bluuebunny/crossref_metadata_2025 huggingface dataset:
The signature of granulation in a solar power spectrum as seen with co5bold
Authors: Lundkvist Mia S , Ludwig Hans-Günter , Collet Remo , Straus Thomas
Published: November 2020

The granulation background seen in the power spectrum of a solar-like oscillator poses a serious challenge for extracting precise and detailed information about the stellar oscillations. Using a 3D hydrodynamical simulation of the Sun computed with co5bold, we investigate various background models to infer, using a Bayesian methodology, which one provides the best fit to the background in the simulated power spectrum. We find that the best fit is provided by an expression including the overall power level and two characteristic frequencies, one with an exponent of two and one with a free exponent taking on a value around six. We assess the impact of the 3D hydro-code on this result by repeating the analysis with a simulation from S tagger and find that the main conclusion is unchanged. However, the details of the resulting best fits differ slightly between the two codes, but we explain this difference by studying the effect of the spatial resolution and the duration of the simulation on the fit. Additionally, we look into the impact of adding white noise to the simulated time series as a simple way to mimic a real star. We find that, as long as the noise level is not too low, the results are consistent with the no-noise case.
Discovery of thermonuclear Type-I X-ray bursts from the X-ray binary MAXI J1807+132
Authors: Albayati A C , Altamirano D , Jaisawal G K , Bult P , Rapisarda S , Mancuso G C , Güver T , Arzoumanian Z , Chakrabarty D , Chenevez J , Court J M C , Gendreau K C , Guillot S , Keek L , Malacaria C , Strohmayer T E
Published: November 2020

MAXI J1807+132 is a low-mass X-ray binary (LMXB) first detected in outburst in 2017. Observations during the 2017 outburst did not allow for an unambiguous identification of the nature of the compact object. MAXI J1807+132 that was detected in outburst again in 2019 and was monitored regularly with Neutron Star Interior Composition Explorer(NICER). In this paper, we report on 5 days of observations during which we detected three thermonuclear (Type-I) X-ray bursts, identifying the system as a neutron star LMXB. Time-resolved spectroscopy of the three Type-I bursts revealed typical characteristics expected for these phenomena. All three Type-I bursts show slow rises and long decays, indicative of mixed H/He fuel. We find no strong evidence that any of the Type-I bursts reached the Eddington Luminosity; however, under the assumption that the brightest X-ray burst underwent photospheric radius expansion, we estimate a <12.4 kpc upper limit for the distance. We searched for burst oscillations during the Type-I bursts from MAXI J1807+132 and found none (<10 per cent amplitude upper limit at 95 per cent confidence level). Finally, we found that the brightest Type-I burst shows a ∼1.6 s pause during the rise. This pause is similar to one recently found with NICER in a bright Type-I burst from the accreting millisecond X-ray pulsar SAX J1808.4–3658. The fact that Type-I bursts from both sources can show this type of pause suggests that the origin of the pauses is independent of the composition of the burning fuel, the peak luminosity of the Type-I bursts, or whether the NS is an X-ray pulsar.
MobiDB: intrinsically disordered proteins in 2021
Authors: Piovesan Damiano , Necci Marco , Escobedo Nahuel , Monzon Alexander Miguel , Hatos András , Mičetić Ivan , Quaglia Federica , Paladin Lisanna , Ramasamy Pathmanaban , Dosztányi Zsuzsanna , Vranken Wim F , Davey Norman E , Parisi Gustavo , Fuxreiter Monika , Tosatto Silvio C E
Published: November 2020

The MobiDB database (URL: https://mobidb.org/) provides predictions and annotations for intrinsically disordered proteins. Here, we report recent developments implemented in MobiDB version 4, regarding the database format, with novel types of annotations and an improved update process. The new website includes a re-designed user interface, a more effective search engine and advanced API for programmatic access. The new database schema gives more flexibility for the users, as well as simplifying the maintenance and updates. In addition, the new entry page provides more visualisation tools including customizable feature viewer and graphs of the residue contact maps. MobiDB v4 annotates the binding modes of disordered proteins, whether they undergo disorder-to-order transitions or remain disordered in the bound state. In addition, disordered regions undergoing liquid-liquid phase separation or post-translational modifications are defined. The integrated information is presented in a simplified interface, which enables faster searches and allows large customized datasets to be downloaded in TSV, Fasta or JSON formats. An alternative advanced interface allows users to drill deeper into features of interest. A new statistics page provides information at database and proteome levels. The new MobiDB version presents state-of-the-art knowledge on disordered proteins and improves data accessibility for both computational and experimental users.
Changes of air quality during the pandemic and airborne transmission issues
Authors: Zhao Weijie
Published: November 2020

The COVID-19 pandemic has killed more than 1 000 000 people within nine months in 2020. The world is changed as the cities were locked down, the traffic reduced, and people forced to work from home and keep social distance. These controlling measures also resulted in drastic reduction of the emission of many air pollutants, providing researchers an unprecedented large-scale natural experiment in examining how the air quality would respond to a strong forcing. In this panel discussion held on 22 September 2020, five experts gathered to discuss their observations and analyses, as well as the current understanding and misconception about airborne transmission.

This Forum article is dedicated to Prof. Martin Williams of the Imperial College London, who intended to join the panel discussion but passed away one day before it.

Guy Brasseur

Professor of Max Planck Institute for Meteorology, Germany

Junji Cao

Professor of Institute of Earth Environment, Chinese Academy of Sciences, China

Aijun Ding

Dean and Professor of School of Atmospheric Sciences, Nanjing University, China

Lidia Morawska

Professor of Queensland University of Technology, Australia

Tong Zhu (Chair)

Dean and Professor of College of Environmental Sciences and Engineering, Peking University, China
Adherence to Direct-Acting Antiviral Therapy in People Actively Using Drugs and Alcohol: The INCLUD Study
Authors: Brooks Kristina M , Castillo-Mancilla Jose R , Morrow Mary , MaWhinney Samantha , Rowan Sarah E , Wyles David , Blum Joshua , Huntley Ryan , Salah Lana M , Tehrani Arya , Bushman Lane R , Anderson Peter L , Kiser Jennifer J
Published: November 2020

Background

Hepatitis C virus treatment in persons who use drugs (PWUD) is often withheld due to adherence and reinfection concerns. In this study, we report treatment outcomes, technology-based adherence data, and adherence predictors in PWUD and/or alcohol.

Methods

INCLUD was a prospective, open-label study of ledipasvir/sofosbuvir for 12 weeks in PWUD aged 18–70 years. Participants were randomized to wireless (wirelessly observed therapy) or video-based directly observed therapy (vDOT). Drug use was assessed every 2 weeks. Sustained virologic response (SVR) was examined by intention-to-treat and as-treated. Factors associated with missing ≥1 dose(s) between visits were examined using generalized linear models.

Results

Sixty participants received ≥1 ledipasvir/sofosbuvir dose (47 human immunodeficiency virus [HIV]/hepatitis C virus [HCV], 13 HCV only; 78% male; 22% black; 25% cirrhotic). Substance use occurred at 94% of person-visits: 60% marijuana, 56% alcohol, 37% methamphetamine, 22% opioids, 17% cocaine, and 20% injection drug use. The SVR by intention-to-treat was 86.7% (52 of 60) and as-treated was 94.5% (52 of 55). Confirmed failures included 1 relapse, 1 reinfection, and 1 unknown (suspected reinfection). Median total adherence was 96% (interquartile range [IQR], 85%–100%; range, 30%–101%), and between-visit adherence was 100% (IQR, 86%–100%; range, 0%–107%). The odds of missing ≥1 dose between visits increased with HIV coinfection (2.94; 95% confidence interval [CI], 1.37–6.32; P = .006), black race (4.09; 95% CI, 1.42–11.74; P = .009), methamphetamine use (2.51; 95% CI, 1.44–4.37; P = .0.001), and cocaine use (2.12; 95% CI, 1.08–4.18; P = .03) and decreased with marijuana use (0.34; 95% CI, 0.17–0.70; P = .003) and vDOT (0.43; 95% CI, 0.21–0.87; P = .02).

Conclusions

Persons who use drugs achieved high SVR rates with high, but variable, ledipasvir/sofosbuvir adherence using technology-based methods. These findings support efforts to expand HCV treatment in PWUD.
Postdural Puncture Headache Related to Procedure: Incidence and Risk Factors After Neuraxial Anesthesia and Spinal Procedures
Authors: Kim Jung Eun , Kim Sung Hoon , Han Richard Jin Woo , Kang Min Hey , Kim Jae Hun
Published: November 2020

Objective

Postdural puncture headache (PDPH) is a potential complication of certain neuraxial anesthesia and spinal procedures, and some risk factors for PDPH have been identified. However, there have been no detailed analyses of rates and risk factors of PDPH after various spinal and neuraxial anesthesia procedures.

Methods

Patient data from January 1, 2015, to December 31, 2017, were retrospectively analyzed. The patients underwent dural puncture procedures (spinal anesthesia, lumbar puncture [spinal tap], lumbar cerebrospinal fluid [CSF] drainage) or nondural puncture procedures (transforaminal epidural injection, interlaminar epidural injection, epidural catheterization with patient-controlled analgesia for delivery). PDPH incidence and risk factors were evaluated.

Results

For dural puncture procedures, PDPH incidence was 2.96%, and risk factors were younger age, female sex, and lumbar puncture. Larger needle gauge was a risk factor according to Student t-test but not during logistic regression analysis. PDPH incidence was higher after lumbar puncture using a 22 G Tuohy needle (4.63%) than after lumbar CSF drainage using an 18 G Tuohy needle (3.05%). For nondural puncture procedures, PDPH incidence was 0.53% and did not differ between procedure types; no risk factors were identified.

Conclusions

PDPH incidence and risk factors depended on the type of neuraxial anesthesia and spinal procedures. PDPH incidence after lumbar puncture using a 22 G Tuohy needle was higher than that after lumbar CSF drainage using an 18 G Tuohy needle, suggesting that catheter insertion may reduce PDPH risk. In non-dural puncture procedures, PDPH risk did not differ according to type of procedure, and no risk factors were found.
AAAPT: Assessment of the Acute Pain Trajectory
Authors: Bayman Emine O , Oleson Jacob J , Rabbitts Jennifer A
Published: November 2020

Objective

Define and contrast acute pain trajectories vs. the aggregate pain measurements, summarize appropriate linear and nonlinear statistical analyses for pain trajectories at the patient level, and present methods to classify individual pain trajectories. Clinical applications of acute pain trajectories are also discussed.

Setting

In 2016, an expert panel involving the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION), American Pain Society (APS), and American Academy of Pain Medicine (AAPM) established an initiative to create a pain taxonomy, named the ACTTION-APS-AAPM Pain Taxonomy (AAAPT), for the multidimensional classification of acute pain. The AAAPT panel commissioned the present report to provide further details on analysis of the individual acute pain trajectory as an important component of comprehensive pain assessment.

Methods

Linear mixed models and nonlinear models (e.g., regression splines and polynomial models) can be applied to analyze the acute pain trajectory. Alternatively, methods for classifying individual pain trajectories (e.g., using the 50% confidence interval of the random slope approach or using latent class analyses) can be applied in the clinical context to identify different trajectories of resolving pain (e.g., rapid reduction or slow reduction) or persisting pain. Each approach has advantages and disadvantages that may guide selection. Assessment of the acute pain trajectory may guide treatment and tailoring to anticipated symptom recovery. The acute pain trajectory can also serve as a treatment outcome measure, informing further management.

Conclusions

Application of trajectory approaches to acute pain assessments enables more comprehensive measurement of acute pain, which forms the cornerstone of accurate classification and treatment of pain.
3G Internet and Confidence in Government
Authors: Guriev Sergei , Melnikov Nikita , Zhuravskaya Ekaterina
Published: November 2020

How does mobile broadband internet affect approval of government? Using Gallup World Poll surveys of 840,537 individuals from 2,232 subnational regions in 116 countries from 2008 to 2017 and the global expansion of 3G mobile networks, we show that on average, an increase in mobile broadband internet access reduces government approval. This effect is present only when the internet is not censored, and it is stronger when the traditional media are censored. 3G helps expose actual corruption in government: revelations of the Panama Papers and other corruption incidents translate into higher perceptions of corruption in regions covered by 3G networks. Voter disillusionment had electoral implications. In Europe, 3G expansion led to lower vote shares for incumbent parties and higher vote shares for the antiestablishment populist opposition. Vote shares for nonpopulist opposition parties were unaffected by 3G expansion.
JAK1 selective inhibitors for the treatment of spondyloarthropathies
Authors: White Jonathan P E , Coates Laura C
Published: November 2020

As our understanding of the pathogenesis of SpA improves, focus has turned to the role janus kinase (JAK)-mediated signal transduction and inhibiting its actions as a therapeutic mechanism. Small molecule inhibitors of JAK exist, with variable selectivity for the different JAK isoforms. Less selective JAK inhibitors have variable efficacy and safety profiles, prompting the investigation of selective JAK1 inhibition. In this review, we summarize the current phase 2 and 3 clinical trial data, evaluating the use of JAK1 selective inhibitors in the treatment of SpA, particularly AS and PsA. Selective JAK1 inhibition offers a promising therapeutic approach, however further longer-term trials are needed to fully establish their efficacy and safety at higher doses, and their use in the greater continuum of SpA.
Neural indicators of food cue reactivity, regulation, and valuation and their associations with body composition and daily eating behavior
Authors: Cosme Danielle , Lopez Richard B
Published: November 2020

Exposure to food cues activates the brain’s reward system and undermines efforts to regulate impulses to eat. During explicit regulation, lateral prefrontal cortex activates and modulates the activity in reward regions and decreases food cravings. However, the extent to which between-person differences in the recruitment of regions associated with reward processing, subjective valuation and regulation during food cue exposure—absent instructions to regulate—predict body composition and daily eating behaviors is unclear. In this preregistered study, we pooled data from five functional magnetic resonance imaging (fMRI) samples (N = 262) to examine whether regions associated with reward, valuation and regulation, as well as whole-brain pattern expression indexing these processes, were recruited during food cue exposure and associated with body composition and real-world eating behavior. Regression models for a single a priori analytic path indicated that univariate and multivariate measures of reward and valuation were associated with individual differences in body mass index and the enactment of daily food cravings. Specification curve analyses further revealed reliable associations between univariate and multivariate neural indicators of reactivity, regulation and valuation and all outcomes. These findings highlight the utility of these methods to elucidate brain–behavior associations and suggest that multiple processes are implicated in proximal and distal markers of eating behavior.
Aberrant Interoceptive Accuracy in Patients With Schizophrenia Performing a Heartbeat Counting Task
Authors: Koreki Akihiro , Funayama Michitaka , Terasawa Yuri , Onaya Mitsumoto , Mimura Masaru
Published: November 2020

Introduction

Although self-disturbances and emotional disturbances are common in schizophrenia, there is no integrated understanding to explain these symptoms. Interoception has a crucial role in the development of self and emotion, and interoceptive abnormality could lead to such symptoms.

Methods

We compared interoceptive accuracy between controls and patients with schizophrenia. Forty-two patients and 30 healthy controls were recruited and their interoceptive accuracy was assessed using a heartbeat counting task. Participants were instructed to count the number of times they felt their own heartbeat during various measurement periods. Interoceptive accuracy was calculated based on the discrepancy between the number of reported and actual heartbeats during the measurement period. Participants also performed a time estimation task and were instructed to count the number of seconds there were during the same period. Time accuracy was calculated in a similar manner to that for the heartbeat. Participants also completed a questionnaire regarding interoception to assess their subjective experiences.

Results

Interoceptive accuracy was significantly lower among patients with schizophrenia than in healthy controls (P = .017), even after controlling for age, sex, time accuracy, anxiety, depression, educational level, and heart rate (HR). In addition, patients’ positive and negative symptoms were significantly associated with their HR-adjusted interoceptive accuracy, especially hallucination. The discrepancy between HR-adjusted interoceptive accuracy and the score of the questionnaire was significantly associated with positive symptoms, especially delusion, but not negative symptoms.

Discussion

These findings suggest that patients with schizophrenia have aberrant interoception. Aberrant interoception in schizophrenia could be a novel therapeutic target in future.
A standardized model to study effects of varying 24-h colostrum dose on postnatal growth and development
Authors: Suárez-Trujillo Aridany , Senn L Kirsten , Teeple Kelsey , Casey Theresa M , Stewart Kara R
Published: November 2020

Survival, feed efficiency, growth, and fertility of swine are dependent on colostrum intake in the first 24 h after birth. This study determined the effects of three doses of a homogeneous colostrum sample on 24-h body weight, rectal temperature (RT), immunocrit, and growth and survival to postnatal day (PND) 7. Three female piglets were selected from eight litters (n = 24 piglets) at birth, removed from their litter, and bottle-fed 10% (COL10, n = 8), 15% (COL15, n = 8), or 20% (COL20, n = 8) colostrum based on birth weight over 12 bottle feedings every 2 h. At 24 h, piglets were weighed, RT recorded, and blood was collected to measure immunocrit. Piglets were returned to the litter of origin, and weight was measured daily until PND 7. Colostrum dose had an overall effect on weight gain at 24 h, RT, immunocrit, and growth to PND 7 (P < 0.05). Piglets in the 20% BrW colostrum group had greater weight gain, RT, and immunocrit at 24 h than COL10 piglets (P < 0.05), but these variables were not different between COL15 and the other treatments. Despite no difference in average daily gain after being returned to their litters, the greater weight (P < 0.05) in COL20 compared to COL10 and COL15 was sustained over 7 d. Seven piglets in each treatment survived to PND 7. This model using standardized doses of a homogeneous colostrum sample enables controlled studies aimed at understanding the role of 24-h colostrum intake on piglet development.
The Association of α Angle on Disease Severity in Adolescent Femoroacetabular Impingement
Authors: Youngman Tyler R. , Wagner K. John , Montanez Benjamin , Johnson Benjamin L. , Wilson Phillip L. , Morris William Z. , Sucato Daniel J. , Podeszwa David A. , Ellis Henry B.
Published: November 2020

Background:

Femoroacetabular Impingement (FAI) is a common cause of hip pain in adolescent patients. Clinical exam and radiographic markers, such as α angle and lateral center edge angle (LCEA), are commonly used to aid in the diagnosis of this condition. The purpose of this study was to correlate preoperative α angle and LCEA with preoperative symptoms, intraoperative findings, and preoperative and postoperative patient reported outcomes (PROs) in the adolescent patient.

Methods:

A retrospective analysis of prospectively collected data was conducted for all patients who underwent operative intervention for FAI at an academic institution over an 11-year period. Preoperative imaging was obtained and measured for LCEA and α angle. PROs (modified Harris Hip Score, Hip Disability and Osteoarthritis Outcome Score, and UCLA score) were collected preoperatively, as well as 1, 2, and 5 years postoperatively. Operative intervention was either open surgical hip dislocation or arthroscopic, and intraoperative disease was graded using the Beck Classification system. Patients with minimum 1-year follow-up were included in statistical analysis.

Results:

There were 86 hips (64 female hips) included with an average age of 16.3 years (range, 10.4 to 20.5 y), with an average of 37 months of follow-up. There was no correlation between severity of preoperative symptoms or difference between pre and postoperative PROs for both α angle and LCEA. Overall, significant improvement was noted in modified Harris Hip Score, Hip Disability and Osteoarthritis Outcome Score, and UCLA Score (P<0.001 for each). Independent of preoperative symptoms, increased α angle correlated with more severe intraoperative labral disease (P<0.001), and longer length of labral tear (Corr 0.295, P<0.01). Femoral head and acetabular articular cartilage damage did not correlate with α angle or LCEA, nor did overall severity of disease.

Conclusions:

In adolescent patients with FAI, increased α angle was found to significantly correlate with labral pathology, including increased length of tear and severity of disease, irrespective of preoperative symptoms or postoperative patient reported outcomes.

Level of Evidence:

Level III—retrospective.
Effects of Antibiotic Use on Outcomes in Cancer Patients Treated Using Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis
Authors: Yu Yang , Zheng Peng , Gao Lei , Li Haiyuan , Tao Pengxian , Wang Dengfeng , Ding Fanghui , Shi Qianling , Chen Hao
Published: November 2020

Antibiotic (ATB) use seems to negatively affect the outcomes of immune checkpoint inhibitors (ICIs). The aim of this review is to clarify whether ATB use influences the efficacy of ICI treatment in cancer patients. Databases of MEDLINE, Embase, and Cochrane Library were searched for reports published in English between January 2007 and December 2019. We included studies that compared the outcomes of ATB use and no-ATB use in cancer patients using ICIs. Two reviewers independently selected eligible studies and extracted the data. Meta-analysis was performed with pooling of unadjusted hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS), and with pooling of odds ratios (ORs) for objective response rate (ORR). Thirty-eight studies involving 8409 patients were finally included for qualitative or quantitative analyses. Cancer types included renal cell carcinoma, non–small cell lung cancer, urothelial carcinoma, melanoma, gastrointestinal cancer, and others. Meta-analyses revealed that ATB use was associated with poor OS [HR: 1.80, 95% confidence interval (CI): 1.44–2.26, P<0.001], PFS (HR: 1.55, 95% CI: 1.26–1.91, P<0.001) and ORR (OR: 0.63, 95% CI: 0.42–0.95, P=0.03). Subgroup analysis found that these relationships were not influenced by cancer type or ICI regimens, but were dependent on the timing of ATB use. Narrative results of multivariable analyses further confirmed the negative effects of ATB use on OS and PFS. In cancer patients using ICIs, pre-ATB use close to the start of ICI treatment (within 60 d) was detrimental to outcomes in terms of OS, PFS, and ORR.
Differential impact of keratinocytes and fibroblasts on nociceptor degeneration and sensitization in small fiber neuropathy
Authors: Kreß Luisa , Hofmann Lukas , Klein Thomas , Klug Katharina , Saffer Nadine , Spitzel Marlene , Bär Frederik , Sommer Claudia , Karl Franziska , Üçeyler Nurcan
Published: November 2020

Peripheral denervation and pain are hallmarks of small fiber neuropathy (SFN). We investigated the contribution of skin cells on nociceptor degeneration and sensitization. We recruited 56 patients with SFN and 31 healthy controls and collected skin punch biopsies for immunohistochemical and immunocytochemical analysis of netrin-1 (NTN1) and proinflammatory and anti-inflammatory cytokine expression patterns. We further applied coculture systems with murine dorsal root ganglion (DRG) neurons for skin cell–nerve interaction studies and patch-clamp analysis. Human keratinocytes attract murine DRG neuron neurites, and the gene expression of the axon guidance cue NTN1 is higher in keratinocytes of patients with SFN than in controls. NTN1 slows and reduces murine sensory neurite outgrowth in vitro, but does not alter keratinocyte cytokine expression. In the naive state, keratinocytes of patients with SFN show a higher expression of transforming growth factor-β1 (P < 0.05), while fibroblasts display higher expression of the algesic cytokines interleukin (IL)-6 (P < 0.01) and IL-8 (P < 0.05). IL-6 incubation of murine DRG neurons leads to an increase in action potential firing rates compared with baseline (P < 0.01). Our data provide evidence for a differential effect of keratinocytes and fibroblasts on nociceptor degeneration and sensitization in SFN compared with healthy controls and further supports the concept of cutaneous nociception.
Characteristics and perceptions of the US nurse practitioner hospitalist workforce
Authors: Kaplan Louise , Klein Tracy A.
Published: November 2020

Background:

The use of nurse practitioners (NPs) as hospitalists has grown over the last two decades. Based on current educational preparation, certification, and scope of practice, the acute care NP is considered by professional standards the best prepared to care for the needs of acutely and critically ill patients. Little is known about this sector of the NP workforce.

Purpose:

The study was designed to identify the NP hospitalist workforce's characteristics and describe the NP hospitalist workforce's perception of the work environment.

Methods:

We deployed five questions in the 2019 American Association of Nurse Practitioners National NP Sample Survey. Of 880 respondents working in an eligible inpatient setting, 366 responded that they work as hospitalists caring for adult patients.

Results:

Most respondents (n = 275, 74.7%) were certified in primary care. On-the-job training was the most common qualification to be an NP hospitalist (n = 274, 75%). The majority (n = 252, 68.9%) had a collaborative relationship with a physician at their site. Job satisfaction was significantly correlated with full utilization of one's education and practicing to the fullest extent of the state's scope of practice with an r(360) = .719, p = .00 (two-tailed).

Implications for practice:

The prevalence of on-the-job training as the most common preparation for the hospitalist role suggests a need to evaluate the effectiveness and outcomes of NPs not initially educated as acute care NPs who work as hospitalists. Nurse practitioner educators should address the evolving workforce needs of both primary and acute care practice when planning and implementing educational programs.
The millennial engagement, resiliency and retention study: What does your millennial advanced practice registered nurse workforce really want?
Authors: Harris Marianne D. , Williams Lisa M. , Duke Rebecca
Published: November 2020

Background:

Increasing the use of advanced practice nurses may be one of the most viable options to meeting the burgeoning health care demands of older Americans and impending provider shortage over the next two decades. However, keeping the millennial workforce engaged and retained continues to be a significant challenge for health care administrators.

Purpose:

The purpose of this study was to understand the intergenerational advanced practice registered nurse (APRN) workforce and assess what job satisfaction factors impact APRN intention to stay, and explore how variables such as resiliency style and age affect retention in these young careerists.

Methods:

This was a single-center, cross-sectional descriptive study using survey methodology. A total of 405 APRNs from all specialties and practice sites from a large Midwestern Academic Medical Center were eligible to participate. A total of 165 APRNs completed the survey, which was a 41% response rate.

Results:

There were no significant differences in mean resiliency scores by age cohort (p > .05) or a higher intention to leave in millennial-aged APRNs versus older APRNs (p > .05); however, there were significant mean differences in job satisfaction responses that warrant consideration in millennial versus older “baby boomer” APRNs on items such as professional growth, compensation, monetary bonuses, and expanding procedures and skills within scope of practice.

Implications for practice:

Understanding generational differences in APRN job satisfaction assists hospital leaders to develop strategies to support, engage, and retain younger careerists, which may help mitigate turnover.
Effects of heparinoid bridging in patients with mechanical heart valves
Authors: Torres Michelle
Published: November 2020

Background:

Patients with mechanical heart valves (MHVs) require long-term oral anticoagulation therapy to protect against thromboembolisms. Invasive procedures with high bleeding risks require oral anticoagulation therapy cessation. Currently, guidelines recommend the use of either subcutaneous low-molecular-weight heparin or intravenous unfractionated heparin in the perioperative period. It is unclear whether the evidence supports the use of one heparinoid over the other.

Objectives:

To compare the effectiveness of low-molecular-weight heparin and unfractionated heparin bridging based on the adverse outcomes of thromboembolisms, major bleeding, and death during the perioperative period.

Date sources:

A literature search was conducted using PubMed, EMBASE, CINAHL, and the Cochrane Library. Five studies comparing the two bridging therapies in chronically anticoagulated MHV patients met the inclusion criteria.

Conclusions:

No statistical significance was found for the endpoints of thromboembolism and death. One study found a statistically significant higher occurrence of major bleeding in patients treated with unfractionated heparin. In all the studies, major bleeding occurred more often than thromboembolisms. Findings were limited by the study designs and methodologies.

Implications for practice:

Based on the available evidence, neither low-molecular-weight heparin nor intravenous heparin bridging was found to be more effective in reducing the occurrence of adverse events. This may be due in part to the study designs and lack of standardized bridging protocols used in the studies reviewed. Nurse practitioners should remain informed about bridging protocols and weigh the risk versus benefit of each bridging agent when caring for patients with MHVs.
Military parents' perceptions of separation for their younger children
Authors: Agazio Janice , Cunningham Craig A. , Amos-Mejia Danielle
Published: November 2020

Many studies are available in the literature considering effects of deployment on older school age and adolescent children, but less is known about the effects on younger children. The purpose of this study was to describe the experience of deployment/separation for military children aged 4–10 years from both the deployed parent and stay-at-home parent's experiences. Parents completed demographics followed by an interview to describe the child's reaction to separation. Thematic analysis was used to identify children's reactions and intervention strategies. Thirty-eight families, encompassing 57 children aged 4–10 who experienced a separation or deployment within the past 2 years participated. Interviews included 24 military members and 34 spouses (most frequently the mothers) completed the interview and research instruments. Interview data revealed a turbulent experience for families resulting from frequent and repeated separations. Parents actively employed strategies garnered from military-provided materials and informal interaction with other military parents. The different perspectives provided new insights as to the strategies military families find successful during separations and will be useful in providing anticipatory guidance.
Otosclerosis in an Urban Population
Authors: Choi Jonathan S. , Sweeney Alex D. , Alava Ibrahim , Lovin Benjamin D. , Lindquist Nathan R. , Appelbaum Eric N. , Vrabec Jeffrey T.
Published: November 2020

Objective:

To investigate the evolving prevalence of otosclerosis in a large urban population.

Methods:

A retrospective review of patients in a large, urban, public health system was conducted from January 2010 to August 2019 to identify subjects with otosclerosis. Diagnostic testing included audiometry and computed tomography scans. Sex, age at diagnosis, treatment received, race, ethnicity, and country of birth were analyzed for each subject and compared with all eligible patients in the reference population.

Results:

A total of 134 patients from a reference population of 672,839 were diagnosed with otosclerosis and analyzed. The otosclerosis patients were predominantly Hispanic (73%), of which the majority were foreign born (87%). The average age at onset was 46 years and 59% were women. The overall prevalence of otosclerosis was 20 of 100,000 patients. The crude prevalence of otosclerosis by ethnicity was 43 of 100,000 for Hispanics, 12.6 of 100,000 for Caucasians, and 3 of 100,000 for African Americans. Within the Hispanic population, the prevalence of otosclerosis was 60 of 100,000 for foreign-born individuals and 16 of 100,000 for those born in the USA (odds ratio [OR] = 3.69, [95% confidence interval [CI], 2.02–6.76], p < 0.0001). Prevalence was not significantly different among Caucasians and US-born Hispanics.

Conclusion:

Otosclerosis in the studied population was most common among Hispanic patients, though it was strongly influenced by country of birth. The “imported” otosclerosis cases are best explained by environmental influence rather than ethnic susceptibility. This discrepancy is likely due to variance in measles immunization rates among North and Central American countries before 1990.
Assessing the Impact of EQ-5D Country-specific Value Sets on Cost-utility Outcomes
Authors: van Dongen Johanna M. , Jornada Ben Ângela , Finch Aureliano P. , Rossenaar Milou M.M. , Biesheuvel-Leliefeld Karolien E.M. , Apeldoorn Adrie T. , Ostelo Raymond W.J.G. , van Tulder Maurits W. , van Marwijk Harm W.J. , Bosmans Judith E.
Published: November 2020

Purpose:

To assess the impact of EQ-5D country-specific value sets on cost-utility outcomes.

Methods:

Data from 2 randomized controlled trials on low back pain (LBP) and depression were used. 3L value sets were identified from the EuroQol Web site. A nonparametric crosswalk was employed for each tariff to obtain the likely 5L values. Differences in quality-adjusted life years (QALYs) between countries were tested using paired t tests, with United Kingdom as reference. Cost-utility outcomes were estimated for both studies and both EQ-5D versions, including differences in QALYs and cost-effectiveness acceptability curves.

Results:

For the 3L, QALYs ranged between 0.650 (Taiwan) and 0.892 (United States) in the LBP study and between 0.619 (Taiwan) and 0.879 (United States) in the depression study. In both studies, most country-specific QALY estimates differed statistically significantly from that of the United Kingdom. Incremental cost-effectiveness ratios ranged between €2044/QALY (Taiwan) and €5897/QALY (Zimbabwe) in the LBP study and between €38,287/QALY (Singapore) and €96,550/QALY (Japan) in the depression study. At the NICE threshold of €23,300/QALY (≈£20,000/QALY), the intervention’s probability of being cost-effective versus control ranged between 0.751 (Zimbabwe) and 0.952 (Taiwan) and between 0.230 (Canada) and 0.396 (Singapore) in the LBP study and depression study, respectively. Similar results were found for the 5L, with extensive differences in ICERs and moderate differences in the probability of cost-effectiveness.

Conclusions:

This study indicates that the use of different EQ-5D country-specific value sets impacts on cost-utility outcomes. Therefore, to account for the fact that health state preferences are affected by sociocultural differences, relevant country-specific value sets should be used.
Idiopathic Retroperitoneal Fibrosis With Intense Uptake of 68Ga-Fibroblast Activation Protein Inhibitor and 18F-FDG
Authors: Pan Qingqing , Luo Yaping , Zhang Wen
Published: November 2020

A 26-year-old man presented with a retroperitoneal mass with left urinary tract obstruction and hydronephrosis recently. 18F-FDG PET/CT showed the retroperitoneal mass had intense and homogeneous FDG avidity. In 68Ga-FAPI PET/CT, the retroperitoneal mass showed intense radioactivity without other organ involvements. The patient was finally diagnosed with idiopathic retroperitoneal fibrosis. After treatment, the follow-up CT showed significant decrease in size of the retroperitoneal mass. The current case indicated that idiopathic retroperitoneal fibrosis had active uptake of 68Ga-FAPI.
Hypocalcemia in trauma patients: A systematic review
Authors: Vasudeva Mayank , Mathew Joseph K. , Groombridge Christopher , Tee Jin W. , Johnny Cecil S. , Maini Amit , Fitzgerald Mark C.
Published: November 2020

BACKGROUND

During hemorrhagic shock and subsequent resuscitation, pathways reliant upon calcium such as platelet function, intrinsic and extrinsic hemostasis, and cardiac contractility are disrupted. The objective of this systematic review was to examine current literature for associations between pretransfusion, admission ionized hypocalcemia, and composite outcomes including mortality, blood transfusion requirements, and coagulopathy in adult trauma patients.

METHODS

This review was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. We searched Ovid MEDLINE and grey literature from database inception till May 3, 2020. Case series and reports were excluded. Reference lists of appraised studies were also screened for articles that the aforementioned databases might not have captured. The Newcastle-Ottawa Scale was used to assess study quality.

RESULTS

A total of 585 abstracts were screened through database searching and alternative sources. Six unique full-text studies were reviewed, of which three were excluded. Admission ionized hypocalcemia was present in up to 56.2% of the population in studies included in this review. Admission ionized hypocalcemia was also associated with increased mortality in all three studies, with increased blood transfusion requirements in two studies, and with coagulopathy in one study.

CONCLUSION

Hypocalcemia is a common finding in shocked trauma patients. While an association between admission ionized hypocalcemia and mortality, blood transfusion requirements, and coagulopathy has been identified, further prospective trials are essential to corroborating this association.

LEVEL OF EVIDENCE

Systematic review, level III.
Mortality Rates in Transplant Recipients and Transplantation Candidates in a High-prevalence COVID-19 Environment
Authors: Mamode Nizam , Ahmed Zubir , Jones Gareth , Banga Neal , Motallebzadeh Reza , Tolley Hannah , Marks Steve , Stojanovic Jelena , Khurram Muhammad A. , Thuraisingham Raj , Popoola Joyce , Ghazanfar Abbas , Game David , Sran Kiran , Dor Frank J.M.F. , Lucisano Gaetano , Sinha Manish , Olsburgh Jonathon , Willicombe Michelle
Published: November 2020

Background.

The risk of COVID-19 infection in transplant recipients (TRs) is unknown. Patients on dialysis may be exposed to greater risk of infection due to an inability to isolate. Consideration of these competing risks is important before restarting suspended transplant programs. This study compared outcomes in kidney and kidney/pancreas TRs with those on the waiting list, following admission with COVID-19 in a high-prevalence region.

Methods.

Audit data from all 6 London transplant centers were amalgamated. Demographic and laboratory data were collected and outcomes included mortality, intensive care (ITU) admission, and ventilation. Adult patients who had undergone a kidney or kidney/pancreas transplant, and those active on the transplant waiting list at the start of the pandemic were included.

Results.

One hundred twenty-one TRs and 52 waiting list patients (WL) were admitted to hospital with COVID-19. Thirty-six TR died (30%), while 14 WL patients died (27% P = 0.71). There was no difference in rates of admission to ITU or ventilation. Twenty-four percent of TR required renal replacement therapy, and 12% lost their grafts. Lymphocyte nadir and D-dimer peak showed no difference in those who did and did not die. No other comorbidities or demographic factors were associated with mortality, except for age (odds ratio of 4.3 [95% CI 1.8-10.2] for mortality if aged over 60 y) in TR.

Conclusions.

TRs and waiting list patients have similar mortality rates after hospital admission with COVID-19. Mortality was higher in older TRs. These data should inform decisions about transplantation in the COVID era.
RNA silencing machinery contributes to inability of BSBV to establish infection in Nicotiana benthamiana: evidence from characterization of agroinfectious clones of Beet soil-borne virus
Authors: Mahillon Mathieu , Decroës Alain , Peduzzi Chloé , Romay Gustavo , Legrève Anne , Bragard Claude
Published: November 2020

Beet soil-borne virus (BSBV) is a sugar beet pomovirus frequently associated with Beet necrotic yellow veins virus, the causal agent of the rhizomania disease. BSBV has been detected in most of the major beet-growing regions worldwide, yet its impact on this crop remains unclear. With the aim to understand the life cycle of this virus and clarify its putative pathogenicity, agroinfectious clones have been engineered for each segment of its tripartite genome. The biological properties of these clones were then studied on different plant species. Local infection was obtained on agroinfiltrated leaves of Beta macrocarpa. On leaves of Nicotiana benthamiana, similar results were obtained, but only when heterologous viral suppressors of RNA silencing were co-expressed or in a transgenic line down regulated for both dicer-like protein 2 and 4. On sugar beet, local infection following agroinoculation was obtained on cotyledons, but not on other tested plant parts. Nevertheless, leaf symptoms were observed on this host via sap inoculation. Likewise, roots were efficiently mechanically infected, highlighting low frequency of root necrosis and constriction, and enabling the demonstration of transmission by the vector Polymyxa betae. Altogether, the entire viral cycle was reproduced, validating the constructed agroclones as efficient inoculation tools, paving the way for further studies on BSBV and its related pathosystem.
Temporal Associations between Community Incidence of COVID-19 and Nursing Home Outbreaks in Ontario, Canada
Authors: Malikov Kamil , Huang Qing , Shi Shengli , Stall Nathan M. , Tuite Ashleigh R. , Hillmer Michael P.
Published: November 2020

The risk of nursing home COVID-19 outbreaks is strongly associated with the rate of infection in the communities surrounding homes, yet the temporal relationship between rising rates of community COVID-19 infection and the risk threshold for subsequent nursing home COVID-19 outbreaks is not well defined. This population-based cohort study included all COVID-19 cases in Canada’s most populous Province of Ontario between March 1-July 16, 2020. We evaluated the temporal relationship between trends in the number of active community COVID-19 cases and the number of nursing home outbreaks. We found that the average lag time between community cases and nursing home outbreaks was 23 days for Ontario overall, with substantial variability across geographic regions. We also determined thresholds of community incidence of COVID-19 associated with a 75% probability of observing a nursing home outbreak 5, 10 and 15 days into the future. For the province overall, when daily active COVID-19 community cases are 2.30 per 100,000 population, there is a 75% probability of a nursing home outbreak occurring five days later.
Biofunctionalized Two-dimensional MoS2 Receptors for Rapid Response Modular Electronic SARS-CoV-2 and Influenza A Antigen Sensors
Authors: Muratore C. , Muratore M.K. , Austin D.R. , Look P. , Benton A.K. , Beagle L.K. , Motala M.J. , Moore D.C. , Brothers M.C. , Kim S.S. , Krupa K. , Back T.A. , Grant J.T. , Glavin N. R.
Published: November 2020

Multiplex electronic antigen sensors for detection of SARS-Cov-2 spike glycoproteins or hemagglutinin from Influenza A in liquid samples with characteristics resembling extracted saliva were fabricated using scalable processes with potential for economical mass-production. The sensors utilize the sensitivity and surface chemistry of a two-dimensional MoS2 transducer for attachment of antibody fragments in a conformation favorable for antigen binding. Ultra-thin layers (3 nm) of amorphous MoS2 were directly sputtered over the entire sensor chip at room temperature and laser annealed to create an array of semiconducting 2H-MoS2 active sensor regions between metal contacts. The semiconducting region was functionalized with monoclonal antibody Fab (fragment antigen binding) fragments derived from whole antibodies complementary to either SARS-CoV-2 S1 spike protein or Influenza A hemagglutinin using a papain digestion to cleave the antibodies at the disulfide hinges. The high affinity for the MoS2 transducer surface with some density of sulfur vacancies for the antibody fragment base promoted chemisorption with antigen binding regions oriented for interaction with the sample. The angiostatin converting enzyme 2 (ACE2) receptor protein for the SARS-CoV-2 spike glycoprotein, was tethered to a hexa-histidine (his6) tag at its c-terminus both for purification purposes, as well as a motif for binding to MoS2. This modified protein was also investigated as a bio-recognition element. Electrical resistance measurements of sensors functionalized with antibody fragments and exposed to antigen concentrations ranging from 2-20,000 picograms per milliliter revealed selective responses in the presence of complementary antigens with sensitivity to SARS-CoV-2 or influenza A on the order of pg/mL and comparable to gold-standard diagnostics such as Polymerase Chain Reaction (PCR) analysis. Lack of antigen sensitivity for the larger ACE2 BRE further demonstrates the utility of the engineered antibody fragment/transducer interface in bringing the target antigen closer to the transducer surface for sensitivity required for early detection viral diagnostics.