriate price for the company’s share and if it was the correct time for the company to go public.

The case provides an opportunity to discuss the valuation of unseasoned equity using market multiples and discounted cash flow models. Students are invited to value At-Tahur’s stock in light of the company’s planned expansion and take a position on whether the IPO strike price of PKR 21 was correct. The case also allows for a discussion of IPO trends, costs and benefits of going public and the IPO underpricing phenomenon.
Absent or Mild Coronary Calcium Predicts Low-Risk Stress Test Results and Outcomes in Patients Considered for Flecainide Therapy
Authors: Anderson Jeffrey L. , Knight Stacey , McCubrey Raymond O. , May Heidi T. , Mason Steve , Bunch Thomas J. , Min David B. , Cutler Michael J. , Le Viet T. , Muhlestein Joseph B. , Knowlton Kirk U.
Published: September 2021

Background:

Flecainide is a useful antiarrhythmic for atrial fibrillation (AF). However, because of ventricular proarrhythmia risk, a history of myocardial infarction (MI) or coronary artery disease (CAD) is a flecainide exclusion, and stress testing is used to exclude ischemia. We assessed whether absent/mild coronary artery calcium (CAC) can supplement or avoid the need for stress testing.

Methods:

We assessed ischemic burden using regadenoson Rb-82 PET/CT in 1372 AF patients ≥50 years old without symptoms or signs of clinical CAD. CAC was determined qualitatively by low dose attenuation computed tomography (CT) (n = 816) or by quantitative CT (n = 556). Ischemic burden and clinical outcomes were compared by CAC burden.

Results:

Patients with CAC absent or mild (n = 766, 57.2%) were younger, more frequently female, and had higher BMI but lower rates of diabetes, hypertension, and dyslipidemia. Average ischemic burden was lower in CAC-absent/mild patients, and CAC-absent/mild patients showed greater coronary flow reserve, had fewer referrals for coronary angiography, and less often had obstructive CAD. Revascularization at 90 days was lower, and the rate of longer-term major adverse cardiovascular events was favorable.

Conclusions:

An easily administered, inexpensive, low radiation CAC scan can identify a subset of flecainide candidates with a low ischemic burden on PET stress testing that rarely needs coronary angiography/intervention and has favorable outcomes. Absent or mild CAC-burden combined with other clinical information may avoid or complement routine stress testing. However, additional, ideally randomized and multicenter trials are indicated to confirm these findings before replacing stress testing with CAC screening in selecting patients for flecainide therapy in clinical practice.
Angular control of differential shape-memory alloy spring actuator for underactuated dynamic system
Authors: Banu Sundareswari M , Then Mozhi G , Dhanalakshmi K
Published: September 2021

This article dwells on two technical aspects, the design and implementation of an upgraded version of the differential shape-memory alloy–based revolute actuator/rotary actuating mechanism for stabilization and position control of a two-degree-of-freedom centrally hinged ball on beam system. The actuator is configured with differential and inclined placement of shape-memory alloy springs to provide bidirectional angular shift. The shape-memory alloy spring actuator occupies a smaller space and provides more extensive reformation with justifiable actuation force than an equally able shape-memory alloy wire. The cross or diagonal architecture of shape-memory alloy springs provides force amplification and reduces the actuator’s control effort. The shape-memory alloy spring–embodied actuator’s function is exemplified by the highly dynamic underactuated custom-designed ball balancing system. The ball position control is experimentally demonstrated by cascade control using the control laws that have been unattempted for shape-memory alloy actuated systems; the ball is positioned with linear (integer-order and fractional-order) proportional–integral–derivative controllers optimized with genetic algorithm and particle swarm optimization at the outer/primary loop. Angular control of the shape-memory alloy actuated beam is obtained with nonlinear (integer-order and fractional-order sliding mode control) control algorithms in the inner/secondary loop.
Preparations of exploration of immediate hypersensitivity to antineoplastic agents: An oncology pharmacy perspective
Authors: Dubromel Amélie , Caffin Anne-Gaëlle , Hacard Florence , Vantard Nicolas , Baudouin Amandine , Herledan Chloé , Larbre Virginie , Schwiertz Vérane , Nosbaum Audrey , Pralong Pauline , Nicolas Jean-François , Berard Frédéric , Rioufol Catherine , Ranchon Florence
Published: September 2021

Background

Cancer patients are being exposed to antineoplastic drugs more frequently and for longer periods, resulting in a higher risk of hypersensitivity reactions. The aim of this study was to assess the pharmaceutical time and direct cost of drug allergy explorations following immediate hypersensitivity reactions to antineoplastic agents.

Methods

A micro-costing method was used to collect data on consumption of human and material resources for allergy exploration preparations. The monetisation was carried out on the basis of prices and hourly wage costs applied in 2018. The number and type of allergy explorations prepared by the pharmacy as well as nature of antineoplastic drugs tested, and the number of culprit drugs reintroductions were collected.

Results

Almost 1.5 h is required to realise allergy tests for one patient including pharmacist time for prescription analysis and pharmacy technician's time for tests preparation. The mean manufacturing cost of these tests is estimated at €62.87 (€57.82–65.49) per culprit drug for one patient. Programming patients according to culprit drugs tested allows rationalising healthcare provider time and increasing efficiency. From January 2010 to December 2018, 277 patients were tested and 490 allergy explorations were performed, corresponding to more than 5000 preparations. Mostly, the culprit drug could be reintroduced ( n = 383, 78.2%) allowing patients to receive the best possible treatment.

Conclusion

Management of hypersensitivity reactions is constantly progressing, as it contributes to improving patient care in oncology. This activity is time-consuming for the pharmacy team but allows patients with previous hypersensitivity reaction to continue effective treatment.
Abjection, Masculinity, and Sacrifice: The Reek of Death in Game of Thrones
Authors: Johnston Susan
Published: September 2021

The masculinities of HBO’s Game of Thrones (2011–2019) are marked not just by violence and exploitation, but by contingency, fragility, and abjection. This article draws on theories of abjection to read the abject masculinity of Sandor Clegane, Samwell Tarly, and Theon Greyjoy in the context of theories of hegemonic and hypermasculinity, and, through Greyjoy in particular, tracks his movement from hypermasculinity, through abjection and torture, to a custodial and sacrificial and thus life-giving masculinity, which stands in profound opposition to the hegemonic masculinity of power and domination.
In Denmark we eat pork and shake hands! Islam and the anti-Islamic emblems of cultural difference in Danish neo-nationalism
Authors: Lindhardt Martin
Published: September 2021

This article argues that constructions of Danishness and Danish culture in neo-nationalist right-wing discourse have increasingly become structured around a marked opposition to Islam and Muslim immigrants. My analysis draws on Frederik Barth’s understanding of ethnic identity as constituted through processes of demarcation of boundaries vis-à-vis other groups. In such processes, certain cultural phenomena, both material and immaterial, can be elevated to emblems of cultural difference or symbolic markers of an in-group’s shared identity. The article explores how different phenomena such as freedom of speech, pork, winter swimming/mixed-gender swimming and handshakes have become salient topics of political and public debates about integration and Islam in Denmark. I argue that these phenomena have all become emblematic of an allegedly distinctive Danish culture because they serve the purpose of demarcating symbolic boundaries vis-à-vis Islam.
A mask-based infection control method for screening endoscopy may prevent SARS-CoV-2 transmission and relieve staff anxiety
Authors: Nadatani Yuji , Higashimori Akira , Takashima Shingo , Maruyama Hirotsugu , Otani Koji , Fukunaga Shusei , Hosomi Shuhei , Tanaka Fumio , Fujii Hideki , Nakano Akemi , Taira Koichi , Kamata Noriko , Nagami Yasuaki , Kimura Tatsuo , Fukumoto Shinya , Watanabe Toshio , Kawada Norifumi , Fujiwara Yasuhiro
Published: September 2021

Objectives:

Endoscopy confers high risk for acquiring coronavirus disease 2019. Although guidelines recommend that medical staff use personal protective equipment, no infection control equipment have been established for patients. This study aimed to clarify the usefulness of two face masks we had designed for transnasal and transoral endoscopy.

Methods:

The efficacy of the masks was evaluated by simulating coughing in a mannequin with fluorescent dyes and mapping the droplet trajectory and number. The number of aerosols generated during endoscopy was clinically evaluated in the endoscopy room. Overall, 4356 screening endoscopies were performed with the patients wearing our masks at Medcity21, a health checkup facility, between June and December 2020; the effects of the masks on the patient’s condition were evaluated retrospectively. An 11-item paper-based survey was performed by the endoscopy staff 6 months after the adoption of the mask-based infection control method.

Results:

Use of both masks reduced the number of droplets released during the simulation. Clinically, the use of both masks did not affect the patients’ conditions during endoscopy and prevented an increase in the aerosols in the endoscopy room. This mask-based infection control method was favorably received, and all staff indicated that understanding the efficacy of our mask-based infection control reduced their anxiety regarding infection. Until December 2020, none of our staff had contracted SARS-CoV-2.

Conclusion:

Our mask-based infection control method is easy to adopt, inexpensive, and effective; understanding its effectiveness may help ease the fear of infection among endoscopy staff.
Effect of Demineralized Bone Matrix, Bone Marrow Mesenchymal Stromal Cells, and Platelet-Rich Plasma on Bone Tunnel Healing After Anterior Cruciate Ligament Reconstruction: A Comparative Micro-Computed Tomography Study in a Tendon Allograft Sheep Model
Authors: Hexter Adam T. , Karali Aikaterina , Kao Alex , Tozzi Gianluca , Heidari Nima , Petrie Aviva , Boyd Ashleigh , Kalaskar Deepak M. , Pendegrass Catherine , Rodeo Scott , Haddad Fares , Blunn Gordon
Published: September 2021

Background:

The effect of demineralized bone matrix (DBM), bone marrow–derived mesenchymal stromal cells (BMSCs), and platelet-rich plasma (PRP) on bone tunnel healing in anterior cruciate ligament reconstruction (ACLR) has not been comparatively assessed.

Hypothesis:

These orthobiologics would reduce tunnel widening, and the effects on tunnel diameter would be correlated with tunnel wall sclerosis.

Study Design:

Controlled laboratory study.

Methods:

A total of 20 sheep underwent unilateral ACLR using tendon allograft and outside-in interference screw fixation. The animals were randomized into 4 groups (n = 5 per group): Group 1 received 4mL of DBM paste, group 2 received 10 million BMSCs in fibrin sealant, group 3 received 12 mL of activated leukocyte-poor platelet-rich plasma, and group 4 (control) received no treatment. The sheep were euthanized after 12 weeks, and micro-computed tomography scans were performed. The femoral and tibial tunnels were divided into thirds (aperture, midportion, and exit), and the trabecular bone structure, bone mineral density (BMD), and tunnel diameter were measured. Tunnel sclerosis was defined by a higher bone volume in a 250-µm volume of interest compared with a 4-mm volume of interest surrounding the tunnel.

Results:

Compared with the controls, the DBM group had a significantly higher bone volume fraction (bone volume/total volume [BV/TV]) (52.7% vs 31.8%; P = .020) and BMD (0.55 vs 0.47 g/cm3; P = .008) at the femoral aperture and significantly higher BV/TV at femoral midportion (44.2% vs 32.9%; P = .038). There were no significant differences between the PRP and BMSC groups versus controls in terms of trabecular bone analysis or BMD. In the controls, widening at the femoral tunnel aperture was significantly greater than at the midportion (46.7 vs 41.7 mm2; P = .034). Sclerosis of the tunnel was common and most often seen at the femoral aperture. In the midportion of the femoral tunnel, BV/TV ( r = 0.52; P = .019) and trabecular number ( r S = 0.50; P = .024) were positively correlated with tunnel widening.

Conclusion:

Only DBM led to a significant increase in bone volume, which was seen in the femoral tunnel aperture and midportion. No treatment significantly reduced bone tunnel widening. Tunnel sclerosis in the femoral tunnel midportion was correlated significantly with tunnel widening.

Clinical Relevance:

DBM might have potential clinical use to enhance healing in the femoral tunnel after ACLR.
How does Medical Assistance in Dying affect end-of-life care planning discussions? Experiences of Canadian multidisciplinary palliative care providers
Authors: Ho Anita , Norman Joshua S. , Joolaee Soodabeh , Serota Kristie , Twells Louise , William Leeroy
Published: September 2021

Background:

More than a dozen countries have now legalized some form of assisted dying, and additional jurisdictions are considering similar legislations or expanding eligibility criteria. Despite the persistent controversies about the relationship between medicine, palliative care, and assisted dying, many people are interested in assisted dying. Understanding how end-of-life care discussions between patients and specialist palliative care providers may be affected by such legislation can inform end-of-life care delivery in the evolving socio-cultural and legal environment.

Aim:

To explore how the Canadian Medical Assistance in Dying legislation affects end-of-life care discussions between patients and multidisciplinary specialist palliative care providers.

Design:

Qualitative thematic analysis of semi-structured interviews.

Participants:

Forty-eight specialist palliative care providers from Vancouver (n = 26) and Toronto ( n = 22) were interviewed in person or by phone. Participants included physicians ( n = 22), nurses ( n = 15), social workers ( n = 7), and allied health professionals ( n = 4).

Results:

Qualitative thematic analysis identified five notable considerations associated with Medical Assistance in Dying affecting end-of-life care discussions: (1) concerns over having proactive conversations about the desire to hasten death, (2) uncertainties regarding wish-to-die statements, (3) conversation complexities around procedural matters, (4) shifting discussions about suffering and quality of life, and (5) the need and challenges of promoting open-ended discussions.

Conclusion:

Medical Assistance in Dying challenges end-of-life care discussions and requires education and support for all concerned to enable compassionate health professional communication. It remains essential to address psychosocial and existential suffering in medicine, but also to provide timely palliative care to ensure suffering is addressed before it is deemed irremediable. Hence, clarification is required regarding assisted dying as an intervention of last resort. Furthermore, professional and institutional guidance needs to better support palliative care providers in maintaining their holistic standard of care.
Beyond aid: Sustainable responses to meeting language communication needs in humanitarian contexts
Authors: Moser-Mercer Barbara , Qudah Somia , Ali Malkawi Mona Nabeel , Mutiga Jayne , Al-Batineh Mohammed
Published: September 2021

This article navigates the complexity of the humanitarian system, the potential of the humanitarian-development nexus, and the commitments of the World Humanitarian Summit of 2016 as a backdrop to designing sustainable interpreter training programmes. It argues that these programmes must be locally designed to respond to real needs and developed and implemented by local actors living and working in the contexts where building trained interpreter capacity is essential to the success of the humanitarian agenda. It further highlights the crucial importance of decolonising aid and empowering local actors in efforts to advance the cause and quality of multilingual communication in crisis contexts. Two case studies from conflict-affected regions in the Middle East and East Africa—Jordan and Kenya—illustrate how cross-cutting issues from national, regional and international politics, humanitarian agendas, international aid, Higher Education in Emergencies, and country-specific policy agendas inform the design, development, and implementation of university-level training programmes in humanitarian interpreting.
The brain-derived neurotrophic factor prompts platelet aggregation and secretion
Authors: Boukhatem Imane , Fleury Samuel , Welman Melanie , Le Blanc Jessica , Thys Chantal , Freson Kathleen , Best Myron G. , Würdinger Thomas , Allen Bruce G. , Lordkipanidzé Marie
Published: September 2021

Brain-derived neurotrophic factor (BDNF) has both autocrine and paracrine roles in neurons, and its release and signaling mechanisms have been extensively studied in the central nervous system. Large quantities of BDNF have been reported in circulation, essentially stored in platelets with concentrations reaching 100- to 1000-fold those of neurons. Despite this abundance, the function of BDNF in platelet biology has not been explored. At low concentrations, BDNF primed platelets, acting synergistically with classical agonists. At high concentrations, BDNF induced complete biphasic platelet aggregation that in part relied on amplification from secondary mediators. Neurotrophin-4, but not nerve growth factor, and an activating antibody against the canonical BDNF receptor tropomyosin-related kinase B (TrkB) induced similar platelet responses to BDNF, suggesting TrkB could be the mediator. Platelets expressed, both at their surface and in their intracellular compartment, a truncated form of TrkB lacking its tyrosine kinase domain. BDNF-induced platelet aggregation was prevented by inhibitors of Ras-related C3 botulinum toxin substrate 1 (Rac1), protein kinase C, and phosphoinositide 3-kinase. BDNF-stimulated platelets secreted a panel of angiogenic and inflammatory cytokines, which may play a role in maintaining vascular homeostasis. Two families with autism spectrum disorder were found to carry rare missense variants in the BDNF gene. Platelet studies revealed defects in platelet aggregation to low concentrations of collagen, as well as reduced adenosine triphosphate secretion in response to adenosine diphosphate. In summary, circulating BDNF levels appear to regulate platelet activation, aggregation, and secretion through activation of a truncated TrkB receptor and downstream kinase-dependent signaling.
CBFB-MYH11 fusion transcripts distinguish acute myeloid leukemias with distinct molecular landscapes and outcomes
Authors: Huang Benjamin J. , Smith Jenny L. , Wang Yi-Cheng , Taghizadeh Kassra , Leonti Amanda R. , Ries Rhonda E. , Liu Yanling , Kolekar Pandurang , Tarlock Katherine , Gerbing Robert , Crowgey Erin , Furlan Scott N. , Shaw Timothy I. , Hagiwara Kohei , Wei Lisa , Cooper Todd M. , Gamis Alan S. , Aplenc Richard , Kolb E. Anders , Farrar Jason E. , Triche Timothy , Alonzo Todd A. , Ma Xiaotu , Meshinchi Soheil
Published: September 2021

Key Points

CBFB-MYH11 transcripts and KIT mutations predict relapse in AML. High-risk CBFB-MYH11 transcripts are associated with distinct transcriptional landscapes and upregulation of early hematopoiesis genes.
Cranial shape diversification in horses: variation and covariation patterns under the impact of artificial selection
Authors: Hanot Pauline , Bayarsaikhan Jamsranjav , Guintard Claude , Haruda Ashleigh , Mijiddorj Enkhbayar , Schafberg Renate , Taylor William
Published: September 2021

The potential of artificial selection to dramatically impact phenotypic diversity is well known. Large-scale morphological changes in domestic species, emerging over short timescales, offer an accelerated perspective on evolutionary processes. The domestic horse (Equus caballus) provides a striking example of rapid evolution, with major changes in morphology and size likely stemming from artificial selection. However, the microevolutionary mechanisms allowing to generate this variation in a short time interval remain little known. Here, we use 3D geometric morphometrics to quantify skull morphological diversity in the horse, and investigate modularity and integration patterns to understand how morphological associations contribute to cranial evolvability in this taxon. We find that changes in the magnitude of cranial integration contribute to the diversification of the skull morphology in horse breeds. Our results demonstrate that a conserved pattern of modularity does not constrain large-scale morphological variations in horses and that artificial selection has impacted mechanisms underlying phenotypic diversity to facilitate rapid shape changes. More broadly, this study demonstrates that studying microevolutionary processes in domestic species produces important insights into extant phenotypic diversity.
ST-segment resolution as a marker for severe myocardial fibrosis in ST-segment elevation myocardial infarction
Authors: Dong Qian , Wen Xuesong , Chang Guanglei , Xia Rui , Wang Sihang , Yang Yunjing , Tao Yi , Zhang Dongying , Qin Shu
Published: September 2021

Objective

To investigate the relationship between ST-segment resolution (STR) and myocardial scar thickness after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI).

Methods

Forty-two STEMI patients with single-branch coronary artery stenosis or occlusion were enrolled. ST-segment elevations were measured at emergency admission and at 24 h after PCI. Late gadolinium-enhanced cardiac magnetic resonance imaging (CMR-LGE) was performed 7 days after PCI to evaluate myocardial scars. Statistical analyses were performed to assess the utility of STR to predict the development of transmural (> 75%) or non-transmural (< 75%) myocardial scars, according to previous study.

Results

The sensitivity and specificity of STR for predicting transmural scars were 96% and 88%, respectively, at an STR cut-off value of 40.15%. The area under the curve was 0.925. Multivariate logistic proportional hazards regression analysis disclosed that patients with STR < 40.15% had a 170.90-fold higher probability of developing transmural scars compared with patients with STR ≥ 40.15%. Pearson correlation and linear regression analyses showed STR percentage was significantly associated with myocardial scar thickness and size.

Conclusion

STR < 40.15% at 24 h after PCI may provide meaningful diagnostic information regarding the extent of myocardial scarification in STEMI patients.
Falls prevention at GP practices: a description of daily practice
Authors: Meekes Wytske M. A. , Leemrijse Chantal J. , Weesie Yvette M. , van de Goor Ien A. M. , Donker Gé A. , Korevaar Joke C.
Published: September 2021

Background

General practitioners (GPs) can be considered the designated professionals to identify high fall risk and to guide older people to fall preventive care. Currently it is not exactly known how GPs treat this risk. This study aims to investigate GPs’ daily practice regarding fall preventive care for frail older patients.

Methods

Sixty-five GPs from 32 Dutch practices participated in this study for a period of 12 months. When a GP entered specific International Classification of Primary Care-codes related to frailty and/or high fall risk in their Electronic Health Records, a pop-up appeared asking “Is this patient frail?”. If the GP confirmed this, the GP completed a short questionnaire about patient’s fall history and fear of falling (FOF), and the fall preventive care provided.

Results

The GPs completed questionnaires regarding 1394 frail older patients aged ≥75. Of 20% of these patients, the GPs did not know whether they had experienced a fall or not. The GPs did not know whether a FOF existed in even more patients (29%). Of the patients with a fall history and/or a FOF (N = 726), 37% (N = 271) received fall preventive care. Two main reasons for not offering fall preventive care to these patients were: I) the patient finds treatment too intensive or too much of a hassle (37%), and II) the GP identified a high fall risk but the patient did not acknowledge this (14%). When patients were treated for high fall risk, the GP and the physiotherapist were the most frequently involved health care providers. The involved health care providers most often treated mobility limitations, cardiovascular risk factors, and FOF.

Conclusions

The results from this study show that GPs were frequently not aware of their frail patient’s fall history and/or FOF and that the majority of the frail older patients with a fall history and/or FOF did not receive fall preventive care. Developing systematic screening strategies for the primary care setting enhancing the identification of high fall risk and the provision of fall preventive care may improve patients’ quality of life and reduce health care costs.
Clinical outcomes in patients co-infected with COVID-19 and Staphylococcus aureus: a scoping review
Authors: Adalbert Jenna R. , Varshney Karan , Tobin Rachel , Pajaro Rafael
Published: September 2021

Background

Endemic to the hospital environment, Staphylococcus aureus (S. aureus) is a leading bacterial pathogen that causes deadly infections such as bacteremia and endocarditis. In past viral pandemics, it has been the principal cause of secondary bacterial infections, significantly increasing patient mortality rates. Our world now combats the rapid spread of COVID-19, leading to a pandemic with a death toll greatly surpassing those of many past pandemics. However, the impact of co-infection with S. aureus remains unclear. Therefore, we aimed to perform a high-quality scoping review of the literature to synthesize the existing evidence on the clinical outcomes of COVID-19 and S. aureus co-infection.

Methods

A scoping review of the literature was conducted in PubMed, Scopus, Ovid MEDLINE, CINAHL, ScienceDirect, medRxiv, and the WHO COVID-19 database using a combination of terms. Articles that were in English, included patients infected with both COVID-19 and S. aureus, and provided a description of clinical outcomes for patients were eligible. From these articles, the following data were extracted: type of staphylococcal species, onset of co-infection, patient sex, age, symptoms, hospital interventions, and clinical outcomes. Quality assessments of final studies were also conducted using the Joanna Briggs Institute’s critical appraisal tools.

Results

Searches generated a total of 1922 publications, and 28 articles were eligible for the final analysis. Of the 115 co-infected patients, there were a total of 71 deaths (61.7%) and 41 discharges (35.7%), with 62 patients (53.9%) requiring ICU admission. Patients were infected with methicillin-sensitive and methicillin-resistant strains of S. aureus, with the majority (76.5%) acquiring co-infection with S. aureus following hospital admission for COVID-19. Aside from antibiotics, the most commonly reported hospital interventions were intubation with mechanical ventilation (74.8 %), central venous catheter (19.1 %), and corticosteroids (13.0 %).

Conclusions

Given the mortality rates reported thus far for patients co-infected with S. aureus and COVID-19, COVID-19 vaccination and outpatient treatment may be key initiatives for reducing hospital admission and S. aureus co-infection risk. Physician vigilance is recommended during COVID-19 interventions that may increase the risk of bacterial co-infection with pathogens, such as S. aureus, as the medical community’s understanding of these infection processes continues to evolve.
The association between ambient air pollution and scarlet fever in Qingdao, China, 2014–2018: a quantitative analysis
Authors: Jiang Fachun , Wei Tao , Hu Xiaowen , Han Yalin , Jia Jing , Pan Bei , Ni Wei
Published: September 2021

Background

We conducted a distributed lag non-linear time series analysis to quantify the association between air pollution and scarlet fever in Qingdao city during 2014–2018.

Methods

A distributed lag non-linear model (DLNM) combined with a generalized additive mixed model (GAMM) was applied to quantify the distributed lag effects of air pollutions on scarlet fever, with daily incidence of scarlet fever as the dependent variable and air pollutions as the independent variable adjusted for potential confounders.

Results

A total of 6316 cases of scarlet fever were notified, and there were 376 days occurring air pollution during the study period. Scarlet fever was significantly associated with air pollutions at a lag of 7 days with different relative risk (RR) of air pollution degrees [1.172, 95% confidence interval (CI): 1.038–1.323 in mild air pollution; 1.374, 95% CI 1.078–1.749 in moderate air pollution; 1.610, 95% CI 1.163–2.314 in severe air pollution; 1.887, 95% CI 1.163–3.061 in most severe air pollution].

Conclusions

Our findings show that air pollution is positively associated with scarlet fever in Qingdao, and the risk of scarlet fever could be increased along with the degrees of air pollution. It contributes to developing strategies to prevent and reduce health impact from scarlet fever and other non-vaccine-preventable respiratory infectious diseases in air polluted areas.
Association between hyperpyrexia and poststroke outcomes in patients with recanalization after mechanical thrombectomy: a retrospective cohort study
Authors: Chen Man , Fang Jinghuan , Wu Xintong , Liu Qin , Feng Ling , He Li
Published: September 2021

Background

Limited data are available for evaluating the relationship between the prognosis and body temperature (BT) in patients treated with mechanical thrombectomy (MT), especially in those with successful recanalization. We aimed to explore the prognostic value of BT in predicting outcomes of stroke recovery at 3 months poststroke.

Methods

We retrospectively analyzed the relationship among BT levels as a continuous variable, with fever (BT ≥ 37.5℃) as a binary variable, and obtained several outcomes of interest. Subjects were stratified according to successful recanalization (thrombolysis in cerebral infarction scores of 2b-3) following MT. Functional independence was defined as a modified Rankin scale (mRS) score of 0–2.

Results

In total, 258 patients were included. The proportion of patients with functional independence was significantly lower among patients with BT ≥ 37.5℃ than among those with BT < 37.5 °C (45.3 % versus 23.0 %; P < 0.001). In the multivariate analysis, hyperpyrexia (especially BT ≥ 38 °C) was significantly associated with poor 3-month outcomes in patients treated with MT. Subgroup analysis was conducted by comparing the successful recanalization group with the non-recanalization group, showing that BT ≥ 37.5 °C was associated with a significantly lower proportion of functional independence in the recanalized patients. Besides, the Kaplan-Meier model showed that the fever group had significantly lower survival rates than the non-fever group during the 3-month follow-up.

Conclusions

In patients treated with MT, hyperpyrexia is an independent predictor of poststroke outcomes at 3 months, particularly in those with successful recanalization.
Comparison of fear, anxiety and self-efficacy of childbirth among primiparous and multiparous women
Authors: Shakarami Aazam , Mirghafourvand Mojgan , Abdolalipour Somyieh , Jafarabadi Mohammad Asghari , Iravani Mina
Published: September 2021

Background

The aim of this study was to compare fear of childbirth, state and trait anxiety, and childbirth self-efficacy among primiparous and multiparous women in Ahvaz, southwest of Iran.

Methods

This cross-sectional study was conducted with 200 pregnant women (100 primiparous and 100 multiparous women) who had been admitted to the maternity ward of hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. The instruments used for data collection in this study included a demographic questionnaire, Delivery Fear Scale (DFS), Spielberger's State-Trait Anxiety Inventory (STAI), and Childbirth Self-Efficacy Inventory (CBSEI). The data were analyzed by chi-square test and independent t-test. Also, the univariate general linear model was used by adjusting for the socio-demographic and obstetric characteristics that were considered as possible confounding variables.

Results

The mean score of DFS in primiparous women was significantly higher than that of multiparous women. The mean of the overall score of childbirth self-efficacy of primiparous women was significantly lower than that of multiparous women. The mean score of the outcome expectancies and self-efficacy expectancies was significantly lower in primiparous women compared with multiparous women. There was no statistically significant difference between the two groups in terms of the mean score of STAI. After adjusting for possible confounding variables, the differences between the two groups in terms of fear of childbirth scores, overall childbirth self-efficacy score and self-efficacy expectancies remained significant.

Conclusion

Given the high fear of childbirth and low childbirth self-efficacy in primiparous women compared to the multiparous women, appropriate interventions should be adopted by health care providers in order to reduce fear and improve childbirth self-efficacy in primiparous women.
Normative data for the 6-min walk test in 11–14 year-olds: a population-based study
Authors: Kasović Mario , Štefan Lovro , Petrić Vilko
Published: September 2021

Background

The 6-min walk test (6MWT) has become an established measure for assessing exercise capacity in children with chronic diseases. However, little evidence has been provided regarding population-based normal data in healthy children. The main purpose of the study was to provide normative data in a large sample of children.

Methods

In this cross-sectional study, 4352 children between 11 and 14 years were recruited (66% girls). The main outcome measure was the distance walked for six minutes. Sex- and age-specific percentile values (5th, 15th, 25th, 50th, 75th, 85th and 95th) for the 6MWT were created and the differences and correlations were examined by the analysis of variance and Pearson’s coefficient of correlation.

Results

The mean distance walked in 6 min was 576 ± 93 m in boys and 545 ± 92 m in girls, respectively. The mean walking speed for boys and girls was 98 ± 5 m/min and 91 ± 6 m/min. Older boys and girls performed better, compared to their younger counterparts (p for age < 0.001). The 6MWT was significantly correlated with age (r = 0.24, p < 0.001), height (r = 0.09, p < 0.001), weight (r =  − 0.13, p < 0.001) and body-mass index (r =  − 0.26, p < 0.001).

Conclusions

This is the first population-based study aiming to provide normative data for the 6MWT in healthy children between 11 to 14 years. Children in lower percentiles are ‘target groups’ for special intervention aiming to enhance the performance.
Mechanosensitive cation channel Piezo1 contributes to ventilator-induced lung injury by activating RhoA/ROCK1 in rats
Authors: Zhang Yang , Jiang Lulu , Huang Tianfeng , Lu Dahao , Song Yue , Wang Lihui , Gao Ju
Published: September 2021

Background

Mechanical ventilation can induce or aggravate lung injury, which is termed ventilator-induced lung injury (VILI). Piezo1 is a key element of the mechanotransduction process and can transduce mechanical signals into biological signals by mediating Ca2+ influx, which in turn regulates cytoskeletal remodeling and stress alterations. We hypothesized that it plays an important role in the occurrence of VILI, and investigated the underlying mechanisms.

Methods

High tidal volume mechanical ventilation and high magnitude cyclic stretch were performed on Sprague–Dawley rats, and A549 and human pulmonary microvascular endothelial cells, respectively, to establish VILI models. Immunohistochemical staining, flow cytometry, histological examination, enzyme-linked immunosorbent assay, western blotting, quantitative real-time polymerase chain reaction and survival curves were used to assess the effect of Piezo1 on induction of lung injury, as well as the signaling pathways involved.

Results

We observed that Piezo1 expression increased in the lungs after high tidal volume mechanical ventilation and in cyclic stretch-treated cells. Mechanistically, we observed the enhanced expression of RhoA/ROCK1 in both cyclic stretch and Yoda1-treated cells, while the deficiency or inhibition of Piezo1 dramatically antagonized RhoA/ROCK1 expression. Furthermore, blockade of RhoA/ROCK1 signaling using an inhibitor did not affect Piezo1 expression. GSMTx4 was used to inhibit Piezo1, which alleviated VILI-induced pathologic changes, water content and protein leakage in the lungs, and the induction of systemic inflammatory mediators, and improved the 7-day mortality rate in the model rats.

Conclusions

These findings indicate that Piezo1 affects the development and progression of VILI through promotion of RhoA/ROCK1 signaling.