bluuebunny/crossref_metadata_2025 huggingface dataset:
The physical origins of low-mass spin bias
Authors: Tucci Beatriz , Montero-Dorta Antonio D , Abramo L Raul , Sato-Polito Gabriela , Artale M Celeste
Published: October 2020

At z = 0, higher-spin haloes with masses above $\log (M_{\text{c}}/h^{-1}\, \text{M}_\odot)\simeq 11.5$ have a higher bias than lower-spin haloes of the same mass. However, this trend is known to invert below this characteristic crossover mass, Mc. In this paper, we measure the redshift evolution and scale dependence of halo spin bias at the low-mass end and demonstrate that the inversion of the signal is entirely produced by the effect of splashback haloes. These low-mass haloes tend to live in the vicinity of significantly more massive haloes, thus sharing their large-scale bias properties. We further show that the location of the redshift-dependent crossover mass scale Mc(z) is completely determined by the relative abundance of splashbacks in the low- and high-spin subpopulations. Once splashback haloes are removed from the sample, the intrinsic mass dependence of spin bias is recovered. Since splashbacks have been shown to account for some of the assembly bias signal at the low-mass end, our results unveil a specific link between two different secondary bias trends: spin bias and assembly bias.
Diabetic Foot Infections: Local Prevalence of and Case–Control Study of Risk Factors for Methicillin-Resistant Staphylococcus aureus and Pseudomonas aeruginosa
Authors: Kim Justin J , Lydecker Alison , Davé Rohini , Bork Jacqueline T , Roghmann Mary-Claire
Published: October 2020

We identified deep diabetic foot infections by culture and conducted a case–control study examining the risk factors for moderate to severe methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PsA) diabetic foot infections. Our MRSA prevalence was lower than literature values; PsA was higher. Gangrene may be predictive of Pseudomonas infection.
Development of an optical photon-counting imager with a monolithic Geiger Avalanche Photodiode array
Authors: Nakamori Takeshi , Ouchi Yuga , Ogihara Risa , Terasawa Toshio , Kato Yuhei , Shibata Shinpei
Published: October 2020

We have developed a sensor system based on an optical photon-counting imager with high timing resolution, aiming for highly time-variable astronomical phenomena. The detector is a monolithic Geiger-mode avalanche photodiode array customized in a Multi-Pixel Photon Counter with a response time on the order of nanoseconds. This paper evaluates the basic performance of the sensor and confirms the gain linearity, uniformity, and low dark count. We demonstrate the system’s ability to detect the period of a flashing light-emitting diode, using a data acquisition system developed to obtain the light curve with a time bin of 100 μs. The Crab pulsar was observed using a 35-cm telescope without cooling, and the equipment detected optical pulses with a period consistent with the data from the radio ephemeris. Although improvements to the system will be necessary for more reliability, the system has been proven to be a promising device for exploring the time-domain optical astronomy.
Skin microvascular dysfunction in systemic lupus erythematosus patients with and without cardiovascular risk factors
Authors: Koletsos Nikolaos , Gkaliagkousi Eugenia , Lazaridis Antonios , Triantafyllou Areti , Anyfanti Panagiota , Dolgyras Panagiotis , Dipla Konstantina , Galanopoulou Vasiliki , Aslanidis Spyros , Douma Stella
Published: October 2020

Objectives

Patients with SLE have increased cardiovascular mortality. Alterations in both macro- and micro-circulation have been associated with cardiovascular disease. We sought to assess skin microvascular function by using laser speckle contrast analysis (LASCA) in patients with SLE, with and without cardiovascular disease and risk factors.

Methods

Continuous blood flow was recorded using a LASCA device during baseline, a 5-min arterial occlusion and a 5-min reperfusion period.

Results

Thirty-five patients with SLE (85.7% women) with a median disease duration 12.0 (6.5–17.5) years and a mean age of 46.3 (8.6) years and 31 controls matched for age, sex and BMI were enrolled. During reperfusion, SLE patients exhibited a smaller peak magnitude compared with controls (161.0 (47.1) vs 197.2 (41.4)%, respectively, P =0.002). Results remained unchanged among 24 SLE patients without cardiovascular disease compared with the control group (169.2 (48.1) vs 195.6 (34.0)%, respectively, P =0.002).

Conclusion

Our study shows, for the first time, that patients with SLE, even without overt cardiovascular disease or risk factors, exhibit a blunted microvascular reactivity during reperfusion compared with controls. These results show that skin microvascular dysfunction is present in SLE independently of the CV burden that these patients bear and may represent an early sign of vascular damage.
Race and Ethnicity in the Social Work Grand Challenges
Authors: Rao Smitha , Woo Bongki , Maglalang Dale Dagar , Bartholomew Melissa , Cano Manuel , Harris Abril , Tucker Ty B
Published: October 2020

Race, ethnicity, and racism (RER) are interconnected with the critical problems tackled in the Grand Challenges for Social Work (GCSW). Yet, the extent to which the GCSW discuss the central role of RER is less clear. This article investigates how the GCSW integrate RER in their discourse. Using content analysis, authors examined all 21 concept papers that comprise the 12 initial GCSW to determine their attention to RER. Authors assessed whether each paper made any reference to race or ethnicity, whether race or ethnicity was considered as a primary theme, and whether racism was mentioned. Nine GCSW had at least one paper that mentioned race or ethnicity; seven had at least one paper that treated race and ethnicity as a major construct. Five GCSW contained at least one paper that discussed racism’s impacts on their topical interests. None of the papers analyzed in the study defined or specified their conceptualization of racism. The GCSW are strategically positioned to widen and deepen social work’s focus on RER, and the recent adoption of the 13th GCSW to “Eliminate racism” is an important first step. Authors encourage the social work field to embrace a more explicit, renewed, and continued commitment to eradicating systemic racism.
Wood properties and transcriptional responses of poplar hybrids in mixed cropping with the nitrogen-fixing speciesRobinia pseudoacacia
Authors: Euring Dejuan , Janz Dennis , Polle Andrea
Published: October 2020

Cultivation of fast-growing tree species is often confined to marginal land. Mixed cropping with Robinia pseudoacacia, a legume tree species that forms a symbiosis with N2-fixing bacteria, has been proposed to be a measure to improve soil fertility and to achieve beneficial effects on the cocultivated tree species. The goal of our study was to examine the influence of a Robinia mixture on wood chemistry, anatomy and gene expression in poplar. We hypothesized that annual wood growth is stimulated in species mixtures due to the positive effects of Robinia on nitrogen availability and complementary resource use. Alternatively, we hypothesized that competition, especially for water, has negative effects on the wood growth of poplar. We used two commercial biomass clones, Hybride 275 (H275, Populus trichocarpa × Populus maximowiczii) and Max1 (Populus nigra × P. maximowiczii), which were planted at two locations with contrasting soil fertility in monoculture or mixed plots with Robinia to investigate the annual wood increment, wood nitrogen and δ13C, wood anatomy (length, cell wall thickness, lumina and frequencies of fibers and vessels) and transcriptional profiles in the developing xylem of 4-year-old stems. In a mixture with Robinia, the annual stem increment was reduced, nitrogen in wood was enhanced, δ13C in wood was decreased, vessel and fiber frequencies were increased and fiber lengths and fiber lumina were decreased. Transcriptional profiles showed stronger differences between the genotypes and sites than between mono and mixed cultivation. The transcriptional abundances of only one gene (the putative nitrate transporter, NRT1.2) and one gene ontology term (‘immune system process’) were significantly enriched in wood-forming tissues in response to the mixture, irrespective of the poplar genotype and growth location. Weighted gene coexpression network analyses extracted gene modules that linked wood nitrogen mainly to vessel traits and wood δ13C with fiber traits. Collectively, molecular and anatomical changes in poplar wood suggest beneficial effects on the water and N supply in response to the mixture with Robinia. These alterations may render poplars less drought-susceptible. However, these benefits are accompanied by a reduced wood increment, emphasizing that other critical factors, presumably light competition or allelopathic effects, overrule a potential growth stimulation.
Surgical Elbow Dislocation Approach to the Distal Humerus for Apparent Capitellar and Lateral Condyle Fractures in Adults
Authors: Hoyt Benjamin W. , Clark DesRaj M. , Walsh Sarah A. , Pensy Raymond A.
Published: October 2020

Objectives:

Access to fractures of the distal humeral capitellum, trochlea, and lateral condyle is difficult through traditional approaches due to limited anterior articular exposure for direct reduction and fixation. The purpose of this study is to evaluate the relative articular exposure of a surgical dislocation (SD) approach to the distal humerus compared with olecranon osteotomy (OO).

Methods:

Eight paired elbows from 4 cadavers underwent either SD or OO approach. Methylene blue staining demarcated visualized articular surface before disarticulation of the elbows. The main outcome measures were average visualized total distal humeral articular surface and anterior and posterior surface, and capitellar surface relative to the total surfaces was compared for each surgical approach using unpaired parametric t-tests.

Results:

Intraclass correlation between raters was 0.995. The median exposed articular surface for SD and OO approaches was 90.0% and 62.8%, respectively. The overall exposure was significantly greater for the dislocation technique (P = 0.0003). With respect to specific regions of the distal humeral articular surface, SD allowed significantly greater visualization of the anterior surface (95.9% vs. 48.9%, P < 0.0001) and capitellum (100% vs. 40.4%, P < 0.0001).

Conclusion:

The surgical elbow dislocation approach to the distal humerus permits near total exposure of the anterior articular surface and the entire capitellum. Our data support this approach for anterior articular fractures of the distal humerus, to include those fractures that extend to the medial surface of the trochlea.
A Multicenter Observational Study on the Postoperative Outcomes of C3 Laminectomy in Cervical Double-door Laminoplasty
Authors: Nakajima Koji , Nakamoto Hideki , Kato So , Doi Toru , Matsubayashi Yoshitaka , Taniguchi Yuki , Yoshida Yuichi , Kawamura Naohiro , Nakarai Hiroyuki , Higashikawa Akiro , Tozawa Keiichiro , Takeshita Yujiro , Fukushima Masayoshi , Iizuka Masaaki , Ono Takashi , Shirokoshi Tomohiko , Azuma Seiichi , Tanaka Sakae , Oshima Yasushi
Published: October 2020

Study Design:

Multicenter retrospective observational study.

Objective:

To determine the differences between C3 laminectomy (LN) and C3 laminoplasty (LP) in cervical LP.

Summary of Background Data:

Interlaminar bony fusion after cervical LP is reported to be related to a decrease in postoperative range of motion (ROM) or neurological disorder. However, it remains uncertain whether C3 LN affects patient-reported outcomes, especially after double-door LPs. Therefore, this study aimed to investigate the effect of C3 LN compared with C3 LP in cervical double-door LP.

Patients and Methods:

Using our prospective database, consecutive patients with degenerative cervical myelopathy undergoing cervical double-door LP in 7 hospitals between April 2017 and May 2018 were enrolled. Before and 1 year after the surgeries, we collected the details of patient background data, operative factors, radiologic findings such as C2–C7 ROM angle and C2–C3 interlaminar bony fusion, the Japanese Orthopaedic Association (JOA) score, postoperative satisfaction, neck pain, and patient-reported outcomes such as Short Form-12 (SF-12), EuroQol 5 Dimension (EQ-5D), Neck Disability Index (NDI), and the Core Outcome Measures Index (COMI) for the neck.

Results:

In all, 152 patients were enrolled, including 97 undergoing C3 LP and 55 undergoing C3 LN. There were no significant differences in patient background data, complications, and operative factors. C2–C3 interlaminar bony fusion occurred more often in the C3 LP group (22.6% vs. 5.7%). There were also no differences in the C2–C7 angle, C2–C7 ROM angle, the JOA score, patient satisfaction, neck pain, SF-12, EQ-5D, NDI, and COMI between the groups.

Conclusions:

C2–C3 bony fusion after cervical double-door LP occurred more often in the C3 LP group than in the C3 LN group. C3 LN resulted in similar outcomes in complication rate, radiographic outcomes, and clinical outcomes compared with those of C3 LP.

Level of Evidence:

Level III.
HTRA1-related autosomal dominant cerebral small vessel disease
Authors: Liu Jing-Yi , Zhu Yi-Cheng , Zhou Li-Xin , Wei Yan-Ping , Mao Chen-Hui , Cui Li-Ying , Peng Bin , Yao Ming
Published: October 2020

Background

Homozygous or compound heterozygous mutations in high temperature requirement serine peptidase A1 (HTRA1) gene are responsible for cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL). Recently, increasing evidence has shown that heterozygous HTRA1 mutations are also associated with cerebral small vessel disease (CSVD) with an autosomal dominant pattern of inheritance. This study was aimed to analyze the genetic and clinical characteristics of HTRA1-related autosomal dominant CSVD.

Methods

We presented three new Chinese cases of familial CSVD with heterozygous HTRA1 mutations and reviewed all clinical case reports and articles on HTRA1-related autosomal dominant CSVD included in PUBMED by the end of March 1, 2020. CARASIL probands with genetic diagnosis reported to date were also reviewed. The genetic and clinical characteristics of HTRA1-related autosomal dominant CSVD were summarized and analyzed by comparing with CARASIL.

Results

Forty-four HTRA1-related autosomal dominant CSVD probands and 22 CARASIL probands were included. Compared with typical CARASIL, HTRA1-related autosomal dominant probands has a higher proportion of vascular risk factors (P < 0.001), a later onset age (P < 0.001), and a relatively slower clinical progression. Alopecia and spondylosis can be observed, but less than those in the typical CARASIL. Thirty-five heterozygous mutations in HTRA1 were reported, most of which were missense mutations. Amino acids located close to amino acids 250–300 were most frequently affected, followed by these located near 150∼200. While amino acids 250∼300 were also the most frequently affected region in CARASIL patients, fewer mutations precede the 200th amino acids were detected, especially in the Kazal-type serine protease domain.

Conclusions

HTRA1-related autosomal dominant CSVD is present as a mild phenotype of CARASIL. The trend of regional concentration of mutation sites may be related to the concentration of key sites in these regions which are responsible for pathogenesis of HTRA1-related autosomal dominant CSVD.
Differential lung ventilation assessed by electrical impedance tomography in ultrasound-guided anterior suprascapular nerve block vs. interscalene brachial plexus block
Authors: Petroff David , Wiegel Martin , Pech Virginia , Salz Peter , Mrongowius Julia , Reske Andreas W.
Published: October 2020

BACKGROUND

Ultrasound-guided interscalene brachial plexus block (ISB) is used to control pain after shoulder surgery. Though effective, drawbacks include phrenic nerve block and motor block of the hand. The ultrasound-guided anterior approach to perform suprascapular nerve block (SSNB) may provide a good alternative.

OBJECTIVE

To compare lung ventilation and diaphragmatic activity on the operated side in ISB and SSNB.

DESIGN

Randomised, controlled patient-blinded and assessor-blinded trial.

SETTING

Outpatient surgical clinic with recruitment from June 2017 to January 2018.

PATIENTS

Fifty-five outpatients scheduled for arthroscopic shoulder surgery were allocated randomly to receive SSNB or ISB. Technical problems with monitoring devices unrelated to the intervention led to exclusion of seven patients. The remaining 48 (n=24 in each group) were followed up for 24 h without drop-outs.

INTERVENTIONS

Patients received 10 ml of ropivacaine 1.0% wt/vol for both procedures.

OUTCOME MEASURES

Percentage lung ventilation on the operated side was the primary endpoint as assessed with electrical impedance tomography (EIT). Secondary endpoints were hemidiaphragmatic motion on the operated side, pain, opioid use, hand strength and numbness, and patient satisfaction.

RESULTS

Before regional anaesthesia, the lung on the operated side contributed a median [IQR] of 50 [42 to 56]% of the total lung ventilation. Postoperatively, it was 40 [3 to 50]% (SSNB) vs. 3 [1 to 13]% (ISB) for an adjusted difference of 23 (95% CI, 13 to 34)%, (P < 0.001). Hemidiaphragmatic motion was 1.90 (95% CI, 1.37 to 2.44 cm), (P < 0.001) lower in the ISB group compared with the SSNB group. Hand strength was 11.2 (95% CI 3.6 to 18.9), (P = 0.0024) kg greater for SSNB and numbness was observed in 0% (SSNB) vs. 46% (ISB) of patients, P < 0.001. Pain was low in the first 6 h after surgery in both groups with slightly, but not significantly, lower values for ISB. No meaningful or significant differences were found for opioid use or patient satisfaction.

CONCLUSION

An ultrasound-guided anterior approach to SSNB preserves ipsilateral lung ventilation and phrenic function better than a standard ISB.

TRIAL REGISTRATION

drks.de identifier: DRKS00011787.
Role of Stem Cell–Derived Microvesicles in Cardiovascular Disease
Authors: Kraus Lindsay , Mohsin Sadia
Published: October 2020

The role of stem cells in augmenting reparative processes in the heart after ischemic injury has been successfully demonstrated in small and large animal models. However, the outcomes of cell therapy in clinical trials have been somewhat variable, with overall effects of autologous stem cell therapies demonstrating a modest improvement in cardiac structure and function. How stem cells repair the heart after cardiac injury is still not well understood. Most recent studies suggest that adult derived stem cells act primarily through paracrine signaling to exert beneficial effects, including modulation of immune response, stimulation of new blood vessel formation, or by inducing mature myocytes to transiently reenter the cell cycle, rather than robust direct differentiation of the transplanted cells into myocytes. In addition, data from multiple laboratory results confirmed clearance of stem cells themselves within a few days still leading to functional benefits further confirming the role of paracrine signaling in augmenting cardiac reparative processes rather than direct differentiation of cells. These findings rapidly evolved the field of extracellular vesicles specifically microvesicles (MVs) as they are active hubs of autocrine, paracrine, and endocrine signaling targeting different biological processes. The beneficial effects seen after stem cell transplantation could be linked to the cardioprotective factors packaged in the MVs secreted from stem cells. Therefore, stem cell MVs provide a new avenue for the treatment of cardiovascular disease through a multitude of mechanisms including cellular communication within the stem cell niches, delivery of genetic information, regulation of the immune system in the heart, and stimulation of angiogenesis which will be discussed in this review.
Effects of Carvedilol and Thyroid Hormones Co-administration on Apoptotic and Survival Proteins in the Heart After Acute Myocardial Infarction
Authors: Ortiz Vanessa Duarte , Türck Patrick , Teixeira Rayane , Belló-Klein Adriane , de Castro Alexandre Luz , Araujo Alex Sander da Rosa
Published: October 2020

Cellular death and survival signaling plays a key role in the progress of adverse cardiac remodeling after acute myocardial infarction (AMI). Therapeutic strategies, such as co-treatment with beta-blocker carvedilol and thyroid hormones (THs), give rise to new approaches that can sustain the cellular homeostasis after AMI. Therefore, we sought to investigate the effects of carvedilol and TH co-administration on apoptosis and survival proteins and on cardiac remodeling after AMI. Male Wistar rats were distributed in 5 groups as follows: sham-operated group (SHAM), infarcted group (MI), infarcted plus carvedilol group (MI+C), infarcted plus TH group (MI+TH), and infarcted plus carvedilol and TH co-treatment group (MI+C+TH). Echocardiographic analysis was performed, and hearts were collected for western blot evaluation. The MI group presented systolic posterior wall thickness loss, an increase in the wall tension index, and an increase in atrial natriuretic peptide tissue levels than the SHAM group. However, in the MI+C+TH group, these parameters were equally to the SHAM group. Moreover, whereas the MI group showed Bax protein expression elevated in relation to the SHAM group, the MI+C+TH group presented Bax reduction and also Akt activation compared with the MI group. In addition, the MI+TH group revealed beta-1 adrenergic receptor (β1AR) upregulation compared with the MI and MI+C groups, whereas the MI+C+TH group presented lower levels of β1AR in relation to the SHAM and MI+TH groups. In conclusion, we suggest that carvedilol and TH co-administration may mediate its cardioprotective effects against adverse cardiac remodeling post-AMI through the Bax reduction, Akt activation, and β1AR decrease.
Chronic Application of Low-Dose Aspirin Affects Multiple Parameters of Three Blood Cellular Types and Antithrombin Activity: A 1:1:1 Propensity Score Matching Analysis
Authors: Li Xiao-li , Wang Qiang , Yin Hui-jun , Wang Yao-hui , Cao Jian , Fan Li
Published: October 2020

The mechanisms of aspirin antithrombotic actions have not been fully elucidated. We re-analyzed the data from the project Aspirin Resistance in Patients with Ischemic Atherothrombotic Diseases from April 2008 to June 2010. A total of 530 subjects were classified into 3 groups, including 40 patients without aspirin use, 24 patients taking 25–50 mg/d aspirin, and 466 patients taking 75–100 mg/d aspirin over 1 month. By 1:1:1 propensity score matching adjusting 15 primary clinical covariates, 51 patients (n = 17 per group) comprised the final sample. Hemostasis-related parameters and high platelet reactivity as measured by arachidonic acid–induced and adenosine diphosphate–induced light transmission aggregometry were compared in the 3 groups. A dose-dependent relationship was observed between aspirin and decreased high platelet reactivity incidence (PAA < 0.001, PADP < 0.01, respectively), decreased monocyte ratio (P = 0.052), increased antithrombin activity (P < 0.001), and increased platelet distribution width (P < 0.05). Aspirin at 25–50 mg/d is related to the lowest red blood cell (RBC) count, whereas 75–100 mg/d aspirin showed the highest RBC count among the 3 groups (4.52 ± 0.35 × 1012/L vs. 4.35 ± 0.57 × 1012/L vs. 4.80 ± 0.59 × 1012/L, P = 0.046). Our finding demonstrated that aspirin exerts its antithrombotic effects at least by antiplatelet function, enhancing antithrombin activity and suppressing monocytes in vivo. In addition, 3 blood cell types, namely RBCs, monocytes, and platelets, are involved in the aspirin antithrombotic mechanism. The cellular response to aspirin partially enhances the antithrombotic effects while partially inhibiting the effects.
Cutaneous Blastomycosis and Systemic Findings
Authors: Han Jane J. , Lake Eden
Published: October 2020

Blastomycosis is a disease that has the ability to affect nearly any organ system, most commonly causing pulmonary disease. Diagnosis of blastomycosis therefore presents a unique problem for clinicians because of its diverse array of presentations. Cutaneous disease secondary to pulmonary disease may be the initial manifestation of blastomycosis. Cutaneous disease also has variable presentations from pustules to warty verrucous or ulcerated lesions. This article will focus on the cutaneous presentation of blastomycosis, including primary inoculation and secondary disseminated types, as well as other manifestations of blastomycosis in other organ systems. Diagnostic methods and general treatment guidelines will also be discussed.
Vaping in the Workplace
Authors: Romberg Alexa R. , Diaz Megan C. , Briggs Jodie , Stephens Daniel K. , Rahman Basmah , Graham Amanda L. , Schillo Barbara A.
Published: October 2020

Objective:

Describe workplace vaping, prevalence of observed use, attitudes, and perceptions among US adults.

Methods:

Employees of companies with more than 150 employees, drawn from an opt-in national online panel (N = 1607), ages 18 to 65, completed an online survey in November 2019.

Results:

Majority (61.6%) observed coworkers vaping at work and 19.1% reported vaping at work themselves. Participants perceived workplace vaping as moderately harmful (M = 1.9 out of 3), 63.2% were bothered by workplace vaping and 52.1% thought it decreased workplace productivity among non-users. Multiple regression models found workplace vaping prevalence varied by industry and participant characteristics, and attitudes about it varied by tobacco use status.

Conclusions:

Workplace vaping and vaping exposure is common in US workplaces. Employees, particularly non-users, hold generally negative perceptions of workplace vaping. Comprehensive policies to prevent workplace vaping are needed to protect workers.
Menstrual Cycle Patterns and Irregularities in Hired Latinx Child Farmworkers
Authors: Varnell Rebecca R. , Arnold Taylor J. , Quandt Sara A. , Talton Jennifer W. , Chen Haiying , Miles Christopher M. , Daniel Stephanie S. , Sandberg Joanne C. , Anderson Kim A. , Arcury Thomas A.
Published: October 2020

Purpose:

This study identifies the menstrual cycle irregularities of Latinx child and adolescent farmworkers.

Methods:

Child and adolescent farmworkers aged 13 to 20 years completed questionnaires about menstrual cycle patterns in 2019, and wore silicone passive collection wristbands for pesticide detection in 2018. Menstrual cycle irregularities were determined from the American College of Obstetricians and Gynecologists committee opinion.

Results:

Half of participants experienced any menstrual cycle irregularity; the most frequent irregularities were cycle length (38.6%) and having gone 90 days or more without a menstrual period (20.4%). Pesticides were detected in 92.9% of the wristbands; most participants were exposed to an endocrine disrupting chemical (EDC) pesticide.

Conclusion:

Half of Latinx children and adolescents hired farmworkers experience irregular menstrual cycles, and most are exposed to EDCs. Inclusion of occupational and menstrual histories in child and adolescent medical visits is critical.
Cardiorespiratory Fitness of Firefighters
Authors: McKinney Zeke J. , Bovard Ralph S. , Starchook-Moore Maria N. , Ronneberg Kevin , Xi Min , Bredeson Dani M. , Schwartz Erin C. , Thelen Sandra L. , Nash Trista L. , Dickinson Mark , McDonough Thomas , Hirdman Kara , Pronk Nicolaas P.
Published: October 2020

Objective:

To address which body composition (BC) measures best correlate with cardiorespiratory fitness (CRF) in firefighters and develop a model for accurate CRF estimation compared with traditional methods.

Methods:

Career firefighters had body mass index (BMI) and waist circumference (WC) measured in addition to body fat percentage (FM%) by dual-energy x-ray absorptiometry (DXA). CRF as maximum oxygen uptake (VO2max) was estimated by rowing machine and measured by indirect calorimetry in a treadmill exercise test.

Results:

Fifty two firefighters participated (92.3% men). Univariate correlations with BMI were best with WC. Univariate correlations with VO2max were best with FM%. Obesity classifications by BC measures agreed weakly at best. Multivariate analysis of several variables yielded an improved VO2max estimate (R
2 = 0.70).

Conclusions:

Fire departments may benefit from more sophisticated measures of BC and CRF to evaluate firefighter fitness.
The Clinical Site Visit: Perspectives of Physical Therapist Students
Authors: Greco Jamie L. , Kupczynski Lori , Silberman Nicki , Hammock Amy
Published: October 2020

Introduction.

Best practice in clinical education includes actions to ensure strong partnerships and close, consistent communication among all stakeholders. One way this can be accomplished is through a site visit. There is limited literature supporting the most preferred communication for conducting these visits. Perspectives of physical therapist students (PTS) about the site visit process are scarce. This study explored whether PTS perceive site visits as important, PTS' preferred method of communication used to conduct these visits, and the reasons underlying these preferences.

Number of Subjects.

One hundred thirty-five PTS.

Materials and Methods.

A mixed-methods, sequential explanatory design was used. A survey was sent to current PTS and recent graduates. Additional qualitative data were collected from a subset of 8 PTS from the sample using semistructured interviews.

Results.

Statistical analysis showed no relationship between the level of clinical experience and preferences for communication methods and no significant differences in levels of importance of site visits. A majority of PTS preferred future visits be conducted in person as opposed to other methods of communication or having no site visit. Students indicated that in-person site visits offer more truthful communication and that although a telephone call may be “sufficient” for a site visit, in-person site visits are necessary when students are having difficulties in the clinic.

Conclusions.

Students are cognizant of the nonverbal cues that occur with in-person communication and that these cues add to the transparency and truthfulness of conversations. Nonverbal communication may be most impactful for the PTS experiencing difficulties during a clinical experience. Given the barriers for conducting site visits, this study provides information that can assist in the decision-making process for communication methods used to conduct these visits. Further research is needed to determine if there is alignment between PTS' perspectives and those of other stakeholders.
A review of glucagon-like peptide 1 receptor agonist and sodium-glucose cotransporter 2 inhibitor cardiovascular trials: Implications for practice
Authors: Battise Dawn M. , Olin Jacqueline L.
Published: October 2020

Background:

Atherosclerotic cardiovascular disease is the leading cause of morbidity and mortality for people with type 2 diabetes mellitus (T2DM). Previous pharmacological management recommendations focused primarily on glucose lowering. However, new data demonstrate that select glucagon-like peptide 1 receptor agonists (GLP1 RA) and sodium-glucose cotransporter 2 inhibitors (SGLT2is) not only provide glucose lowering but also can reduce the risk of cardiovascular (CV) disease.

Objectives:

The purpose of this study was to evaluate the current data regarding CV benefits of GLP1 RA and SGLT2i in select patients with T2DM and the impact on clinical guidelines so that nurse practitioners may optimize pharmacologic management of patients with T2DM.

Data sources:

A literature review was conducted using the PubMed and CINAHL complete databases to identify studies with CV benefits of GLP1 RA and SGLT2i. Pivotal clinical trials were selected for review.

Conclusions:

Select GLP1 RA and SGLT2i can reduce the risk of major adverse CV events, death from CV cases, or hospitalization due to heart failure (HF) in patients with a history of, or at high risk for, CV disease.

Implications for practice:

Based on data from major CV outcomes trials, clinical guidelines recommend GLP1a or SGLT2i in select patients for glucose lowering and CV risk reduction. In addition, even in patients who have achieved glycemic goals, these agents can provide additional benefit by reducing the incidence of major CV adverse events or hospitalization for HF. Understanding the data will help nurse practitioners select the most appropriate agent for a given individual based on comorbidities.
A national study of personal accomplishment, burnout, and satisfaction with work–life integration among advance practice nurses relative to other workers
Authors: Dyrbye Liselotte N. , West Colin P. , Kelsey Elizabeth A. , Gossard Andrea A. , Satele Daniel , Shanafelt Tait
Published: October 2020

Background:

There is a high prevalence of burnout among health care professionals, but little remains known about burnout and satisfaction with work–life integration (WLI) among advance practice nurses (APNs).

Purpose:

To evaluate burnout and satisfaction with WLI among APNs compared with other US workers.

Methods:

A national sample of APNs and a probability-based sample of US workers completed a survey that measured burnout and satisfaction with WLI.

Results:

Of the 976 (47%) APNs who completed the survey 64% had high personal accomplishment, 36.6% had symptoms of overall burnout, and 60.6% were satisfied with their WLI. In multivariable analysis, work hours (for each additional hour odds ratio [OR] 1.03, 95% confidence interval [CI] 1.02–1.04, p < .001) and working in an outpatient setting (overall p = .03; referent hospital: outpatient, OR 1.80, 95% CI 1.17–2.18; other/unknown, OR 1.41, 95% CI 0.90–2.22, p = .13) were independently associated with having higher odds of burnout. Work hours were also independently associated with lower odds of satisfaction with WLI (for each additional hour OR 0.94, 95% CI 0.94–0.95, p < .001). Advance practice nurses were not more likely to have burnout or have greater struggles with WLI than other workers.

Implications for practice:

Findings from this study suggest APNs have high levels of personal accomplishment and a favorable occupational health profile. Advance practice nurses do not appear at higher risk of burnout or dissatisfaction with WLI than other US workers.
Ambulatory blood pressure monitoring: A nurse practitioner run program
Authors: Burke Christine , Haut Catherine , Hussong Kelly , Zaritsky Joshua
Published: October 2020

Background:

Ambulatory blood pressure monitoring (ABPM) is a standard screening tool for the diagnosis of hypertension in children, adolescents, and adults. However, there is confusion and misunderstanding about which guidelines can provide the most accurate diagnostic values.

Local problem:

At a large, free-standing pediatric hospital, ABPM testing was historically being conducted by both nephrology and cardiology departments. The nephrology service was using the American Heart Association (AHA) guidelines, published in 2014 for interpretation of results and for diagnosis of hypertension, whereas the cardiology service depended on the 2004 National High Blood Pressure Education Program (NHBEP) fourth report, which led to discrepancies in diagnosis of hypertension in this patient population.

Methods:

A nurse practitioner–led quality improvement project was designed and implemented to determine the best method of ABPM monitoring and test interpretation based on comparing results of patients using height, gender, and application of either the 2004 NHBEP fourth report or 2014 AHA guidelines.

Interventions:

Using a retrospective chart review, ABPM monitoring results from both cardiology and nephrology services were reviewed and compared to identify the most accurate methods and to recommend changes to practice.

Results:

Accuracy of interpretation for ABPM is best accomplished using the 2014 AHA guidelines.

Conclusions:

Using a single method of interpretation provides consistent diagnosis and treatment of hypertension in children. Nurse practitioners can apply this knowledge in other settings to manage hypertension and provide similar services in different settings, including primary care.
Telemedicine and adherence monitoring in children with asthma
Authors: Blake Kathryn V.
Published: October 2020

Purpose of review

Telemedicine, defined as synchronous video visits between a provider and a child with asthma, often takes place in the school setting. This review examines the new electronic sensors for adherence monitoring and studies that used telemedicine in the school setting to improve asthma outcomes.

Recent findings

School-based telemedicine provides an important service to families of school-aged children who have difficulty due to time and distance in planning and keeping in-person appointments with primary or specialty providers. Significant improvements in objective measures of asthma control are inconsistently observed although caregiver and parent quality of life and child self-management behaviors are improved and satisfaction is high. Assessment and outcomes related to adherence are mentioned in studies but results are not often reported. However, it appears that adherence interventions are beneficial while maintained but the effects are not sustained upon intervention discontinuation.

The school setting provides a convenient and suitable environment to conduct telemedicine visits between school-aged children and their primary care or specialty provider. Electronic adherence sensors allow review of controller and rescue medication use through a cloud-based dashboard and provides an opportunity for real-time assessment and intervention by providers to improve asthma outcomes.
Managing chronic rhinosinusitis in severe asthma
Authors: Ramaswamy Uma S. , Patel Vijay A. , Lee Stella E.
Published: October 2020

Purpose of review

Over half of all patients with severe asthma have chronic rhinosinusitis (CRS). Although distinct and specialized in function and form, the upper and lower airways share similar and inter-related pathophysiologic mechanisms. The severity of CRS particularly in patients with nasal polyps can correlate with that of asthma and vice versa. The purpose of this review is to elucidate the relationship between these conditions and summarize key elements in the management of these patients.

Recent findings

Several advances have been made in the evaluation and treatment of patients with CRS and asthma. Further understanding of inflammatory endotypes common to both CRS and severe asthma hopefully will provide appropriate and effective treatments and improve patient outcomes.

CRS significantly impairs quality of life, and therapies are targeted toward improving patient symptoms, and hopefully in the future, treating the underlying immune dysfunction. Management of CRS and severe asthma requires a multidisciplinary approach. Further real-world studies are necessary to determine the best treatment algorithm for these patients.
Current management of type III and IV laryngotracheoesophageal clefts: the case for a revised cleft classification
Authors: Jáuregui Emmanuel J. , Propst Evan J. , Johnson Kaalan
Published: October 2020

Purpose of review

This review summarizes the paediatric laryngotracheoesophageal cleft (LTEC) literature, with an emphasis on recent trends, evaluation and management, surgical techniques, postoperative care of Type III and IV LTECs, and to propose a revised cleft classification system that more accurately reflects our current understanding of these anomalies.

Recent findings

There are a number of techniques described to address Type III and IV LTEC, from endoscopic to open approaches with thoracotomy. The surgical approach should be tailored to the length of the cleft and its proximity to important anatomical structures. On the basis of review of the literature, we propose a modified Benjamin-Inglis classification (MBI) with subcategories to address this issue. Postoperative complications are common, namely, tracheoesophageal fistulae and tracheomalacia, which may necessitate subsequent procedures or prolonged tracheostomy dependence.

The medical and surgical management of Type III and IV LTEC is challenging with a high rate of morbidity and mortality. The rarity and difficulties in management of these malformations have made large cohort studies difficult, thus generalizable recommendations have been elusive. Experience and patient selection are critical for successful endoscopic repair. Anterior cervical approach, often with complete laryngofissure, appears to be the most common and preferred method for open repairs, though some use a lateral approach. The proposed MBI classification appears to be a useful adjunct to aid in surgical decision-making for deeper LTEC.
Nurse Residency Immersion
Authors: Shinners Jean , Deasy Patty
Published: October 2020

Structured, evidence-based nurse residency programs have been accepted as necessary for the successful transition of new graduate nurses, and the coordination of programs is a large part of the nursing professional development practitioner role. Using best practices, the nursing professional development practitioner determines the development and design of the nurse residency program, including identification of competencies, curriculum, clinical experiences, and residency length.
Use of the SIGN IM nail system to stabilize tibiotalocalcaneal arthrodesis in two African hospital settings
Authors: Burke Sydney E. , Wangai Isaac K. , Koech Geoffrey K. , Galat Jeremiah D. , Galat Daniel D. , Lundy Douglas W.
Published: October 2020

Objectives:

To determine the effectiveness and describe the technique of using the Surgical Implant Generation Network (SIGN) nail to augment tibiotalocalcaneal (TTC) arthrodesis in the developing world.

Design:

Retrospective review of the SIGN database and description of surgical technique.

Setting:

Two centers in rural Kenya, East Africa.

Patients:

Fifty-seven patients with ankle/hindfoot arthritis or severe trauma. We were able to follow 17 through complete arthrodesis.

Invention:

TTC arthrodesis stabilized with SIGN nail.

Main outcome measure:

Radiographic arthrodesis and return to function.

Result:

Of the patients with significant follow-up, arthrodesis occurred in an average of 19.3 ± 7.5 weeks from the date of surgery.

Conclusions:

Recognizing the obstacles to follow-up, the SIGN nail placed with the Herzog curve apex posterior is shown to be an effective device to stabilize a TTC arthrodesis in a limited subgroup of patients with full follow-up.
Association of Risk of Mortality in Pediatric Patients Transferred From Scene by Helicopter With Major But Not Minor Injuries
Authors: Duffens Ali , Grigorian Areg , de Virgilio Christian , Chin Theresa , Kim Dennis , Lekawa Michael , Schubl Sebastian D. , Nahmias Jeffry
Published: October 2020

Objectives

Helicopter emergency medical services (HEMS) are used for 16% of pediatric trauma. National HEMS guidelines advised that triage criteria be standardized for pediatric patients. A national report found pediatric HEMS associated with decreased mortality compared with ground emergency medical services (GEMS) but did not control for transport time. We hypothesized that the rate of HEMS has decreased nationally and the mortality risk for HEMS to be similar when adjusting for transport time compared with GEMS.

Methods

The Pediatric Trauma Quality Improvement Program (2014–2016) was queried for patients younger than 16 years transported by HEMS or GEMS. A multivariable logistic regression was used.

Results

From 25,647 patients, 4527 (17.7%) underwent HEMS. The rate of HEMS from scene decreased from 21.2% in 2014 to 18.2% in 2016. The rate of HEMS for minor trauma (Injury Severity Score <15) decreased from 14.9% in 2014 to 13.5% in 2016 and major trauma (Injury Severity Score > 15) from 38.4% in 2014 to 35.9% in 2016. After controlling for predictors of mortality and transport time, HEMS was associated with decreased risk of mortality for only those with major injuries transferred from scene (odds ratio, 0.48; 95% confidence interval, 0.26–0.88; P = 0.01) compared with GEMS.

Conclusions

The rate of HEMS in pediatric trauma has decreased. However, there is room for improvement as 14% of those with minor trauma are transported by HEMS. Given the similar risk of mortality compared with GEMS, further development of guidelines that avoid the unnecessary use of HEMS appears warranted. However, utilization of HEMS for transport of pediatric major trauma should continue.
Do Victims of Abusive Head Trauma Visit Emergency Departments More Often Than Children Hospitalized for Fever? A Case-Control Study
Authors: Bailhache Marion , Lafagne Ambre , Lagarde Marie , Richer Olivier
Published: October 2020

Objective

During the first years of life, infant crying is a common trigger of abusive head trauma (AHT). Emergency department (ED) use by AHT victims before visits for child abuse symptoms is not well known, particularly for infant crying. Furthermore, diagnosis could be missed. In the same period, fever is a common reason for hospitalization unconnected with AHT. The main goal of our study was to compare the ED use by AHT victims before visits for child abuse symptoms and by children of the same age hospitalized for fever.

Methods

We conducted a retrospective case-control study from 2011 to June 2018 in a French hospital. We compared cases of AHT selected using the International Classification of Diseases and control subjects hospitalized in the general pediatric unit for fever without immunodeficiency matched in age. Univariate and multivariate analyses were performed.

Results

Among the 75 victims of AHT, 5 had at least 1 previous ED visit not linked with abuse. None had visited for infant crying. Among the control subjects, 34 had at least 1 previous ED visit, including 6 for infant crying. Among the 57 dyads of controls and cases living in the hospital's area, the controls had significantly more previous ED visits than the cases (P < 0.001). There were more male infants among the cases (72% vs. 55%, P = 0.033).

Conclusions

Our study suggests that AHT victims had no more ED visits before visits for child abuse symptoms, particularly not for infant crying.
Carbon Monoxide-Releasing Molecule-3 Ameliorates Acute Lung Injury in a Model of Hemorrhagic Shock and Resuscitation: Roles of p38MAPK Signaling Pathway
Authors: Bai Jing , Bai Yang , Wang Xu-Peng , Zheng Wei-Chao , Zhang Li-Min
Published: October 2020

Objective:

It was reported that carbon monoxide-releasing molecule-3 (CORM-3) administration immediately after hemorrhagic shock and resuscitation (HSR) ameliorates the HSR-induced acute lung injury (ALI); however, the specific mechanism of the protective effects against HSR-induced ALI remains unclear.

Methods:

To induce hemorrhagic shock, rats were bled to a mean arterial blood pressure of 30 mm Hg for 45 min and then resuscitated with shed blood via the left vein. CORM-3 (4 mg/kg or 8 mg/kg) was respectively administrated after HSR. Twelve  hours post-HSR, lung injury was assessed by wet/dry (W/D) ratio, hematoxylin-eosin staining staining, and lung ultrasound; the apoptotic and pyroptotic macrophages were measured by immunofluorescence staining; and the expression of phosphorylated p38 mitogen activated protein kinase (p-p38MAPK) and total p38MAPK was measured by western blotting. SB203580 (5 mg/kg), a special inhibitor of p-p38MAPK, was administrated by abdominal cavity to assess the roles of p38MAPK in HSR-induced ALI.

Results:

Increased B-line score, lung injury score, and W/D ratio indicated the fact of ALI after HSR. Twelve hours post-HSR, CORM-3 administration significantly decreased the B-line score, lung injury score, W/D ratio, apoptotic and pyroptotic macrophages, and the expressions of p-p38MAPK. Further, SB203580 not only reduced HSR-induced ALI, but also enhanced the protective effects of CORM-3 against ALI.

Conclusion:

We identified the protective effects of CORM-3 against HSR-induced ALI. The mechanism might be related to the inhibition of p38MAPK signaling pathway in lung macrophages.