bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of maternal positioning during cardiopulmonary resuscitation: a systematic review and meta-analyses
Authors: Enomoto Naosuke , Yamashita Tomoyuki , Furuta Marie , Tanaka Hiroaki , Ng Edmond S. W. , Matsunaga Shigetaka , Sakurai Atsushi ,   on behalf of the Japan Resuscitation Council Maternal task force, Kato Rie , Takahashi Shinji , Takeda Jun , Nakao Masahiro , Nakamura Eishin , Nii Masafumi , Yamahata Yoshihiro , Tsuji Makoto , Maenaka Takahide , Baba Shinji , Hosokawa Yuki , Nonogi Hiroshi , Aibiki Mayuki , Ikeyama Takanari , Isayama Tetsuya , Iwami Taku , Kuroda Yasuhiro , Sakamoto Tetsuya , Shimizu Naoki , Nagayama Masao , Nishiyama Chika , Hatanaka Tetsuo , Hosono Shigeharu , Matsuyama Tasuku
Published: February 2022

Background

Although rare, cardiac arrest during pregnancy is the leading cause of maternal death. Recently, its incidence has been increasing worldwide because more pregnant women have risk factors. The provision of early, high-quality cardiopulmonary resuscitation (CPR) plays a major role in the increased likelihood of survival; therefore, it is important for clinicians to know how to manage it. Due to the aortocaval compression caused by the gravid uterus, clinical guidelines often emphasise the importance of maternal positioning during CPR, but there has been little evidence regarding which position is most effective.

Methods

We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, and OpenGrey (updated on April 3, 2021). We included clinical trials and observational studies with reported outcomes related to successful resuscitations.

Results

We included eight studies from the 1,490 screened. The eight studies were simulation-based, crossover trials that examine the quality of chest compressions. No data were available about the survival rates of mothers or foetuses/neonates. The meta-analyses showed that resuscitation of pregnant women in the 27°–30° left-lateral tilt position resulted in lower quality chest compressions. The difference is an 19% and 9% reduction in correct compression depth rate and correct hand position rate, respectively, compared with resuscitations in the supine position. Inexperienced clinicians find it difficult to perform chest compressions in the left-lateral tilt position.

Conclusions

Given that manual left uterine displacement allows the patient to remain supine, the resuscitation of women in the supine position using manual left uterine displacement should continue to be supported. Further research is needed to fill knowledge gaps regarding the effects of maternal positioning on clinical outcomes, such as survival rates following maternal cardiac arrest.
The Kaiser Permanente Research Bank Cancer Cohort: a collaborative resource to improve cancer care and survivorship
Authors: Feigelson Heather Spencer , Clarke Christina L. , Van Den Eeden Stephen K. , Weinmann Sheila , Burnett-Hartman Andrea N. , Rowell Sarah , Scott Shauna Goldberg , White Larissa L. , Ter-Minassian Monica , Honda Stacey A. A. , Young Deborah R. , Kamineni Aruna , Chinn Terrence , Lituev Alexander , Bauck Alan , McGlynn Elizabeth A.
Published: February 2022

Background

The Kaiser Permanente Research Bank (KPRB) is collecting biospecimens and surveys linked to electronic health records (EHR) from approximately 400,000 adult KP members. Within the KPRB, we developed a Cancer Cohort to address issues related to cancer survival, and to understand how genetic, lifestyle and environmental factors impact cancer treatment, treatment sequelae, and prognosis. We describe the Cancer Cohort design and implementation, describe cohort characteristics after 5 years of enrollment, and discuss future directions.

Methods

Cancer cases are identified using rapid case ascertainment algorithms, linkage to regional or central tumor registries, and direct outreach to KP members with a history of cancer. Enrollment is primarily through email invitation. Participants complete a consent form, survey, and donate a blood or saliva sample. All cancer types are included.

Results

As of December 31, 2020, the cohort included 65,225 cases (56% female, 44% male) verified in tumor registries. The largest group was diagnosed between 60 and 69 years of age (31%) and are non-Hispanic White (83%); however, 10,076 (16%) were diagnosed at ages 18–49 years, 4208 (7%) are Hispanic, 3393 (5%) are Asian, and 2389 (4%) are Black. The median survival time is 14 years. Biospecimens are available on 98% of the cohort.

Conclusions

The KPRB Cancer Cohort is designed to improve our understanding of treatment efficacy and factors that contribute to long-term cancer survival. The cohort’s diversity - with respect to age, race/ethnicity and geographic location - will facilitate research on factors that contribute to cancer survival disparities.
Negative emotional status and influencing factors among young employees in center of disease control and prevention
Authors: Han Lu , Li Qiyu , Zhang Yu , Liu Tuo , Niu Ran , Wang Qi , Zhao Lina
Published: February 2022

Background

Negative emotions among employees have become a public problem that increase the risk of developing the disease and accelerate its progression. This study aimed to investigate the status and influencing factors of negative emotions among young employees in center of disease control and prevention.

Methods

Participants included 6099 employees aged 40 or below in center of disease control and prevention (CDC) of 32 province of China were interviewed by online questionnaire survey. The emotional conditions of anxiety and depression, and their influencing factors were analyzed.

Results

A total of 5353 valid questionnaires were collected with the recovery rate of 87.77%. 2871 cases of young employees had different degrees of negative emotions at work, accounting for about 53.60%. Regression analysis showed that gender, professional title, educational level, job satisfaction, chronic diseases, daily sleep duration, average weekly overtime, physical activity time, and sugary beverage intake were the influencing factors of negative emotions (P < 0.05). Male, primary and below, never working overtime and daily physical activity time more than 30 min were protective factors for negative emotions (OR vale were 0.79, 0.68, 0.39 and 0.63, respectively, P < 0.05). Bachelor degree or above, poor job satisfaction, chronic disease, daily sleep duration less than 8 h and drinking one to three sugary drinks a week were the risk factors for negative emotion (OR vale were1.21, 4.32, 2.16, 2.75 and 1.20, respectively, P < 0.05).

Conclusion

Due to the influence of work pressure, lifestyle, chronic diseases and other factors, young employees in CDC have a certain degree of negative emotions at work, which should be paid enough attention. Meanwhile, corresponding measures should be taken according to the influencing factors to reduce the occurrence of negative emotions.
Prognostic value of computed tomographic findings in acute respiratory distress syndrome and the response to prone positioning
Authors: Chen You-Yi , Kuo Jerry Shu-Hung , Ruan Sheng-Yuan , Chien Ying-Chun , Ku Shih-Chi , Yu Chong-Jen , Chien Jung-Yien
Published: February 2022

Background

Prone positioning enables the redistribution of lung weight, leading to the improvement of gas exchange and respiratory mechanics. We aimed to evaluate whether the initial findings of acute respiratory distress syndrome (ARDS) on computed tomography (CT) are associated with the subsequent response to prone positioning in terms of oxygenation and 60-day mortality.

Methods

We retrospectively included patients who underwent prone positioning for moderate to severe ARDS from October 2014 to November 2020 at a medical center in Taiwan. A semiquantitative CT rating scale was used to quantify the extent of consolidation and ground-glass opacification (GGO) in the sternal, central and vertebral regions at three levels (apex, hilum and base) of the lungs. A prone responder was identified by a 20% increase in the ratio of arterial oxygen pressure (PaO2) to the fraction of oxygen (FiO2) or a 20 mmHg increase in PaO2.

Results

Ninety-six patients were included, of whom 68 (70.8%) were responders. Compared with nonresponders, responders had a significantly greater median dorsal–ventral difference in CT-consolidation scores (10 vs. 7, p = 0.046) but not in CT-GGO scores (− 1 vs. − 1, p = 0.974). Although dorsal–ventral differences in neither CT-consolidation scores nor CT-GGO scores were associated with 60-day mortality, high total CT-GGO scores (≥ 15) were an independent factor associated with 60-day mortality (odds ratio = 4.07, 95% confidence interval, 1.39–11.89, p = 0.010).

Conclusions

In patients with moderate to severe ARDS, a greater difference in the extent of consolidation along the dependent-independent axis on CT scan is associated with subsequent prone positioning oxygenation response, but not clinical outcome regarding survival. High total CT-GGO scores were independently associated with 60-day mortality.
Knowledge, attitudes, and perceptions associated with HPV vaccination among female Korean and Chinese university students
Authors: Kim Hae Won , Lee Eun Ju , Lee Young Jin , Kim Seo Yun , Jin You Jing , Kim Youngji , Lee Jung Lim
Published: February 2022

Background

Human papillomavirus (HPV) vaccination is a form of primary prevention for cervical cancer. The HPV vaccination rate of female university students is not high in Korea and China. Therefore, the purpose of this study was to identify and compare the factors associated with intention to receive HPV vaccination between Korean and Chinese female university students.

Methods

The participants were 273 Korean and 317 Chinese female university students who had not been vaccinated for HPV, and data were collected using a self-reported questionnaire about attitudes toward HPV vaccination, HPV knowledge, perceptions of HPV infection, and intention to receive HPV vaccine.

Results

There were no significant differences between the Korean and Chinese female university students in HPV knowledge, attitudes, perceptions, and vaccination intention. The factors influencing the intention of HPV vaccination in Korean students were a positive attitude toward the HPV vaccine and a high HPV knowledge score. For Chinese students, sexual experience, awareness of genital warts, a positive attitude toward the HPV vaccine, a high HPV knowledge scores, a perception of the seriousness of HPV infection, and negative emotions regarding HPV infection were significant factors.

Conclusions

It is important to improve attitudes and knowledge about HPV and the HPV vaccine in order to enhance HPV vaccination both in Korea and China. Perceived seriousness and negative emotions regarding HPV infection should be used as a framework to develop subject-tailored interventions in China.
Analgesic, anti-inflammatory and acute oral toxicity profile of leaf and bark extracts of Albizia procera
Authors: Mani Sangeetha , Duraipandian Chamundeeswari , Chidambaram Saravana Babu
Published: February 2022

Background

Pain and inflammation are associatory events in cancer, diabetes, cardiovascular diseases, arthritis and other chronic diseases. Corticosteroids, non-steroidal anti-inflammatory drugs exert potential side effects on long term use. This study was aimed to investigate the acute oral toxicity, anti-inflammatory and analgesic activities of leaf and bark extracts of Albizia procera in experimental animal models.

Methods

Ethyl acetate, ethanol, and hydroalcoholic extracts of Albizia procera (leaf and bark) were subjected for acute oral toxicity, anti-inflammatory and analgesic screening. Carrageenan and cotton pellet granuloma models were used to assess acute and chronic anti-inflammatory effects, respectively. Intraplanar formalin test was used to assess the analgesic activity.

Results

All the extracts of Albizia procera were found to be well-tolerated up to 2000 mg/kg in female rats. Ethanolic leaf (ETLE) and bark (ETBE) of Albizia procera showed anti-inflammatory actions. But, only ETBE produced significant protection in chronic inflammation and analgesic activity.

Conclusion

In summary, Albizia procera possess significant anti-inflammatory and analgesic properties. This study adds evidence on the traditional use of Albizia procera plant for treating painful inflammatory disorders.
Impact of CancelRx on discontinuation of controlled substance prescriptions: an interrupted time series analysis
Authors: Watterson Taylor L. , Stone Jamie A. , Gilson Aaron , Brown Roger , Xiong Ka Z. , Schiefelbein Anthony , Ramly Edmond , Kleinschmidt Peter , Semanik Michael , Craddock Lauren , Pitts Samantha I. , Woodroof Taylor , Chui Michelle A.
Published: February 2022

Background

Prescription opioid misuse is a serious national crisis; in 2018 the top drugs involved in prescription overdose deaths included pain medications (opioids), benzodiazepines, and stimulants. Health information technology (health IT) provides a means to address this crisis through technologies that streamline the prescribing and discontinuation process. CancelRx is a health IT function that communicates when medications, such as controlled substances, are discontinued at the clinic and therefore should not be filled at the pharmacy. Prior to CancelRx, the communication of discontinued medications was a manual process, requiring the patient or a clinic staff member to personally contact the pharmacy to inform them of the change. The objective of this study was to assess how controlled substance medication discontinuations were communicated over time, before and after the implementation of CancelRx.

Methods

Secondary data from a midwestern academic health system electronic health record and pharmacy platform were collected 12-months prior to CancelRx implementation and for 12-months post implementation. The study utilized an interrupted time series analysis (ITSA) to capture the percentage of controlled substance medications that were discontinued in the clinic’s electronic health record and discontinued in the pharmacy’s dispensing software. The ITSA plotted the percentage of successful discontinuation messages over time, particularly after the health system’s implementation of CancelRx, a novel technology.

Results

After CancelRx implementation there was an immediate (change = 77.7 percentage point) and significant (p < 0.001) increase in the number of controlled substance medications that were successfully discontinued at the pharmacy after being discontinued in the clinic. This change was sustained in the year following CancelRx (slope = 0.03 pp, 95% CI − 0.050 to 0.110) and did not revert to pre-CancelRx levels. The health IT functionality was able to effectively complete discontinuation tasks and potentially reduce workload for clinic staff.

Conclusions

Overall, this study demonstrates the role that technology can play in promoting communication between clinics and pharmacies, especially when medications such as controlled substances are discontinued.
Keeping calm on a busy day—an interpersonal skill home care patients desire in health workers: hermeneutical phenomenological method
Authors: Watz Siw , Ingstad Kari
Published: February 2022

Background

In Western countries, many health and social care provisions have been transferred to primary care, and most older patients wish to remain in their own homes for as long as possible. For older patients who live alone, health workers could be their only personal contacts. Hence, health workers’ personal skills affect their relationships with these patients. Accordingly, this study aimed to shed light on the interpersonal skills needed by health workers to establish good relationships with older home care patients and highlight the importance of interpersonal skills training in nursing education.

Methods

This study adopted a hermeneutical phenomenological approach. The qualitative method was used to elicit data on patients’ perspectives. Ten home care patients were interviewed individually in their own homes between December 2019 and January 2020.

Results

Despite individual variations, health workers’ interpersonal skills are of significance with regard to the social well-being of patients living at home. The findings revealed that patients want health workers to be mentally present, congruent in their communications, calm and relaxed during the available time spent with them, and capable of facilitating autonomy.

Conclusions

It is important to present patients’ perspectives to ensure that nursing education is geared towards patients’ best interests.

Trial registration number

The Norwegian Centre for Research Data (NSD): 953937.
Pan-cancer analysis of oncogenic role of Programmed Cell Death 2 Like (PDCD2L) and validation in colorectal cancer
Authors: Gao Huabin , Xu Cheng , Liang Jiangtao , Ge Songhan , Zhang Fenfen , Tuo Ying , Shi Huijuan , Han Anjia
Published: February 2022

Background

Programmed Cell Death 2 Like (PDCD2L) correlates with cell proliferation, apoptosis and mouse embryonic development. However, the role of PDCD2L in human cancers is unclear.

Methods

Multiple bioinformatic methods, in vitro function experiments and validation were performed to clarify the oncogenic role of PDCD2L in human cancers.

Results

Our study found that PDCD2L was aberrantly expressed in multiple types of human cancers, and associated with clinical stage and molecular subtype. Furthermore, overexpression of PDCD2L predicted poor overall survival in adrenocortical carcinoma(ACC), kidney chromophobe(KICH), acute myeloid leukemia(LAML), brain lower grade glioma(LGG),liver hepatocellular carcinoma(LIHC), mesothelioma(MESO), uveal melanoma(UVM) and poor diseases free survival in ACC, bladder urothelial carcinoma(BLCA), cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC), kidney renal clear cell carcinoma(KIRC), kidney renal papillary cell carcinoma(KIRP), LGG, LIHC, and UVM. PDCD2L expression was negatively associated with cancer associated fibroblast in breast invasive carcinoma (BRCA), lung squamous cell carcinoma (LUSC), sarcoma (SARC), stomach adenocarcinoma (STAD) and testicular germ cell tumors (TGCT). Mechanically, we found that PDCD2L expression was associated with apoptosis, invasion and cell cycle by investigating single cell sequencing data. For further validation, PDCD2Lwas highly expressed in colorectal cancer (CRC) cell lines and tissue samples compared with the normal colon cell line and non-tumor adjacent colorectal mucosa tissues. PDCD2L knockdown induced the apoptosis and proliferation of CRC cells.

Conclusions

Our study shows that the oncogenic role of PDCD2L in various cancers and PDCD2L could be served as a biomarker of CRC.
Skeletal muscle wasting and long-term prognosis in patients undergoing rectal cancer surgery without neoadjuvant therapy
Authors: Giani Alessandro , Famularo Simone , Fogliati Alessandro , Riva Luca , Tamini Nicolò , Ippolito Davide , Nespoli Luca , Braga Marco , Gianotti Luca
Published: February 2022

Background

Derangement of body composition has been associated with dismal long-term survival in several gastrointestinal cancers including rectal tumors treated with neoadjuvant therapies. The role of specific preoperative anthropometric indexes on the oncologic outcomes of patients undergoing upfront surgery for rectal cancer has not been investigated.

The aim of the study is to evaluate the association of body composition and overall survival in this specific cohort.

Methods

Lumbar computed tomography images, obtained within the 30 days previous to surgery, between January 2009 and December 2016, were used to calculate population-specific thresholds of muscle mass (sarcopenia), subcutaneous and visceral adiposity, visceral obesity, sarcopenic obesity, and myosteatosis. These body composition variables were related with overall survival (OS), tumor-specific survival (TSS), and disease-free survival (DFS). OS, TSS, and DFS were evaluated by the Kaplan-Meier method. Cox regression analysis was used to identify independent predictors of mortality, tumor-specific mortality, and recurrence, and data were presented as hazard ratio (HR) and 95% confidence interval (CI).

Results

During the study period, 411 patients underwent rectal resection for cancer, and among these, 129 were without neoadjuvant chemoradiation. The median follow-up was 96.7 months. At the end of the follow-up, 41 patients (31.8%) had died; of these, 26 (20.1%) died for tumor-related reasons, and 36 (27.1%) experienced disease recurrence.

One-, three-, and five-year OS was 95.7%, 86.0%, and 76.8% for non-sarcopenic patients versus 82.4%, 58.8%, and 40.0% for sarcopenic ones respectively (p < 0.001). Kaplan-Meier survival curves comparing sarcopenic and non-sarcopenic patients showed a significant difference in terms of OS (log-rank < 0.0001). Through multivariate Cox regression, overall mortality risk was associated only with sarcopenia (HR 1.96; 95%CI 1.03–3.74; p = 0.041). Disease stage IV and III (HR 13.75; 95% CI 2.89–65.6; p < 0.001 and HR 4.72; 95% CI 1.06–21.1; p = 0.043, respectively) and sarcopenia (HR 2.62; 95% CI 1.22–5.6; p = 0.013) were independently associated with TSS. The other body composition indexes investigated showed no significant association with prognosis.

Conclusions

These results support the inclusion of body composition assessment for prognostic stratification of rectal cancer patients undergoing upfront resection.
Toxicity study in a pig model of intraperitoneal collagenase as an “enzymatic scalpel” directed to break stroma in order to generate a new perspective for peritoneal carcinomatosis approach: an experimental research
Authors: Garcia-Arranz M. , Villarejo-Campos P. , Barambio J. , Garcia Gomez-Heras S. , Vega-Clemente L. , Guadalajara H. , García-Olmo D.
Published: February 2022

Background

This study aimed to measure the toxicity resulting from collagenase administration to the peritoneal cavity in a pig model as a preliminary step to break down the stroma surrounding tumors.

Methods

Eight pigs were treated with 2 different collagenase concentrations previously tested in rats by our group. Time and temperature were controlled using a peritoneal lavage system (PRS System, Combat Medical Ltd.) identical to that used in human surgeries through hyperthermic intraperitoneal chemotherapy (HIPEC); 2 additional pigs were treated with peritoneal lavage only. Samples of blood and peritoneal fluid were collected pre-treatment, immediately after treatment, and 24 h postoperatively. In addition, histological studies and blood collagenase levels were measured.

Results

No complications were observed during the surgeries. Intraoperative images evidenced the release of peritoneal tissue during collagenase treatment. After surgery, the animals showed no signs of pain. Diet and mobility were normal at 4 h postoperatively, and there were no significant differences in hematologic or biochemical parameters. Quantification of MMP1 and MMP2 in all samples as measured by absorbance showed no differences in blood collagenase levels between pre-treatment, post-treatment, and 24 h postoperatively.

None of the animals treated with collagenase showed peritoneal adhesions during the second surgery. Histologically, peritoneal organs and serous structures did not show any microscopic alterations associated with collagenase treatment in any group.

Conclusion

Lavage of the peritoneal cavity with doses of up to 100,000 collagen digestion units/animal for 30 min is safe and removes connective tissue from the peritoneal cavity.
Gene signatures of circulating breast cancer cell models are a source of novel molecular determinants of metastasis and improve circulating tumor cell detection in patients
Authors: Fina Emanuela , Cleris Loredana , Dugo Matteo , Lecchi Mara , Ciniselli Chiara Maura , Lecis Daniele , Bianchi Giulia Valeria , Verderio Paolo , Daidone Maria Grazia , Cappelletti Vera
Published: February 2022

Background

Progression to stage IV disease remains the main cause of breast cancer-related deaths. Increasing knowledge on the hematogenous phase of metastasis is key for exploiting the entire window of opportunity to interfere with early dissemination and to achieve a more effective disease control. Recent evidence suggests that circulating tumor cells (CTCs) possess diverse adaptive mechanisms to survive in blood and eventually metastasize, encouraging research into CTC-directed therapies.

Methods

On the hypothesis that the distinguishing molecular features of CTCs reveal useful information on metastasis biology and disease outcome, we compared the transcriptome of CTCs, primary tumors, lymph-node and lung metastases of the MDA-MB-231 xenograft model, and assessed the biological role of a panel of selected genes, by in vitro and in vivo functional assays, and their clinical significance in M0 and M+ breast cancer patients.

Results

We found that hematogenous dissemination is governed by a transcriptional program and identified a CTC signature that includes 192 up-regulated genes, mainly related to cell plasticity and adaptation, and 282 down-regulated genes, involved in chromatin remodeling and transcription. Among genes up-regulated in CTCs, FADS3 was found to increases cell membrane fluidity and promote hematogenous diffusion and lung metastasis formation. TFF3 was observed to be associated with a subset of CTCs with epithelial-like features in the experimental model and in a cohort of 44 breast cancer patients, and to play a role in cell migration, invasion and blood-borne dissemination. The analysis of clinical samples with a panel of CTC-specific genes (ADPRHL1, ELF3, FCF1, TFF1 and TFF3) considerably improved CTC detection as compared with epithelial and tumor-associated markers both in M0 and stage IV patients, and CTC kinetics informed disease relapse in the neoadjuvant setting.

Conclusions

Our findings provide evidence on the potential of a CTC-specific molecular profile as source of metastasis-relevant genes in breast cancer experimental models and in patients. Thanks to transcriptome analysis we generated a novel CTC signature in the MDA-MB-231 xenograft model, adding a new piece to the current knowledge on the key players that orchestrate tumor cell hematogenous dissemination and breast cancer metastasis, and expanding the list of CTC-related biomarkers for future validation studies.
A subdermal tagging technique for juvenile sturgeon using a new self-powered acoustic tag
Authors: Liss Stephanie A. , Li Huidong , Deng Zhiqun Daniel
Published: February 2022

Background

A new technology for a self-powered acoustic tag (SPT) was developed for active tracking of juvenile fish, intended to avoid the typical battery life constraints associated with active telemetry technology. We performed a laboratory study to evaluate a subdermal tagging technique for the SPT and effects of the tag on survival, tag retention, and growth in juvenile white sturgeon (Acipenser transmontanus).

Results

Survival was associated with tag retention. White sturgeon implanted with the SPT (n = 30) had 93% survival and tag retention by day 28, 67% by day 101, and 38% by day 595 post-tagging. Sturgeon implanted with a passive integrated transponder (PIT) tag only (control group) had 96% survival and tag retention by day 28, and through day 101 post-tagging. Fish in the PIT group were repurposed after day 101, so no comparisons with this group were made at day 595 post-tagging. Specific growth rate (SGR) for fork length was a median of 0.25% day−1by day 28 for the SPT group, which was significantly lower than the PIT group (median: 0.42% day−1;n = 27). The SPT and PIT groups had similar SGR fork length by day 101 post-tagging (0.22 and 0.25% day−1, respectively). SGR weight was also lower for the SPT group compared to the PIT group on day 28 (1.39 and 2.11% day−1, respectively), but the difference again dissipated by day 101 (0.79 and 0.88% day−1, respectively).

Conclusion

The tagging technique and placement of the SPT allowed the tag to remain upright along the flank of the sturgeon to ensure maximum battery output of the SPT; however, retention rates of the SPT were not ideal. We provided suggestions to improve the tagging technique. Suggestions included tagging fish that are > 400 mm FL, moving the incision location to extend the cavity and create a pocket for the placement of the SPT, and performing a quantitative wound-healing evaluation. Future studies are therefore recommended to evaluate these suggestions.
Perspectives from law enforcement officers who respond to overdose calls for service and administer naloxone
Authors: Smiley-McDonald Hope M. , Attaway Peyton R. , Richardson Nicholas J. , Davidson Peter J. , Kral Alex H.
Published: February 2022

Background

Many law enforcement agencies across the United States equip their officers with the life-saving drug naloxone to reverse the effects of an opioid overdose. Although officers can be effectively trained to administer naloxone, and hundreds of law enforcement agencies carry naloxone to reverse overdoses, little is known about what happens on scene during an overdose call for service from an officer’s perspective, including what officers perceive their duties and responsibilities to be as the incident evolves.

Methods

The qualitative study examined officers’ experiences with overdose response, their perceived roles, and what happens on scene before, during, and after an overdose incident. In-person interviews were conducted with 17 officers in four diverse law enforcement agencies in the United States between January and May 2020.

Results

Following an overdose, the officers described that overdose victims are required to go to a hospital or they are taken to jail. Officers also described their duties on scene during and after naloxone administration, including searching the belongings of the person who overdosed and seizing any drug paraphernalia.

Conclusion

These findings point to a pressing need for rethinking standard operating procedures for law enforcement in these situations so that the intentions of Good Samaritan Laws are upheld and people get the assistance they need without being deterred from asking for future help.
Good things come to those who mate: analysis of the mating behaviour in the menstruating rodent, Acomys cahirinus
Authors: McKenna Jarrod , Bellofiore Nadia , Temple-Smith Peter
Published: February 2022

Background

The Egyptian spiny mouse (Acomys cahirinus) is the only known rodent to exhibit true, human-like menstruation and postpartum ovulation, and is an important new model for reproductive studies. Spiny mice do not produce a visible copulatory plug, and calculation of gestational age is therefore restricted by the need to use mated postpartum dams. The current inefficient method of monitoring until parturition to provide a subsequent estimate of gestational age increases study duration and costs. This study addressed this issue by comparing the mating behaviour of spiny mice across the menstrual cycle and proposes a more accurate method for staging and pairing animals that provides reliable estimates of gestational age. In experiment 1, mating behaviour was recorded overnight to collect data on mounting, intromission, and ejaculation (n = 5 pairs per stage) in spiny mice paired at menses and at early and late follicular and luteal phases of the menstrual cycle. In experiment 2, female spiny mice were paired at the follicular or luteal phases of the menstrual cycle to determine any effect on the pairing-birth interval (n = 10 pairs).

Results

We report a broad mating window of ~ 3 days during the follicular phase and early luteal phase of spiny mice. Males displayed a discrete ‘foot twitch’ behaviour during intromission and a brief copulatory lock during ejaculation. Litters were delivered after 40–43 days if pairing occurred during the mating window, compared with 46–48 days for spiny mice paired in the late luteal phase. When pairing occurred during the late luteal phase or menses no mating activity was observed during the recording period.

Conclusion

This study clearly demonstrates an effect of the menstrual cycle on mating behaviour and pregnancy in the spiny mouse and provides a reliable and more effective protocol for estimating gestational age without the need for postpartum dams.
External Validation of the 2003 Leibovich Prognostic Score in Patients Randomly Assigned to SORCE, an International Phase III Trial of Adjuvant Sorafenib in Renal Cell Cancer
Authors: Oza Bhavna , Eisen Tim , Frangou Eleni , Stewart Grant D. , Bex Axel , Ritchie Alastair W.S. , Kaplan Rick , Smith Benjamin , Davis Ian D. , Stockler Martin R. , Albiges Laurence , Escudier Bernard , Larkin James , Joniau Steven , Hancock Barry , Hermann Gregers G. , Bellmunt Joaquim , Parmar Mahesh K.B. , Royston Patrick , Meade Angela
Published: February 2022

PURPOSE

The 2003 Leibovich score guides prognostication and selection to adjuvant clinical trials for patients with locally advanced renal cell carcinoma (RCC) after nephrectomy. We provide a robust external validation of the 2003 Leibovich score using contemporary data from SORCE, an international, randomized trial of sorafenib after excision of primary RCC.

METHODS

Data used to derive the 2003 Leibovich score were compared with contemporary data from SORCE. Discrimination and calibration of the metastasis-free survival outcome were assessed in data from patients with clear-cell RCC, using Cox proportional hazards regression, Kaplan-Meier curves, and calculation of Harrell's c indexes. Secondary analyses involved three important SORCE groups: patients with any non–clear-cell subtype, papillary, and chromophobe carcinomas.

RESULTS

Four hundred seven recurrences occurred in 982 patients in the Leibovich cohort and 520 recurrences were recorded in 1,445 patients in the primary SORCE cohort. Clear discrimination between intermediate-risk and high-risk SORCE cohorts was shown; hazard ratio 2.74 (95% CI, 2.29 to 3.28), c-index 0.63 (95% CI, 0.61 to 0.65). A hazard ratio of 0.61 (95% CI, 0.53 to 0.70) confirmed poor calibration of the two cohorts. Discrimination was observed in secondary populations, with c-indexes of 0.64 (95% CI, 0.59 to 0.69) for non–clear-cell RCC, 0.63 (95% CI, 0.56 to 0.69) for papillary RCC, and 0.65 (95% CI, 0.55 to 0.76) for chromophobe RCC.

CONCLUSION

The 2003 Leibovich score discriminates between intermediate-risk and high-risk clear-cell and non–clear-cell RCC groups in contemporary data, supporting its use for risk stratification in adjuvant clinical trials. Over time, metastasis-free survival for patients with locally advanced RCC has improved. Contemporary data from adjuvant RCC trials should be used to improve prognostication for patients with RCC.
Impact of the Oncology Care Model on Use of Supportive Care Medications During Cancer Treatment
Authors: Brooks Gabriel A. , Landrum Mary Beth , Kapadia Nirav S. , Liu Pang-Hsiang , Wolf Robert , Riedel Lauren E. , Hsu Van Doren , Jhatakia Parekh Shalini , Simon Carol , Hassol Andrea , Keating Nancy L.
Published: February 2022

PURPOSE

The Oncology Care Model (OCM) is an episode-based alternative payment model for cancer care that seeks to reduce Medicare spending while maintaining care quality. We evaluated the impact of OCM on appropriate use of supportive care medications during cancer treatment.

METHODS

We evaluated chemotherapy episodes assigned to OCM (n = 201) and comparison practices (n = 534) using Medicare claims (2013-2019). We assessed denosumab use for beneficiaries with bone metastases from breast, lung, or prostate cancer; prophylactic WBC growth factor use for beneficiaries receiving chemotherapy for breast, lung, or colorectal cancer; and prophylactic use of neurokinin-1 (NK1) antagonists and long-acting serotonin antagonists for beneficiaries receiving chemotherapy for any cancer type. Analyses used a difference-in-difference approach.

RESULTS

After its launch in 2016, OCM led to a relative reduction in the use of denosumab for beneficiaries with bone metastases receiving bone-modifying medications (eg, 5.0 percentage point relative reduction in breast cancer episodes [90% CI, –7.1 to –2.8]). There was no OCM impact on use of prophylactic WBC growth factors during chemotherapy with high or low risk for febrile neutropenia. Among beneficiaries receiving chemotherapy with intermediate febrile neutropenia risk, OCM led to a 7.6 percentage point reduction in the use of prophylactic WBC growth factors during breast cancer episodes (90% CI, –12.6 to –2.7); there was no OCM impact in lung or colorectal cancer episodes. Among beneficiaries receiving chemotherapy with high or moderate emetic risk, OCM led to reductions in the prophylactic use of NK1 antagonists and long-acting serotonin antagonists (eg, 6.0 percentage point reduction in the use of NK1 antagonists during high emetic risk chemotherapy [90% CI, –9.0 to –3.1]).

CONCLUSION

OCM led to the reduced use of some high-cost supportive care medications, suggesting more value-conscious care.
The Prognosis of Skip Metastasis in Papillary Thyroid Microcarcinoma Is Better Than That of Continuous Metastasis
Authors: Weng Huai-Yu , Yan Ting , Qiu Wang-Wang , Fan You-Ben , Yang Zhi-Li
Published: February 2022

Context

A few papillary thyroid microcarcinomas (PTMCs) may have skip metastasis (SLNM), but the risk factors remain controversial and the prognosis is unclear.

Objectives

To investigate the incidence, lymph node metastasis (LNM) patterns, risk factors, and prognosis of SLNM in PTMCs.

Methods

We reviewed the medical records of PTMC patients who underwent thyroid surgery in our institution. Analyses of risk factors were performed for SLNM. Recurrence-free survival (RFS) of SLNM, central lymph node metastasis (CLNM), and continuous metastasis (CLNM and lateral lymph node metastasis [CLNM + LLNM]) were compared after propensity score matching (PSM).

Results

SLNM was detected in 1.7% (50/3923) and frequently involved level III (66.7%). Compared with CLNM + LLNM, SLNM had more LNM at a single level (P < 0.01) and less LNM at 2 levels (P < 0.05). A tumor size of 0.5 to 1 cm (odds ratio [OR], 2.26; 95% CI, 1.27-4.00) and location in the upper pole (OR, 3.30; 95% CI, 2.02-5.40) were independent risk factors for SLNM. A total of 910 (23.2%) PTMCs with LNM were included in the prognostic analysis. At a median follow-up of 60 months, the RFS of SLNM did not differ from that of CLNM (P = 0.10) but was significantly higher than that of CLNM + LLNM (P < 0.01) after using PSM.

Conclusions

When the tumor size is 0.5 to 1 cm or its location is in the upper pole, we must remain vigilant to SLNM in PTMC. Because its prognosis is comparable to that of only CLNM and better than that of CLNM + LLNM, less intensive treatment should be considered.
Fluctuations in Metabolites and Bone Markers Across the Menstrual Cycle in Eumenorrheic Women and Oral Contraceptive Users
Authors: He Weiwei , Dam Tine Vrist , Thøgersen Rebekka , Hansen Mette , Bertram Hanne Christine
Published: February 2022

Context

Little is known about changes in circulating metabolites during the menstrual cycle and how use of oral contraceptives (OCs) affects these changes.

Objectives

To study fluctuations in circulating metabolite and bone marker levels during the menstrual/pill cycle in eumenorrheic women and OC users.

Methods

Plasma samples were collected from 28 eumenorrheic women and 10 OC users at 7 to 9 time points across a menstrual/pill cycle. Longitudinal and cross-sectional analyses were performed to examine the cycle- and OC-induced variations in the plasma metabolite and bone turnover marker levels.

Results

In eumenorrheic women, plasma levels of alanine, glutamine, threonine, and tyrosine varied significantly across the menstrual cycle, and all dropped to the lowest level around day 21 of the menstrual cycle. These amino acid concentrations were negatively correlated with fluctuations in progesterone and/or estrogen levels. A between-group analysis showed that plasma levels of alanine, glutamine, glycine, proline, and tyrosine were lower in OC users than in nonusers. Concomitantly, plasma C-terminal telopeptide of type I collagen (CTX) and N-terminal propeptide of type I procollagen (PINP) levels were lower in OC users. Intriguingly, when all data were pooled, variations in CTX and PINP levels were positively correlated with fluctuations in proline and glycine concentrations (r > 0.5 or 0.3 < r < 0.5, P < 0.05).

Conclusions

The menstrual cycle and the use of OCs alter plasma levels of metabolites and bone turnover markers in young women. While the impact of these findings remains to be established, the lower glycine level among OC users and the accompanying lower CTX level supports that the use of OCs lowers collagen turnover in young women and may thereby have long-term implications for bone health among OC users.
Wireless Single-Lead ECG Monitoring to Detect New-Onset Postoperative Atrial Fibrillation in Patients After Major Noncardiac Surgery: A Prospective Observational Study
Authors: Jokinen Johan D. V. , Carlsson Christian J. , Rasmussen Søren M. , Nielsen Olav W. , Winkel Bo G. , Jorgensen Lars N. , Achiam Michael P. , Mølgaard Jesper , Sørensen Helge B. D. , Aasvang Eske K. , Meyhoff Christian S. ,   for the WARD Project Group
Published: February 2022

BACKGROUND:

New-onset postoperative atrial fibrillation (POAF) is associated with several cardiovascular complications and higher mortality. Several pathophysiological processes such as hypoxia can trigger POAF, but these are sparsely elucidated, and POAF is often asymptomatic. In patients undergoing major gastrointestinal cancer surgery, we aimed to describe the frequency of POAF as automatically estimated and detected via wireless repeated sampling monitoring and secondarily to describe the association between preceding vital sign deviations and POAF.

METHOD:

Patients ≥60 years of age undergoing major gastrointestinal cancer surgery were continuously monitored for up to 4 days postoperatively. Electrocardiograms were obtained every minute throughout the monitoring period. Clinical staff were blinded to all measurements. As for the primary outcome, POAF was defined as 30 consecutive minutes or more detected by a purpose-built computerized algorithm and validated by cardiologists. The primary exposure variable was any episode of peripheral oxygen saturation (Spo
2) <85% for >5 consecutive minutes before POAF.

RESULTS:

A total of 30,145 hours of monitoring was performed in 398 patients, with a median of 92 hours per patient (interquartile range [IQR], 54–96). POAF was detected in 26 patients (6.5%; 95% confidence interval [CI], 4.5–9.4) compared with 14 (3.5%; 95% CI, 1.94–5.83) discovered by clinical staff in the monitoring period. POAF was followed by 9.4 days hospitalization (IQR, 6.5–16) versus 6.5 days (IQR, 2.5–11) in patients without POAF. Preceding episodes of Spo
2 <85% for >5 minutes (OR, 1.02; 95% CI, 0.24-4.00; P = .98) or other vital sign deviations were not significantly associated with POAF.

CONCLUSIONS:

New-onset POAF occurred in 6.5% (95% CI, 4.5–9.4) of patients after major gastrointestinal cancer surgery, and 1 in 3 cases was not detected by the clinical staff (35%; 95% CI, 17–56). POAF was not preceded by vital sign deviations.
Queer Allusion: Wilde, Housman, Cullen
Authors: Gargaillo Florian
Published: February 2022

This essay argues for the distinctive role of allusion in queer poetry of the pre-Stonewall era, using the work of Oscar Wilde, A. E. Housman, and Countee Cullen as case studies. Most allusions depend on implicit verbal echoes that can be identified by readers able and willing to recognize them. That mix of secrecy and openness was especially attractive to gay poets, since it enabled them to express their desires obliquely by writing through authors who hinted at similar experiences. Queer allusion thus offers an alternative to long-standing theories of influence that describe poetry’s relationship to the past in terms of debt or competition. Unlike these models, queer allusion allowed poets to foster connections on the page and find relief from the loneliness that was endemic to gay life.
“Les Hommes ont toute l’autorité”
Authors: Herdman Emma
Published: February 2022

A Renaissance querelle was primarily litigious. As such, it was heavily gendered: women, who were culturally expected to be conciliatory, not argumentative, were excluded from the law courts. This article uses the example of Madeleine des Roches—a widow, and so legally “capable,” like her unmarried daughter, Catherine—to consider how women negotiated the challenges of legal quarreling. It analyzes the strategies des Roches employed, in her poetry and in her published correspondence, to avoid being perceived as quarrelsome, to bind her judicially influential addressees in obligation to her, and to object to women’s exclusion from the law. It thus shows how des Roches’s references to the court cases that plagued her widowhood actively engaged both with the individual quarrels of these specific cases and with a more general quarrel with the injustices of an exclusive and often obstructive process of law. Des Roches’s rejection of overtly agonistic writing in favor of discreetly powerful methods of persuasion reflects her objection to quarreling—as an unwelcome distraction from the literary self-expression that she maintains is a woman’s intellectual right—even as she engaged with both the law courts and the querelle des femmes.
Antoinette Deshoulières’s Cat
Authors: Taylor Helena
Published: February 2022

This article examines the poet Antoinette Deshoulières’s (1638–94) interventions in a number of querelles. It focuses on a series of poems that appeared in 1678–79, early in her career, and written as if from her pet cat. Often dismissed for their frivolity, these poems instead reveal Deshoulières’s engagement with the Quarrel of the Ancients and Moderns and the debates about the animal machine. While such interventions constituted an important strategy for making a name for herself, they are characterized by elusiveness. Although that elusiveness has been read as a gendered strategy of modesty, this article shows instead that her equivocal and even parodic, burlesque way of intervening in the two quarrels is consistent with her skepticism and presents readers with a hermeneutical challenge that disrupts the rhetorical logic of a quarrel. Deshoulières’s interventions invite us to reflect on the roles of gender, genre, and interpretation in early modern quarrels and their study.
A Woman’s Words
Authors: Seth Catriona
Published: February 2022

Right at the end of the eighteenth century, a famous poet, Ponce-Denis Écouchard Le Brun, denounced women writers and a literary dispute ensued. While it mobilized a number of authors, one poem stands out in accounts of the quarrel: Constance Pipelet’s “Épître aux femmes.” A study of the timeline shows that this was not in fact part of the original exchanges and that its central role is due on the one hand to a retrospective delineation of the events by a woman poet with a vested interest and, on the other, to its ambition and quality. The case poses several questions around authorial identity, gender-based judgments, the role of periodicals, and the literary construction of quarrels both as they occur and after they are over.