bluuebunny/crossref_metadata_2025 huggingface dataset:
The Changing Demographics of Humanism
Authors: Trejo Yazmín A. G.
Published: January 2021

What do we know about the social and demographic characteristics of humanists? This chapter seeks to answer that question by offering a way to measure humanism via data from the 2014 Pew Research Center’s Religious Landscape Study (RLS). In addition to the existence of various types of humanism, findings indicate the presence of gender imbalance in humanist circles and potential for growth in the number of humanists in the United States, as young people are overrepresented. However, this particular cohort also lacks racial and ethnic diversity. It is important to note that, given there is no survey specifically examining humanists, this chapter serves only as a building block for understanding the prevalence of humanism and its demographic characteristics.
Thirteenth-Century Engagements with Thomas Aquinas
Authors: Barnes Corey L.
Published: January 2021

Before he gained the status of received authority, Thomas Aquinas influenced scholastic thought by shaping conversations around and by establishing approaches to specific topics. Scholastic thinkers engaged in these conversations and with these specific topics in various ways, both directly and indirectly. While the Correctoria controversy reflected direct engagements with Aquinas, whether critical or supportive, the majority of scholastic engagements with Thomas was more indirect. Typical examples can be found in the works of Giles of Rome, Siger of Brabant, Godfrey of Fontaines, and Henry of Ghent. Among other topics, these thinkers engaged with Thomas on the possibility of an eternal world, on the unicity of substantial form, and on the relationship between esse and essentia. Engagements with Aquinas were complicated by Stephen Tempier’s condemnations of 1277, which touched upon some Thomistic positions and more generally reframed scholastic approaches to philosophical speculations with theological bearings.
Late Twentieth-Century Reception of Aquinas in Analytical Philosophy
Authors: Haldane John
Published: January 2021

Within two decades of Bertrand Russell writing, ‘There is little of the true philosophic spirit in Aquinas’ (Russell 1945), interest in Thomas’s ideas had begun to develop among philosophers in the ‘analytic’ or ‘analytical’ tradition of which Russell had been one of the founders. The causes of this were several, but prominent were first, a reaction against a strong reductive and scientistic strand in that tradition, viz. ‘logical positivism’; second, the interest taken in Aquinas by Peter Geach following his conversion to Roman Catholicism; and third, the activities of British Dominicans in translating Aquinas’s Summae, and in organizing meetings between lay philosophers and priests and other religious to discuss themes from Aquinas and issues in contemporary secular philosophy. From this beginning, and advanced by the work of Anthony Kenny, interest developed in Britain, Australia, and the United States, and then beyond the Anglophone world.
The Distinctive Unity of the Human Being in Aquinas
Authors: Cory Therese Scarpelli
Published: January 2021

This chapter explores the fundamental vision of the human being at the core of Aquinas’ anthropology. Aquinas has typically been construed as defending a fundamentally ‘Aristotelian’ vision of the human being. I show that this label has generated a skewed reading of Aquinas. Accordingly, this chapter does not lay claim to identify what it would take for an anthropology to be authentically ‘Thomistic’. Instead, it makes a proposal concerning what I argue is the ‘guiding vision’ of Aquinas’ anthropology: namely the ‘distinctive unity of the human’. Aquinas prioritizes this notion of distinctive unity in the different areas of his anthropology. I explore how this distinctive unity is expressed (a) in Aquinas’ account of the human soul as the ‘horizon’ of the bodily and spiritual worlds, and (b) in his definition of the human being as ‘rational animal’.
Innovating the Public Sector in Australia
Authors: Lewis Jenny M.
Published: January 2021

Innovation has become an increasingly important public policy and public sector reform trend in Australia and in other nations as governments search for new ways to tackle challenging societal problems. Innovation follows on from other reform trends that have been argued about, implemented, and constantly updated (most notably the New Public Management) since the 1970s, but also has distinct attributes. This chapter examines the meaning of public sector innovation and explores how it differs to other approaches to public sector reform. It describes Australian innovation policy at the national level and examines two main varieties of it: innovation as technology, and innovation as culture. Australia’s approach to innovation policy has sometimes focused on individuals (public servants), and at other times on public sector organizations and systems. Innovation labs/units, as one aspect of Australian public sector innovation policy, demonstrate Australia’s general alignment with international trends in this area of public policy.
Impact of the COVID-19 pandemic on hospitalizations for acute coronary syndromes: a multinational study
Authors: Araiza-Garaygordobil D , Montalto C , Martinez-Amezcua P , Cabello-Lopez A , Gopar-Nieto R , Alabrese R , Almaghraby A , Catoya-Villa S , Chacon-Diaz M , Kaufmann C C , Corbi-Pascual M , Deharo P , El-Tahlawi M , Elgohari-Abdelwahab A , Guerra F , Jarakovic M , Martinez-Gomez E , Moderato L , Montero S , Morejon-Barragan P , Omar A M , Jorge-Pérez P , Przybyło P , Selim E , Sinan U Y , Stratinaki M , Tica O , Trêpa M , Uribarri A , Uzokov J , Wilk K , Czerwińska-Jelonkiewicz K , Sionis A , Gierlotka M , Leonardi S , Krychtiuk K A , Tavazzi G
Published: January 2021

Background

COVID-19 has challenged the health system organization requiring a fast reorganization of diagnostic/therapeutic pathways for patients affected by time-dependent diseases such as acute coronary syndromes (ACS).

Aim

To describe ACS hospitalizations, management, and complication rate before and after the COVID-19 pandemic was declared.

Design

Ecological retrospective study. Methods: We analyzed aggregated epidemiological data of all patients > 18 years old admitted for ACS in twenty-nine hub cardiac centers from 17 Countries across 4 continents, from December 1st, 2019 to April 15th, 2020. Data from December 2018 to April 2019 were used as historical period.

Results

A significant overall trend for reduction in the weekly number of ACS hospitalizations was observed (20.2%; 95% confidence interval CI [1.6, 35.4] P = 0.04). The incidence rate reached a 54% reduction during the second week of April (incidence rate ratio: 0.46, 95% CI [0.36, 0.58]) and was also significant when compared to the same months in 2019 (March and April, respectively IRR: 0.56, 95%CI [0.48, 0.67]; IRR: 0.43, 95%CI [0.32, 0.58] p < 0.001). A significant increase in door-to-balloon, door-to-needle, and total ischemic time (p <0.04 for all) in STEMI patents were reported during pandemic period. Finally, the proportion of patients with mechanical complications was higher (1.98% vs. 0.98%; P = 0.006) whereas GRACE risk score was not different.

Conclusions

Our results confirm that COVID-19 pandemic was associated with a significant decrease in ACS hospitalizations rate, an increase in total ischemic time and a higher rate of mechanical complications on a international scale.
CDS Momentum: Slow-Moving Credit Ratings and Cross-Market Spillovers
Authors: Lee Jongsub , Naranjo Andy , Sirmans Stace
Published: January 2021

This paper highlights the adverse consequences of sluggish credit rating updates in creating information efficiency distortions and investment anomalies. We first document significant credit default swap (CDS) return momentum yielding 7.1% per year. We further show that cross-market momentum strategies based on information in past CDS performance generates an alpha of 10.3% per year in stocks and 7.3% per year in bonds. These CDS momentum and cross-market effects are stronger among more liquid, informationally rich CDS contracts whose CDS spreads move in anticipation of important, yet slow-moving, credit rating changes. (JEL G12, G14)

Received February 19, 2020; editorial decision July 10, 2020 by Editor Jeffrey Pontiff. Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Resistance Gene Pyramiding and Rotation to Combat Widespread Soybean Cyst Nematode Virulence
Authors: Meinhardt Clinton , Howland Amanda , Ellersieck Mark , Scaboo Andrew , Diers Brian , Mitchum Melissa G.
Published: January 2021

Soybean cyst nematode (SCN) is an important pathogen of soybean causing >$1 billion in yield losses annually in the United States. Planting SCN-resistant soybean cultivars is the primary management strategy. Resistance genes derived from the plant introduction (PI) 88788 (rhg1-b) and PI 548402 (Peking; rhg1-a and Rhg4) are the main types of resistance available in commercial cultivars. The PI 88788 rhg1-b resistance allele is found in the majority of SCN-resistant cultivars in the north central United States. The widespread use of PI 88788 rhg1-b has led to limited options for farmers to rotate resistance sources to manage SCN. Consequently, overreliance on a single type of resistance has resulted in the selection of SCN populations that have adapted to reproduce on these resistant cultivars. Here we evaluated the effectiveness of rotating soybean lines with different combinations of resistance genes to determine the best strategy for combating the widespread increase in virulent SCN and limit future nematode adaptation to resistant cultivars. Eight SCN populations were developed by continuous selection of a virulent SCN field population (Heterodera glycines [HG] type 1.2.5.7) on a single resistance source or in rotation with soybean pyramiding different resistance gene alleles derived from PI 88788 (rhg1-b), PI 437654 (rhg1-a and Rhg4), PI 468916 (cqSCN-006 and cqSCN-007), and PI 567516C (Chr10). SCN population densities were determined for eight generations. HG type tests were conducted after the eighth generation to evaluate population shifts. The continued use of rhg1-b or 006/007 had limited effectiveness for reducing SCN type 1.2.5.7 population density, whereas rotation to the use of rhg1-a/Rhg4 resistance significantly reduced SCN population density but selected for broader SCN virulence (HG type 1.2.3.5.6.7). A rotation of rhg1-a/Rhg4 with a pyramid of rhg1-b/006/007/Chr10 was the most effective combination at both reducing population density and minimizing selection pressure. Our results provide guidance for implementation of a strategic SCN resistance rotation plan to manage the widespread virulence on PI 88788 and sustain the future durability of SCN resistance genes.
Probiotics for preventing recurrent bacterial vaginosis
Authors: Webb Lauren
Published: January 2021

Multiple studies have shown that oral or vaginal probiotics can effectively treat and prevent recurrent bacterial vaginosis. The dose, route, and treatment protocols vary greatly between studies, but many have shown a statistically significant reduction in the rate of recurrence of bacterial vaginosis. Further research is needed to determine the adequate dose, specific probiotic, optimal duration, and route of administration, with or without antibiotics.
Developing Academic Leadership From a Distance: A Health Professions Education Practicum Course
Authors: Samuel Anita , Durning Steven J. , Larsen Kelsey L.
Published: January 2021

Problem

Leadership skills are fundamental to the successful practice of health professions education (HPE), but HPE degree programs struggle with providing meaningful leadership instruction from a distance.

Approach

The leaders of the HPE program at the Uniformed Services University of the Health Sciences developed a practicum course to give learners guided experiences in their daily leadership roles and responsibilities from a distance. The ongoing practicum course, started in fall 2018 and broadly framed by the principles of deliberate practice and self-directed learning, involves a 6-step process where learners: (1) identify leadership competency/ies to develop, (2) identify roles and responsibilities in their own work settings that involve elements of leadership, (3) develop a learning agreement that identifies personal leadership goals for the practicum activity, (4) are assigned expert preceptors by practicum directors, (5) initiate regular meetings with their preceptors to receive feedback and expert advice, and (6) end the practicum activity with a debriefing reflection between themselves and their preceptors. Practicum activity timelines are flexible and preceptors work with learners through the lifespan of the project. Learners can participate in multiple practicum activities as they improve different leadership competencies.

Outcomes

Since fall 2018, 36 learners have participated in 83 practicum activities, 45 (54%) of which have been completed. The practicum activities show that leadership competencies are most often embedded within other activities and are unique to every situation. Reflecting on practice, collaborating in teams, and negotiating and resolving conflict are the most commonly identified leadership competencies learners want to improve. Feedback on the practicum from learners has been positive.

Next Steps

This practicum course provides a model that can be applied in various organizational contexts. In the future, the authors plan to collect data from both learners and preceptors about their experiences and solicit feedback from learners’ employers and supervisors.
Mini-anterior approach for surgical reduction of developmental dysplasia of the hip: a case series
Authors: Thabet Mahmoud El-Badawy , AbdelWahab Ahmed M. , Imam Ahmed Hatem
Published: January 2021

Background:

Our hypothesis was that the mini-anterior approach gives adequate exposure with satisfactory result in patients with developmental dysplasia of the hip.

Methods:

Twenty-three hips in 20 patients who had developmental dysplasia of the hip (18 girls and two boys) underwent surgical reduction using the mini-anterior approach. The incision extended from a point about 1 cm below and medial to the anterior iliac superior spine obliquely to a point about 1 cm lateral to the femoral pulsation. The average patient age at the time of surgery was 15 mo.

Results:

Clinical results were evaluated according to the modified McKay criteria and the cosmetic appearance of the wound. Excellent wound cosmetic appearance was present in all patients. Twenty-two hips (95.7%) were rated clinically as excellent to good, whereas only one hip was rated as fair. According to radiographic Severin grading, 20 hips (86.4%) were rated as excellent to good and only three hips (13.6%) were rated as fair.

Conclusions:

The mini-anterior approach can be used safely in patients with dysplasia of the hip who are younger than 20 mo with adequate exposure and minimal soft-tissue dissection.

Level of Evidence:

Level IV.
Functional Ability Classification Based on Moderate and Severe Kinesophobia and Demoralization Scores in Degenerative Spine Patients
Authors: Haddas Ram , Lieberman Isador , Sandu Cezar D. , Sambhariya Varun , Block Andrew
Published: January 2021

Study Design.

A prospective cohort study.

Objective.

To assess the relationship of fear avoidance and demoralization on gait and balance and determine a threshold score for the Tampa Scale for Kinesophobia (TSK) and the Demoralization Scale (DS) that identifies spine patients with gait and balance dysfunction amplified by underlying psychological factors.

Summary of Background Data.

Fear avoidance and demoralization are crucial components of mental health that impact the outcomes in spine surgery. However, interpreting their effect on patient function remains challenging. Further establishing this correlation and identifying a threshold of severity can aid in identifying patients in whom a portion of their altered gait and balance may be amplified by underlying psychologic distress.

Methods.

Four hundred five symptomatic spine patients were given the TSK and DS questionnaires. Patient's gait and balance were tested with a human motion capture system. A TSK score of 41 and a DS score of 30 were chosen as thresholds to classify moderate versus severe dysfunction based on literature and statistical analysis.

Results.

Higher TSK and DS scores were correlated with worse walking speed (P < 0.001), longer stride time (P = 0.001), decreased stride length (P < 0.048), and wider step width (<0.001) during gait as well as increased sway across planes (P = 0.001) during standing balance. When classified by TSK scores >41, patients with more severe fear avoidance had slower walking speed (P < 0.001), longer stride time (P = 0.001), shorter stride length (P = 0.004), increased step width (P < 0.001), and increased sway (P = 0.001) compared with their lower scoring counterparts. Similarly, patients with DS > 30 had slower walking speed (P = 0.012), longer stride time (P = 0.022), and increased sway (P = 0.003) compared with their lower scoring counterparts.

Conclusion.

This study demonstrates that fear avoidance and demoralization directly correlate with worsening gait and balance. Furthermore, patients with TSK > 41 and DS > 30 have more underlying psychological factors that contribute to significantly worse function compared with lower scoring peers. Understanding this relationship and using these guidelines can help identify and treat patients whose gait dysfunction may be amplified by psychologic distress.

Level of Evidence: 3
Defining a Surgical Invasiveness Threshold for Increased Risk of a Major Complication Following Adult Spinal Deformity Surgery
Authors: Neuman Brian J. , Harris Andrew B. , Klineberg Eric O. , Hostin Richard A. , Protopsaltis Themistocles S. , Passias Peter G. , Gum Jeffrey L. , Hart Robert A. , Kelly Michael P. , Daniels Alan H. , Ames Christopher P. , Shaffrey Christopher I. , Kebaish Khaled M.
Published: January 2021

Study Design.

Retrospective review.

Objectives.

The aim of this study was to define a surgical invasiveness threshold that predicts major complications after adult spinal deformity (ASD) surgery; use this threshold to categorize patients into quartiles by invasiveness; and determine the odds of major complications by quartile.

Summary of Background Data.

Understanding the relationship between surgical invasiveness and major complications is important for estimating the likelihood of major complications after ASD surgery.

Methods.

Using a multicenter database, we identified 574 ASD patients (more than 5 levels fused; mean age, 60 ± 15 years) with minimum 2-year follow-up. Invasiveness was calculated as the ASD Surgical and Radiographic (ASD-SR) score. Youden index was used to identify the invasiveness score cut-off associated with optimal sensitivity and specificity for predicting major complications. Resulting high- and low-invasiveness groups were divided in half to create quartiles. Odds of developing a major complication were analyzed for each quartile using logistic regression (alpha = 0.05).

Results.

The ASD-SR cutoff score that maximally predicted major complications was 90 points. ASD-SR quartiles were 0 to 65 (Q1), 66 to 89 (Q2), 90 to 119 (Q3), and ≥120 (Q4). Risk of a major complication was 17% in Q1, 21% in Q2, 35% in Q3, and 33% in Q4 (P < 0.001). Comparisons of adjacent quartiles showed an increase in the odds of a major complication from Q2 to Q3 (odds ratio [OR] 1.8; 95% confidence interval [CI]: 1.0–3.0), but not from Q1 to Q2 or from Q3 to Q4. Patients with ASD-SR scores ≥90 were 1.9 times as likely to have a major complication than patients with scores <90 (OR 1.9, 95% CI 1.3–2.9). Mean ASD-SR scores above and below 90 points were 121 ± 25 and 63 ± 17, respectively.

Conclusion.

The odds of major complications after ASD surgery are significantly greater when the procedure has an ASD-SR score ≥90. ASD-SR score can be used to counsel patients regarding these increased odds.

Level of Evidence: 3
The health economics of infertility treatment
Authors: Lilford Richard
Published: January 2021

The health economics of infertility raises a number of issues that are not generally considered in the standard canon for health economic assessment of health technology assessments. Six issues stand out, which are briefly considered in turn.
Clinical value of assessing serum levels of inflammatory cytokines in the early diagnosis of patients with primary liver carcinoma: a retrospective observational study
Authors: He Chengwen , Wei Qin , Zhu Jun , Qin Qin , Wang Huaizhou , Liu Shanrong
Published: January 2021

Objective:

To identify potential early diagnostic markers for hepatitis B progression to primary liver carcinoma using routine immunological tests based on 6 cytokine combinations.

Methods:

Eight hundred and ninety-nine patients with hepatitis B progressing to early primary liver carcinoma admitted to and treated at Changhai Hospital, Naval Military Medical University, Shanghai, China between March 2015 and June 2017 were included in this observational study, including 666 patients with HBsAg
+
, HBeAb
+
, HBcAb
+
liver carcinoma and 233 patients with HBsAg
+
, HBeAg
+
, HBcAb
+
liver carcinoma. Receiver operating characteristic (ROC) curves were used to evaluate the efficiency of the different cytokine in the diagnosis of hepatocellular carcinoma in patients with hepatitis B. This study was approved by the Institutional Review Board of Changhai Hospital, Naval Military Medical University, China (approval No. CHEC2020-080) on June 6, 2020.

Results:

Changed levels of interleukin (IL)-1β, IL-2R, IL-8, and tumor necrosis factor (TNF)-α were statistically significant (
P
< 0.05). The area under the ROC curve, sensitivity, specificity, positive predictive value, negative predictive value, and Youden index for the diagnosis of primary liver carcinoma using the combination of IL-1β, IL-2R, IL-8, and TNF-α were 0.938, 79.2%, 96.7%, 96%, 82.0%, 0.759, respectively. The serum alpha-fetoprotein level in patients with primary liver carcinoma was positively correlated with IL-2R (
r
=0.3502,
P
< 0.001), IL-8 (
r
=0.1558,
P
=0.0273), and TNF-α (
r
=0.2544,
P
< 0.001) levels. The equation fitted to the results was logit(
P
)=0.086+ 0.01 × IL-2R-0.001 × IL-8-0.033 × TNF-α-0.041 × IL-1β.

Conclusion:

Our study establishes a novel, potentially valuable diagnostic model based on four cytokines related to the early stages of liver carcinoma.
The Role of Osteoclasts in Psoriatic Arthritis
Authors: Wang Zhen-Zhen , Wang Hong-Sheng
Published: January 2021

Psoriatic arthritis (PsA) is a chronic immune-mediated inflammatory disease related to psoriasis involving bone and cartilage. It is a heterogeneous disorder with a variety of clinical manifestations, which can include peripheral arthritis, axial spondylitis, enthesitis, skin and nail disease, dactylitis, uveitis, osteitis, inflammatory bowel disease. The distinctive feature of PsA is enthesitis. The characteristic bone erosion at the bone–pannus junction in PsA is mediated by osteoclasts, which are multinucleated giant cells derived from hematopoietic stem cells. Although the pathological mechanism of osteoclasts in PsA is mainly related to the destruction of the diseased joint, the exact pathogenesis of PsA is complex and the factors involved in initiation and termination of osteoclast need to be further explored. Much attention has been paid to the importance of osteoclast in psoriasis arthritis for decades. Based on the role of osteoclasts in PsA, our review discusses the formation and characteristics of multinucleated osteoclasts in PsA, summarizes current developments in osteoclast-related pathways in PsA including classical receptor activator of nuclear factor-κB-receptor activator of nuclear factor-κB ligand-osteoprotegerin pathway and immunomodulatory factors, as well as their advances and corresponding treatment. At present, the molecular and signal pathway that interacts with osteoclasts in the pathogenesis of PSA has not been fully elucidated, therefore more detailed studies are expected in the near future.
Evaluation of the algorithm of Anticlot Assistant: an anticoagulant management system based on mobile health technology
Authors: Liu Xiulun , Xie Guihua , Li Yetao , Xiang Daokang , Zhang Yongchun , Chen Xinbu , Long Juan
Published: January 2021

The purpose is to evaluate the algorithm of Anticlot Assistant, a novel anticoagulant management system based on mobile health technology which was developed to facilitate patient self-management. The eligible patients managed warfarin therapy with usual care, following the prescriptions of the doctors. The actual prescriptions of doctors and the virtual recommendations by Anticlot Assistant were compared and analyzed. There were no significant differences between the next test dates recommended by Anticlot Assistant and those prescribed by doctors. The mean warfarin dosage prescribed by doctors was lower than that recommended by Anticlot Assistant (2.74 ± 1.17 vs. 2.79 ± 1.21 mg, 95% confidence interval for the difference: −0.01–−0.09, P = 0.019, n = 139), resulting in the international normalized ratio a high time below the therapeutic range (TTR) (29.9 ± 17.9%), and a low time above TTR [0.0% (0.0–18.7%)]. A mixed linear model revealed that ’the variations of the dosages prescribed by doctors from those recommended by Anticlot Assistant’ were positively correlated with ’variations of next international normalized ratios from TTR’ after controlling for other factors (estimate of the effect = 0.231, 95% confidence interval: 0.034–0.428, P = 0.022). Anticlot Assistant can mimic the doctors’ prescriptions for the next test date and the warfarin dosages recommended by Anticlot Assistant might be more reasonable than those prescribed by doctors, which indicated that the algorithm was reliable and it was possible for the patients to manage warfarin therapy themselves with the aid of Anticlot Assistant.
Lidocaine effects on coagulation assessed by whole blood rotational thromboelastometry
Authors: Scarlatescu Ecaterina , Marchenko Sergey P. , Tomescu Dana R.
Published: January 2021

Lidocaine may be beneficial when added in solutions for the preservation of vascular grafts or solid organs as it has anti-inflammatory, endothelial protective, and antithrombotic effects. However, the mechanisms of lidocaine-induced changes in hemostasis were not elucidated until now. The aim of the study was to examine the effect of increasing concentrations of lidocaine on coagulation parameters and blood-clotting kinetics using velocity curves of clot formation assessed by rotational thromboelastometry. Ex-vivo blood coagulation using whole blood from healthy volunteers was studied with rotational thromboelastometry. For each volunteer, four assays were performed: saline control and samples with lidocaine end blood concentrations of 0.3, 0.6, and 0.9%. In this in-vitro study, whole blood from 15 healthy volunteers was used. Lidocaine concentration of 0.3% prolonged the initiation phase of clotting without significant differences in the propagation phase or clot stability and inhibited clot lysis compared with the control group. Higher lidocaine concentrations (0.6 and 0.9%) resulted in prolongation of both initiation and propagation phases and decreased clot firmness compared with the control group. Lysis was significantly increased only in the 0.6% lidocaine group compared with control. Although lidocaine concentration of 0.3% only delays coagulation initiation, the 0.6% concentration inhibits all phases of hemostasis and increases clot lysis compared with control. Higher lidocaine concentration results in very weak clot formation with very low lysis visible on thromboelastometry. More research is needed to explain the effects of lidocaine on clotting kinetics.
Vascular activation is a strong predictor of mortality in coronavirus disease 2019 patients on the ICU
Authors: De Jongh Raf , Ninivaggi Marisa , Mesotten Dieter , Bai Cui , Marcus Berend , Huskens Dana , Stragier Hendrik , Miszta Adam , Verbruggen Jasmine , de Laat-Kremers Romy M.W. , Grieten Jef , de Laat Bas
Published: January 2021

Respiratory failure in coronavirus disease 2019 (COVID-19) patients is one of the most frequent causes for referral to the ICU. A significant percentage of these patients does not survive the infection due to thromboembolic complications. Furthermore, the vascular system seems also to be involved in the pathogenesis. To investigate the role of hemostasis and endothelium on the outcome of COVID-19 patients admitted to the ICU. Blood was drawn from 16 ICU COVID-19 patients for hemostatic analysis. Patients were followed-up till discharge (n = 11) or death (n = 5). Parameters related to both coagulation and fibrinolysis, though disturbed, were not associated with mortality. Contrarily, activated Von Willebrand factor was increased and ADAMTS13 levels were decreased by two-fold in nonsurvivors compared with survivors. Our data established the involvement of the Von Willebrand factor-ADAMTS13 axis in the COVID-19 pathogenesis, thereby demonstrating that these plasma proteins seem to be strong predictors for ICU mortality.
Comparison of safety and efficiency of corneal topography-guided photorefractive keratectomy and combined with crosslinking in myopic correction
Authors: Li Li , Zhang Bo , Hu Yijun , Xiong Lu , Wang Zheng
Published: January 2021

To compare the safety and efficiency of simple corneal topography-guided (T-CAT) photorefractive keratectomy (PRK) and T-CAT PRK combined with crosslinking (CXL) to correct myopia with borderline suspicious tomography.

Eyes with suspicious tomography (not classified as forme fruste keratoconus) underwent PRK combined with CXL. The suspicious tomography showed irregular posterior corneal morphology or maximum elevation value of the central 6 mm zone of the posterior surface (MEL) >15 μm, or Belin/Ambrósio Enhanced Ectasia Index (BAD-D) was >1.6. The PRK group was generated and matched within 2 μm for MEL, 0.3 for BAD-D value, and 0.5 D for manifest refractive spherical equivalent (MRSE) compared with the PRK-CXL group.

PRK-CXL exhibited a larger MRSE (0.09 ± 0.22 D vs −0.03 ± 0.24 D, P = .02) and a larger sphere (0.14 ± 0.22 D vs 0.01 ± 0.21 D, P = .002) compared with PRK alone at 18 months postoperatively. The magnitude change and relative change rate of stiffness parameter A1 in the PRK-CXL were smaller than in the PRK group (−15.72 ± 14.56 vs −19.95 ± 14.37, P = .04, for magnitude change and −0.16 ± 0.15 vs −0.20 ± 0.14, P = .02, for relative change rate). In the PRK-CXL and PRK groups, 4.8% and 6.9% of eyes suffered grade 0.5 haze at postoperative 18-month. No cases of ectasia were reported in either group.

PRK in combination with prophylactic crosslinking showed comparable safety and efficacy, but higher biomechanical stability compared to PRK alone, thus, the additional CXL plays a measurable role in reducing the change in corneal biomechanical properties after PRK in suspicious eyes.
Effect of a serum lactate monitoring recommendation policy on patients treated with linezolid
Authors: Im Jae Hyoung , Lee Jin-Soo , Chung Moon-Hyun , Kwon Hea Yoon , Lee Man-Jong , Baek Ji Hyeon
Published: January 2021

Lactic acidosis is one of the most fatal adverse effects of linezolid, an antibiotic used to treat serious infections caused by antibiotic-resistant bacteria. However, the measures to prevent lactic acidosis have not been well established.

We performed a retrospective study to analyze the impact of applying a serum lactate monitoring recommendation policy in patients treated with linezolid.

Since September 2011, we have recommended inpatient monitoring of serum lactate levels in patients treated with linezolid at our hospital. Patients were divided into two groups according to whether they were seen during the non-recommendation or recommendation periods. The frequency of serum lactate monitoring, linezolid-induced lactatemia, lactic acidosis, critical illness, and death were compared between the two periods.

After September 2011, adherence to the recommendation to monitor serum lactate increased from 6.1% to 60.1%. No difference was observed in the incidence of linezolid-induced lactatemia and lactic acidosis between the two periods. However, there was a significant difference in the incidence of linezolid-induced critical illness between the non-recommendation and recommendation periods (3 vs 0 cases, P = .044).

In patients treated with linezolid, serum lactate monitoring led to early detection of lactatemia, thus enabling rapid rescue. We recommend regular monitoring of serum lactate in all patients treated with linezolid.
Effects of aerobic exercise, traditional Chinese exercises, and meditation on depressive symptoms of college student
Authors: Song Jian , Liu Zhi-zhen , Huang Jia , Wu Jing-song , Tao Jing
Published: January 2021

Background:

Non-pharmacological intervention methods such as rehabilitation training or psychological treatment are mostly used in the treatment of depression owing to the limitation of adverse reactions such as drug treatment. However, the best non-pharmacological treatment strategy for depression in college students is unclear. Therefore, it is significant to discover non-drug intervention methods that can improve the depression symptoms of college students.

Method:

Electronic databases as of Sep 15, 2019, were searched, and reference lists and pharmaceutical dossiers were reviewed to detect published and unpublished studies from the date of their inception to Sep 15, 2019. With document quality evaluations and data extraction, Meta-Analysis was performed using a random effect model to evaluate the intervention effect of the aerobic exercise, traditional Chinese exercises, and meditation.

Results:

A total of 44 original studies were included. The random effect model was used to combine the effect values with Standard Mean Difference (SMD), and the results were: aerobic exercise [SMD = –0.53, 95% CI (–0.77, –0.30), I2 = 80%, P < .001], traditional Chinese exercises [SMD = –0.42, 95% CI (–0.74, –0.10), I2 = 90%, P = .01], meditation [SMD = –0.51, 95% CI (–0.90, –0.12), I2 = 79%, P = .01]. There was greater heterogeneity among the included studies: aerobic exercise (I2 = 80%, P < .001), traditional Chinese medicine methods (I2 = 90%, P < .001), and meditation (I2 = 79%, P < .001).

Conclusions:

This study revealed that the depression symptoms of college students can be effectively improved by aerobic exercise, traditional Chinese exercises, and meditation. Aerobic exercise would have a better effect on anxiety and stress while traditional Chinese exercise would have a better effect on stress. Further research (such as high-quality randomized controlled trials and long-term follow-up) is required to evaluate the effects of aerobic exercise, traditional Chinese exercise, and meditation on the depressive symptoms of college students to further apply complementary and alternative therapies.

Ethics and dissemination:

The results of the effects of aerobic exercise, traditional Chinese exercises, and meditation on depressive symptoms for a college student will be reported in a peer-reviewed publication. Hopefully, our findings from this meta-analysis can provide the most up-to-date evidence for the contribution to preventing the occurrence of depressive symptoms in college students.
Paraneoplastic pemphigus associated with small lymphocytic lymphoma
Authors: Wang Dafen , Chen Zhilu
Published: January 2021

Introduction:

Paraneoplastic pemphigus (PNP) is a life-threatening autoimmune blistering disease associated with underlying neoplasms. Currently, this disease is very difficult to treat.

Patient concerns:

We reported a rare case of paraneoplastic pemphigus associated with small lymphocytic lymphoma responsive to desmoglein 3 (Dsg3) and bullous pemphigoid (BP) antigen 180.

Diagnoses:

The initial diagnosis was hypothesized to be Stevens-Johnson syndrome based on the severe mucosal erosion and polymorphous skin lesions. However, the histopathological examination of the skin biopsy and immunology revealed PNP.

Interventions:

Anti-tumor therapy, immunosuppression and anti-infective therapy were administered.

Outcomes:

After a series of treatments, the skin lesions had been alleviated remarkably. Enzyme-linked immunoassays indices for Dsg3 and bullous pemphigoid antigen 180 decreased (Dsg3, 32; bullous pemphigoid antigen 180, 70.44). Unfortunately, 2 months later, the patient suffered respiratory failure due to the lung impairment of small lymphocytic lymphoma and infection. Eventually, the patient chose to be discharged from the hospital and lost the opportunity for follow-up treatment as he could not afford the expensive treatment costs.

Lessons:

It is highly susceptible to misdiagnosis due to polymorphous skin lesions. In this case, it was also initially misdiagnosed as Stevens-Johnson syndrome. Therefore, we should pay great attention to differential diagnosis. When refractory stomatitis and mucosal erosions occur, the possibility of PNP should be considered first. At the same time, pathology, immunology and other related tests as well as the examination of primary tumors should be carried out as soon as possible.
Examined lymph node count is not associated with prognosis in elderly patients with pN0 thoracic esophageal cancer
Authors: Zhang Guoqing , Guo Xiaofeng , Yuan Lulu , Gao Zhen , Li Jindong , Li Xiangnan
Published: January 2021

The purpose of this study was to determine whether the number of lymph nodes dissected predicts prognosis in surgically treated elderly patients with pN0 thoracic esophageal cancer. We searched the Surveillance, Epidemiology, and End Results database and identified the records of younger (<75 years) and older (≥75 years) patients with pN0 thoracic esophageal cancer between 1998 and 2015. The patient characteristics, tumor data, and postoperative variables were analyzed in this study. The Kaplan-Meier method and a Cox proportional hazard model were used to compare overall and cause-specific survival. Data from 1,792 esophageal cancer patients (older: n = 295; younger: n = 1497) were included. The survival analysis showed that the overall and cause-specific survival in the patients with ≥15 examined lymph nodes (eLNs) was significantly superior to that in the patients with 1 to 14 eLNs (P < .001); however, the difference disappeared in the older patients. After stratification by the tumor location, histology, pT classification, and differentiation between the younger and older cohorts to analyze the association between eLNs and survival, we found that the differences remained significant in most subgroups in the younger cohort. There were no differences in any subgroups of older patients. This study replicated the previously identified finding that long-term survival in patients with extensive lymphadenectomy was significantly superior to that in patients with less extensive lymphadenectomy. However, less extensive lymphadenectomy may be an acceptable treatment modality for elderly patients with pN0 thoracic esophageal cancer.
Double antithrombotic therapy for prevention of bleeding and ischemic events after percutaneous coronary intervention in patients with atrial fibrillation
Authors: Qiu Mei , Liu Shu-Yan , Zhou Hai-Rong
Published: January 2021

Background:

The efficacy of double antithrombotic therapy (DAT) vs. triple antithrombotic therapy (TAT) for prevention of bleeding and ischemic events in patients with atrial fibrillation following percutaneous coronary intervention (PCI) is unclear in those subgroups defined by the 5 factors (i.e., sex, age, race, history of diabetes, and type of P2Y12 inhibitor). We aimed to assess the efficacy of DAT vs TAT in these patient subgroups.

Methods:

We searched PubMed and relevant websites to include related randomized controlled trials (RCTs). Two endpoints of interest were clinically significant bleeding and major adverse cardiac events (MACE). Meta-analysis was performed stratified by 5 factors of interest (i.e., sex, age, race, history of diabetes, and type of P2Y12 inhibitor) to obtain pooled hazard ratio (HR) and 95% confidence interval (CI). Meta-regression analysis was conducted to evaluate subgroup effects. We detected publication bias by Egger test and funnel plots.

Results:

We included 4 RCTs for meta-analysis. DAT vs TAT significantly reduced the risk of clinically significant bleeding (HR 0.56, 95% CI 0.50–0.63). This effect of DAT was observed in most subgroups of interest (HR ranged from 0.54 to 0.69), and was consistent across various subgroups defined by each of the 5 factors of interest (Psubgroup ranged from 0.290 to 0.794). DAT vs TAT led to the similar risk of MACE (HR 0.98, 95% CI 0.89–1.08). This effect of DAT was observed in all subgroups of interest (all 95% CIs of HRs were across 1.0), and was consistent across various subgroups defined by each of the 5 factors of interest (Psubgroup ranged from 0.308 to 0.828). Publication bias was found only in one subgroup.

Conclusions:

Compared with TAT, DAT significantly reduces the risk of clinically significant bleeding and leads to the similar risk of MACE in patients with atrial fibrillation following PCI, irrespective of sex, age, race, history of diabetes, and type of P2Y12 inhibitor used at baseline.
Interpersonal Violence Throughout the Lifespan
Authors: Holliday Ryan , Forster Jeri E. , Schneider Alexandra L. , Miller Christin , Monteith Lindsey L.
Published: January 2021

Background:

Female veterans experience interpersonal violence (ie, physical and sexual violence) more often than male veterans and nonveteran females. There is limited knowledge of types of interpersonal violence across the lifespan in relation to suicidal ideation and suicide attempt. Prior research has also focused on those accessing the Veterans Health Administration (VHA) care.

Objective:

This study examined if physical and sexual violence at differing time points (ie, premilitary, during military service) were associated with suicidal ideation and a suicide attempt at subsequent time points. We anticipated that violence would be associated with an increased risk of suicidal ideation and attempt; however, given limited prior research, we were uncertain which types of violence and time points would be associated with risk.

Research Design:

Data from a cross-sectional national survey.

Subjects:

A total of 407 female veterans using, formerly using, or who never used VHA care.

Measures:

Suicidal ideation, suicide attempt, physical violence, and sexual violence were assessed.

Results:

Premilitary sexual, but not physical, violence was associated with military suicidal ideation. Both premilitary and military sexual and physical violence were associated with postmilitary suicidal ideation. Premilitary and military sexual, but not physical, violence were associated with a postmilitary suicide attempt. These results were maintained after accounting for VHA use. A significant model for military suicide attempt was not generated.

Conclusions:

Assessment of premilitary and military sexual violence among female veterans is warranted within the context of suicide risk assessment and prevention. Preventing sexual violence among female veterans may be important for preventing suicidal ideation and attempt.
Ultrasound Imaging and Guidance in Common Wrist/Hand Pathologies
Authors: Mezian Kamal , Ricci Vincenzo , Jačisko Jakub , Sobotová Karolína , Angerová Yvona , Naňka Ondřej , Özçakar Levent
Published: January 2021

Wrist/hand pain is a prevalent musculoskeletal condition with a great spectrum of etiologies (varying from overuse injuries to soft tissue tumors). Although most of the anatomical structures are quite superficial and easily evaluated during physical examination, for several reasons, the use of ultrasound imaging and guidance has gained an intriguing and paramount concern in the prompt management of relevant patients. In this aspect, the present review aims to illustrate detailed cadaveric wrist/hand anatomy to shed light into better understanding the corresponding ultrasonographic examinations/interventions in carpal tunnel syndrome, trigger finger, de Quervain tenosynovitis, rhizarthrosis, and the radiocarpal joint arthritis. In addition, evidence from the literature supporting the rationale why ultrasound guidance is henceforth unconditional in musculoskeletal practice is also exemplified.
Secondary Care of Cleft Lip and Palate: Analysis of Dentofacial Orthopedic and Orthognathic Treatments
Authors: Ferri Joël , Schlund Matthias , Nicot Romain , Lauwers Ludovic , Nazat Dominique , Touzet-Roumazeille Sandrine
Published: January 2021

Introduction:

Orthodontic and orthognathic management of cleft lip and/or palate (CLP) is a highly controversial subject. We present herein a retrospective study of 214 secondary cases followed over 22 years in order to assess the factors of successful management.

Material and methods:

The study focuses on the results of gingivoperiosteoplasty, and occlusal stability. Nine subgroups were identified, taking into account the age of the patients, the history of surgery on the alveolar region, and the presence or absence of skeletal discrepancy.

Results:

Results clearly demonstrate a higher rate of poor outcomes and failures in the multioperated population. The success rate of the graft is 80.82% in the multioperated population versus 100% non-multioperated population. Periodontitis problem or orthodontic difficulties affect 19.17% of the patient in the multioperated groups versus 12% in the other groups. Relapse, particularly the transversal dimension, is also found mostly in the multi-operated population: 17.8% versus 6% in the non-multioperated population.

Discussion:

Several factors are involved in the success of orthodontics, dentofacial orthopedics, and orthognathic surgery of CLP patients. Our study shows that previous surgeries, especially when they are multiple with repeated failures, jeopardize the chances of success of secondary treatments. This is explained by the secondary fibrosis of the tissues around the cleft. Finally, major palatal surgeries performed early, have adverse effects on maxillary growth. Many other factors play an important role in the stability of the success that are linked with orofacial functions. These data must be taken into account in the treatment of CLP patients.