bluuebunny/crossref_metadata_2025 huggingface dataset:
Screw‐in‐screw fixation of fragility sacrum fractures provides high stability without loosening—biomechanical evaluation of a new concept
Authors: Zderic Ivan , Wagner Daniel , Schopper Clemens , Lodde Moritz , Richards Geoff , Gueorguiev Boyko , Rommens Pol , Acklin Yves P.
Published: October 2020

Surgical treatment of fragility sacrum fractures with percutaneous sacroiliac (SI) screw fixation is associated with high failure rates. Turn‐out is detected in up to 20% of the patients. The aim of this study was to evaluate a new screw‐in‐screw implant prototype for fragility sacrum fracture fixation. Twenty‐seven artificial hemipelvises were assigned to three groups (n = 9) for instrumentation of an SI screw, the new screw‐in‐screw implant prototype, ora transsacral screw. Before implantation, a vertical osteotomy was set in zone 1 after Denis. All specimens were biomechanically tested to failure in upright position. Validated setup and test protocol were used for complex axial and torsional loading applied through the S1 vertebral body to promote turn‐out of the implants. Interfragmentary movements were captured via optical motion tracking. Screw motions were evaluated by means of triggered anteroposterior X‐rays. Interfragmentary movements and implant motions were significantly higher for SI screw fixation compared to both transsacral and screw‐in‐screw fixations. In addition, transsacral screw and screw‐in‐screw fixations revealed similar construct stability. Moreover, screw‐in‐screw fixation successfully prevented turn‐out of the implant that remained during testing at 0° rotation for all specimens. From biomechanical perspective, fragility sacrum fracture fixation with the new screw‐in‐screw implant prototype provides higher stability than an SI screw, being able to successfully prevent turn‐out. Moreover, it combines the higher stability of transsacral screw fixation with the less risky operational procedure of SI screw fixation and can be considered as their alternative treatment option.
Use of contemporary biomaterials in chronic osteomyelitis treatment: Clinical lessons learned and literature review
Authors: Geurts Jan A. P. , van Vugt Tom A. G. , Arts Jacobus J. C.
Published: October 2020

Chronic osteomyelitis has always been a therapeutic challenge for patient and surgeon due to the specific problems related with bone infection and bacterial biofilm eradication. Other than being the cause of infection or facilitating spread or persistence of infection, biomaterials are also becoming a tool in the treatment of infection. Certain novel biomaterials have unique and ideal properties that render them perfectly suited to combat infection and are therefore used more and more in the treatment of chronic bone infections. In case of infection treatment, there is still debate whether these properties should be focused on bone regeneration and/or their antimicrobial properties. These properties will be of even greater importance with the challenge of emerging antimicrobial resistance. This review highlights indications for use and specific material properties of some commonly used contemporary biomaterials for this indication as well as clinical experience and a literature overview.
On the value of the 2017 classification of phenotype and gingival recessions
Authors: Pini Prato GiovanPaolo , Di Gianfilippo Riccardo
Published: October 2020

The 2017 World Workshop completely restructured knowledge in periodontology with a series of official consensus statements jointly agreed upon by the American Academy of Periodontology and the European Federation of Periodontology. Among them, the 2017 classification of phenotype and gingival recession successfully incorporated the most relevant previous classifications into a treatment‐oriented diagnostic matrix. Despite the significant advantages related with the implementation of this new classification of gingival recessions, recent articles still report data based on previous outdated systems. Therefore, the present commentary aimed to dive into the key advantages of the 2017 classification of phenotype and gingival recession, and to stress why it should be fully integrated into research and practice settings.
Ultrasound First for Removal of Nonpalpable Contraceptive Implants
Authors: Herzog Jackson , Walker Lisa , Sutter Christopher , Azar Nami , Nakamoto Dean
Published: October 2020

The Sound Judgment Series consists of invited articles highlighting the clinical value of using ultrasound first in specific clinical diagnoses where ultrasound has shown comparative or superior value. The series is meant to serve as an educational tool for medical and sonography students and clinical practitioners and may help integrate ultrasound into clinical practice.
National Analysis of 30‐Day Readmission Following Inpatient Sinus Surgery for Chronic Rhinosinusitis
Authors: Khoury Habib , Bellamkonda Nikhil , Benharash Peyman , Lee Jivianne T. , Wang Marilene B. , Suh Jeffrey D.
Published: October 2020

Objectives

To characterize the incidence, causes, risk factors, and costs of 30‐day readmission after inpatient functional endoscopic sinus surgery (FESS) for patients with chronic rhinosinusitis.

Study Design

Retrospective cohort study.

Methods

The Nationwide Readmissions Database was used to characterize readmission after inpatient sinus surgery for chronic rhinosinusitis from 2015 to 2017. International Classification of Disease codes were used to identify the patient population, which included 5,644 patients. Incidence, causes, costs, and predictors of readmission were analyzed and determined.

Results

Among 6,386 patients who underwent inpatient FESS, 742 (11.6%) were readmitted within 30 days of discharge. On univariate analysis, patients who were readmitted were more commonly older than 70 years (23.3% vs. 16.2%); had a higher burden of comorbidities including chronic kidney disease (15.0% vs. 7.8%), diabetes (25.6% vs. 20.4%), and hypertension (13.5% vs. 8.5%); had a greater rate of postoperative complications (20.7% vs. 12.2%); and had a longer length of stay (12.4 vs. 6.9 days) compared to patients who were not readmitted. Readmissions cost an additional $27,141 per patient. On multivariable analysis, age greater than 70 years, Medicaid insurance, several comorbidities, prolonged length of stay, postoperative neurologic complications, and lower hospital volume were independent predictors of 30‐day readmission. The most common cause for readmission was infection (36.3%).

Conclusion

Readmission following inpatient FESS is not uncommon. Identification and management of preoperative comorbidities, optimized patient selection for inpatient surgery, and thorough postoperative discharge care may improve patient outcomes and decrease healthcare expenditures.

Level of Evidence

3 Laryngoscope, 131:E1422–E1428, 2021
A National Evaluation of Food Insecurity in a Head and Neck Cancer Population
Authors: Berger Michael H. , Lin Harrison W. , Bhattacharyya Neil
Published: October 2020

Objectives/Hypothesis

To determine the food security status of patients with a history of head and neck cancer and compare to other types of cancer.

Study Deign

A retrospective analysis using the National Health Interview Series.

Methods

The National Health Interview Series (NHIS) for the calendar years 2014 to 18 was used to elicit food security status (secure, marginally secure/not secure) among adult patients with a history of throat/pharynx head and neck cancer (pHNC), thyroid cancer, and colon cancer. The relationship between food security and the primary site was compared and subanalyses were performed according to sex, race, and ethnicity.

Results

The study population included 199.0 thousand patients with pHNC, with 17.7% (95% confidence interval, 10.5%–28.1%) of pHNC patients reporting their food security status as marginally secure or not secure. Food insecurity was significantly higher among pHNC patients when compared to thyroid cancer (insecurity 10.7%, [7.7%–14.7%]) and colon cancer patients (10.1%, [7.8%–13.2%]). Among pHNC patients, there was no significant difference in rates of food insecurity when stratified by gender, race, or ethnicity. However, black individuals were more likely to have food insecurity with a history of thyroid or colon cancer (P < .042) and Hispanics were more likely to have food insecurity with a history of thyroid cancer (P = .005).

Conclusions

Food insecurity disproportionally affects patients with a history of pHNC, though there is less demographic variability when compared to other cancer primary sites. Food security assessments should be part of the tailored approach to survivorship management in head and neck cancer.

Level of Evidence

4 Laryngoscope, 131:E1539–E1542, 2021
Prognostic Impact of Metastatic Site and Pattern in Patients with Metastatic Head and Neck Cancer
Authors: Bollig Craig A. , Newberry Christopher I. , Galloway Tabitha L. I. , Zitsch Robert P. , Hanly Elyse K. , Zhu Vivian L. , Pagedar Nitin , Nallani Rohit , Bur Andres M. , Spanos William C. , Jorgensen Jeffrey B.
Published: October 2020

Objectives/Hypothesis

Investigate the relationship between site and pattern of distant metastasis (DM) and overall survival (OS) in a multi‐institutional cohort of patients with DM head and neck cancer (HNC).

Study Design

Retrospective review.

Methods

283 patients treated at 4 academic centers in the Midwest HNC Consortium between 2000 and 2015 were retrospectively reviewed. Disease patterns were divided between solitary metastatic versus polymetastatic (≥2 sites) disease. Survival functions for clinically relevant variables were estimated using Kaplan‐Meier and Cox proportional hazards models.

Results

Median OS for all patients was 9.0 months (95% confidence interval [CI]: 7.4–10.6). Lung (n = 220, 77.7%) was the most common site of DM, followed by bone (n = 90, 31.8%), mediastinal lymph nodes (n = 55, 19.4%), liver (n = 41, 14.5%), and brain (n = 17, 6.0%). Bone metastases were independently associated with the worst prognosis (hazard ratio [HR] = 1.6, 95% CI: 1.3–2.1). On univariate analysis, brain metastases were associated with improved prognosis (HR = 0.5, 95% CI: 0.3–0.9), although this was not statistically significant on the multivariate analysis. Polymetastatic disease was present in the majority of patients (n = 230, 81.3%) and was associated with a worse prognosis compared to solitary metastatic disease (HR = 1.4, 95% CI: 1.0–2.0).

Conclusion

Our large, multi‐institutional review indicates that both the metastatic pattern and site of DM impact OS. Polymetastatic disease and bone metastasis are associated with worse prognosis, independent of treatment received.

Level of Evidence

4 Laryngoscope, 131:E1838–E1846, 2021
An evaluation of the effects of microstructural characteristics and frost heave on the remediation of saline‐alkali soils in the Yellow River Delta, China
Authors: Li Kesheng , Li Quanxin , Geng Yuhan , Liu Chuanxiao
Published: October 2020

In the Yellow River Delta of China, soil salinization is of serious concern from both agricultural and environmental perspectives. In this study we investigated the microstructural characteristics of saline‐alkali soils in this region and explored the influence of frost heave on soil microstructure. Soil mineral composition, pore distribution, particle arrangement, and pore characteristics were measured using X‐ray diffraction (XRD), mercury intrusion porosimetry (MIP), and scanning electron microscopy (SEM). Soil pore characteristics, overall porosity, and unconfined compressive strength (UCS) were measured at water content of 10, 15, 20, 25% (w/w) before and after freezing at −10°C. The results showed that deterioration of soil physical properties was largely caused by dense particle arrangement, high proportion of ultra‐micropore‐specific surface area, and poor pore distribution, rather than mineral content or particle size distribution. The microstructure of saline‐alkali soil was greatly improved by frost heave with the overall porosity and UCS of frost heave‐treated soil samples significantly higher than for the control. Moreover, particle cementation decreased with increasing soil water content. This study demonstrated that a combination of XRD, SEM, and MIP offers accurate evaluation of the microstructural characteristics of saline‐alkali soils, and frost heave may serve as an economically sustainable and technically feasible method for saline‐alkali soil amelioration in the Yellow River Delta.
Weed management for landscape scale restoration of global temperate grasslands
Authors: Humphries Talia , Florentine Singarayer K. , Dowling Kim , Turville Chris , Sinclair Steve
Published: October 2020

Globally, temperate grasslands have been significantly degraded as a result of urbanisation, grazing and agriculture. Weeds now dominate most of these ecosystems, resulting in the loss of ecosystem services, reduced carrying capacity for farmers, and reduction of habitat for native plants and animals. This paper reviews the literature relating to temperate grassland restoration efforts across the globe, noting which techniques and combinations have been used successfully to reduce weed dominance and promote native recruitment and establishment. This review concludes that, using a combination of four restoration techniques, provided the highest level of success, with the caveat that, ongoing weed management should be budgeted for in all projects. There is no single optimal method for restoration and weed control, with success depending on specific site conditions and the scope and aims of particular projects. However, any form of target plant transfer was observed to significantly enhance the restoration's success and reduce exotic plant biomass. There is clearly a need for an increase in long‐term monitoring of restoration projects in order to make more confident assumptions.
Scrutiny of hospital safety measures snares California psychiatric facility
Authors: Enos Gary
Published: October 2020

A months‐long effort by California nurses to highlight deficient COVID‐19 safety protocols among some of the state's largest hospital companies has contributed to a citation and fine announced against a Kaiser Permanente psychiatric facility.
MHA annual state report finds rising MH rates pre‐COVID
Authors: Canady Valerie A.
Published: October 2020

Mental Health America's (MHA's) 2021 State of Mental Health in America report released last week confirms that rising mental health issues and poor access to care have only worsened — even before the pandemic. The results make Americans ill‐prepared from the start to tackle the mental health effects of the pandemic, the report states.
APA poll finds rise in anxiety related to COVID‐19, election
Authors: Canady Valerie A.
Published: October 2020

A new public opinion poll released Oct. 21 by the American Psychiatric Association (APA) found that 62% of Americans feel more anxious than they did at this time last year. That marks a sizeable increase over APA polls of the past three years, in which the number has ranged between 32% and 39%, APA officials stated in a news release.
Expansion of a compressible non‐barotropic fluid in vacuum
Authors: Yu Rongfeng
Published: October 2020

In this paper, we consider a region occupied by viscous or inviscid compressible magnetohydrodynamic fluids and surrounded by vacuum. It is shown that the fluid region will expand at least linearly in time as soon as there are no singularities. The expanding rate is proportional to initial total energy and is inversely proportional to initial mass. The result indicates an interesting fact that the expansion of the viscous monatomic fluids seems similar to that of the inviscid fluids.
Magnetic field detection using fiber bundle and magnetic fluid as sensors
Authors: Samian  , Zaidan Andi H. , Arifianto Akbar S. , Pujiyanto  , Taufiq Ahmad
Published: October 2020

The method for detecting magnetic fields based on magnetic fluid (MF) and fiber bundle was successfully demonstrated. The sensor works by measuring changes in the refractive index of MF due to changes in magnetic fields. Using MF with a concentration of 2.5%, the proposed sensor successfully detected a magnetic field in the range of 25.3 to 83.5 mT with a resolution of 3.3 mT.
Technical Note: Evaluating automatic tube current modulation in CT using the standard CTDI dosimetry phantom
Authors: Papadakis Antonios E. , Damilakis John
Published: October 2020

Purpose

To assess the utility of the standard body CTDI phantom in characterizing the operation scheme of tube current modulation (TCM) systems in CT.

Methods

The body CDTI phantom was used to characterize two TCM systems: TCM1 and TCM2, implemented in scanners from different vendors. The phantom was aligned at the gantry isocenter in two configurations. In configuration A, the facet planes of the phantom were parallel to the patient table, while in configuration B they were vertical to the patient table and parallel to the patient’s long axis. Acquisitions were performed using the routine abdominal examination protocol. mA(z) profiles were recorded from images’ DICOM header. The water equivalent diameter (dw) and oval ratio (OR) were calculated as a function of z‐axis location. Image noise was defined as the standard deviation (SD) of the mean Hounsfield unit value measured in a region of interest at the center of the phantom’s image. Regression analysis was performed to modulated mA and SD vs dw and OR. The spatial concordance between the change in phantom size and change in mA (SCmA) was calculated as the percent difference in the slope of mA(z) change between the 1st and 2nd half of the phantom. The corresponding spatial concordance between the change in phantom size and change in image noise (SCnoise) was calculated.

Results

Modulated mA(z) along the z‐axis did not substantially differentiate between configurations A and B. Correlation between ln(mA) and OR was found to be higher compared to correlation between ln(mA) and dw. SCmA was 48% for TCM1 and 33% for TCM2. The corresponding SCnoise was 29% for TCM1 and 16% for TCM2.

Conclusion

Apart from routine CT dosimetry evaluations, the standard CTDI phantom positioned in configuration A or B may additionally be used by medical physicists to evaluate the performance of TCM operational characteristics.
Maternal Allocation of Lipids to Eggs by Southern Flounder after Diet Changes
Authors: Mejri Sahar , Burns Corinne M. , Hou Zhenxin , Fuiman Lee A.
Published: October 2020

Maturation and spawning diets for flatfish broodstock, such as Southern Flounder Paralichthys lethostigma, have received little research attention, despite their critical role in the reproductive performance. During the spawning season, which is when Southern Flounder broodstock produce multiple egg batches, they rely on their diet to supply nutrients to the eggs. Lipids are an important class of nutrients for offspring development. The objective of this brief communication is to describe the changes in egg lipid classes during the spawning season following a diet change. Female broodstock were fed three diets after the first spawn (week 0)—a control diet (equal weights of Spanish Sardines Sardinella aurita and brown shrimp Farfantepenaeus aztecus), a shrimp-only diet, and a sardine-only diet (n = 3, 3, and 4, respectively)—for a period of 6 weeks and the lipid composition of the eggs was measured every 2 weeks. The change to a diet of sardines only or shrimp only altered the concentrations of egg lipid classes, indicating that egg composition is affected by maternal dietary intake over a period of 2 weeks or less. Females that were fed the sardine-only diet produced eggs with higher levels of ketones and acetone-mobile polar lipids and lower levels of hydrocarbons than did females that were fed shrimp, exhibiting changes that were consistent with the differences between the diets. The shift to the sardine-only diet had little effect on total lipids, triacylglycerols, free fatty acids, and sterols in the eggs. The change to the shrimp-only diet resulted in subtle but consistent decreases in all of the lipids, except wax/steryl esters at week 2, followed by gradual increases. This suggests that the shrimp-only diet provided insufficient nutrition and that the females mobilized stored lipids to compensate. These preliminary results revealed interesting patterns that, with further research, could lead to improved diets and feeding protocols for the production of Southern Flounder.
Evaluating Remote Site Incubators in Michigan Streams: Implications for Arctic Grayling Reintroduction
Authors: Mock Alan J. , Ruetz Carl R. , McNair James N. , Mays Dan , Martell Archie
Published: October 2020

The successful use of remote site incubators (RSIs) to rear eggs of Arctic Grayling Thymallus arcticus along Montana streams has sparked interest in reestablishing the species in Michigan. As a preparatory step, we assessed the efficacy of RSIs by deploying them along three Michigan streams during 2 years using surrogate eggs from Rainbow Trout Oncorhynchus mykiss. Our objectives were to (1) compare hatching success between two different RSI designs (19-L versus 265-L RSIs), (2) test whether the removal of dead eggs (“picking”) from 19-L RSIs affected hatching success, and (3) develop a simple model to predict fry yield and its uncertainty. Overall survival was 41.3% in 2018 and 52.4% in 2019. Differences in survival between unpicked 19-L and 265-L RSIs tended to be small, with mean differences from 4.82% (95% CI = –0.60 to +10.25) in 2018 to 0.08% (95% CI = –0.14 to +0.30) in 2019. On average, picked 19-L RSIs had greater, although not always statistically significant, survival than unpicked 19-L RSIs during both years (mean difference = 1.6% [2018] and 10.4% [2019]). We documented a significant positive correlation between survival and RSI flow rate. Survival abruptly declined in unpicked 19-L RSIs when RSI flow rates dropped below ~0.3 L/min, suggesting that removing dead eggs from 19-L RSIs likely increased survival when RSI flow rates were <0.3 L/min. The most notable result from our fry yield model was that increasing the number of RSIs reduced the coefficient of variation in fry yield following a pattern of diminishing returns, suggesting two or three RSIs usually will be a good choice. We showed that 19-L and 265-L RSIs can be used successfully in Michigan streams, with our model providing a tool for managers to explore the relative importance of several properties of RSI design and operation on fry yield and uncertainty.
Increased risk of incident dementia following use of anticholinergic agents: A systematic literature review and meta‐analysis
Authors: Dmochowski Roger R. , Thai Sydney , Iglay Kristy , Enemchukwu Ekene , Tee Silvia , Varano Susann , Girman Cynthia , Radican Larry , Mudd Paul N. , Poole Charles
Published: October 2020

Background/rationale

Long‐term treatment with anticholinergic agents may increase the risk of cognitive impairment or dementia. This systematic literature review and meta‐analysis aimed to assess the impact of ≥3 months of exposure to anticholinergics as a class on the risk of dementia, mild cognitive impairment, and change in cognitive function. The impact of anticholinergic agents specifically used to treat overactive bladder was also evaluated.

Materials and Methods

A systematic literature review was conducted to identify English language articles evaluating the impact of anticholinergic use for ≥3 months on dementia or cognitive function in adult patients. Databases searched included PubMed, Embase, and the Cochrane Library. Meta‐analyses were conducted using random‐effects models; 95% confidence intervals (CIs) and 95% prediction intervals (PIs) were reported.

Results

A total of 2122 records were identified. Out of those, 21 studies underwent qualitative synthesis and 6 reported endpoints relevant for inclusion in a meta‐analysis assessing the risk of incident dementia. The overall rate ratio for incident dementia was 1.46 (95% CI: 1.17–1.81; 95% PI: 0.70–3.04; n = 6). The risk of incident dementia increased with increasing exposure (n = 3). In addition, two studies from the meta‐analysis reported an increased risk of dementia with ≥3 months of use of bladder antimuscarinics (adjusted odds ratios ranged from 1.21 to 1.65, depending on exposure category).

Conclusion

Anticholinergic use for ≥3 months increased the risk of dementia on average by an estimated 46% versus nonuse. This relationship was consistent in studies assessing overactive bladder medications. The risk of developing dementia should be carefully considered in the context of potential benefit before prescribing anticholinergics.
Receptor GPR91 contributes to voiding function and detrusor relaxation mediated by succinate
Authors: Mossa Abubakr , Velasquez‐Flores Monica , Cammisotto Philippe G. , Campeau Lysanne
Published: October 2020

Aim

Succinate activates the receptor GPR91 identified in the bladder. The present study aims to unravel the mechanisms of bladder relaxation by succinate and how the receptor is involved in structural and functional changes of the bladder.

Methods

Physiological recordings of bladder function were carried out by cystometry and organ bath from C57BL/6 mice, homozygous GPR91−/− mice, and Sprague–Dawley (SD) rats. GPR91 expression was confirmed by polymerase chain reaction and tissue morphology was examined by light (Masson trichrome) and fluorescence microscopy. Nitric oxide (NO) and ATP secretion were measured.

Results

Bladders of GPR91 KO mice had a greater mass to body weight ratio with a thicker bladder wall compared to C57BL/6 mice. They also displayed increased basal and maximal bladder pressures, and decreased intercontraction intervals, bladder capacity, micturition volume, and compliance. During cystometry, bladders of SD rats and C57BL/6 mice instilled with succinate (10 mM) showed signs of relaxation while bladders of GPR91 KO mice were unresponsive. Similarly, in organ bath, succinate relaxed bladder strips preincubated with carbachol, except GPR91 KO ones. Relaxation was stronger in the presence of urothelium and independent of NO synthesis. Bladder strips from all mice groups showed similar responses to KCl, carbachol, and electrical stimulation. In vitro, succinate increased NO secretion in urothelial cell culture of both C57BL6 and GPR91 KO mice while ATP secretion was potently decreased by succinate in C57BL6 culture only.

Conclusion

Succinate through GPR91 is essential to bladder structure and contraction. GPR91 relaxes the detrusor partially by decreasing urothelial ATP secretion.
Did we do everything we could have? Nurses’ contributions to medicines optimization: A mixed‐methods study
Authors: Logan Vera , Keeley Sarah , Akerman Kevin , De Baetselier Elyne , Dilles Tinne , Griffin Nia , Matthews Lisa , Van Rompaey Bart , Jordan Sue
Published: October 2020

Aim

To explore UK professionals’ interpretations of medicines optimization and expansion of nurses’ roles.

Design

This mixed‐methods study sought professionals’ views on nurses’ involvement, competency and engagement in monitoring patients for adverse effects of medicines, monitoring adherence, prescribing and patient education.

Method

An online survey and interviews were undertaken with nurses, doctors and pharmacists in Wales and England, May 2018 to July 2019.

Results

In all, 220 nurses, 17 doctors and 62 pharmacists responded to the online survey, and 24 professionals were interviewed. Nurses were divided over extending their roles, with 123/220 (55.9%) wishing to extend roles in monitoring patients for possible adverse drug reactions (ADRs), 111/220 (50.5%) in adherence monitoring, 121/220 (55.0%) in prescribing and 122/220 (55.4%) in patient education. The best‐qualified nurses were the most willing to increase involvement in monitoring patients for ADRs (aOR 13.00, 1.56–108.01). Interviews revealed that both nurses and doctors assumed the other profession was undertaking this monitoring. Respondents agreed that increasing nurses’ involvement in medicines optimization would improve patient care, but expressed reservations about nurses’ competencies. Collaboration between nurses and doctors was suboptimal (rated 7/10 at best) and between nurses and pharmacists even more so (6/10 at best).

Conclusion

Juxtaposition of datasets identified problems with medicines optimization: although most respondents agreed that increasing nurses’ involvement would positively impact practice, their educational preparation was a barrier. Only ~50% of nurses were willing to expand their roles to fill the hiatus in care identified and ensure that at least one profession was taking responsibility for ADR monitoring.

Impact

To improve multiprofessional team working and promote patient safety, nurse leaders should ensure patients are monitored for possible ADRs by at least one profession. Initiatives expanding nurses’ roles in medicines optimization and prescribing might be best targeted towards the more educated nurses, who have multidisciplinary support.
Infant temperament as a predictor of maternal attachment: A Jordanian study
Authors: Abuhammad Sawsan , AlAzzam Manar , AbuFarha Rana
Published: October 2020

Aim

To investigate the relationship between maternal bonding and infant temperament during the first year of infant's life. Moreover, it also wanted to explore which perinatal factors could influence the quality of maternal attachment.

Method

A cross‐sectional study design was used to collect data from a sample of 277 mothers during the period of May–October 2018. The participants were asked to complete a three‐part survey that was developed to collect data on maternal attachment and infant temperament. Data was collected between March 2019–June 2019.

Results

The analysis of the data revealed that there was a significant relationship between infant temperament and maternal attachment [F(2, 95) = 6.783, p‐value = .001]. It also revealed that the factors that most influenced maternal attachment were infant temperament and planned pregnancy, which together explained 54% of the variance in maternal attachment (R2  =  7.5).

Conclusion

Maternal attachment in Jordanian mothers can be explained by two significant factors: infant temperament and planning for pregnancy.
Maternal Employment and Infant BMI z Score in a US Birth Cohort
Authors: Oddo Vanessa M. , Hoyo Cathrine , Østbye Truls , Benjamin‐Neelon Sara E.
Published: October 2020

Objective

The purpose of this study was to investigate the association between maternal employment and infant BMI z score.

Methods

Longitudinal data from 520 mother‐infant dyads participating in the Nurture Study, an observational cohort in the southeastern United States, were leveraged. Women were categorized as employed or nonemployed at 3, 6, 9, and 12 months, and measured anthropometrics were used to calculate infants’ BMI z scores at the corresponding time points. BMI z score was defined using the World Health Organization standard. Household income was an effect modifier. Therefore, income‐stratified (≤$40,000/y vs. >$40,000/y) linear regression models, with individual fixed effects, were used to examine associations between change in maternal employment status and BMI z scores among infants aged 3 to 12 months. Fixed effects controlled for time‐invariant confounders (race/ethnicity, infant gender). This study also controlled for marital status and infant age.

Results

More women from higher‐income (68.4%) versus lower‐income households (52.6%) were employed. Among lower‐income households, change from nonemployment to employment was associated with higher infant BMI z scores (β = 0.12; 95% CI: −0.01 to 0.25, P = 0.07). Among higher‐income households, change in maternal employment status was associated with lower infant BMI z scores (β = −0.72; 95% CI: −1.17 to −0.27, P = 0.02).

Conclusions

Maternal employment was related to infant adiposity. The direction of the association varied by household‐level income.
Do Patients Regret Having Received Systemic Treatment for Advanced Non-Small Cell Lung Cancer: A Prospective Evaluation
Authors: Hollen Patricia J. , Gralla Richard J. , Gentzler Ryan D. , Hall Richard D. , Coyne Bethany , Cheng Haiying , Halmos Balazs , Gildersleeve Jane , Calderon Claudia , Hinton Ivora , Weiss Geoffrey , Crawford Jeffrey , Cerise Jane , Lesser Martin
Published: October 2020

Background

Thousands of patients annually receive treatment for advanced non-small cell lung cancer (NSCLC), but little is known about their views on the decision to receive that treatment, or regret. This trial prospectively evaluated the incidence of regret and whether baseline characteristics, patient decision-making parameters, or clinical progress early in the treatment course predicts regret.

Materials and Methods

Patients receiving systemic treatment for advanced NSCLC completed every 3-week patient reported outcome (PRO) assessment using the electronic Lung Cancer Symptom Scale (eLCSS-QL), including the 3-Item Global Index (3-IGI; assessing overall distress, activities, and quality of life [QL]). A prespecified secondary aim was to determine the frequency of regret evaluated at 3 months after starting treatment. Patients were randomized to usual care or enhanced care (which included use of the DecisionKEYS decision aid).

Results

Of 164 patients entered, 160 received treatment and 142 were evaluable for regret. In total, 11.5% of patients and 9% of their supporters expressed regret. Baseline characteristics did not predict regret; regret was rarely expressed by those who had a less than 20% decline or improvement in the 3-IGI PRO score after two treatment cycles. In contrast, when asked if they would make the same decision again, only 1% not having a 20% 3-IGI decline expressed regret, versus 14% with a 3-IGI decline (p = .01).

Conclusion

The majority of patients having regret were identified early using the PRO 3-IGI of the eLCSS-QL measure. Identifying patients at risk for regret allows for interventions, including frank discussions of progress and goals early in the treatment course, which could address regret in patients and their supporters.

Implications for Practice

This report documents prospectively, for the first time, the incidence of treatment-related regret in patients with advanced lung cancer and outlines that risk of regret is associated with patient-determined worsening health status early in the course of treatment. Identifying patients at risk for regret early in treatment (before the third cycle of treatment) appears to be crucial. Counseling at that time should include a discussion of consideration of treatment change and the reason for this change.
Weekly Carboplatin and Paclitaxel for Ovarian Cancer: The “Finer Points”
Authors: Muggia Franco
Published: October 2020

First-line ovarian cancer platinum doublet is paclitaxel-carboplatin. Superiority of weekly paclitaxel schedules has not been confirmed; however, a novel schedule with both drugs given weekly (days 1, 8, 15) followed by a 2-week break may be advantageous to some.
PTFE as a toughness modifier of high‐performance PEI/PBT blends: Morphology control during melt processing
Authors: Vásquez‐Rendón Mauricio , Álvarez‐Láinez Mónica Lucía
Published: October 2020

High‐performance PEI/PBT blends are brittle because of phase distribution and blends densification. New morphologies developed by adding PTFE to PEI matrix during melt processing favor the toughness improvement of PEI/PBT blends. Ternary PEI/PBT/PTFE processability is not compromised by PTFE addition, and miscibility study by modulated differential scanning calorimetry and harmonic mean method shows that PTFE does not interfere with PEI and PBT interaction. Dual‐phase and spore‐like morphologies are formed for both PEI/PBT and PEI/PBT/PTFE blends, and they strongly influenced their mechanical performance. Although tensile strength of ternary blends does not decrease by PTFE addition, elongation at break deteriorates for blends with PEI concentrations <70 wt%. Nevertheless, blends with 80 wt% increase their ductility, and a synergic effect is observed in impact resistance results. PTFE acts as an impact modifier of PEI/PBT blends due to its distribution in the PEI matrix as debonded spheres and nanoparticles well‐embedded in PEI matrix.

Highlights

Step‐by‐step melt processing enhances PTFE powders spheroidization

Complete wetting of PTFE in PEI matrix

PTFE do not interfere in partial miscibility of PEI/PBT blends

Nanosized PTFE droplets inhibits PEI densification

PTFE improves elongation at break and toughness of PEI/PBT blends
Clinical utilization of blinatumomab and inotuzumab immunotherapy in children with relapsed or refractory B‐acute lymphoblastic leukemia
Authors: Contreras Cristina F. , Higham Christine S. , Behnert Astrid , Kim Kailyn , Stieglitz Elliot , Tasian Sarah K.
Published: October 2020

Background

The treatment paradigm for patients with relapsed/refractory B‐cell acute lymphoblastic leukemia (rrALL) has been revolutionized given recent clinical trials demonstrating remarkable success of immunotherapies and leading to drug approvals by United States and European agencies. We report experience with commercial blinatumomab and inotuzumab use at two North American pediatric oncology centers in children and adolescents/young adults with B‐ALL.

Procedure

Patients 0‐25 years old treated with the CD19 × CD3 bispecific T cell‐engaging antibody blinatumomab and/or the CD22 antibody‐drug conjugate inotuzumab from January 1, 2010, to June 1, 2018, were eligible. Disease status included relapsed B‐ALL in second or greater relapse, primary chemotherapy‐refractory B‐ALL, or B‐ALL complicated by severe infection precluding delivery of conventional chemotherapy.

Results

We identified 27 patients who received blinatumomab and/or inotuzumab outside of clinical trials during the study period. Four of the 13 patients (31%) with relapsed disease achieved minimal residual disease (MRD)‐negative remission, and five patients (39%) underwent hematopoietic stem cell transplant (HSCT). In the 12 patients with primary chemorefractory B‐ALL treated with immunotherapy, 11 (92%) achieved MRD‐negative remission as assessed by flow cytometry; 10 patients (83%) underwent subsequent HSCT. Two patients with B‐ALL in MRD‐negative remission received blinatumomab due to severe infection and remained in remission after chemotherapy continuation.

Conclusions

Blinatumomab and inotuzumab can induce deep remissions in patients with rrALL and facilitate subsequent HSCT or other cellular therapies. Blinatumomab can also serve as an effective bridging therapy during severe infection. The optimal timing, choice of immunotherapeutic agent(s), and duration of responses require further investigation via larger‐scale clinical trials.
A novel hybrid polyurethane composites with ZnO particles and sheath palm residues: Synergistic effect
Authors: Zanini Noelle C. , de Souza Alana G. , Barbosa Rennan F. S. , Rosa Derval S. , Mulinari Daniella R.
Published: October 2020

Technological advances related to the development of new sustainable materials have driven the search for composites containing green fillers. Polyurethane (PU) composites with natural fibers have stood out; however, these materials have limited mechanical and thermal properties. This study developed hybrid PU composites filled with ZnO and palm sheath residues and evaluated the fiber loading (0, 5, 10, 15, and 20 wt%) on morphological, chemical, thermal, crystalline, and mechanical properties. Microscopic and scanning electron microscopy images showed that ZnO promoted homogeneous and isotropic cell structures. Sheath palm residues were well dispersed throughout the PU matrix and increased the foam's density and further decreased the cell sizes due to limited expansion caused by the fibers that altered nucleation and growth mechanisms. Strong hydrogen bonds formed between the fillers and the PU matrix resulted in a new network that improved thermal resistance. Also, crystallinity enhanced PU chains' organization due to filler incorporation, and these changes on the PU matrix increased impact resistance. The best results were obtained for the hybrid PU composite with 20 wt% of palm fiber. The properties improvements show the reinforcements' character in PU foams with environmentally friendly materials.
New prescription of antihyperglycemic agents among patients with diabetes in Germany: Moderate concordance between health insurance data and self‐reports
Authors: Brüne Manuela , Andrich Silke , Haastert Burkhard , Kaltheuner Matthias , Icks Andrea
Published: October 2020

Purpose

To analyze the concordance of new prescription of antihyperglycemic agents between two data sources: patients' self‐reports and statutory health insurance (SHI) data among patients with diabetes.

Methods

Within a cross‐sectional study, 494 patients with diabetes were interviewed if and which new prescriptions of diabetes medication they received within the last 3 or 6 months. SHI data for 12 months were linked to cover these periods. For the agreement measurement, SHI data was set as reference, and kappa, positive predictive value (PPV), and sensitivity were calculated for single Anatomical Therapeutic Chemical (ATC) codes and cumulated code groups.

Results

The number of new prescriptions within 3 or 6 months was low, with 5.5% (n = 27) for Metformin/self‐report being the highest. Contingency tables were unbalanced and showed large numbers in the no/no‐cells. Regarding non‐agreement, we found new prescriptions slightly more often in SHI data only than in self‐reports only, with insulin and metformin representing an exception. Agreement results were moderate with large confidence intervals (CI). The values for cumulated “all drugs in diabetes” were: kappa = 0.58 (95% CI: 0.51‐0.65), PPV = 62.0 (53.4‐70.2), sensitivity = 55.6 (47.3‐63.6).

Conclusions

Patients reported a low number of new prescriptions within the last 3 or 6 months. In general we found moderate agreement and in case of non‐agreement that self‐report no/SHI yes was slightly more frequent than vice versa. These results were based on small case numbers, but could nevertheless be considered when collecting self‐reported information on the prescription of antihyperglycemic agents.
Characterization of Telehealth Use in Veterans With Spinal Cord Injuries and Disorders
Authors: Hatch Maya N. , Martinez Rachael N. , Etingen Bella , Cotner Bridget , Hogan Timothy P. , Wickremasinghe Itala M. , Sippel Jennifer , Smith Bridget M.
Published: October 2020

Background

Individuals with spinal cord injuries and disorders (SCI/D) require frequent interdisciplinary health care to address impairments in mobility, autonomic function, and secondary complications. Telehealth has the capacity to substantially transform health care delivery and improve care by increasing access and communication. However, relatively little is known about telehealth use in this specific population. Here we attempt to fill part of this gap.

Objective

To investigate the frequency and characteristics associated with telehealth use in Veterans with SCI/D.

Design

Cross‐sectional, descriptive project.

Setting

Veterans Health Administration (VHA) facilities.

Participants

A total of 15 028 Veterans living with SCI/D who received services from the VHA SCI/D System of Care.

Intervention

Not applicable.

Outcome Measures

Frequency and characteristics associated with VHA telehealth utilization.

Results

Of the 15 028 Veterans with SCI/D included in the evaluation, 17% used some form of telehealth in VHA Fiscal Year (FY)2017. Veterans older than 65 years of age had lower odds (odds ratio [OR] = 0.88, P < .05, confidence interval [CI] 0.80‐0.98) of using telehealth. Being Caucasian (OR = 1.29, P < .01, CI 1.09‐1.52), living in rural areas (OR = 1.16, P < .01, CI 1.05‐1.28), living greater distances away from the VHA (P < .01 for all distances), and being in priority group 8, meaning that Veterans have higher copayment requirements (OR = 1.46, P < .001, CI 1.19‐1.81), were all significantly associated with greater odds of telehealth use. The most frequent types of telehealth used were real‐time clinical video and store‐and‐forward between a provider and patient within the same hub network.

Conclusion

There are opportunities to increase telehealth adoption in the SCI/D arena. The findings from this project highlight which Veterans are currently using telehealth services, as well as gaps regarding telehealth adoption in this population.
Triphilic pentablock copolymers with perfluoroalkyl segment in central position
Authors: Heinz Daniel , Meister Annette , Hussain Hazrat , Busse Karsten , Kressler Jörg
Published: October 2020

Adding perfluoroalkyl (PF) segments to amphiphilic copolymers yields triphilic copolymers with new application profiles. Usually, PF segments are attached as terminal blocks via Cu(I) catalyzed azide‐alkyne cycloaddition (CuAAC). The purpose of the current study is to design new triphilic architectures with a PF segment in central position. The PF segment bearing bifunctional atom transfer radical polymerization (ATRP) initiator is employed for the fabrication of triphilic poly(propylene oxide)‐b‐poly(glycerol monomethacrylate)‐b‐PF‐b‐poly(glycerol monomethacrylate)‐b‐poly(propylene oxide) PPO‐b‐PGMA‐b‐PF‐b‐PGMA‐b‐PPO pentablock copolymers by a combined ATRP and CuAAC reaction approach. Differential scanning calorimetry indicates the PF‐initiator to undergo a solid–solid phase transition at 63°C before the final crystal melting at 95°C. This is further corroborated by polarized optical microscopy and X‐ray diffraction studies. The PF‐initiator could successfully polymerize solketal methacrylate (SMA) under typical ATRP conditions producing well‐defined Br‐PSMA‐b‐PF‐b‐PSMA‐Br triblock copolymers that are then converted into PPO‐b‐PSMA‐b‐PF‐b‐PSMA‐b‐PPO pentablock copolymer via CuAAC reaction. Subsequently, acid hydrolysis of the PSMA blocks afforded water soluble well‐defined triphilic pentablock copolymers PPO‐b‐PGMA‐b‐PF‐b‐PGMA‐b‐PPO with fluorophilic central segment, hydrophilic middle blocks, and lipophilic outer blocks. The triphilic block copolymers could self‐assemble, depending upon the preparatory protocol, into spherical and filament‐like phase‐separated nanostructures as revealed by transmission electron microscopy.
Proteome Analyses Reveal S100A11, S100P, and RBM25 Are Tumor Biomarkers in Colorectal Cancer
Authors: Guo Ai‐Jun , Wang Feng‐Jie , Ji Qiang , Geng Hui‐Wu , Yan Xu , Wang Lin‐Qi , Tie Wei‐Wei , Liu Xiao‐Ying , Thorne Rick F. , Liu Gang , Xu A‐Man
Published: October 2020

Purpose

The prognosis for colorectal cancer (CRC) patients is drastically impacted by the presence of lymph node or liver metastases at diagnosis or resection. On this basis it is sought to identify novel proteins as biomarkers and determinants of CRC metastasis.

Experimental Design

Proteomic analyses are undertaken using primary tissues from ten Chinese CRC patients presenting with or without liver metastases and immunohistochemistry used to validate selected proteins in an independent patient cohort.

Results

Comparing CRC against paired normal adjacent tissues identifies 1559 differentially expressed proteins (DEPs) with 974 upregulated and 585 downregulated proteins, respectively. The highest number of DEPs is selectively associated with metastatic tumors (519 upregulated and 267 downregulated proteins, respectively) with a smaller number of unique DEPs identified only in non‐metastatic CRC cases (116 upregulated and 29 downregulated proteins, respectively). The remaining DEPs are commonly expressed in both non‐metastatic and metastatic tumors. The upregulation of three representative DEPs (S100A11, S100P, and RBM25) is confirmed using immunohistochemistry against 154 CRC tissues embedded in a tissue microarray.

Conclusions and Clinical Relevance

The data reveal both previously identified CRC biomarkers along with novel candidates which provide a ready resource of DEPs in CRC for further investigation.