bluuebunny/crossref_metadata_2025 huggingface dataset:
A single-centre analysis of in-stent restenosis after left main stenting
Authors: Jariwala P , Jadhav KARTIK
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Percutaneous coronary interventions (PCI) can be the standard of care for left main (LM) coronary artery disease. In-stent restenosis (ISR) is a rare complication and is associated with patient- and procedure-specific aspects. The aim of our analysis is to evaluate the incidence and the predictors of ISR after left main PCI.

Methods

From June 2018 till June 2019, 156 LM procedures were performed in our centre with second-generation drug-eluting stents (DES). Our registry includes a wide spectrum of patients, with stable coronary artery disease and with acute coronary syndrome, including STEMI, unprotected and protected LM, high and low SYNTAX scores, with or without true bifurcation disease (engagement). 

Results

In 22.3 percent of the patients, previous percutaneous or surgical revascularization was found. In 78 percent of cases, the recommended care method was provisional stenting, and in 68 percent, IVUS support was used. In hospital discharge the 1st, 6th, 12th month, and each year afterwards, patients were prospectively followed up for MACE (defined as death, stroke, symptom triggered repeat revascularization).

According to our data, the only predictor of ISR at multivariate analysis turned out to be type II  diabetes mellitus (OR = 3.84; 95% CI: 1.18-13.65, p = 0.007), while sex, age, prior revascularisation and the clinical presentation at admission (stable or acute), stent technique and complex anatomy were not. All patients with significant ISR were retreated successfully; 38 (24%) of them interventionally and in 3 (1.92%) of the cases, surgically.

Conclusions

According to the results from our registry, composed of all-comer patients, restenosis after PCI of LM with second-generation DES is an infrequent event. The most common location of IRS is at the ostium of the circumflex artery and distal left main. Type II diabetes mellitus is the only predictor of ISR at multivariate analysis.
P2Y12 pre-treatment for NSTE-ACS in a tertiary hospital centre: real world compliance experience with ESC 2020 guidelines
Authors: Kaul R , Khoo J , Pender P , Hopkins A , Lo S
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background

The 2020 ESC guidelines for managing NSTE-ACS recommend against routine pre-treatment with a P2Y12 receptor inhibitor if coronary anatomy is not known and an early (<24h) invasive management is planned. With delayed (>24h) invasive management, pre-treatment may be considered in selected cases.

Purpose

Evaluate antiplatelet pre-treatment practices for NSTE-ACS in a tertiary cardiology centre in Australia.

Methods

Retrospective analysis of NSTE-ACS cases from January to August 2021 were obtained from the cardiac laboratory database. Patients on a P2Y12 inhibitor prior to presentation were excluded. Clinical, demographic, angiographic and medication data were obtained from the electronic database.

Results

85 cases were included. Mean age was 62 ± 11.5 and 81% were male. The prevalence of hypertension, hypercholesterolaemia, type 2 diabetes and active smoking was 54.8%, 51.2%, 38.1% and 34.5% respectively. Mean time to angiography was 1.7 ± 1.4 days and the median peak pre-procedural troponin T was 191.5 (80 to 852). Access was predominantly radial (84.5%) with the remainder femoral (15.5%).

Angiographic findings included, obstructive disease amenable to percutaneous coronary intervention (50.0%), obstructive disease for surgical revascularisation (22.6%), and non-obstructive disease (27.4%). The mean time from angiography to surgical revascularisation was 6.4 ± 4.4 days. Three patients (3.6%) had bleeding [managed conservatively], specifically upper limb haematoma, groin haematoma, and haemoptysis.

The majority of patients (79.8%) received P2Y12 inhibitors (40.5% clopidogrel and 39.3% ticagrelor) prior to angiography. Of these, 49.3% had percutaneous angioplasty, 17.9% had surgical revascularisation and 32.8% had non-obstructive disease (managed with single antithrombotic agent). Of those who did not receive P2Y12 inhibitors [n = 17, 20.2%]. Of these, 53% had percutaneous angioplasty, 40% had surgical revascularisation, and 5% had non-obstructive disease.

Conclusions

Overall, pre-treatment with a P2Y12 inhibitor was still very common, risking delays to bypass surgery and increasing bleeding. Practice did not generally align with contemporary ESC 2020 guidelines. Understanding the reasons for guideline non-compliance would be important for optimising treatments. Education for emergency and cardiology staff as well as creation of local practice policies may help increase compliance with evidence-based guidelines.
The impact of blood pressure variation on mortality and symptomatic intracerebral hemorrhage in stroke patients after thrombolytic therapy
Authors: Kotruchin P , Kliangsa-Ard H , Mitsungnern T , Imoun S , Kongbunkiat K
Published: February 2022

Funding Acknowledgements

Type of funding sources: Public Institution(s). Main funding source(s): Faculty of Medicine, Khon Kaen University

Introduction Blood pressure variation (BPV) was one of the risk factors for unfavorable stokes outcomes. However, the association between BPV and short-term outcomes in stroke patients after received thrombolysis (recombinant tissue plasminogen activator; rt-PA) was limited.

Objectives We aimed to determine the association between BPV and mortality and symptomatic intracerebral hemorrhage (s-ICH) in stroke patients after rt-PA administration.

Methods This was a cross-sectional study in a specialized stroke unit of our university hospital, during 2015-2019. Adult ischemic-stroke patients who were eligible for receiving rt-PA were enrolled. Supine BP was measured just before starting rt-PA and at 0, 4, 8, 12, 16, 20, and 24 hours after completing rt-PA administration. The standard deviation (SD), coefficient of variation (CV), and successive variation (SV) of both systolic blood pressure (SBP) and diastolic blood pressure (DBP) were calculated. Final outcomes were in-hospital mortality, or s-ICH.

Results There were 278 patients enrolled, 138 men (49.6%), and mean age 65 ± 13 years old. Ten patients died (3.6%) and 27 patients had s-ICH (9.7%). There were 86 (30.9%) patients who received IV nicardipine before and after rt-PA. All BPV profiles of SBP were associated with mortality and s-ICH. Odds ratio (OR) for mortality were as follows; SD, 1.10 (1.02-1.19); CV, 1.13 (1.02-1.25); and SV, 1.07 (1.01-1.13), and OR for s-ICH were as follows; SD, 1.07 (1.02-1.14); CV, 1.11 (1.03-1.19); and SV, 1.05 (1.01-1.10). The BPV profiles of DBP also showed significant positive association with mortality and s-ICH. However, mean SBP and DBP, and time to rt-PA were not associated with both outcomes.

Conclusions BPV profiles of both SBP and DPB were positively associated with mortality and s-ICH in stroke patients after receiving rt-PA, independent of BP levels. Further study on the optimal BPV and the treatment towards it is crucial.
An intervention in general practice to improve the management of Lyme borreliosis in Denmark
Authors: Knudtzen Fredrikke Christie , Jensen Thøger Gorm , Andersen Nanna Skaarup , Johansen Isik Somuncu , Hovius Joppe W , Skarphédinsson Sigurdur
Published: February 2022

Background

Our objectives were to improve the following outcomes in patients with Lyme borreliosis (LB) through an educational intervention in general practice: (i) increase the number of hospital referrals on suspicion of LB, (ii) increase the number of cerebrospinal fluid (CSF) tests examined for Borrelia burgdorferi antibody index, (iii) decrease the number of serum-B. burgdorferi antibody tests ordered, (iv) shorten delay from symptom onset to hospital in Lyme neuroborreliosis (LNB) patients, (v) increase LB knowledge among general practitioners.

Methods

A prospective non-blinded non-randomized intervention trial on the island of Funen, Denmark. The intervention included oral and written education about LB and was carried out in areas with an LNB incidence ≥4.7/100.000 between 22 January 2019 and 7 May 2019. Results were compared between the intervention group (49 general practices) and the remaining general practices in Funen (71 practices) 2 years before and after the intervention.

Results

In the study period, 196 patients were referred on suspicion of LB, a 28.9% increase in the intervention group post-intervention, 59.5% increase in the control group (P = 0.47). The number of CSF-Borrelia-antibody index tests increased 20.8% in the intervention group, 18.0% in the control group (P = 0.68), while ordered serum-B. burgdorferi antibody tests declined 43.1% in the intervention group, 34.5% in the control group (P = 0.30). 25.1% had the presence of serum-B. burgdorferi antibodies. We found no difference in LNB pre-hospital delay before and after intervention or between groups (P = 0.21). The intervention group performed significantly better on a follow-up questionnaire (P = 0.02).

Conclusion

We found an overall improvement in LB awareness and referrals among general practitioners but could not show any effect of the intervention on clinical outcomes of LNB.
Phylogenetic diversity and plant growth-promoting activities of rhizobia nodulating fenugreek (Trigonella foenum-graecumLinn.) cultivated in different agroclimatic regions of India
Authors: Khairnar Mitesh , Hagir Ashwini , Parmar Krupa , Sayyed R Z , James Euan K , Rahi Praveen
Published: February 2022

Fenugreek (Trigonella foenum-graecum Linn.), is an extensively cultivated legume crop used as a herb, spice, and traditional medicine in India. The symbiotic efficiency and plant growth-promoting potential of fenugreek rhizobia depend on the symbiont strain and environmental factors. We isolated 176 root-nodulating bacteria from fenugreek cultivated in different agroclimatic regions of India. MALDI-TOF MS-based identification and phylogenetic analyses based on 16S rRNA and five housekeeping genes classified the fenugreek-rhizobia as Ensifer (Sinorhizobium) meliloti. However, the strains represent separate sub-lineages of E. meliloti, distinct from all reported sub-lineages across the globe. We also observed the spatial distribution of fenugreek rhizobia, as the three sub-lineages of E. meliloti recorded during this study were specific to their respective agroclimatic regions. According to the symbiotic gene (nodC and nifH) phylogenies, all three sub-lineages of E. meliloti harboured symbiotic genes similar to symbiovar meliloti; as with the housekeeping genes, these also revealed a spatial distribution for different clades of sv. meliloti. The strains could nodulate fenugreek plants and they showed plant growth-promoting potential. Significant differences were found in the plant growth parameters in response to inoculation with the various strains, suggesting strain-level differences. This study demonstrates that fenugreek rhizobia in India are diverse and spatially distributed in different agro-climatic regions.
The fucose-specific lectin gene AOL_s00054g276 affects trap formation and nematocidal activity of the nematophagous fungus Arthrobotrys oligospora
Authors: Si Jiali , Dong Xinyuan , Zhang Guanghui , Lu Hengqian , Tang Kaijing , Zhang Li , Kong Xiaowei , Sheng Kangliang , Wang Jingmin , Zha Xiangdong , Wang Yongzhong
Published: February 2022

Nematode-trapping fungi are natural enemies of nematodes in nature. Arthrobotrys oligospora, a typical nematode-trapping fungus with a clear genetic background, can capture and infect nematodes by forming adhesive three-dimensional networks. Lectins, a class of glycoproteins containing glycosyl-specific recognition domains, play an important role in biological recognition. However, the fucose-specific lectins have rarely been studied regarding the process of preying on nematodes. In this study, we characterized the biological role of the fucose-specific lectin-encoding gene AOL_s00054g276 (g276) in A. oligospora. The gene g276 was first deleted based on homologous recombination, then the phenotype and nematocidal activity of the Δg276 mutant was evaluated. The results showed that the deletion of gene g276 delayed trap formation and weakened its nematocidal activity; however, mycelial growth, conidia production, conidial germination rates and adaption to environmental stresses were not affected. Our results suggest that the fucose-specific lectin-encoding gene g276 might be associated with the morphogenesis of this fungus, and its deletion resulted in a significantly low density of three-dimensional traps (P < 0.05) and a significantly low nematode-trapping efficiency (P < 0.001). These findings provide a basis for further elucidating the mechanism of A. oligospora preying on nematodes and lay a foundation for the development and utilization of fungal-derived lectins for nematode control in the future.
Proteome expansion in thePotyviridaeevolutionary radiation
Authors: Pasin Fabio , Daròs José-Antonio , Tzanetakis Ioannis E
Published: February 2022

Potyviridae, the largest family of known RNA viruses (realm Riboviria), belongs to the picorna-like supergroup and has important agricultural and ecological impacts. Potyvirid genomes are translated into polyproteins, which are in turn hydrolyzed to release mature products. Recent sequencing efforts revealed an unprecedented number of potyvirids with a rich variability in gene content and genomic layouts. Here, we review the heterogeneity of non-core modules that expand the structural and functional diversity of the potyvirid proteomes. We provide a family-wide classification of P1 proteinases into the functional Types A and B, and discuss pretty interesting sweet potato potyviral ORF (PISPO), putative zinc fingers, and alkylation B (AlkB)—non-core modules found within P1 cistrons. The atypical inosine triphosphate pyrophosphatase (ITPase/HAM1), as well as the pseudo tobacco mosaic virus-like coat protein (TMV-like CP) are discussed alongside homologs of unrelated virus taxa. Family-wide abundance of the multitasking helper component proteinase (HC-pro) is revised. Functional connections between non-core modules are highlighted to support host niche adaptation and immune evasion as main drivers of the Potyviridae evolutionary radiation. Potential biotechnological and synthetic biology applications of potyvirid leader proteinases and non-core modules are finally explored.
Analysis of genotype-by-environment interactions in a maize mapping population
Authors: Hudson Asher I , Odell Sarah G , Dubreuil Pierre , Tixier Marie-Helene , Praud Sebastien , Runcie Daniel E , Ross-Ibarra Jeffrey
Published: February 2022

Genotype-by-environment interactions are a significant challenge for crop breeding as well as being important for understanding the genetic basis of environmental adaptation. In this study, we analyzed genotype-by-environment interactions in a maize multiparent advanced generation intercross population grown across 5 environments. We found that genotype-by-environment interactions contributed as much as genotypic effects to the variation in some agronomically important traits. To understand how genetic correlations between traits change across environments, we estimated the genetic variance–covariance matrix in each environment. Changes in genetic covariances between traits across environments were common, even among traits that show low genotype-by-environment variance. We also performed a genome-wide association study to identify markers associated with genotype-by-environment interactions but found only a small number of significantly associated markers, possibly due to the highly polygenic nature of genotype-by-environment interactions in this population.
Age-Specific Mortality During the 2020 COVID-19 Pandemic and Life Expectancy Changes in the United States and Peer Countries, 1980–2020
Authors: Masters Ryan K , Woolf Steven H , Aron Laudan Y
Published: February 2022

Objectives

Since the 1980s, life expectancy at birth (e0) in the United States has fallen steadily behind that of other high-income countries, widening the U.S. e0 disadvantage. We estimate how that disadvantage was affected by high mortality rates in 2020, the first full year of the coronavirus disease 2019 pandemic.

Methods

We contrast male and female e0 in the United States and 18 peer countries for years 1980, 1995, 2010, 2019, and 2020. Using Arriaga decomposition, we show how differences in age-specific death rates have contributed to U.S. e0 disadvantages.

Results

In 2020, U.S. male and female e0 changed by −2.33 (−2.50, −2.15) and −1.69 (−1.85, −1.53) years, respectively, whereas corresponding changes in peer countries averaged −0.67 (−0.82, −0.51) and −0.50 (−0.65, −0.35) years, respectively. This accelerated a longstanding and widening U.S. e0 disadvantage relative to its peers, which increased from 3.49 to 5.15 years in males and from 2.78 to 3.97 years in females between 2019 and 2020. Whereas deaths before age 65 accounted for 55% and 40% of declines in U.S. male and female life expectancy, respectively, they accounted for only 24% and 11% of the respective declines in peer countries.

Discussion

U.S. life expectancy declines in 2020 were larger than in peer countries and involved deaths across a broader age range, particularly among young and middle-aged adults. Both the longstanding U.S. e0 disadvantage and acute losses of life in 2020 signal the need for systemic policy changes in the United States.
The Impact of Care Intensity and Work on the Mental Health of Family Caregivers: Losses and Gains
Authors: Kolodziej Ingo W K , Coe Norma B , Van Houtven Courtney H
Published: February 2022

Objectives

We estimate the causal impact of intensive caregiving, defined as providing at least 80 h of care per month, and work on the mental health of caregivers while considering possible sources of endogeneity in these relationships.

Methods

We use 2 linked data sources from the United States by matching caregivers in the National Study of Caregiving with corresponding care recipients in the National Health and Aging Trends Study for years 2011–2017. We address possible sources of endogeneity in the relationships between caregiving, work, and mental health by using instrumental variables methodology, instrumenting for both caregiving and work behavior. We examine 2 measures used to screen for depression (PHQ-2, psychodiagnostic test) and anxiety (GAD-2, generalized anxiety disorders screening instrument), a composite measure that combines these measures (PHQ-4), and positive well-being variables to ascertain possible gains from caregiving.

Results

Providing at least 80 h of care per month to a parent compared to less intensive caregiving increases the PHQ-4 scale for anxiety and depression disorders. This is driven by the screening score for anxiety and not psychodiagnostic test scores for depression. Relationship quality decreases substantially for intensive caregivers, and intensive caregiving leads to less satisfaction that the care recipient is well-cared for. We do not find offsetting mental health gains for intensive caregivers compared to nonintensive caregivers. Work does not independently affect the mental health of caregivers.

Discussion

Caregiver interventions that reduce objective demands or support intensive caregivers could reduce or prevent well-being losses and improve the caregiver’s relationship with the recipient.
Cardiovascular Mortality Gap Between the United States and Other High Life Expectancy Countries in 2000–2016
Authors: Acosta Enrique , Mehta Neil , Myrskylä Mikko , Ebeling Marcus
Published: February 2022

Objectives

Reductions in U.S. cardiovascular disease (CVD) mortality have stagnated. While other high life expectancy countries (HLCs) have also recently experienced a stall, the stagnation in CVD mortality in the United States appeared earlier and has been more pronounced. The reasons for the stall are unknown. We analyze cross-national variations in mortality trends to quantify the U.S. exceptionality and provide insight into its underlying causes.

Methods

Data are from the World Health Organization (2000–2016). We quantified differences in levels and trends of CVD mortality between the United States and 17 other HLCs. We decomposed differences to identify the individual contributions of major CVD subclassifications (ischemic heart disease [IHD], stroke, other heart diseases). To identify potential behavioral explanations, we compared trends in CVD mortality with trends in other causes of death related to obesity, smoking, alcohol, and drugs.

Results

Our study has four central findings: (a) U.S. CVD mortality is consistently higher than the average of other HLCs; (b) the U.S.–HLC gap declined until around 2008 and increased thereafter; (c) the shift from convergence to divergence was mainly driven by slowing IHD and stroke mortality reductions and increasing mortality from other CVD causes; (d) among the potential risk factors, only obesity- and alcohol-related mortality showed age-specific temporal changes that are similar to those observed for cardiovascular mortality.

Discussion

The exceptional changes in U.S. CVD mortality are driven by a distinct pattern of slowing reductions in IHD and stroke mortality and deteriorating mortality from other CVD causes. Obesity and alcohol abuse appear to be interrelated factors.
Adult Children’s Intergenerational Mobility and Older Adults’ Self-Rated Health: A U.S.–China Comparison
Authors: Qin Yue
Published: February 2022

Objectives

This study examines whether and how adult children’s educational mobility is associated with the self-rated health of older adults aged 50 and above in China and the United States.

Methods

The analytic sample included 12,445 Chinese respondents from the 2011 to 2013 China Health and Retirement Longitudinal Study, and 17,121 US respondents from the 2010 to 2012 Health and Retirement Study. Multinomial logistic regression was employed to examine the relationship between children’s educational mobility and parents’ self-rated health, and the Karlson-Holm-Breen-method was used for mediation analysis.

Results

Adult children’s upward mobility was associated with their parents’ better health in both countries. This association was mediated by child-to-parent economic support, as well as parents’ social engagement and depressive symptoms in China; in the United States, parents’ depression was the only significant mediator.

Discussion

This study is among the first to empirically show the benefit of adult children’s upward mobility for their parents’ health. The cross-national differences in the mediating paths suggest that the cross-over effect of children’s intergenerational mobility on their parents’ health is embedded within specific sociocultural contexts.
Exploring job satisfaction among pharmacy professionals in the Arab world: a multi-country study
Authors: Al-Jumaili Ali Azeez , Sherbeny Fatimah , Elhiny Rehab , Hijazi Bushra , Elbarbry Fawzy , Rahal Mohamad , Bukhatwa Salma , Khdour Maher , Thomas Dixon , Khalifa Sherief , Hamad Anas
Published: February 2022

Objectives

The study objectives were to (1) describe the characteristics of the pharmacy professionals and (2) explore the association between job satisfaction and factors, such as work control, work stress, workload and organization and professional commitments.

Methods

This study was a cross-sectional design. The survey items were mainly adapted from the US National Pharmacist Workforce Survey. An electronic (Qualtrics) questionnaire was posted on pharmacist social media in several Arab countries. The survey link was posted from 22 March 2021 to 1 May 2021. The multiple linear regression measured the association between 12 independent variables and pharmacist job satisfaction.

Key findings

A total of 2137 usable surveys were received from pharmacists (54.7% female) working in 18 Arabic countries. The job satisfaction rate varied among countries in the Arab world. The fields with the highest satisfaction average included pharmaceutical marketing, academia and the pharmaceutical industry. At the same time, pharmacists working in community pharmacy and Ministry of Health/administrative positions had the lowest satisfaction rates. Overall, pharmacist satisfaction was average (3.1 out of 5). The pharmacists had the lowest satisfaction averages with income and job expectations. The pharmacists with bachelor’s degrees had significantly lower satisfaction than pharmacists with postgraduate degrees. Male pharmacists had significantly higher job satisfaction compared with female pharmacists. Workload and the feelings of organization and professional commitments had significant positive associations with job satisfaction.

Conclusions

The pharmacy profession in Arabic countries faced several challenges that negatively impacted job satisfaction. Improving work environment, professional management, income and organization loyalty is necessary to enhance pharmacist job satisfaction.
People Doing Things: Residual Subject Realism in the Study of Religion
Authors: DeJonge Michael P
Published: February 2022

This article considers a common theoretical mood within the discipline of religious studies, one that is skeptical about the reality of religion but confident about the reality of people doing things. Analyzing this mood within the context of recent discussions surrounding realism, I argue that this mix of anti-realism with respect to religion and realism with respect to people doing things testifies to the lingering effects of a subject philosophy. Such residual subject-philosophical realism in turn suggests the uneven reception of structure philosophy, a way of thinking that rules out straightforward reference to the reality not only of religion but of people doing things as well. A more faithful reception of structure-philosophical insights suggests opportunities for re-theorizing the reality of religion.
Gjøkvatn revisited: repeated visual observations of plankton swarms in a subarctic forest lake
Authors: Klemetsen Anders
Published: February 2022

Distinct swarms of Bosmina longispina (Leydig, 1860) (Crustacea: Cladocera) were visually observed and described in Gjøkvatn, a Norwegian forest lake at 69°N, in 1969 and again in 1996 and 2021. The repeated observations after many years show that Bosmina swarms occur regularly in the lake. The swarming is likely to be an anti-predation behaviour against the predatory cladoceran Polyphemus pediculus (Linnaeus, 1761).
Leaf and root phenology and biomass ofEriophorum vaginatumin response to warming in the Arctic
Authors: Ma Ting , Parker Thomas , Fetcher Ned , Unger Steven L , Gewirtzman Jon , Moody Michael L , Tang Jianwu
Published: February 2022

The response of plant leaf and root phenology and biomass in the Arctic to global change remains unclear due to the lack of synchronous measurements of above- and belowground parts. Our objective was to determine the phenological dynamics of the above- and belowground parts of Eriophorum vaginatum in the Arctic and its response to warming. We established a common garden located at Toolik Lake Field Station; tussocks of E. vaginatum from three locations, Coldfoot, Toolik Lake and Sagwon, were transplanted into the common garden. Control and warming treatments for E. vaginatum were set up at the Toolik Lake during the growing seasons of 2016 and 2017. Digital cameras, a handheld sensor and minirhizotrons were used to simultaneously observe leaf greenness, normalized difference vegetation index and root length dynamics, respectively. Leaf and root growth rates of E. vaginatum were asynchronous such that the timing of maximal leaf growth (mid-July) was about 28 days earlier than that of root growth. Warming of air temperature by 1 °C delayed the timing of leaf senescence and thus prolonged the growing season, but the temperature increase had no significant effect on root phenology. The seasonal dynamics of leaf biomass were affected by air temperature, whereas root biomass was correlated with soil thaw depth. Therefore, we suggest that leaf and root components should be considered comprehensively when using carbon and nutrient cycle models, as above- and belowground productivity and functional traits may have a different response to climate warming.
Poorly differentiated muscle-invasive giant cell tumor of the bladder leads to unfavorable clinical outcome
Authors: Karasavvidou Foteini , Mitrakas Lampros , Strataki Maria , Anastasiou Dimitrios , Koukoulis Georgios , Tzortzis Vassilios
Published: February 2022

Urothelial carcinoma of the urinary bladder is a common clinical entity. Recently, researchers focused on the emerging clinical significance of histologic variants, because they may need special therapy and their prognosis differs. Hereby, we describe a case of a giant cell osteoclast-like urothelial carcinoma of the urinary bladder.
Achilles Tendon and Patellar Tendon Structure in Combat Soldiers Following Prevention Exercises
Authors: Steinberg Nili , Funk Shani , Zeev Aviva , Waddington Gordon , Svorai-Litvak Shany , Pantanowitz Michal
Published: February 2022

Introduction

Military training that increases physical stress on musculoskeletal morphology also increases the risk of orthopedic injuries. Somatosensory prevention programs that reduce stress and improve functionality could be beneficial for better organization of tendon structure. The aim of this study was to investigate the impact of a somatosensory prevention exercise on the tendon structure (percentage of echo-type fibers; A-P and M-L diameters and cross-sectional area) of the Achilles tendon and patellar tendon among combat soldiers.

Materials and Methods

These tendons of male Infantry soldiers aged 18-21 were screened before and after a 14-week training course. The intervention group, who performed preventative exercises, included 108 soldiers (BMI = 23.85 ± 2.76), while the control group, who participated in the same military course without these exercises, included 98 soldiers (BMI = 24.26 ± 4.03). Ultrasound scanning for tendon structure included percent of echo-type I-IV fibers, A-P diameter, M-L diameter, and cross-sectional area parameters.

Results

Time by group interaction was found for echo-type I and II in both tendons. No significant differences were found between the two groups in the pretesting percentage of echo-type IV fibers of the Achilles tendon (P = .522), in echo-type III fibers of the Achilles tendon (P = .833), and echo-type IV fibers of the patellar tendon (P = .162). Greater pre-post differences in echo-type III and IV fibers were found in the control group compared with the intervention group for both the Achilles tendon (P = .021, P = .002) and the patellar tendon (P < .001, P < .001).

Conclusion

Increased damaged fibers (echo-type III and IV) of both tendons were found among the control group, yet not among soldiers who performed prevention exercises.
Respiratory Infections Are More Common Than Healthcare Records Indicate: Results From an Anonymous Survey
Authors: Richard Stephanie A , Danaher Patrick J , White Brian , Mende Katrin , Colombo Rhonda E , Burgess Timothy H , Coles Christian L
Published: February 2022

Introduction

Influenza-like illnesses (ILIs) are common in military populations and can impair mission-readiness, particularly in the current severe acute respiratory syndrome coronavirus 2 pandemic; therefore, it is important to identify potential risk factors for infection and better understand the burden of infection.

Materials and Methods

A survey was administered to military medical trainees living in a congregated setting on JBSA Fort Sam Houston, Texas, from January 2017 to February 2019. The survey included questions about ILI experience and potential ILI risk factors.

Results

2,121 individuals completed the survey. Respondents had a median age of 21 years, 46% were female, 32.6% were Air Force, 33.6% were Army, and 33.8% were Navy/Marines. Among the 815 (38%) who reported an ILI during training, 40% sought health care. The primary reasons for seeking healthcare included illness severity, concern about transmission, and accessibility of healthcare. Over half (54%) of the trainees who reported an ILI said the ILI had an impact on their performance, including reduced study time, missed physical training, and missed class. Multivariate model results indicate that women and younger trainees (<30 years) were more likely to report having had an ILI (women: OR 1.58, (95% CI 1.30, 1.92); age <30 years: OR 1.58, (1.06, 2.36)). In a subset analysis, those who reported washing their hands 10+ times per day were less likely to report an ILI (OR 0.61 (0.42, 0.89)).

Conclusions

ILIs are likely to be more common during training than healthcare records indicate and may result in decreased training effectiveness. Increasing access to handwashing facilities and education about the importance of handwashing to prevent the spread of disease will likely reduce the ILI burden in this population.
The efficacy and safety of anifrolumab in Japanese patients with systemic lupus erythematosus: TULIP-2 subanalysis
Authors: Tanaka Yoshiya , Atsumi Tatsuya , Okada Masato , Miyamura Tomoya , Ishii Tomonori , Nishiyama Susumu , Matsumura Ryutaro , Hayashi Nobuya , Abreu Gabriel , Tummala Raj , Morand Eric F , Takeuchi Tsutomu
Published: February 2022

Objectives

Evaluate the efficacy and safety of anifrolumab in the subpopulation of Japanese patients with systemic lupus erythematosus (SLE) in phase 3 TULIP-2 trial.

Methods

TULIP-2 was a 52-week randomized placebo-controlled trial (N = 362) that evaluated efficacy and safety of anifrolumab 300 mg IV every 4 weeks vs. placebo in patients with moderate to severe SLE who were receiving standard therapy. We performed a post hoc analysis of the primary and key secondary endpoints, and safety, of TULIP-2 in the Japanese subpopulation.

Results

In the Japanese subpopulation (anifrolumab, n = 24; placebo, n = 19), the proportion of patients who achieved a British Isles Lupus Assessment Group–based Composite Lupus Assessment response at Week 52 (primary endpoint) was greater in the anifrolumab group vs. placebo [50.0% (12/24) vs. 15.8% (3/19); treatment difference: 34.2%, 95% confidence interval 6.9, 61.5; nominal p = .014]. Improvement in skin activity and flare rates (key secondary endpoints) were favourable for anifrolumab vs. placebo. Consistent with the overall population, anifrolumab had an acceptable safety and tolerability profile.

Conclusions

The efficacy and safety of anifrolumab 300 mg in Japanese patients with SLE was consistent with the demonstrated clinical profile of anifrolumab for the overall TULIP-2 population.
Next-generation sequencing of cerebrospinal fluid for clinical molecular diagnostics in pediatric, adolescent and young adult brain tumor patients
Authors: Miller Alexandra M , Szalontay Luca , Bouvier Nancy , Hill Katherine , Ahmad Hamza , Rafailov Johnathan , Lee Alex J , Rodriguez-Sanchez M Irene , Yildirim Onur , Patel Arti , Bale Tejus A , Benhamida Jamal K , Benayed Ryma , Arcila Maria E , Donzelli Maria , Dunkel Ira J , Gilheeney Stephen W , Khakoo Yasmin , Kramer Kim , Sait Sameer F , Greenfield Jeffrey P , Souweidane Mark M , Haque Sofia , Mauguen Audrey , Berger Michael F , Mellinghoff Ingo K , Karajannis Matthias A
Published: February 2022

Background

Safe sampling of central nervous system tumor tissue for diagnostic purposes may be difficult if not impossible, especially in pediatric patients, and an unmet need exists to develop less invasive diagnostic tests.

Methods

We report our clinical experience with minimally invasive molecular diagnostics using a clinically validated assay for sequencing of cerebrospinal fluid (CSF) cell-free DNA (cfDNA). All CSF samples were collected as part of clinical care, and results reported to both clinicians and patients/families.

Results

We analyzed 64 CSF samples from 45 pediatric, adolescent and young adult (AYA) patients (pediatric = 25; AYA = 20) with primary and recurrent brain tumors across 12 histopathological subtypes including high-grade glioma (n = 10), medulloblastoma (n = 10), pineoblastoma (n = 5), low-grade glioma (n = 4), diffuse leptomeningeal glioneuronal tumor (DLGNT) (n = 4), retinoblastoma (n = 4), ependymoma (n = 3), and other (n = 5). Somatic alterations were detected in 30/64 samples (46.9%) and in at least one sample per unique patient in 21/45 patients (46.6%). CSF cfDNA positivity was strongly associated with the presence of disseminated disease at the time of collection (81.5% of samples from patients with disseminated disease were positive). No association was seen between CSF cfDNA positivity and the timing of CSF collection during the patient’s disease course.

Conclusions

We identified three general categories where CSF cfDNA testing provided additional relevant diagnostic, prognostic, and/or therapeutic information, impacting clinical assessment and decision making: (1) diagnosis and/or identification of actionable alterations; (2) monitor response to therapy; and (3) tracking tumor evolution. Our findings support broader implementation of clinical CSF cfDNA testing in this population to improve care.
Waterborne Outbreaks in Hemodialysis Patients and Infection Prevention
Authors: Kanamori Hajime , Weber David J , Flythe Jennifer E , Rutala William A
Published: February 2022

Individuals treated with dialysis are at high risk for healthcare-associated infections. We conducted a literature review of outbreaks associated with water in hemodialysis during years 2011–2021 to understand the role of water as a source of infections for patients receiving hemodialysis with a focus on the risks associated with dialysis water and dialysate. For dialysis patients, water and dialysate have been a source of healthcare-associated pathogens, including nontuberculous mycobacteria and gram-negative bacilli as well as systemic reactions due to gram-negative bacilli–associated endotoxin. Lapses in infection prevention practices and dialysis water management were primarily involved in waterborne outbreaks. Dialysis clinics should adhere to recommendations regarding monitoring and levels of bacteria and endotoxin in hemodialysis water and dialysate. Since hemodialysis patients are at increased risk of healthcare-associated infections, it is important for healthcare personnel to adhere to infection prevention guidelines in hemodialysis patient care, especially hand hygiene, aseptic technique, cleaning/disinfection, and water management.
The Doctor Will FaceTime You Now: Commentary on Telehealth in Cancer Care
Authors: Feinberg Jacqueline , Sonoda Yukio
Published: February 2022

The use of telehealth was already on the rise, but the COVID-19 pandemic caused an increase in the use of telehealth services. This commentary considers the benefits of and common concerns with the use of telemedicine in the oncology setting.
Lucy Hutchinson and the Business of Memoirs
Authors: Keeble N H
Published: February 2022

Until comparatively recently, Lucy Hutchinson’s Memoirs were read as a personal and private document, and, even though their significance as a primary historical source is now increasingly recognized, it is still generally assumed that they were conceived solely for circulation within her own family. Their true business, however, is with public affairs and posterity. Like the many other late seventeenth-century memoirs, they anticipate a posthumous readership, to whom they present an apologetic, justificatory, and highly partisan, account of the recent past, participating in a literary contest for the master narrative of seventeenth-century history. This argument is pursued through a comparative analysis of the Memoirs and other examples of its curious hybrid genre, part autobiography, part historiography, taking up their compositional and publishing history, their implied readership, and Hutchinson’s binary categorization of historical agents as ‘children of light and of darkness’. Unusually, Hutchinson does not identify these with the Civil War antagonists. The former, embodied in the idealized Christian gentleman John Hutchinson, fail in their ‘just defence of English liberties’ because of those on the Parliamentarian, Puritan, and republican side who betray the Good Old Cause as the Israelites betrayed Moses after their liberation. This is Hutchinson’s witness to posterity.
The Challenge of Defining Depression
Authors: Rottenberg Jonathan
Published: February 2022

This chapter grapples with the challenges of
defining depression, including challenges that arise from imprecise use of language.
Depression is at its core a kind of mood state. Mood states organize humans’ minds and
bodies and motivate them to pursue goals. It is possible to understand depression by
focusing on the scientific principles that explain why humans and other organisms have
mood. A key goal is to become a more educated consumer of one’s own mood and to
understand the forces that operate on mood more generally. This framework can allow for
an understanding of why people become depressed; why depression has occurred over human
history; and why depression might become epidemic during some periods in human history,
including the present day.
The Syndrome of Clinical Depression
Authors: Rottenberg Jonathan
Published: February 2022

Depression is a syndrome. This chapter explains
the general concept of a syndrome and outlines the specific symptoms that characterize
the mood syndrome of clinical depression. Evidence for the validity of the depressive
syndrome is briefly discussed. For each symptom, clinical examples are provided. In
addition to the official symptoms of depression, there are “unofficial” symptoms or
problems that are commonly observed in depressed persons. The reader is given tools to
distinguish clinical depression from an ordinary sad mood. The concept of mood severity
is explained, with examples of mild versus more severe clinical depression. Finally,
some of the differences and similarities between unipolar and bipolar mood syndromes are
enumerated.
The Prevalence of Depression
Authors: Rottenberg Jonathan
Published: February 2022

Depression has been called the “common cold” of
psychiatry, but just how common is it? In this chapter, the challenges of arriving at
accurate prevalence numbers are considered, including the absence of historical data.
Contemporary international prevalence figures for both point and lifetime prevalence of
depression are reviewed. Depression is a significant public health problem because it is
common, impairing, and often recurrent. Evidence is presented for the idea that the
prevalence of depression is increasing. Although several lines of evidence support the
idea that there is a contemporary depression epidemic, particularly among younger
people, there are also important critiques that need to be considered. This chapter
offers the reader tools for sifting through these claims.
Life After Depression
Authors: Rottenberg Jonathan
Published: February 2022

Most writing on depression considers how
depressed people might become well rather than what they should do to stay well once
they have recovered. This chapter focuses on the concept of life “after” depression.
Guidance is offered regarding how formerly depressed people might think about their
history of depression and learn from the experience of depression as a means to move
their life in more productive directions. The value of taking inventory in the aftermath
of depression on what benefits and harms mood is considered, along with the value of
developing plans to actively manage mood during recovery. Depression can offer an
opportunity to exit counterproductive life and mood patterns. Clinical examples of
positive learning from depression are offered. The chapter closes with consideration of
what individuals should do if depression symptoms return.
Charting a New Future for Depression
Authors: Rottenberg Jonathan
Published: February 2022

Although some aspects of depression have
improved, depression remains a rampant and misunderstood problem. One major obstacle is
that dialogue concerning depression is still clouded by a number of myths about the
condition. This chapter reviews these myths and discusses steps that the individual can
take to challenge these myths and improve the broader dialogue about depression. More
broadly, individuals can take several different approaches to raise the profile of
depression as a social and political issue and ensure that adequate resources are placed
into depression research and treatment. Although the present is challenging, concerted
actions by individuals and groups can challenge myths about depression and ultimately
improve the future for those who struggle with this misunderstood condition.
Civil Resistance
Authors: Chenoweth Erica
Published: February 2022

This book provides a basic empirical introduction to what everyone should know about civil resistance,
discussing patterns of civil resistance in fairly general terms. It focuses on global trends, patterns,
and dynamics rather than in- depth accounts of specific historical examples of nonviolent resistance. It
also uses examples of civil resistance campaigns to illustrate different points and defers to other
experts for those interested in specific knowledge about in-depth theoretical and conceptual
discussions, as well as detailed knowledge about the workings of particular campaigns. The book is not
intended to be the last word on civil resistance, as it is an emergent phenomenon, and the world is
changing rapidly. Ten years from now, one might write an entirely different book on the subject,
revising many of the tables, charts, and substantive conclusions. The best way to read this book is to
see whether the text resonates with one's observations, intuitions, and experiences. It points out that
this book should not be considered as a prescriptive manual on how to do civil resistance. People who
are waging nonviolent struggle are always in the best position to decide for themselves the best course
of action to take. There is no generalizable recipe for effective resistance anyway. But there are
distinct lessons from the past that could inform the present and the future.
The Basics
Authors: Chenoweth Erica
Published: February 2022

This chapter dives deeper into the core concepts or basics of civil resistance. It determines
which methods count as civil resistance and which methods do not, and how pragmatic uses of
civil resistance intersect with moral claims. It also reviews the definition of civil
resistance, which is a form of struggle in which unarmed people coordinate a variety of actions
to build power and force change. The chapter addresses some common misconceptions about civil
resistance. It explores the ideas that civil resistance requires passively accepting suffering,
that civil resistance means being civil and respectful, that protest is the primary form of
civil resistance, that civil resistance is only available to people in privileged positions, and
that the methods of civil resistance cannot be abused for unjustified or immoral aims.
Gender
Authors: Erickson-Schroth Laura , Davis Benjamin
Published: February 2022

This book serves as an introduction to the topic of gender. The term
gender was first distinguished from sex in the 1950s, when
psychologists began to discuss the idea of gender roles—behaviors and responsibilities given to people
by a society rather than flowing from their biology. Over the last two decades, transgender people have
expanded people’s understanding of gender even further, introducing to the mainstream the concept of
gender identity, an individual’s understanding of their own gender. Along the way, there have been
numerous debates and controversies: What is the influence of biology on gender? How does the media
impact gender and gender roles? Do transgender people reinforce gender stereotypes or help to free us
from them? The book explores these questions, providing basic definitions and tracing the history of
gender as a concept; the role of biology, psychology, and culture on gender; and gender norms over time
and across the globe.