bluuebunny/crossref_metadata_2025 huggingface dataset:
Position
Authors: Dixon R. M. W.
Published: February 2022

This chapter discusses the prepositions that relate to position, which fall into four sets: vertical position, horizontal position, distance, and passage. It outlines prepositions in the vertical position that includes over, under, above, below, beneath, and underneath, while the horizontal position includes behind, ahead (-of), in-front(-of), back, forth, forward(s), and backward(s). Distance covers beyond, near(-to), close-to, and far-from and passage covers along, alongside, across, through, and throughout. The chapter demonstrates how the pairs of prepositions over/under and above/below that can be substituted one for the other in some circumstances. Both over and under have considerable metaphorical extensions from their basic spatial senses, noting that over features in some prepositional verbs and a couple of score phrasal verbs, whereas under is in a handful of phrasal verbs.
Separation
Authors: Dixon R. M. W.
Published: February 2022

This chapter talks about away /ə’wei/ that continues the Old English on-weg or a-wag, the noun side goes back to OE sīde with a- being added to create adverb aside /ə’said/ in the fourteenth century, and and apart /ə’pa:t/ was taken over from French. It explores how away, aside, and apart each feature in some phrasal verbs and can each be extended to a phrasal preposition by adding from. By virtue of the final from, each of the prepositions is a proclitic to a following noun phrase (NP). The chapter clarifies how the adverb apart requires an NP with plural reference, which can be in intransitive subject function or in transitive object function. The referents of the plural NP may be separated when the preposition apart-from is employed in place of the adverb.
Temporal
Authors: Dixon R. M. W.
Published: February 2022

This chapter discusses three prepositions with an exclusively temporal meaning, which include since, until/till, and during and three more that have a temporal primary meaning, which include after (and afterward(s)), before (and beforehand), and past. It examines a preposition with temporal meaning that is more closely linked to a noun phrase (NP) with a spatial or relational sense and is demonstrated by the possibilities for placement in questions. A preposition with temporal meaning is closely tied to its following NP. The chapter elaborates how both preposition and NP may be moved to the front of the sentence but not the NP alone when the NP is put into question form. Since, till/until, after, and before have an unusual grammatical property as they can mark a peripheral constituent that is either an NP or a declarative clause.
Interview with Nigel Hitchin
Authors: McCartney Mark
Published: February 2022

Nigel Hitchin has spent most of his academic life at Oxford. Commencing as an undergraduate at Jesus College in 1965, he continued at Oxford for his doctoral studies and held appointments as researcher and college fellow before being appointed Savilian Professor of Geometry in 1997. While the centre of gravity of his life has been in Oxford, his career has been interspersed with significant periods at Princeton, Stony Brook, Warwick, and Cambridge. In this interview he reflects on a career in mathematics which has spanned more than half a century.
Moulding the Self and the World
Authors: Stenger Jan R.
Published: February 2022

This chapter considers ideas on the process and outcomes of self-formation in Macrobius, Themistius, Gregory of Nyssa, and Boethius. Taking inspiration from notions of Bildung developed by German idealism, it shows that these authors conceptualized the process of self-cultivation as a transformative and constructive engagement of the subject with the objective world. They dismissed the common idea that education was a receptive process leading to the acquisition of knowledge and skills. Instead, they proposed that, for formation in the truest sense to take place, it was essential that the individual embraced an object that was different, something ‘other’, yet without alienating him/herself. They suggested that during this engagement the subject at the same time constructs the object (the external world) and develops him/herself with the goal of perfection. Human fulfilment as the essence of formation was seen not as an autonomous activity but meant establishing a meaningful relationship between the human subject and the world outside. These educational theories were essentially theories about what it meant to be human and how to embody this humanity in the fullest sense.
Periphrases and irregular paradigms in Italo-Romance
Authors: Cruschina Silvio
Published: February 2022

Morphomes constitute autonomous distributional patterns that are purely morphological and internal to the morphological component. These patterns often originate as the accidental product of sound change but are subsequently preserved and replicated in diachrony in a way that suggests that they have become cognitive templates or abstract generalizations for speakers. Morphomes are not confined to synthetic structures but extend to other phenomena such as periphrastic constructions of various types. The chapter shows that in southern Italo-Romance, morphomic distributions have analogues within grammaticalized periphrases, including motion and progressive periphrases with double inflexion, as well as modal periphrases. Crucially, a necessary condition for a periphrastic paradigm to be morphomically modelled is grammaticalization. Indeed, the morphophonological changes that are typically described in terms of grammaticalization and morphologization provide the conditions for a morphomic attraction to a recurrent pattern of irregularity.
The loss of analyticity in the history of Romanian verbal morphology
Authors: Dragomirescu Adina , Nicolae Alexandru , Zafiu Rodica
Published: February 2022

This chapter investigates the relation between syntheticity and analyticity in the history of Romanian. Empirically, we note that, against the traditional hypothesis that in the passage from Latin to Romance older synthetic forms were extensively replaced by novel analytic formations, there is a set of old Romanian periphrastic constructions which disappeared in the passage to modern Romanian, and our goal is to provide an explanation for this less frequent linguistic change. By bringing to the fore data from old and modern Romanian, as well as dialectal Daco-Romanian material, we show that the facts are best explained by appealing to structural factors (the feature matrix of Romanian auxiliaries) rather than functional factors (competition between functionally equivalent forms, their learnèd nature, or rare occurrence in usage).
The Fears and Promises of the 1920s and 1930s
Authors: Mantie Roger
Published: February 2022

Chapter 5 centers on demonstrating how American societal attitudes in the 1920s and 1930s (the interwar period) sustained and extended concerns about conduct. Due to a perceived decrease in working hours, many social observers of the day expressed fears and concerns over the “use and abuse of leisure.” How people used their time became a focus of those who believed that ordinary people could not be trusted to use their newfound leisure time responsibly, thus leading to the downfall of society. The democratization of music (i.e., music making deemed acceptable to society’s moral guardians) through widespread instruction became viewed as one of the preferred solutions to the “threat of leisure.” School music, taught by specialized teachers, would help attain the goals of music-for-all and lifelong participation, thus realizing the “worthy use of leisure.”
How Should One Live?
Authors: Mantie Roger
Published: February 2022

Chapter 6 is the first chapter of Part III (philosophical perspectives). As the chapter title suggests, the focus here is on happiness (eudaimonia) and pleasure (hedonism). The exploration uses moral philosophy to consider musical leisure in light of W. D. Ross’s “the right” and “the good.” Illustrated with musical examples, well-being (the good life) is advanced as an ethical endeavor. Positive psychology is introduced as a foil to explore how flourishing might be considered in light of upbringing (paideia). The chapter concludes with speculations on how musical leisure and the good life might be reconsidered as a form of ethical seeking.
Music Education as Leisure Education
Authors: Mantie Roger
Published: February 2022

The goal of Chapter 9 is to argue for a reimagined music education based on a qualified version of leisure education. Central to the chapter is the “paradox of paternalism,” where conceptions of the art of living are viewed as dependent on a form of education understood as exposure and development requiring a more knowledgeable other. The goal of this education, however, is freely chosen ethical seeking rather than conduct modification. Key here are discussions of socialization, where parenting involvement and parenting logics are considered alongside formal education practices. In this light, school music is viewed, positively, as “quasi-curricular,” where the goals of amateurism, serious leisure, and leisure satisfaction justify music as a truly public good.
GLYCEROIDEA GRUBE, 1850
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Glyceroidea include two clades Glyceridae Grube, 1850 (often called‘bloodworms’) and Goniadidae Kinberg, 1866.
SPIONIDAE GRUBE, 1850
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Named after Spio, one of the Nereids from Greek mythology, Spionidae represents one of the larger taxonomic groupings and currently is poorly understood in a phylogenetic sense and hence needs substantial revision.
AEOLOSOMATIDAE LEVINSON, 1884
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Aeolosomatidae is a group of minute worms living almost exclusively in freshwater habitats.
CLITELLATA MICHAELSEN, 1919
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Clitellata is clade of hermaphroditic, direct-developing Annelida found worldwide in most aquatic and terrestrial habitats. They comprise nearly half of the total known species diversity of Annelida, with an estimated 8800 accepted species.
MALDANIDAE MALMGREN, 1867
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Maldanidae (bamboo-worms) are easily recognizable in that the body is comprised of a set number of long cylindrical segments which, combined with low rows of hooked chaetae, results in a bamboo-like appearance. Depending on the group, adult Maldanidae range in size from 3 mm to more than 200 mm in length and usually have a fixed maximum number of segments from fewer than 20 up to 29, depending on the taxon. Exceptions are Gravierella and Macroclymene, which may have from 30 to 70 segments and the number is seemingly not constant within these taxa. In life, Maldanidae can be bright red to pale with bands of varying colours (Pl. 11a, b), or even transparent. The anterior region can also be distinctly pigmented. Following recent phylogenetic analyses and systematic revisions, Maldanidae is divided into several named clades: Euclymeninae, Lumbriclymeninae, Maldaninae, Notoproctinae, and Rhodininae.
MELINNIDAE CHAMBERLIN, 1919
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Melinnidae (Pl. 12c, d) is a small taxon of tubicolous Terebelliformia, containing only around 50 accepted species that are generally found in deeper waters. The group’s name is seemingly derived from an ancient Greek women’s name, Melinna, and this was the first genus name for the group (Read and Fauchald, 2021).
ORBINIIDAE HARTMAN, 1942
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Orbiniidae is a diverse group of over 200 named species that are mainly burrowers in shallow to deep marine sediments.
DINOPHILIDAE MACALISTER, 1876
Authors: Rouse Greg W. , Pleijel Fredrik , Ekin Tilic
Published: February 2022

Dinophilus was erected by Schmidt (1848) and the name refers to the whirling motion these worms can show owing to their ciliary movement. Dinophilidae are all small, at less than 3 mm long as adults, and lack chaetae and obvious segmentation.
Effects of pore interconnectivity on bone regeneration in carbonate apatite blocks
Authors: Elsheikh Maab , Kishida Ryo , Hayashi Koichiro , Tsuchiya Akira , Shimabukuro Masaya , Ishikawa Kunio
Published: February 2022

Porous architecture in bone substitutes, notably the interconnectivity of pores, is a critical factor for bone ingrowth. However, controlling the pore interconnectivity while maintaining the microarchitecture has not yet been achieved using conventional methods, such as sintering. Herein, we fabricated a porous block using the crystal growth of calcium sulfate dihydrate, and controlled the pore interconnectivity by limiting the region of crystal growth. The calcium sulfate dihydrate blocks were transformed to bone apatite, carbonate apatite (CO3Ap) through dissolution–precipitation reactions. Thus, CO3Ap blocks with 15% and 30% interconnected pore volumes were obtained while maintaining the microarchitecture: they were designated as CO3Ap-15 and CO3Ap-30, respectively. At 4 weeks after implantation in a rabbit femur defect, new bone formed throughout CO3Ap-30, whereas little bone was formed in the center region of CO3Ap-15. At 12 weeks after implantation, a large portion of CO3Ap-30 was replaced with new bone and the boundary with the host bone became blurred. In contrast, CO3Ap-15 remained in the defect and the boundary with the host bone was still clear. Thus, the interconnected pores promote bone ingrowth, followed by replacement of the material with new bone. These findings provide a useful guide for designing bone substitutes for rapid bone regeneration.
Value fluidity and value anchoring: race, intermediaries and valuation in two housing markets
Authors: Besbris Max , Korver-Glenn Elizabeth
Published: February 2022

This article argues that analysts should examine how individuals perceive and construct value in order to understand persistent forms of inequality. Drawing on years of ethnographic observations of real estate professionals and homeseekers across various segments of the housing markets in Houston, TX and New York, NY, this article develops the concepts of value fluidity and value anchoring to describe how valuation occurs and to better theorize how valuation itself reproduces racial–spatial inequality in housing. It shows that consumers’ valuation criteria can be quite malleable and highly influenced by intermediaries and experts. At the same time, valuation is patterned in reference to existing hierarchies. The article concludes by arguing for the importance of theorizing valuation through observation of market interactions and by showing why investigations of the housing market must focus on intermediaries.
Considerations and opportunities for multilevel HPV vaccine communication interventions
Authors: Oh April , Gaysynsky Anna , Winer Rachel L , Lee Hee Y , Brewer Noel T , White Arica
Published: February 2022

From 2016 to 2019, the National Cancer Institute and the Centers for Disease Control and Prevention funded three Special Interest Projects focused on developing and testing multilevel HPV vaccination communication interventions. In this commentary, we highlight lessons learned from the funded projects, including the importance of engaging community members in the early stages of the research process, the challenges of evaluating multilevel interventions, and the need to consider stakeholder implementation preferences.
Innovative Social Media Summit: Providing a Path for Physicians on Social Media
Authors: Perez Marta J. , Omurtag Kenan , Aagaard Eva , Klingensmith Mary , Bhayani Rakhee K.
Published: February 2022

Problem

Physicians’ voices are valued in society and should be present in mainstream social media where they can provide valuable public health messaging and patient education as well as increase opportunities for medical education, mentoring, and collaboration. However, lack of formal education on effective use of social media prevents many physicians from using it.

Approach

The authors developed a physician-led social media training program to address the need for formal instruction on social media use. The program was presented to medical students, trainees, and faculty at an academic medical institution in August and September 2020. The virtual format included 5 hour-long sessions with presentations by peer experts in social media. Peer physicians with experience using social media presented on a range of topics, including introductions to platforms, how to reach and grow audiences, and use of social media to advance patient education, medical education, and advocacy.

Outcomes

There were 425 cumulative registrations for the 5 sessions of the Social Media Summit. The number of registrants increased for each session, suggesting that interest increased over time. Qualitative and quantitative participant feedback was collected via a brief, voluntary survey. All of the participants who completed the survey (n = 24) reported they were “very satisfied” (58.3%) or “somewhat satisfied” (41.7%) with the Summit.

Next Steps

Physician involvement in social media presents opportunities for public health knowledge, medical education, scientific collaboration, and career advancement. Physicians who have been successful in using social media for these purposes are excellent peer educators and can fill the medical education void in social media training. Future plans include building sustainability of the program, collecting additional quantitative and qualitative feedback to guide improvement, and encouraging reproducibility.
Serious Adverse Events With Injectable Fillers: Retrospective Analysis of 7,659 Patient Outcomes
Authors: Kern Jessica A. , Kollipara Ramya , Hoss Elika , Boen Monica , Wu Douglas C. , Groff William , Goldman Mitchel P.
Published: February 2022

BACKGROUND

In total, 2.7 million injectable filler treatments were performed in 2019 in the United States. Although generally considered to be a safe treatment modality, adverse events may occur in rare situations.

OBJECTIVE

Analyze serious adverse events from injectable filler treatments, including infections, cutaneous necrosis, blindness, or delayed-onset nodule formation, spanning 11 years for 3 board-certified dermatologists and review their incidence, management, and outcomes.

MATERIALS AND METHODS

A retrospective analysis was performed of injectable filler treatments spanning 11 years at a multipractitioner outpatient clinic. Serious adverse events were identified, and treatment measures were documented. A literature search was performed to determine recent trends and outcomes for comparison.

RESULTS

Between January 2009 and August 2020, 18,013 mL of injectable filler was administered to 7,659 patients. Of the 18,013 mL administered, 74.1% comprised hyaluronic acid derivatives, 19.19% poly-l-lactic acid, and 6.71% calcium hydroxylapatite. Four serious adverse events were identified. Three events were delayed-onset skin nodule formation. One adverse event was related to vascular compromise and subsequent cutaneous necrosis. After appropriate treatment, all adverse events resolved without significant long-term sequelae.

CONCLUSION

Serious adverse events associated with injectable fillers, when performed by board-certified dermatologists, are extremely rare and can be successfully managed with appropriate treatment.
Proanthocyanidins Promote Endothelial Cell Viability and Angiogenesis
Authors: Wang Dingkun , Du Zhiyong , Mighri Frej , Xu Zaipin , Wang Lu , Zhang Ze
Published: February 2022

Botanic drugs are reportedly effective in treating ischemic conditions by improving vascular circulation. However, it has been very rare for biomaterial researchers to look into the possibility of using such products in the context of tissue regeneration. This work studied 4 botanic drugs to explore their effects on vascular endothelial cell growth. Human umbilical endothelial cells were cultured in the presence of different doses of astragalus powder extract, astragalus injection, puerarin injection, and proanthocyanidin (PAC). Among the 4 drugs, PAC showed a potent effect on cell viability and stimulated cell growth in a dose-dependent manner. In particular, the PAC under test was able to maintain a high level of cell viability/proliferation comparable with the cells supplemented with the endothelial cell growth medium, at both low and normal serum conditions. Blocking either endothelial cell growth factor receptors or epithelial cell growth factor receptors was ineffective in reducing the stimulatory effect. The PAC released from polyvinyl alcohol cryogels stimulated HUVECs proliferation. The chick embryo chorioallantoic membrane model was further used to test the angiogenicity of PAC, showing that this botanic drug was potent in stimulating vasculature development. This work therefore demonstrates for the first time that PAC is capable of upregulating endothelial cell activity and growth in vitro in the absence of growth factors and that PAC can be loaded and released from drug carriers and can stimulate angiogenesis. These findings suggest the application of PAC in angiogenesis and tissue regeneration.
Efficacy and Safety of Clopidogrel Versus Ticagrelor as Part of Dual Antiplatelet Therapy in Acute Coronary Syndrome—A Systematic Review and Meta-analysis
Authors: Bergh Niklas , Myredal Anna , Nivedahl Per , Petzold Max , Zarin Sultan , Wartenberg Constanze , Wallerstedt Susanna M.
Published: February 2022

The efficacy and safety of clopidogrel compared with ticagrelor as part of dual antiplatelet therapy in patients, and in older patients, with acute coronary syndrome is reviewed. PubMed, Embase, the Cochrane Library, MEDLINE, and HTA databases were searched (September 2, 2020) for randomized controlled trials (RCTs). Pooled risk differences (clopidogrel minus ticagrelor) were estimated using random-effects meta-analyses, and certainty of evidence was assessed according to Grading of Recommendations Assessment, Development, and Evaluation. In all, 29 RCTs were identified. The risk difference for all-cause mortality was 0.6% (−0.03% to 1.3%), cardiovascular (CV) mortality: 0.6% (95% confidence interval: 0.01% to 1.1%), myocardial infarction (MI): 0.9% (0.4% to 1.3%), stent thrombosis: 0.7% (0.4 to 1.1%), clinically significant bleeding: −1.9% (−3.7% to −0.2%), major bleeding: −0.9% (−1.6% to −0.1%), and dyspnea: −5.8% (−7.7% to −3.8%). In older patients, there were no differences between the comparison groups regarding all-cause mortality, CV mortality, and MI, whereas the risk of clinically significant bleeding and major bleeding was lower in the clopidogrel group, −5.9% (−11 to −0.9%, 1 RCT) and −2.4% (−4.4% to −0.3%), respectively. Compared with ticagrelor, clopidogrel may result in little or no difference regarding all-cause mortality. Although not evident in older patients, it cannot be excluded that clopidogrel may be slightly less efficient in reducing the risk of CV mortality and MI, whereas ticagrelor is probably more efficacious in reducing the risk of stent thrombosis. Clopidogrel results in a reduced risk of dyspnea and clinically significant bleeding and in older people probably in a reduced risk of major bleeding.
Icariside II Attenuates Vascular Remodeling Via Wnt7b/CCND1 Axis
Authors: Wu Hong-Yu , Li Jia-Yang , Wen Hao , Li Yi-Qi , Li Ye-Li , Li Guang-Yue , Jiang Yan , Lv Jun-Yuan , Yang Dan-li
Published: February 2022

Angioplasty often fails due to the abnormal proliferation of vascular smooth muscle cells (VSMCs). Success rates of angioplasty may increase following the administration of an agent that effectively ameliorates aberrant vascular remodeling. Icariside II (ICS-II) is a natural flavonol glycoside extract from the Chinese herbal medicine Epimedii that possesses several medicinal qualities that are beneficial in humans. Nevertheless, the role of ICS-II in addressing aberrant vascular remodeling have yet to be clarified. The current investigation studies the molecular effects of ICS-Ⅱ on balloon-inflicted neointimal hyperplasia in rats in vivo and on platelet-derived growth factor–induced vascular proliferation in primary rat aortic smooth muscle cells (VSMCs) in vitro. ICS-II was found to be as effective as rapamycin, the positive control used in this study. ICS-II inhibited neointimal formation in injured rat carotid arteries and notably reduced the expression of Wnt7b. ICS-Ⅱ significantly counteracted platelet-derived growth factor–induced VSMCs proliferation. Cell cycle analysis showed that ICS-II triggered cell cycle arrest during the G1/S transition. Western blot analysis further indicated that this cell cycle arrest was likely through Wnt7b suppression that led to CCND1 inhibition. In conclusion, our findings demonstrate that ICS-II possesses significant antiproliferative qualities that counteracts aberrant vascular neointimal hyperplasia. This phenomenon most likely occurs due to the suppression of the Wnt7b/CCND1 axis.
Ocular injectable treatment options for postcataract macular edema: systematic review
Authors: Ahmadyar Gina , Hansen Ryan
Published: February 2022

The incidence of pseudophakic cystoid macular edema (PCME) ranges from 0.1% to 20% and is the most common cause of postprocedure vision loss. Currently, there is no widely accepted treatment for PCME. Topical nonsteroidal anti-inflammatory drugs as drops given alone or in combination with topical corticosteroids are often used; however, there is a growing body of literature surrounding the off-label use of various ocular injectable medications. The purpose of this systematic literature review was to characterize the current evidence surrounding these treatments and conduct qualitative analysis to assess the risk for bias of each study. 18 total studies were found and evaluated to have moderate (n = 3, 17%) to high risk (n = 15, 83%) of bias. Although the growing body of real-world data favors improvements in visual acuity and anatomical outcomes with these injectable treatments, larger studies with a better study design are needed to demonstrate their role in the management of PCME.
Outcome of astigmatism correction using femtosecond laser combined with cataract surgery: penetrating vs intrastromal incisions
Authors: Wang Li , Scott Wendell , Montes de Oca Ildamaris , Koch Douglas D. , Tauber Shachar , Al-Mohtaseb Zaina
Published: February 2022

Purpose:

To compare the effectiveness of penetrating vs intrastromal femtosecond laser corneal relaxing incisions (CRIs) in reducing corneal astigmatism during cataract surgery.

Settings:

Baylor College of Medicine and Mercy Clinic Eye Specialists.

Design:

Prospective randomized study.

Methods:

248 eyes from 248 patients were included. Patients were randomly assigned to undergo paired penetrating (8 mm optical zone [OZ] at 1 center and 9 mm OZ at the other) or intrastromal CRIs (8 mm OZ at both centers). The lengths of the CRIs were based on published nomograms but modified to take into account posterior corneal astigmatism. Vector analysis was performed, and net corneal changes along the CRI meridian were calculated. Multiple regression analysis was performed to assess factors contributing to net corneal changes.

Results:

Preoperatively, 9% to 18% of eyes had corneal astigmatism of ≤0.5 diopters (D), and 76% to 93% of eyes had postoperative refractive astigmatism of ≤0.5 D (P < .05). Both penetrating and intrastromal CRIs produced significant mean net corneal changes along the CRI meridian (−0.49 to −1.21 D), and 71% to 84% of eyes had postoperative astigmatism vector prediction errors of ≤0.50 D. The 8 mm penetrating CRIs induced greater net corneal changes but more eyes with overcorrection than did the intrastromal and 9 mm penetrating CRIs (all P < .05). Greater net corneal changes occurred with longer CRI length, higher preoperative corneal astigmatism magnitude, and preoperative against-the-rule corneal astigmatism. Nomograms based on anterior and total corneal astigmatism are proposed.

Conclusions:

Both penetrating and intrastromal CRIs were effective in reducing corneal astigmatism during cataract surgery.
Sex Differences in Cardiac Risk Factors in Young Adults
Authors: Davis Erica , Higgins Melinda K. , Wood Kathryn A. , Cimiotti Jeannie , Gary Rebecca A. , Dunbar Sandra B.
Published: February 2022

Background

Coronary artery disease (CAD) is increasing in young adults, and greater understanding of their cardiac risk factors is essential to ensure effective prevention. Given the sex differences in CAD observed in older adults, understanding sex differences in risk factors for this younger group of adults is important. Having insight of cardiac risk factors and sex differences in the young adult population is essential to creating personalized strategies for prevention in nursing care and in this age group.

Objectives

The aims of this study were to determine the differences in CAD risk factors for young adult men and women and examine which factors are related to CAD early in life, ultimately to guide approaches for CAD prevention in primary care.

Methods

In this secondary analysis, 125 017 community-dwelling young adults were evaluated for health behaviors considered as risk factors for CAD. The 2017 Behavior Risk Factor Surveillance System database from the Center for Disease Control was utilized. This database contains questions asked of young adults that would help with risk management for chronic diseases like CAD. Young adults in this article were defined as being between 18 and 44 years of age.

Results

Men reported more cardiovascular risk factors than women and developed risk factors at an earlier age. Women had greater percentages of obesity and low activity levels. In this population, those with hypertension had the highest odds ratio for developing CAD.

Conclusions

Differences between men and women in CAD risk factors included lifestyle and other chronic conditions. Greater prevention efforts should focus on these differences in young men and women to reduce risk factors and prevent the development of CAD.
Treatment of in-stent restenosis with sirolimus-eluting magnesium bioresorbable scaffolds: optical coherence tomography insights
Authors: Cuesta Javier , Rivero Fernando , Bastante Teresa , Antuña Paula , Jiménez-Méndez César , García-Guimaraes Marcos , Alfonso Fernando
Published: February 2022

Objectives

To assess the value of sirolimus-eluting magnesium bioresorbable scaffolds (MgS) in the treatment of patients with in-stent restenosis (ISR). The better option for the treatment of patients with ISR remains unsettled. Bioresorbable vascular scaffolds represent an interesting strategy in this setting to avoid another permanent metal layer. The novel MgS is an attractive option to treat these challenging patients.

Methods

We present the results of the first prospective series of consecutive patients with ISR treated with MgS under optical coherence tomography (OCT) guidance.

Results

A total of 14 patients (15 lesions) were prospectively included. The mean age was 67 ± 9 years and six patients (40%) presented with an acute coronary syndrome. In 10 patients (67%), underlying neoatherosclerosis was disclosed by OCT. An excellent MgS expansion was obtained in all but two patients who showed persistent suboptimal expansion in heavily calcified vessels. Minor residual malapposition (n = 5) and angiographically silent minor edge dissections (n = 8) were readily recognized by OCT. After a median clinical follow-up of 30 (range, 20–54) months, no patient required repeated revascularization, suffered a myocardial infarction or device thrombosis.

Conclusions

These preliminary results suggest a potential role for the MgS in selected patients presenting with ISR.
Distribution and prognostic impact of coronary artery disease and nonischemic cardiomyopathies in patients with electrical storm
Authors: Müller Julian , Behnes Michael , Ellguth Dominik , Schupp Tobias , Taton Gabriel , Reiser Linda , Engelke Niko , Borggrefe Martin , Reichelt Thomas , Bollow Armin , Kim Seung-Hyun , Barth Christian , Weidner Kathrin , Battrawy Ibrahim-El- , Ansari Uzair , Akin Muharrem , Große Meininghaus Dirk , Mashayekhi Kambis , Akin Ibrahim
Published: February 2022

Background

he distribution and prognostic impact of coronary artery disease (CAD) in ES are still under debate.

Methods

Consecutive ES patients with implantable cardioverter-defibrillator (ICD) were included retrospectively from 2002 to 2016. Three analyses were applied to characterize ES patients: (a) ES patients without CAD (non-CAD), (b) ES patients with CAD (CAD), and (c) diagnostic findings assessed by coronary angiography (CA) at the time of ES (immediate CA). CAD was compared with non-CAD ES patients, and progressive CAD was compared with stable CAD ES patients. The primary endpoint was all-cause mortality at 2.5 years. Secondary endpoints were the composite endpoint of first recurrent ventricular tachyarrhythmias and appropriate ICD therapies, and recurrence of ES (ES-R) at 2.5 years.

Results

Within a total of 87 consecutive ES patients. CAD was present in more than two-thirds (67%). However, only 52% patients underwent immediate CA at the time of ES. Here, 84% had CAD, of which 39% revealed progressive CAD with the need of target vessel revascularization (TVR) or cardiac transplantation (n = 1). At long-term follow-up, neither the presence (or absence) of CAD (41% vs. 34%; log rank P = 0.708) nor of progressive CAD (33% vs. 26%; log rank P = 0.372) was associated with all-cause mortality at 2.5 years, and further secondary endpoints including the composite of recurrent ventricular tachyarrhythmias plus appropriate ICD therapies, or ES-R.

Conclusion

In ES patients, CAD was more common than non-CAD-related cardiac diseases, accompanied by an underinvestigated rate of CA despite increasing rates of progressive CAD. CAD had no prognostic impact in ES.
Metal versus plastic stents in the management of benign biliary strictures: systematic review and meta-analysis of randomized controlled trials
Authors: Kamal Faisal , Ali Khan Muhammad , Lee-Smith Wade , Sharma Sachit , Acharya Ashu , Imam Zaid , Jowhar Dawit , Esswein Julia , Kothadia Jiten , Aziz Muhammad , Chandan Saurabh , Arain Mustafa , Howden Colin W , Ismail Mohammad K
Published: February 2022

Benign biliary strictures (BBS) are usually treated with endoscopic retrograde cholangiopancreatography (ERCP) with the placement of multiple plastic stents (MPS) or a covered self-expandable metal stent (CSEMS). In this meta-analysis, we compared the efficacy and safety of MPS and CSEMS in the management of BBS. We reviewed several databases from inception to 28 April 2021 to identify RCTs that compared MPS with CSEMS in the management of BBS. Our outcomes of interest were stricture resolution, stricture recurrence, adverse events, stent migration and mean number of ERCPs to achieve stricture resolution. Data were analyzed using a random-effects model. We included eight RCTs with 524 patients. We found no significant difference in the rate of stricture resolution (risk ratio, 1.02; 95% CI, 0.96–1.10), stricture recurrence (risk ratio, 1.68; 95% CI, 0.72–3.88) or adverse events (risk ratio, 1.17; 95% CI, 0.73–1.87) between groups. Mean number of ERCPs was significantly lower in the CSEMS group (SMD, −1.99; 95% CI, −3.35 to −0.64). The rate of stent migration was significantly higher in the CSEMS group. CSEMS are comparable in efficacy and safety to MPS in the management of BBS but require fewer ERCPs to achieve stricture resolution.
Familiar Infections in Novel Anatomy: Patient Reports of Sexually Transmitted Infections After Gender-Affirming Penile Reconstruction
Authors: Blasdel Gaines , Robinson Isabel , Parker Augustus , Zhao Lee C. , Bluebond-Langner Rachel
Published: February 2022

Background

Sexually transmitted infections (STIs) after penile reconstruction in transgender, nonbinary, and other gender expansive (T/GE) populations have not previously been described, despite known risk factors in the population. After T/GE penile reconstruction, care providers may underdiagnose STI without anatomically appropriate guidelines.

Methods

A detailed anonymous online survey of experiences of T/GE penile reconstruction patients was constructed with community input. Respondents were recruited from online support groups.

Results

A total of 128 T/GE people with experience of penile reconstruction responded to an anonymous survey posted in online support groups from January to May 2020. Seven respondents (5.5%) self-reported 1 or more of the listed STIs at any point after penile reconstruction. All respondents with neourethras were diagnosed with localized STIs in nonurethral (extrapenile) locations only, and lack of vaginectomy was correlated with STI (P = 0.002). Sexually transmitted infections were correlated with reporting sex with cisgender men (P = 0.001), transgender men (P = 0.009), and transgender women (P = 0.012). Of health care access variables, only receiving health care at a community health center was correlated with STI history (P = 0.003).

Conclusions

This exploratory survey indicates that STI occurs after penile reconstruction in T/GE patients. Clinical confirmation is needed to identify specific risk factors and relative susceptibility of postreconstruction anatomy to STIs. Given no previous surveillance recommendations for this population and the correlation of health care provider location with STI prevalence, underdiagnoses are likely. Based on the authors' clinical experience, we describe a urogenital screening algorithm after gender-affirming penile reconstruction.
Using Patient-Reported Outcome Measures to Screen for Cognitive Function Deficits and Stigma in Patients with Single-Suture Craniosynostosis
Authors: Said Abdullah M. , Skolnick Gary B. , Girresch-Ward Sarah , Cradock Mary Michaeleen , Naidoo Sybill D. , Smyth Matthew , Patel Kamlesh B.
Published: February 2022

Children with single-suture craniosynostosis have small but significant deficits in appearance ratings and neurodevelopment. Traditionally, these parameters are studied using a full battery of examinations, which are very time consuming. This study evaluated a convenient method to measure psychosocial parameters in this population by utilizing patient-reported outcomes measures to evaluate cognitive function and stigma. Stigma and cognitive function were measured, using the Patient-Reported Outcomes Measurement Information System and Quality of Life in Neurological Disorders questionnaires, in 59 consecutive patients at least 5 years old presenting to clinic from July of 2018 to January of 2020 with repaired single-suture craniosynostosis. Parents completed parent proxy cognitive function surveys for patients under age 8. Questionnaires were administered electronically as part of clinical care. Scores were automatically transferred to the electronic medical record and correlated with previously acquired Child Behavior Checklist results. Median time to complete the questionnaires was 57 and 49 seconds, respectively. Stigma and cognitive function were significantly correlated with the associated Child Behavior Checklist subscores (Spearman’s rho, −0.384, p = 0.023; and Spearman’s rho, −0.683, p = 0.001, respectively). The Patient-Reported Outcomes Measurement Information System and Quality of Life in Neurological Disorders questionnaires offer a convenient method of screening psychosocial parameters in children with single-suture craniosynostosis that otherwise would be difficult to obtain during standard visits. Short completion times and electronic scoring increase clinical utility.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Diagnostic, II.
Content and Actionability of Recommendations to Providers After Shadow Coaching
Authors: Quigley Denise D. , Qureshi Nabeel , Palimaru Alina , Pham Chau , Hays Ron D.
Published: February 2022

Background and Objectives:

Health care organizations track patient experience data, identify areas of improvement, monitor provider performance, and assist providers in improving their interactions with patients. Some practices use one-on-one provider counseling (“shadow coaching”) to identify and modify provider behaviors. A recent evaluation of a large shadow coaching program found statistically significant improvements in coached providers' patient experience scores immediately after being coached. This study aimed to examine the content of the recommendations given to those providers aimed at improving provider-patient interactions, characterize these recommendations, and examine their actionability.

Methods:

Providers at a large, urban federally qualified health center were selected for coaching based on Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) patient experience scores (92 of 320 providers), shadowed by a trained peer coach for a half to full day and received recommendations on how to improve interactions with their patients. We coded 1082 recommendations found in the 92 coaching reports.

Results:

Reports contained an average of 12 recommendations. About half encouraged consistency of existing behaviors and half encouraged new behaviors. Most recommendations related to behaviors of the provider rather than support staff and targeted actions within the examination room rather than other spaces (eg, waiting room). The most common recommendations mapped to behavioral aspects of provider communication. Most recommendations targeted verbal rather than nonverbal communication behaviors. Most recommendations were actionable (ie, specific, descriptive), with recommendations that encouraged new behaviors being more actionable than those that encouraged existing actions.

Conclusions:

Patient experience surveys are effective at identifying where improvement is needed but are not always informative enough to instruct providers on how to modify and improve their interactions with patients. Analyzing the feedback given to coached providers as part of an effective shadow-coaching program provides details about implementation on shadow-coaching feedback. Recommendations to providers aimed at improving their interactions with patients need to not only suggest the exact behaviors defined within patient experience survey items but also include recommended behaviors indirectly associated with those measured behaviors. Attention needs to be paid to supplementing patient experience data with explicit, tangible, and descriptive (ie, actionable) recommendations associated with the targeted, measured behaviors. Research is needed to understand how recommendations are put into practice by providers and what motivates and supports them to sustain changed behaviors.
No apparent effect of a magnetic pulse on free-flight behaviour in northern wheatears (
Oenanthe oenanthe
) at a stopover site
Authors: Karwinkel Thiemo , Winklhofer Michael , Christoph Paula , Allenstein Dario , Hüppop Ommo , Brust Vera , Bairlein Franz , Schmaljohann Heiko
Published: February 2022

Naïve migrants reach their wintering grounds following a clock-and-compass strategy. During these inaugural migrations, birds internalise, among others, cues from the Earth's magnetic field to create a geomagnetic map, with which they navigate to destinations familiar to them on subsequent migrations. Geomagnetic map cues are thought to be sensed by a magnetic-particle-based receptor, which can be specifically affected by a magnetic pulse. Indeed, the orientation of experienced but not naïve birds was compromised after magnetic pulsing, indicating geomagnetic map use. Little is known about the importance of this putative magnetoreceptor for navigation and decision-making in free-flying migrants. Therefore, we studied in unprecedented detail how a magnetic pulse would affect departure probability, nocturnal departure timing, departure direction and consistency in flight direction over 50–100 km in experienced and naïve long-distant migrant songbirds using a large-scale radio-tracking system. Contrary to our expectations and despite a high sample size (
n
total
= 137) for a free-flight study, we found no significant after-effect of the magnetic pulse on the migratory traits, suggesting the geomagnetic map is not essential for the intermediate autumn migration phase. These findings warrant re-thinking about perception and use of geomagnetic maps for migratory decisions within a sensory and ecological context.
Using average transcription level to understand the regulation of stochastic gene activation
Authors: Chen Liang , Lin Genghong , Jiao Feng
Published: February 2022

Gene activation is a random process, modelled as a framework of multiple rate-limiting steps listed sequentially, in parallel or in combination. Together with suitably assumed processes of gene inactivation, transcript birth and death, the step numbers and parameters in activation frameworks can be estimated by fitting single-cell transcription data. However, current algorithms require computing master equations that are tightly correlated with prior hypothetical frameworks of gene activation. We found that prior estimation of the framework can be facilitated by the traditional dynamical data of mRNA average level
M
(
t
), presenting discriminated dynamical features. Rigorous theory regarding
M
(
t
) profiles allows to confidently rule out the frameworks that fail to capture
M
(
t
) features and to test potential competent frameworks by fitting
M
(
t
) data. We implemented this procedure for a large number of mouse fibroblast genes under tumour necrosis factor induction and determined exactly the ‘cross-talking
n
-state’ framework; the cross-talk between the signalling and basal pathways is crucial to trigger the first peak of
M
(
t
), while the following damped gentle
M
(
t
) oscillation is regulated by the multi-step basal pathway. This framework can be used to fit sophisticated single-cell data and may facilitate a more accurate understanding of stochastic activation of mouse fibroblast genes.
Development and Pilot Testing of a Five Item Traumatic Stress Screener for Use with Adolescents in Pediatric Primary Care
Authors: Ng Lauren C. , Oblath Rachel , Brigham Rebecca , Tai Ming Him , Coles Mandy
Published: February 2022

Objectives

To develop and assess the psychometric properties of the Adolescent Primary Care Traumatic Stress Screen (APCTSS), a five-item yes/no screener for PTSD symptoms in adolescents, and the first developed for pediatric primary care.

Study Design

The APCTSS was developed by combining and adapting the UCLA PTSD Reaction Index for DSM-5 with the adult Primary Care PTSD Screen for DSM-5. Adolescent medicine patients were universally approached during clinic visits. With a response rate of 83.6%, 178 patients aged 13-22 (M=18.4, SD=2.3), 64.4% female; 62.1% Black or African-American and 20.7% Hispanic/Latinx, were enrolled. Patients completed APCTSS, Patient Health Questionnaire for Adolescents (PHQ-A), and Child PTSD Symptom Scale for DSM-5 Interview (CPSS-5-I), and 61 completed the Traumatic Events Screening Inventory for Children (TESI-C).

Results

56.7% reported a criterion A trauma, 30.1% met criteria for PTSD, 7.4% met criteria for subsyndromal PTSD, and 19.0% for post-event impairing symptoms. Scores ≥ 2 on the APCTSS optimized sensitivity (.79; 95% CI=.66 to .89) and specificity (.68; 95% CI=.55 to .76) for PTSD, with an area under the curve (AUC) of .79. Sensitivity (.86; 95% CI=.65 to .90), specificity (.77; 95% CI=.60 to .90), and AUC (.86) were even stronger when the TESI-C was used to assess criterion A for PTSD diagnosis. Over half (56.0%) of patients who screened positive on the APCTSS were missed by the PHQ-A.

Conclusions

The APCTSS shows promise as an internally consistent, valid, and effective tool for identifying adolescents at high risk of PTSD and traumatic stress.