bluuebunny/crossref_metadata_2025 huggingface dataset:
School Nursing in a Pandemic: Striving for Excellence in Santa Fe Public Schools
Authors: Barbee-Lee Myrna , Seymour Kimber , Hett Anita L. , Norris Gillian , Stack Shona , Cartier Allana , Haycox Patricia , Armstrong Leeann , Herbert Laarni
Published: April 2021

When the COVID-19 (coronavirus disease 2019) pandemic led to school closures around the nation in March 2020, the role of the school nurse changed significantly, and it has continued to evolve as districts grapple with how to safely meet students’ academic needs while also protecting the health of their communities. Nurses working for Santa Fe Public Schools in New Mexico have taken their new roles seriously and have been working closely with their district leaders, the New Mexico Department of Health, School Health Advocates, and the Public Education Department to facilitate evidence-based policies and procedures. Activities have included cohorting, contact tracing, resource development, education (of staff and families), planning and implementation of safety procedures, coordination of surveillance testing, and staff screening, along with finding new, COVID safe ways to provide standard school nursing services, including immunization administration, hearing and vision screening, teaching, and promoting wellness and mental health.
Safety and efficacy of a single total dose infusion (1020 mg) of ferumoxytol
Authors: Khan Harris , May Paige , Kuo Elim , Pai Preetika , Boles Katherine , McGee Ashley , Dang Tanaka , Schmit Jessica
Published: April 2021

Purpose:

Iron deficiency anemia (IDA) is the most common type of anemia. A single dose infusion of intravenous (IV) iron is a convenient treatment option. Ferumoxytol is an IV formulation of iron that is typically given in two doses of 510 mg each. Utilizing a single dose of 1020 mg over 15 min has previously been described as safe and effective. In July 2018, we began to administer a single 1020 mg dose of ferumoxytol to patients needing IV iron replacement at the North Florida/South Georgia Veterans Health System. To evaluate the impact of this change, a utilization review was conducted.

Methods:

Outcomes of all patients who received ferumoxytol injections in the 6 months prior to and after the dosing strategy change were analyzed. A total of 140 patients, who received 270 separate IV ferumoxytol infusions, were included in the analysis.

Results:

No significant difference in safety was observed, with one infusion reaction occurring in each group ( p = 1.00). Efficacy also appeared equivalent with no significant difference between the change in hemoglobin for those who received a single 1020 mg dose versus those who received two 510 mg doses ( p = 0.764). As expected, those who received a single total dose infusion of 1020 mg had less clinic utilization ( p < 0.0001).

Conclusion:

In summary, ferumoxytol administered as a 1020 mg single dose infusion was more convenient and should be considered a safe and effective treatment option for IDA.
Clinicopathological parameters for predicting non-invasive follicular thyroid neoplasm with papillary features (NIFTP)
Authors: Jang Eunju , Kim Kwangsoon , Jung Chan Kwon , Bae Ja Seong , Kim Jeong Soo
Published: April 2021

Background:

Criteria for the preoperative diagnosis of non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) have not yet been confirmed. This study aimed to analyze differences in clinicopathological characteristics between follicular variant of papillary thyroid carcinoma (FVPTC) subtypes to determine which parameters are relevant in differentiating NIFTP from other variants.

Methods:

We retrospectively analyzed the records of 199 patients with a preoperative diagnosis of FVPTC who underwent thyroid surgery at Seoul St. Mary’s Hospital (Seoul, Korea) from 2011 to 2015. Clinicopathological features were analyzed retrospectively via a complete review of medical charts and pathology reports of patients.

Results:

The NIFTP and invasive encapsulated FVPTC (EFVPTC) groups showed relatively benign features, with a majority of the patients categorized as Bethesda category III (25.8% and 25.6%, respectively) or IV (34.8% and 30.2%, respectively), while the infiltrative FVPTC group showed more malignant features, with more patients categorized as category V (28.6%) or VI (47.6%) ( p < 0.001). BRAF V600E mutations were significantly less prevalent in the NIFTP group (0%) and invasive EFVPTC group (4.7%) compared with the infiltrative FVPTC group (34.9%) ( p < 0.001). Multivariate analysis showed that absence of BRAF V600E mutation (OR 20.311, p = 0.004) and lymph node metastasis (odds ratio 10.237, p = 0.004) were significantly associated with NIFTP.

Conclusion:

Although Bethesda category was a statistically significant factor in distinguishing FVPTC subtypes, it was not effective in conclusively distinguishing NIFTP and invasive EFVPTC. Absence of BRAF V600E mutation and lymph node metastasis are important features in distinguishing NIFTP from other subtypes.
Significance of autoimmune disease in severe pulmonary hypertension complicating extensive pulmonary fibrosis: a prospective cohort study
Authors: Saggar Rajeev , Giri Paresh C. , Deng Chunqin , Johnson Dana , McCloy Mary K. , Liang Lloyd , Shaikh Faisal , Hong Jason , Channick Richard N. , Shapiro Shelley S. , Lynch Joseph P. , Belperio John A. , Weigt Samuel S. , Ramsey Allison L. , Ross David J. , Sayah David M. , Shino Michael Y. , Derhovanessian Ariss , Sherman Alexander E. , Saggar Rajan
Published: April 2021

The association of autoimmune disease (AI) with transplant‐free survival in the setting of severe Group 3 pulmonary hypertension and extensive pulmonary fibrosis remains unclear. We report cases of severe pulmonary hypertension (mean pulmonary artery pressure ≥35 mmHg and right ventricular dysfunction) and extensive pulmonary fibrosis after pulmonary arterial hypertension‐specific therapy. We used multivariate regression to determine the clinical variables associated with transplant‐free survival. Of 286 screened patients, 55 demonstrated severe pulmonary hypertension and extensive pulmonary fibrosis and were treated with parenteral prostacyclin therapy. The (+)AI subgroup (n = 34), when compared to the (–)AI subgroup (n = 21), was more likely to be female (77% versus 19%) and younger (58.7 ± 12.1 versus 66.0 ± 10.7 years), and revealed lower forced vital capacity (absolute) (1.9 ± 0.7 versus 2.9 ± 1.1 L), higher DLCO (% predicted) (31.1 ± 15.2 versus 23.2 ± 8.0), and increased unadjusted transplant‐free survival (1 year (84.6 ± 6.3% versus 45 ± 11.1%)), 3 years (71 ± 8.2% versus 28.6 ± 11.9%), and 5 years (47.6 ± 9.6% versus 6.4 ± 8.2%); (p = 0.01)). Transplant‐free survival was unchanged after adjusting for age and gender. The pulmonary hemodynamic profiles improved after parenteral prostacyclin therapy, independent of AI status. The baseline variables associated with mortality included age at pulmonary hypertension diagnosis (heart rate (HR) 1.23 (confidence interval (CI) 1.03–1.47); p = 0.02) and presence of AI (HR 0.26 (confidence interval (CI) 0.10–0.70); p < 0.01). Gas exchange was not adversely affected by parenteral prostacyclin therapy. In the setting of severe Group 3 pulmonary hypertension and extensive pulmonary fibrosis treated with pulmonary arterial hypertension‐specific therapy, AI is independently associated with increased transplant‐free survival. Pulmonary hypertension/pulmonary fibrosis associated with AI should be considered in future clinical trials of pulmonary arterial hypertension‐specific therapy in Group 3 pulmonary hypertension.
Fostering Graduate Employability: Rethinking Tanzania’s University Practices
Authors: Mgaiwa Samson John
Published: April 2021

Globalization, partly spurred by technological innovation such as artificial intelligence and robotics, continues to disrupt not only economic trajectories and business models, especially in the developed world, but also the knowledge and skill requirements for graduates entering the labor market. A growing corpus of literature on graduates’ employability has identified barriers to employment ranging from skills mismatch to a lack of soft skills. Although the literature on graduate employability is informative and illuminating, the role of university practices in fostering graduate employability in sub-Saharan Africa, and Tanzania in particular, has been less studied. Drawing on the broader employability literature, this article provides a comprehensive analysis of the best university practices in an effort to address the unemployment problems of university graduates in sub-Saharan Africa and Tanzania in particular. Four critical university best practices for fostering graduate employability are of interest—developing effective university—industry partnerships, aligning university education with a country’s development plans, regular university curriculum reviews, and strengthening quality assurance systems. Therefore, this article contributes to the higher education literature on the role of university practices in fostering graduate employability.
Rural Development Through Non-State Actors in Highlands of Pakistan
Authors: Luqman Muhammad , Ashraf Saleem , Shahbaz Babar , Butt Tahir Munir , Saqib Raheel
Published: April 2021

We explored the contribution and effectiveness of state and non-state institutions in rural development efforts in highlands (Khyber Pakhtunkhwa [KPK] province) of Pakistan. This study employed mixed-methods research design and data were collected from 300 household heads, randomly selected from six villages from two purposively selected districts Mansehra and Nowshehra. Findings showed people in KPK were deprived of due to conflicts, conspiracies and terrorism, poor governance, small landholdings and subsistence farming followed by sluggish marketing system, insufficient education and training for people, and inadequate employment opportunities. Regarding contribution, non-state institutions had more contribution as compared to state institutions. T-test analysis showed that the non-state institutions had an effective provision of agricultural extension and forestry advisory services, education, health services in remote areas, skill development, and provision of microcredit schemes. The results of F-test statistics showed highly significant difference among the perceived effectiveness of rural development activities of different types of non-state actors (localite, cosmopolite, and religious/faith-based) working in the research area. This study recommends state-owned rural development departments revisit their working mechanism and develop synergistic working relationship with the non-state institutions in discharging rural development efforts.
Work Engagement and the Validity of Job Demands–Resources Model Among Nurses in Japan: A Literature Review
Authors: Kato Yuichi , Chiba Rie , Shimazu Akihito
Published: April 2021

Background:

Work engagement (WE) is defined as a positive, fulfilling, and work-related state of mind. Enhancing WE leads to positive outcomes in both individuals and organizations. Although cultural factors may influence the antecedents and outcomes of WE, no reviews summarized these factors among nurses, mainly in Asia. This review aimed to identify the antecedents and outcomes of WE among nurses in Japan. This may offer novel insights into the influencing factors on WE.

Methods:

A literature search was conducted using six data sources: PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PsycINFO, Business Source Premier, Ichushi-Web, and CiNii. A total of 38 studies met the inclusion criteria. Studies that included registered nurses and/or midwives at hospitals or facilities were included in this review. The antecedents and outcomes were classified into four themes based on the job demands–resources model (JD-R model).

Findings:

Many variables in three components of the JD-R model (i.e., job resources, personal resources, and favorable outcomes) exhibited positive relationships with WE as theorized. Many other variables in job demands demonstrated negative relationships with WE as hypothesized. Many factors that were identified in this review were consistent with the JD-R model. The model in turn was found to be applicable among nurses. The antecedents and outcomes in this review were similar to those in previous studies in Western countries, while this review also revealed teamwork nursing as a possible antecedent of WE, which has not previously been reported.

Conclusion/Application to Practice:

Improving job resources (e.g., teamwork nursing) and personal resources may effectively enhance WE among Japanese nurses.
Exploring the Effect of Mindfulness on Burnout in a Pediatric Emergency Department
Authors: Wong Kei U. , Palladino Lauren , Langhan Melissa L.
Published: April 2021

Background:

Burnout is a common phenomenon among health care providers known to adversely affect their mental health and clinical acumen. As mindfulness has been shown to diminish burnout with large-scale interventions, our aim was to assess whether smaller, on-shift activities aimed at increasing mindfulness could decrease burnout among staff in a pediatric emergency department (PED).

Methods:

Prior to the implementation of a series of mindfulness-based activities, a diverse cohort of PED staff including nurses, physicians, nurse practitioners, technicians, and administrative personnel completed electronic preintervention surveys about their demographics, personal mindfulness engagement, and individual baseline burnout level using the Maslach Burnout Inventory (MBI). Trained nurses and physicians served as champions who coordinated on-shift mindfulness activities, and burnout levels were subsequently reassessed using a postintervention survey.

Findings:

Among 83 eligible staff, 75 completed the preintervention and 69 completed the postintervention survey. For the MBI, the majority of staff had moderate to high burnout levels at baseline. Few staff engaged in personal mindfulness activities outside of work. Although 82% of staff participated in the on-shift interventions, no significant differences were found in scores before and after the intervention for emotional exhaustion (20.1 vs. 20, p = .93), depersonalization (7.6 vs. 7.3, p = .97), and personal accomplishment (36.1 vs. 34.8, p = .11).

Conclusion/Application to Practice:

While mindfulness effectively combats burnout, few PED providers regularly practice mindfulness activities. Brief, on-shift mindfulness activities were insufficient to significantly reduce burnout levels. Hospital leadership should consider dedicating resources to more intensive mindfulness activities to combat amplified burnout levels among emergency department staff.
Affective Response to Binge Eating as a Predictor of Treatment Outcomes for Binge-Eating Disorder
Authors: Mason Tyler B. , Smith Kathryn E. , Anderson Lisa M. , Schaefer Lauren M. , Engel Scott G. , Crow Scott J. , Crosby Ross D. , Peterson Carol B. , Wonderlich Stephen A.
Published: April 2021

In this report, we examined baseline affective response to binge eating as a predictor of binge-eating disorder (BED) treatment outcome. Baseline affective response was defined as (a) each individual’s average net change (i.e., area under the curve [AUC]) of positive affect (PA) or negative affect (NA) before and after binge-eating episodes and (b) slope of PA or NA after binge eating across 7 days of ecological momentary assessment. Adults with BED completed integrative cognitive-affective therapy (ICAT-BED) or cognitive behavioral therapy-guided self-help (CBT-gsh). Individuals with greater net increases in PA (AUC) after binge eating at baseline exhibited better treatment response in ICAT-BED at end of treatment and follow-up. NA affective response was significant only at end of treatment; individuals with less rapid postbinge improvements in NA (slope) did better in ICAT-BED, whereas individuals with lower net improvements in NA (AUC) did better in CBT-gsh. Affective response to binge eating may be a marker of BED treatment response.
Atypical Visual Motion-Prediction Abilities in Autism Spectrum Disorder
Authors: Park Woon Ju , Schauder Kimberly B. , Kwon Oh-Sang , Bennetto Loisa , Tadin Duje
Published: April 2021

A recent theory posits that prediction deficits may underlie the core symptoms in autism spectrum disorder (ASD). However, empirical evidence for this hypothesis is minimal. Using a visual extrapolation task, we tested motion-prediction abilities in children and adolescents with and without ASD. We examined the factors known to be important for motion prediction: the central-tendency response bias and smooth-pursuit eye movements. In participants with ASD, response biases followed an atypical trajectory that was dominated by early responses. This differed from control participants, who exhibited response biases that reflected a gradual accumulation of knowledge about stimulus statistics. Moreover, although better smooth-pursuit eye movements for the moving object were linked to more accurate motion prediction in control participants, in participants with ASD, better smooth pursuit was counterintuitively linked to a more pronounced early-response bias. Together, these results demonstrate atypical visual prediction abilities in people with ASD and offer insights into possible mechanisms underlying the observed differences.
Deliberative Choice Strategies in Youths: Relevance to Transdiagnostic Anxiety Symptoms
Authors: Cardinale Elise M. , Pagliaccio David , Swetlitz Caroline , Grassie Hannah , Abend Rany , Costa Vincent , Averbeck Bruno , Brotman Melissa A. , Pine Daniel S. , Leibenluft Ellen , Kircanski Katharina
Published: April 2021

Aberrant decision-making characterizes various pediatric psychopathologies; however, deliberative choice strategies have not been investigated. A transdiagnostic sample of 95 youths completed a child-friendly sequential sampling paradigm. Participants searched for the best offer by sampling a finite list of offers. Participants’ willingness to explore was measured as the number of offers sampled, and ideal task performance was modeled using a Markov decision-process model. As in previous findings in adults, youths explored more offers when lists were long compared with short, yet participants generally sampled fewer offers relative to model-estimated ideal performance. Searching deeper into the list was associated with choosing better price options. Analyses examining the main and interactive effects of transdiagnostic anxiety and irritability symptoms indicated a negative correlation between anxiety and task performance ( p = .01, η p2 = .08). Findings suggest the need for more research on exploratory decision impairments in youths with anxiety symptoms.
Influence of Achilles tendon rupture site on surgical repair outcomes
Authors: Cao Shengxuan , Teng Zhaolin , Wang Chen , Zhou Qian , Wang Xu , Ma Xin
Published: April 2021

Purpose:

This study aims to measure the distance between the common site of Achilles tendon rupture and calcaneal insertion through ultrasound and to compare the outcomes between proximal and distal rupture groups.

Methods:

We investigated the electronic medical records of 117 patients and preoperative ultrasound describing the rupture site. Among 88 patients, we compared the patient-reported outcome and re-rupture rate of proximal and distal rupture groups.

Results:

The mean rupture site of the 117 included subjects was 4.5 ± 1.3 cm. The rupture site had a weak negative correlation with body mass index ( ρ = −0.230, P = 0.013). Furthermore, 77% of the patients with distal rupture reported good outcome (Achilles Tendon Rupture Score > 80) compared to 56% of the patients with proximal rupture ( P = 0.041).

Conclusion:

Patients with proximal rupture had less satisfactory postoperative outcomes than those with distal rupture.
COVID-19 Presenting as Acute Necrotizing Pancreatitis
Authors: Mohammadi Arbati Mohammad , Molseghi Mohammad Hadi
Published: April 2021

The ongoing pandemic of the novel coronavirus disease 2019 (COVID-19) originated in Wuhan, China, in December 2019. Various manifestations of coronavirus (SARS-CoV-2 [severe acute respiratory syndrome coronavirus 2]) have been reported since the pandemic began. Some articles have reported acute pancreatitis in several patients due to COVID-19 infection. In this case report, we introduce a patient in whom SARS-CoV-2 caused necrotizing pancreatitis. Acute abdomen is one of the manifestations of COVID-19. Various causes such as acute pancreatitis and necrotizing pancreatitis can be in the list of differential diagnoses.
Immunotherapy-Induced Sarcoid-Like Reaction: A Shrewd Imitator
Authors: Yasin Hassaan , Yadala Vivek , Khan Noman Ahmed Jang , Graffeo Vincent , Denning Krista , Lebowicz Yehuda
Published: April 2021

A 40-year-old male with a right-sided neck mass was diagnosed with metastatic melanoma. A repeat positron-emission tomography after treatment with combination immunotherapy demonstrated increased hypermetabolic activity in the right supraclavicular, hilar, and mediastinal regions. Immunotherapy was discontinued and a BRAF/MEK inhibitor combination was started. Repeat imaging showed a decrease in size of the neck mass; however, hilar and mediastinal lymph nodes increased in size. A fine needle aspiration of mediastinal lymph nodes was consistent with a granulomatous process. A diagnosis of a sarcoid-like reaction (SLR) was made, and he was started on steroids. A follow-up positron emission tomography showed decreased hilar and mediastinal lymph node hypermetabolic activity. We, therefore, report this rare case of immunotherapy-induced SLR to the expanding literature on immunotherapy-related adverse effects and would like to highlight that SLR can occur in conjunction with disease progression making it challenging to distinguish between the two.
Multimodal Ultrasound Versus MRI for the Diagnosis and Monitoring of Achilles Tendinopathy: A Prospective Longitudinal Study
Authors: Gatz Matthias , Bode Daniela , Betsch Marcel , Quack Valentin , Tingart Markus , Kuhl Christiane , Schrading Simone , Dirrichs Timm
Published: April 2021

Background:

The diagnosis and monitoring of Achilles tendinopathy with imaging are challenging. There is a lack of studies comparing the diagnostic accuracy of magnetic resonance imaging (MRI), brightness mode ultrasound (B-mode), and power Doppler ultrasound with recent technologies such as ultrasound tissue characterization (UTC) and shear wave elastography (SWE).

Purpose:

To assess whether SWE and UTC, which offer quantitative values, show a superior diagnostic accuracy and capacity to detect structural improvement in Achilles tendinopathy compared with MRI, B-mode, or power Doppler.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

Patients with insertional (n = 28) and midportion (n = 38) Achilles tendinopathy were evaluated at baseline and 6-month follow-up using MRI, B-mode, power Doppler, SWE, and UTC. Asymptomatic controls (n = 37) were evaluated at T 0. Diagnostic accuracy was analyzed based on a quantitative receiver operating characteristic (ROC) analysis with quantitative cutoff values (anteroposterior diameter, Öhberg score, UTC echo type, Young modulus) and by semiquantitative Likert scale–based assessment of experienced physicians.

Results:

For diagnosing insertional Achilles tendinopathy, semiquantitative MRI and power Doppler were most favorable (diagnostic accuracy, 95%), while the cross-sectional area of MRI revealed 89% accuracy in the ROC analyses (area under the curve [AUC], 0.911; P < .001). For diagnosing midportion Achilles tendinopathy, semiquantitative MRI and B-mode were most favorable (diagnostic accuracy, 87%), while UTC echo types 3 and 4 revealed 86% and 87% accuracy, respectively, in the ROC analyses (AUC, 0.911 and 0.941, respectively; P < .001). However, for quantitative and semiquantitative evaluation of diagnostic accuracy in both insertional and midportion Achilles tendinopathy, there was no significant difference in favor of one imaging modality over the others. Compared with baseline, only SWE showed a significant change at the 6-month follow-up ( P = .003-.035), but there were only fair to poor monitoring accuracies of 71% (insertion) and 60% (midportion). However, compared with the other modalities, the monitoring accuracy of SWE was significantly higher ( P = .002-.039).

Conclusion:

There was no statistically significant difference in favor of one imaging modality over the others, but MRI revealed the highest overall diagnostic accuracy for the diagnosis of both insertional and midportion Achilles tendinopathy.
Transition to Telehealth Physical Therapy After Hip Arthroscopy for Femoroacetabular Impingement: A Pilot Study With Retrospective Matched-Cohort Analysis
Authors: Horton Brandy S. , Marland Jennifer D. , West Hugh S. , Wylie James D.
Published: April 2021

Background:

Telehealth use has increased significantly of late. However, outside of total hip and knee arthroplasty, there is minimal evidence regarding its efficacy in orthopaedics and postoperative rehabilitation.

Purpose:

To determine the efficacy and cost-effectiveness of a transition to postoperative telehealth physical therapy in patients undergoing hip arthroscopy for femoroacetabular impingement (FAI).

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Included were 51 patients undergoing postoperative physical therapy after hip arthroscopy for FAI. The intervention group consisted of patients undergoing initial in-person visits followed by a transition to telehealth physical therapy for 3 months postoperatively (group 1; n = 17). Comparison groups included patients undergoing in-person physical therapy with the same physical therapy team as the telehealth group (group 2; n = 17) and patients undergoing in-person therapy with a different therapy team at the same facility (group 3; n = 17). All groups were matched 1-to-1 by patient age and sex. All patients completed the short version of the International Hip Outcome Tool (iHOT-12) both preoperatively and at 3 months postoperatively. At 3 months postoperatively, it was determined whether patients met the minimally clinically important difference (MCID; ≥13 points) or substantial clinical benefit (SCB; ≥28 points) or whether they reached a Patient Acceptable Symptomatic State (PASS; ≥64 points). Billed charges were recorded as a measure of cost.

Results:

The overall mean age of the study patients ranged from 33 to 34 years. Among the 3 groups, there was no significant difference in the preoperative, postoperative, or pre- to postoperative change in iHOT-12 scores or in the percentage of patients meeting MCID, SCB, or PASS at 3 months. Group 1 had significantly lower mean costs ($1015.67) compared with group 2 ($1555.62; P = .011) or group 3 ($1896.38; P < .001).

Conclusion:

In this pilot study, telehealth physical therapy after hip arthroscopy was found to lead to similar short-term outcomes and was cost-effective compared with in-person physical therapy.
Measuring Patient Experiences of Integration in Health Care Delivery: Psychometric Validation of IntegRATE Under Controlled Conditions
Authors: Thompson Rachel , Stevens Gabrielle , Elwyn Glyn
Published: April 2021

The objective of this study was to assess the psychometric properties of IntegRATE—a 4-item patient-reported measure of integration in health care delivery—under controlled conditions. Adults who reported having received health care in the previous year were exposed to a fictional health care scenario featuring good, mixed, or poor integration on 1 or 2 occasions. They were then asked to imagine themselves as a patient in the scenario and complete IntegRATE and other measures. The data collected were analyzed to assess the discriminative, concurrent, and divergent validity of IntegRATE and its test–retest reliability and responsiveness using both “sum score” and “top score” scoring approaches. Six-hundred people participated in the study with 190 taking part on 2 occasions. The IntegRATE sum score demonstrated discriminative validity, concurrent validity, divergent validity, and responsiveness and partially demonstrated test–retest reliability. The IntegRATE top score demonstrated concurrent validity, divergent validity, and responsiveness and partially demonstrated discriminative validity and test–retest reliability. We conclude that the IntegRATE sum score exhibits encouraging psychometric properties and performs more optimally than the IntegRATE top score.
Factors Impacting the Decision of an Individual With Lynch Syndrome to Terminate a Health Care Provider Relationship
Authors: Broughel Erin M , Hennig Kelsey , Chu Rebecca , Parker Wendy M , Campo-Engelstein Lisa , Burton-Chase Allison M
Published: April 2021

Lynch syndrome (LS) is a genetic cancer syndrome that puts affected individuals at a significantly higher risk of developing multiple cancers. Participants (n = 57) were recruited through social media. Data were collected through online surveys and phone interviews; the interview data (n = 55) were analyzed to identify provider terminations and the factors that motivated these decisions. Results indicate that individuals with LS terminated their patient–provider relationships due to lack of provider LS knowledge, poor interactions, or a combination of both factors. Findings from this study suggest a need for better interactions between LS patients and providers and increased knowledge of LS-specific care.
Impact of the COVID-19 pandemic on acute surgical patients’ discharge summaries – Experience of Wales worst-hit COVID-19 hospital
Authors: Ooi Rucira , Stimson Imogen Bambrough , Williams Gethin
Published: April 2021

Background

The emergence of the COVID-19 pandemic has placed increased demands on the NHS workforce, especially in medical and intensive care units. The subsequent redistribution of surgical house officers to accommodate this in a single-centre NHS hospital has possibly negatively impacted on the effective discharge notification of acute surgical patients.

Methods

Discharge summaries of all patients directly discharged from a Surgical Assessment Unit were collected on the day of discharge and analysed to identify the date of completion and staff grade of the responsible clinician. Data collection was carried out before the initiation of lockdown measures and continued for a further three weeks during the peak of the COVID-19 pandemic with an interventional period in between. A poster was created and displayed in areas where discharge software could be accessed.

Results

In the initial audit, 36.2% of the 246 patients had delayed discharge summaries with an average of 7 days to complete. On re-evaluation, 45.3% of the 223 patients had delayed discharge summaries, taking an average of 12 days to complete. A survey conducted post-re-audit identified that the most common reason for delayed discharge summaries was due to time constraints associated with the increased workload.

Conclusion

The reallocation of surgical staff in response to the COVID-19 pandemic has affected communication between primary and secondary care, with a rise in delayed discharge letters of acute surgical patients. Given the potential repercussions of these delays, healthcare systems should be aware of this consequence of the pandemic, especially in preparation for any resurgences.
Perception and experience of daylight – Reflections of an architect
Authors: Lowings Luke
Published: April 2021

The information contained in light from our surroundings is often taken for granted because of its ubiquity, and the subliminal nature of the way we normally use it. Revealing the richness and depth of our common human experience through the unexpected qualities of light is seen as an artistic opportunity. An architectural training enables the integration of a subjective and qualitative experience, with the ‘objective’ structures that we are surrounded by. The built space can act as a ‘neutral’ reference onto which the complexity of daylight is superimposed. The author, trained as an architect, has been involved for more than 30 years in the design and construction of non-gallery artworks that engage the experience of natural light in public and semi-public spaces. This practitioner reflection discusses the relation of the position of the observer and sources of light, and how the movement of the viewer acts as a catalyst for revealing their situation through six works of various scales that the author worked on in New York; Boston; Abu Dhabi; London; and Berlin.
Guardian of the Snacks: Toward designing a companion for mindful snacking
Authors: Khot Rohit Ashok , Aggarwal Deepti , Yi Jung-Ying (Lois) , Prohasky Daniel
Published: April 2021

COVID-19 has brought significant changes to our lives and eating practices, where many of us are required to not only stay at home but also eat at home. This is particularly challenging for lone-person households as eating alone can be boring, less motivating and could lead to unhealthy behaviors such as mindless snacking or skipping of meals. To remedy such situations, we present Guardian of the Snacks, a tangible multimodal system that encourages mindful snacking by offering a playful companionship to snacking. The system is customizable to bear the shape of different animals and can be adapted to different snacking scenarios. Like a good companion, it encourages eating but moderates overeating through auditory feedback and playful nudging. In this article, we reflect on our design process and contribute ideas for the future development of technology-driven mindful snacking.
Polymer dots and derived hybrid nanomaterials: A review
Authors: Kausar Ayesha
Published: April 2021

Quantum dots are tiny (∼5 nm) nanoparticles with outstanding electronic, optical, luminescence, and semiconducting properties. Polymer dots are important and unique quantum dots. Polymer dots have been designed and used for advanced hybrid nanomaterials and applications. This review article deliberates scientific trials on design, fabrication, characteristics, and technical solicitations of polymer dot-based nanomaterials. Polymer dots are made from both conducting and non-conducting polymers with appropriate processing techniques. Polymer dots have facile surface modification tendencies. Functional polymer dots have an important use in hybrid/nanocomposite materials. Consequently, polymer dots have been combined with other quantum dots and nanoparticles to form advanced hybrid nanomaterials. Polymer dot-based nanomaterials have unique morphology, conductivity, electrochemical, luminescence, and sensing features. Subsequently, many applications are seen for polymer dot nanomaterials as solar cell, supercapacitor, electronics, probes, gas sensor, biosensor, bioimaging, and drug delivery.
Everolimus regulates the activity of gemcitabine-resistant pancreatic cancer cells by targeting the Warburg effect via PI3K/AKT/mTOR signaling
Authors: Cui Jing , Guo Yao , Wu Heshui , Xiong Jiongxin , Peng Tao
Published: April 2021

Background

Gemcitabine (GEM) resistance remains a significant clinical challenge in pancreatic cancer treatment. Here, we investigated the therapeutic utility of everolimus (Evr), an inhibitor of mammalian target of rapamycin (mTOR), in targeting the Warburg effect to overcome GEM resistance in pancreatic cancer.

Methods

The effect of Evr and/or mTOR overexpression or GEM on cell viability, migration, apoptosis, and glucose metabolism (Warburg effect) was evaluated in GEM-sensitive (GEMsen) and GEM-resistant (GEMres) pancreatic cancer cells.

Results

We demonstrated that the upregulation of mTOR enhanced cell viability and favored the Warburg effect in pancreatic cancer cells via the regulation of PI3K/AKT/mTOR signaling. However, this effect was counteracted by Evr, which inhibited aerobic glycolysis by reducing the levels of glucose, lactic acid, and adenosine triphosphate and suppressing the expression of glucose transporter 1, lactate dehydrogenase-B, hexokinase 2, and pyruvate kinase M2 in GEMsen and GEMres cells. Evr also promoted apoptosis by upregulating the pro-apoptotic proteins Bax and cytochrome-c and downregulating the anti-apoptotic protein Bcl-2. GEM was minimally effective in suppressing GEMres cell activity, but the therapeutic effectiveness of Evr against pancreatic cancer growth was greater in GEMres cells than that in GEMsen cells. In vivo studies confirmed that while GEM failed to inhibit the progression of GEMres tumors, Evr significantly decreased the volume of GEMres tumors while suppressing tumor cell proliferation and enhancing tumor apoptosis in the presence of GEM.

Conclusions

Evr treatment may be a promising strategy to target the growth and activity of GEM-resistant pancreatic cancer cells by regulating glucose metabolism via inactivation of PI3K/AKT/mTOR signaling.
Normal contact performance of mortise and tenon joint: theoretical analysis and numerical simulation
Authors: Xie Qifang , Zhang Baozhuang , Zhang Lipeng , Guo Tiantian , Wu Yajie
Published: April 2021

This article aims to investigate the contact characteristics of mortise and tenon (M&T) joints in the traditional timber structures. In particular, the normal embedded compressive contact between contact surfaces of M&T joint was investigated. Based on basic contact theory and contact characteristics between mortise and tenon, a normal elasto-plastic contact model, which can reflect the real normal contact behavior of M&T joints in traditional wooden structures, was proposed. Coulomb friction contact was utilized to describe the tangential slipping characteristics of the contact surfaces. Micro-morphology scanning tests of wood samples with different roughness were carried out to determine the parameters involved in the normal contact model. The normal contact model subroutine of M&T joint was compiled by FORTRAN language, implemented into ABAQUS through user-defined interface (UINTER). Then the proposed model was verified by shear tests of wood contact surfaces considering different normal pressures. Finally, a finite element model (FEM) of straight tenon joint subjected to cyclic reversed loading, based on the proposed normal elasto-plastic contact model, was developed, and a FEM considering normal “hard contact” between the contact surfaces, was also performed. The simulation results were validated by the experimental results. Results showed that the user-defined normal elasto-plastic contact FEM was more in line with the actual force state and mechanical behavior of M&T joints, which can more accurately predict the failure modes and simulate the hysteretic behavior of M&T joints, compared to the FEM considering normal “hard contact” of the contact surfaces.
Wood density and wood shrinkage in relation to initial spacing and tree growth in black spruce (Picea mariana)
Authors: Zhang Shu Yin , Ren Haiqing , Jiang Zehui
Published: April 2021

This study has quantified basic wood density and various types of wood shrinkage in relation to initial spacing (or initial planting density) and tree growth based on a 48-year-old black spruce (Picea mariana) spacing trial in eastern Canada. A total of 139 sample trees were collected from four initial spacings (3086, 2500, 2066, 1372 trees/ha) for this study. Analyses of variance (ANOVA) show that initial spacing is the most important parameter affecting wood density significantly, followed by tree diameter at breast height (DBH) class. With increasing spacing, wood density, radial and volumetric shrinkage tend to decrease, whereas longitudinal shrinkage tends to increase gradually. The largest spacing has the lowest wood density, the smallest transverse shrinkage and the largest longitudinal shrinkage. Path analysis indicates that wood density is the most important parameter affecting transverse shrinkage, followed by the distance from the pith. Furthermore, much of the variation of the transverse shrinkage with wood density may be due to the initial spacing and tree DBH class. Path analysis also reveals that longitudinal shrinkage is mainly related to log height and tree DBH class. With increasing log height, longitudinal shrinkage tends to increase, and transverse shrinkage tends to decrease. With increasing DBH class, the trees tend to have an increasing longitudinal shrinkage and a decreasing transverse shrinkage. Overall, this study suggests that a large increase in the initial spacing (e.g., 1372 trees/ha) might lead to a significant reduction in both wood density and transverse shrinkage, and a significant increase in longitudinal shrinkage in black spruce.
Analysis of whole-genome re-sequencing data of ducks reveals a diverse demographic history and extensive gene flow between Southeast/South Asian and Chinese populations
Authors: Jiang Fan , Lin Ruiyi , Xiao Changyi , Xie Tanghui , Jiang Yaoxin , Chen Jianhai , Ni Pan , Sung Wing-Kin , Han Jianlin , Du Xiaoyong , Li Shijun
Published: April 2021

Background

The most prolific duck genetic resource in the world is located in Southeast/South Asia but little is known about the domestication and complex histories of these duck populations.

Results

Based on whole-genome resequencing data of 78 ducks (Anas platyrhynchos) and 31 published whole-genome duck sequences, we detected three geographic distinct genetic groups, including local Chinese, wild, and local Southeast/South Asian populations. We inferred the demographic history of these duck populations with different geographical distributions and found that the Chinese and Southeast/South Asian ducks shared similar demographic features. The Chinese domestic ducks experienced the strongest population bottleneck caused by domestication and the last glacial maximum (LGM) period, whereas the Chinese wild ducks experienced a relatively weak bottleneck caused by domestication only. Furthermore, the bottleneck was more severe in the local Southeast/South Asian populations than in the local Chinese populations, which resulted in a smaller effective population size for the former (7100–11,900). We show that extensive gene flow has occurred between the Southeast/South Asian and Chinese populations, and between the Southeast Asian and South Asian populations. Prolonged gene flow was detected between the Guangxi population from China and its neighboring Southeast/South Asian populations. In addition, based on multiple statistical approaches, we identified a genomic region that included three genes (PNPLA8,THAP5, andDNAJB9) on duck chromosome 1 with a high probability of gene flow between the Guangxi and Southeast/South Asian populations. Finally, we detected strong signatures of selection in genes that are involved in signaling pathways of the nervous system development (e.g.,ADCYAP1R1andPDC) and in genes that are associated with morphological traits such as cell growth (e.g.,IGF1R).

Conclusions

Our findings provide valuable information for a better understanding of the domestication and demographic history of the duck, and of the gene flow between local duck populations from Southeast/South Asia and China.
TANTIGEN 2.0: a knowledge base of tumor T cell antigens and epitopes
Authors: Zhang Guanglan , Chitkushev Lou , Olsen Lars Rønn , Keskin Derin B. , Brusic Vladimir
Published: April 2021

We previously developed TANTIGEN, a comprehensive online database cataloging more than 1000 T cell epitopes and HLA ligands from 292 tumor antigens. In TANTIGEN 2.0, we significantly expanded coverage in both immune response targets (T cell epitopes and HLA ligands) and tumor antigens. It catalogs 4,296 antigen variants from 403 unique tumor antigens and more than 1500 T cell epitopes and HLA ligands. We also included neoantigens, a class of tumor antigens generated through mutations resulting in new amino acid sequences in tumor antigens. TANTIGEN 2.0 contains validated TCR sequences specific for cognate T cell epitopes and tumor antigen gene/mRNA/protein expression information in major human cancers extracted by Human Pathology Atlas. TANTIGEN 2.0 is a rich data resource for tumor antigens and their associated epitopes and neoepitopes. It hosts a set of tailored data analytics tools tightly integrated with the data to form meaningful analysis workflows. It is freely available athttp://projects.met-hilab.org/tadb.
Efficacy of 16S rRNA variable regions high-resolution melt analysis for bacterial pathogens identification in periprosthetic joint infections
Authors: Bourbour Samaneh , Emaneini Mohammad , Jabalameli Mahmoud , Mortazavi Seyed Mohammad Javad , Tahmasebi Mohamad Naghi , Taghizadeh Amirheckmat , Sharafatvaziri Arash , Beigverdi Reza , Jabalameli Fereshteh
Published: April 2021

Background

Accurate and rapid identification of microorganisms causing periprosthetic joint infections (PJIs) are necessary for choosing an appropriate antibiotic therapy. Therefore, molecular techniques are suggested for diagnosis in suspected PJIs. The Broad-range PCR and High-Resolution Melt Analysis (HRMA) were evaluated for the identification of causative organisms of PJIs in this study.

Results

For 47 of 63 specimens, both the culture and broad-range PCR were positive. The culture was found to be able of organism’s detection in 74.6% (47/63) of patients. Of 47 positive cultures, 11 (23.4%) were polymicrobial and 36 (76.59%) were monomicrobial cultures, in which 34 (91.89%) cases were detected by HRM assay. The sensitivity, specificity of HRMA vs monomicrobial culture were 91.89, 93.75%, respectively. The sensitivity, specificity of total HRMA (mono + poly) vs culture were 82.92, 93.75%.

Conclusions

HRM assay coupled with broad-range PCR are effective screening, rapid, and relatively cost-effective methods for discrimination of PJIs especially in aiding culture method. Using computer programs such as the Matlab-2018b program for HRM data analysis is also valuable and helpful in diagnosis.
Small RNA sequencing provides candidate miRNA-target pairs for revealing the mechanism of apomixis in Zanthoxylum bungeanum
Authors: Fei Xitong , Lei Yu , Qi Yichen , Wang Shujie , Hu Haichao , Wei Anzhi
Published: April 2021

Background

Apomixis is a form of asexual reproduction that produces offspring without the need for combining male and female gametes, and the offspring have the same genetic makeup as the mother. Therefore, apomixis technology has great application potential in plant breeding. To identify the apomixis types and critical period, embryonic development at different flower development stages of Zanthoxylum bungeanum was observed by cytology.

Results

The results show that the S3 stage is the critical period of apomixis, during which the nucellar cells develop into an adventitious primordial embryo. Cytological observations showed that the type of apomixis in Z. bungeanum is sporophytic apomixis. Furthermore, miRNA sequencing, miRNA-target gene interaction, dual luciferase reporter assay, and RT-qPCR verification were used to reveal the dynamic regulation of miRNA-target pairs in Z. bungeanum apomixis. The miRNA sequencing identified 96 mature miRNAs, of which 40 were known and 56 were novel. Additionally, 29 differentially expressed miRNAs were screened according to the miRNAs expression levels at the different developmental stages. Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment analyses showed that the target genes of the differentially expressed miRNAs were mainly enriched in plant hormone signal transduction, RNA biosynthetic process, and response to hormone pathways.

Conclusions

During the critical period of apomictic embryonic development, miR172c significantly reduces the expression levels of TOE3 and APETALA 2 (AP2) genes, thereby upregulating the expression of the AGAMOUS gene. A molecular regulation model of miRNA-target pairs was constructed based on their interactions and expression patterns to further understand the role of miRNA-target pairs in apomixis. Our data suggest that miR172c may regulates AGAMOUS expression by inhibiting TOE3 in the critical period of apomixis.