bluuebunny/crossref_metadata_2025 huggingface dataset:
Physical link of the polar field buildup with the Waldmeier effect broadens the scope of early solar cycle prediction: Cycle 25 is likely to be slightly stronger than Cycle 24
Authors: Kumar Pawan , Biswas Akash , Karak Bidya Binay
Published: April 2022

Prediction of the solar cycle is challenging but essential because it drives space weather. Several predictions with varying amplitudes of the ongoing Cycle 25 have been made. We show that an aspect of the Waldmeier effect (WE2), i.e. a strong positive correlation between the rise rate and the amplitude of the cycle, has a physical link with the buildup of the previous cycle’s polar field after its reversal. We find that the rise rate of the polar field is highly correlated with the rise rate and the amplitude of the next solar cycle. Thus, the prediction of the amplitude of the solar cycle can be made just a few years after the reversal of the previous cycle’s polar field, thereby extending the scope of the solar cycle prediction to much earlier than the usual time. Our prediction of Cycle 25 based on the rise rate of the previous polar field is 137 ± 23, which is quite close to the prediction 138 ± 26 based on the WE2 computed from the available 2 yr sunspot data of the ongoing cycle.
Factors associated with frailty in rheumatoid arthritis patients with decreased renal function
Authors: Ohashi Yoshifumi , Takahashi Nobunori , Sobue Yasumori , Suzuki Mochihito , Hattori Kyosuke , Kishimoto Kenji , Terabe Kenya , Asai Shuji , Kojima Toshihisa , Kojima Masayo , Imagama Shiro
Published: April 2022

Objectives

To investigate factors associated with frailty in rheumatoid arthritis (RA) patients with decreased renal function.

Methods

RA patients who visited outpatient clinics from June to August 2021 were included (N = 625). Patients with estimated glomerular filtration rate <60 ml/min/1.73 m2 were defined as having decreased renal function (N = 221) and divided into the non-frailty (N = 153) and frailty (N = 58) groups. Patient characteristics were compared between the two groups by univariate analysis. Significant factors in univariate analysis were assessed by logistic regression analysis to determine their association with frailty in patients with decreased renal function.

Results

Patients in the frailty group were older (74.0 vs.79.0 years) and had a longer duration of disease (11.1 vs. 17.8 years), higher Disease Activity Score erythrocyte sedimentation rate (DAS28-ESR; 2.99 vs. 3.80), higher Health Assessment Questionnaire Disability Index (0.42 vs. 1.43), and a lower rate of methotrexate (MTX) use (46.4% vs. 25.9) compared to those in the non-frailty group. Factors associated with frailty in patients with decreased renal function were age (odds ratio: 1.07), duration of disease (1.06), DAS28-ESR (1.85), and MTX use (0.42).

Conclusions

Among factors associated with frailty in RA patients with decreased renal function, improving DAS28-ESR is likely to be the most feasible approach to promote recovery from frailty (200/200 words).
Destructive cervical spondylitis due to Cutibacterium acnes with synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome: A case report
Authors: Oyama Ryunosuke , Iida Keiichiro , Saiwai Hirokazu , Matsumoto Yoshihiro , Nakashima Yasuharu
Published: April 2022

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a spectrum of heterogeneous diseases commonly recognised by skin and osteoarticular lesions. There have been reports of some surgical cases of the progressive, destructive spondylitis associated with SAPHO syndrome, wherein the destructive spondylitis was considered to have developed due to the progression of spondylitis with SAPHO syndrome as the pathogenic bacteria were not isolated. We herein report a surgical case of destructive cervical spondylitis associated with SAPHO syndrome. A 54-year-old woman with a history of palmoplantar pustulosis suffered severe neck pain for 6 months. Radiography and computeed tomography showed sclerosed and collapsed cervical vertebrae, and the patient was referred to our hospital for further evaluation and management upon suspicion of infection or spondylitis with SAPHO syndrome. For the severe neck pain and progressive destruction of cervical vertebrae, we performed posterior fusion surgery with subsequent anterior fusion. Cutibacterium acnes (C. acnes) was isolated by enrichment culture with thioglycolate broth from both the anterior and the posterior tissue samples. We diagnosed pyogenic spondylitis secondary to C. acnes infection and administered doxycycline for 6 weeks after the first surgery. The neck pain was resolved and cervical fusion was achieved one year postoperatively. C. acnes infection could elicit destructive spondylitis. An enrichment culture should be performed to isolate the pathogenic bacteria in cases of destructive spondylitis with SAPHO syndrome.
Steroid-induced osteonecrosis of the humeral head in a 20-year-old man treated with an osteochondral autograft: A case report
Authors: Hotta Tadahiro , Kozono Naoya , Takeuchi Naohide , Nabeshima Akira , Kawahara Shinya , Hamai Satoshi , Akasaki Yukio , Tsushima Hidetoshi , Tashiro Eiji , Konishi Toshiki , Nakashima Yasuharu
Published: April 2022

To our knowledge, only one previous report described the treatment of osteochondral autograft for steroid-induced osteonecrosis of the humeral head (ONHH) in a middle-aged patient. The present report describes a 20-year-old man who was found to have avascular osteonecrosis of the right humeral head after corticosteroid pulse treatment, followed by oral corticosteroid therapy. The patient complained of serious right shoulder pain and limited range of motion (ROM). Anteroposterior (AP) radiographs of the right shoulder revealed a crescent sign at the humeral head, indicating subchondral bone collapse with a linear sclerotic change and normal articular surface of the glenoid. The case was categorized as Stage 3 according to the Cruess classification. In general, Cruess classification Stage 3 is treated with humeral head replacement and shoulder arthroplasty. The patient underwent surgical treatment involving osteochondral autograft transplantation. Autografts were harvested from the right knee. At the 1.5-year follow-up, the patient was pain-free and showed an improved active ROM. Furthermore, AP radiographs demonstrated that the glenohumeral joint space was maintained, and no progression of humeral head collapse was observed. This case may be helpful in decision-making if young patients with ONHH require surgical treatment. Furthermore, osteochondral autograft transplantation may be an effective treatment for ONHH.
Stress fractures in the forefoot after arthrodesis of the hindfoot in a patient with rheumatoid arthritis: A case report
Authors: Yano Koichoro , Ikari Katsunori , Okazaki Ken
Published: April 2022

Rheumatoid arthritis (RA) is an autoimmune disease that attacks multiple joints throughout the body. Ankle arthrodesis (AA) has been the gold standard surgery for end-stage ankle arthritis in patients with RA. Here, we report the case of a 67-year-old woman with RA who had displacement and loosening of total ankle arthroplasty. The ankle was converted to AA using a metal spacer and an intramedullary nail. The patient had no complications in perioperative terms of arthrodesis. However, multiple fractures were found in the metatarsal bones at the routine 3-year follow-up. Although the patient did not remember any symptoms, the clinical outcome deteriorated compared to that a year before. The hindfoot in this case report was fixed completely by an intramedullary nail, while the midfoot had already involved ankylosis because of severe joint destruction present before the surgery. As a result, the range of motion in the joints of the midfoot and hindfoot was lost, and it is probable that an excessive load was applied to the forefoot during push-off by the toes, resulting in a stress fracture. Patients with RA remain at risk of future progressive joint destruction in every joint of their body. Therefore, surgeons should choose a surgery that preserves ankle motion to decrease the rate of adjacent joint degeneration for severe ankle arthropathy in patients with RA.
The metaphorical swiss army knife: The multitude and diverse roles of HEAT domains in eukaryotic translation initiation
Authors: Friedrich Daniel , Marintchev Assen , Arthanari Haribabu
Published: April 2022

Biomolecular associations forged by specific interaction among structural scaffolds are fundamental to the control and regulation of cell processes. One such structural architecture, characterized by HEAT repeats, is involved in a multitude of cellular processes, including intracellular transport, signaling, and protein synthesis. Here, we review the multitude and versatility of HEAT domains in the regulation of mRNA translation initiation. Structural and cellular biology approaches, as well as several biophysical studies, have revealed that a number of HEAT domain-mediated interactions with a host of protein factors and RNAs coordinate translation initiation. We describe the basic structural architecture of HEAT domains and briefly introduce examples of the cellular processes they dictate, including nuclear transport by importin and RNA degradation. We then focus on proteins in the translation initiation system featuring HEAT domains, specifically the HEAT domains of eIF4G, DAP5, eIF5, and eIF2Bϵ. Comparative analysis of their remarkably versatile interactions, including protein–protein and protein–RNA recognition, reveal the functional importance of flexible regions within these HEAT domains. Here we outline how HEAT domains orchestrate fundamental aspects of translation initiation and highlight open mechanistic questions in the area.
Control of bacterial immune signaling by a WYL domain transcription factor
Authors: Blankenchip Chelsea L , Nguyen Justin V , Lau Rebecca K , Ye Qiaozhen , Gu Yajie , Corbett Kevin D
Published: April 2022

Bacteria use diverse immune systems to defend themselves from ubiquitous viruses termed bacteriophages (phages). Many anti-phage systems function by abortive infection to kill a phage-infected cell, raising the question of how they are regulated to avoid cell killing outside the context of infection. Here, we identify a transcription factor associated with the widespread CBASS bacterial immune system, that we term CapW. CapW forms a homodimer and binds a palindromic DNA sequence in the CBASS promoter region. Two crystal structures of CapW suggest that the protein switches from an unliganded, DNA binding-competent state to a ligand-bound state unable to bind DNA. We show that CapW strongly represses CBASS gene expression in uninfected cells, and that phage infection causes increased CBASS expression in a CapW-dependent manner. Unexpectedly, this CapW-dependent increase in CBASS expression is not required for robust anti-phage activity, suggesting that CapW may mediate CBASS activation and cell death in response to a signal other than phage infection. Our results parallel concurrent reports on the structure and activity of BrxR, a transcription factor associated with the BREX anti-phage system, suggesting that CapW and BrxR are members of a family of universal defense signaling proteins.
The ‘Alu-ome’ shapes the epigenetic environment of regulatory elements controlling cellular defense
Authors: Costallat Mickael , Batsché Eric , Rachez Christophe , Muchardt Christian
Published: April 2022

Promoters and enhancers are sites of transcription initiation (TSSs) and carry specific histone modifications, including H3K4me1, H3K4me3, and H3K27ac. Yet, the principles governing the boundaries of such regulatory elements are still poorly characterized. Alu elements are good candidates for a boundary function, being highly abundant in gene-rich regions, while essentially excluded from regulatory elements. Here, we show that the interval ranging from TSS to first upstream Alu, accommodates all H3K4me3 and most H3K27ac marks, while excluding DNA methylation. Remarkably, the average length of these intervals greatly varies in-between tissues, being longer in stem- and shorter in immune-cells. The very shortest TSS-to-first-Alu intervals were observed at promoters active in T-cells, particularly at immune genes, where first-Alus were traversed by RNA polymerase II transcription, while accumulating H3K4me1 signal. Finally, DNA methylation at first-Alus was found to evolve with age, regressing from young to middle-aged, then recovering later in life. Thus, the first-Alus upstream of TSSs appear as dynamic boundaries marking the transition from DNA methylation to active histone modifications at regulatory elements, while also participating in the recording of immune gene transcriptional events by positioning H3K4me1-modified nucleosomes.
EGFR suppresses p53 function by promoting p53 binding to DNA-PKcs: a noncanonical regulatory axis between EGFR and wild-type p53 in glioblastoma
Authors: Ding Jie , Li Xiaolong , Khan Sabbir , Zhang Chen , Gao Feng , Sen Shayak , Wasylishen Amanda R , Zhao Yang , Lozano Guillermina , Koul Dimpy , Alfred Yung W K
Published: April 2022

Background

Epidermal growth factor receptor (EGFR) amplification and TP53 mutation are the two most common genetic alterations in glioblastoma multiforme (GBM). A comprehensive analysis of the TCGA GBM database revealed a subgroup with near mutual exclusivity of EGFR amplification and TP53 mutations indicative of a role of EGFR in regulating wild-type-p53 (wt-p53) function. The relationship between EGFR amplification and wt-p53 function remains undefined and this study describes the biological significance of this interaction in GBM.

Methods

Mass spectrometry was used to identify EGFR-dependent p53-interacting proteins. The p53 and DNA-dependent protein kinase catalytic subunit (DNA-PKcs) interaction was detected by co-immunoprecipitation. We used CRISPR-Cas9 gene editing to knockout EGFR and DNA-PKcs and the Edit-R CRIPSR-Cas9 system for conditional knockout of EGFR. ROS activity was measured with a CM-H2DCFDA probe, and real-time PCR was used to quantify expression of p53 target genes.

Results

Using glioma sphere-forming cells (GSCs), we identified, DNA-PKcs as a p53 interacting protein that functionally inhibits p53 activity. We demonstrate that EGFR knockdown increased wt-p53 transcriptional activity, which was associated with decreased binding between p53 and DNA-PKcs. We further show that inhibition of DNA-PKcs either by siRNA or an inhibitor (nedisertib) increased wt-p53 transcriptional activity, which was not enhanced further by EGFR knockdown, indicating that EGFR suppressed wt-p53 activity through DNA-PKcs binding with p53. Finally, using conditional EGFR-knockout GSCs, we show that depleting EGFR increased animal survival in mice transplanted with wt-p53 GSCs.

Conclusion

This study demonstrates that EGFR signaling inhibits wt-p53 function in GBM by promoting an interaction between p53 and DNA-PKcs.
Cardiac dysfunction in medulloblastoma survivors treated with photon irradiation
Authors: Cacciotti Chantel , Chordas Christine , Valentino Katie , Allen Rudy , Lenzen Alicia , Burns Karen , Nagarajan Rajaram , Manley Peter , Pillay-Smiley Natasha
Published: April 2022

Background

Medulloblastoma is an aggressive central nervous system (CNS) tumor that occurs mostly in the pediatric population. Treatment often includes a combination of surgical resection, craniospinal irradiation (CSI), and chemotherapy. Children who receive standard photon CSI are at risk for cardiac toxicities including coronary artery disease, left ventricular scarring and dysfunction, valvular damage, and atherosclerosis. Current survivorship guidelines recommend routine echocardiogram (ECHO) surveillance. In this multi-institutional study, we describe markers of cardiac dysfunction in medulloblastoma survivors.

Methods

A retrospective chart review of medulloblastoma patients who had photon beam CSI was followed by ECHO between 1980 and 2010 at Lurie Children’s Hospital and Dana-Farber/Boston Children’s Hospital.

Results

During the 30-year study period, 168 medulloblastoma patient records were identified. Included in this study were the 75 patients who received CSI or spinal radiation and ECHO follow-up. The mean age at CSI was 8.6 years (range, 2.9-20), and the mean number of years between radiation therapy (RT) completion and first ECHO was 7.4 (range, 2-16). Mean ejection fraction (EF) was 60.0% and shortening fraction (SF) was 33.8%. Five patients (7%) had abnormal ECHO results: three with EF <50% and two with SF <28%.

Conclusion

The majority of medulloblastoma patients who received CSI have relatively normal ECHOs post-treatment; however, 7% of patients had abnormal ECHOs. The implication of our study for medulloblastoma survivors is that further investigations are needed in this population with a more systematic, longitudinal assessment to determine predictors and screenings.
Being LGBTQ+ and Disabled, a Socially Contradicting
Experience
Authors: Egner Justine E.
Published: April 2022

This chapter explores the ways in which disability and sexuality have been conceptualized and understood as incompatible and how this perceived incompatibility renders LGBTQ+ disabled people invisible within both popular society as well as their identity communities. Employing virtual ethnography, the chapter focuses on the unique experience of intersectional invisibility as described by LGBTQ+ disabled people and organizations in virtual spaces. It explores the relationship between disability and sexuality and disability identities and LGBTQ+ identities through an empirical examination of organizational discourses and personal narratives present in online spaces. Findings suggest that LGBTQ+ disabled people and advocacy groups seek to reject and resist current narratives that render them invisible by broadcasting their experiences through virtual communities and media.
“The beauty of a man is his cattle”
Authors: Whittaker Laryssa
Published: April 2022

“Ubuhle bendoda” is a Zulu song about lobolo, the exchange of bridewealth in the form of cattle. A practice that was never conceptualized simply as transactional, lobolo indexed and cemented social contract between families, and represented the capacity of individuals and families to fulfil their social roles. The song is a favorite in the repertoire of the Field Band Foundation (FBF), a national non-profit youth development organization that provides music education in underprivileged communities in South Africa. This chapter analyzes “Ubuhle bendoda” in the context of the FBF’s work, revealing social and economic change due to colonialism, apartheid, and post-apartheid capitalism. I argue the song provides a heuristic for understanding the way that the FBF addresses present-day socioeconomic inequality through teaching, musical practice, and financial partnerships, resulting in new ethical and economic bases for gender roles, new forms of reciprocity, and new economic vehicles for establishing social relations.
Claims Across Outcomes and Population Ethics
Authors: Adler Matthew D.
Published: April 2022

Prioritarians, unlike utilitarians, believe that well-being has diminishing marginal moral value. This difference is captured in the Pigou-Dalton axiom: a transfer of well-being from a better-off person to a worse-off person, which (a) is non-leaky in the sense that the worse-off one gains exactly what the better-off one loses, (b) still leaves the better-off one at least as well off as the worse-off one, and (c) affects no one else, is a moral improvement. Prioritarianism satisfies the Pigou-Dalton axiom, while utilitarianism does not. Prioritarianism also satisfies the Pareto axioms and an axiom of Anonymity. The axiom cluster Pareto, Pigou-Dalton, and Anonymity can be defended with reference to individuals’ “claims across outcomes.” A claim is a tripartite relation between an individual and two outcomes, which is valenced in terms of her well-being. The moral ranking of two outcomes, in turn, depends upon the valence and strength of individuals’ claims between them. The claims-across-outcome framework helps make the case for prioritarianism as against utilitarianism and other outcome-ranking criteria that fail to satisfy the combination of Pareto, Pigou-Dalton, and Anonymity. Can the claims-across-outcomes framework be extended to the case of variable population, in which the individuals who exist in a given outcome x need not be identical to those who exist in another outcome y? This chapter argues that the framework can be thus extended and that it supports generalized versions of the Pareto, Pigou-Dalton and Anonymity axioms. These axioms, in turn, have implications for a range of topics in population ethics.
Integrated Methods
Authors: Tröndle Martin , Greenwood Steven , Ramakrishnan Chandrasekhar , Uhde Folkert , Egermann Hauke , Tschacher Wolfgang
Published: April 2022

Integration of methods is an option for interdisciplinary research settings, allowing insights into the fleeting moments of aesthetic experience. This chapter aims to exemplify such research settings by introducing two research projects: eMotion: MappingMuseum Experience and ECR—Experimental Concert Research. eMotion concerned aesthetic experiences in the environment of a fine arts museum, and ECR investigates music experience in concerts. Both projects were conducted in ecologically valid environments: the fine art museum and the classical concert hall, respectively. The technical setup of both projects merged different data levels—body movement, heart rate, skin conductance, facial expressions, sociological variables, and emotional and aesthetic evaluations of specific artworks or musical pieces—into an integrated dataset. In both projects, scientists (from musicology, art history, psychology, cultural studies, etc.), technicians, and programmers, as well as practitioners like artists, musicians, and curators, were brought together to intensively cooperate. The chapter elaborates on the aspects of such inter- and transdisciplinary research endeavors.
Movement behaviours and health of children and youth with disabilities: Impact of the 2020 COVID-19 pandemic
Authors: Arbour-Nicitopoulos Kelly P , James Maeghan E , Moore Sarah A , Sharma Ritu , Martin Ginis Kathleen A
Published: April 2022

Objectives

This study examined the acute and longer-term impacts of the COVID-19 pandemic on the movement behaviours and health of children and youth with disabilities (CYD) in Canada.

Methods

Eighty-six parents of CYD completed an online survey twice (May 2020 and November 2020). Interviews were completed with seven families in March 2021.

Results

At both time points, <20% of CYD met the physical activity and sedentary behaviour guidelines, and >50% of CYD met the sleep guideline. No CYD met all three movement guidelines. Nearly one-quarter of CYD reported declines in health from pre-pandemic levels. Interview themes revealed that shifting of routines, unoccupied time, reduced physiotherapy opportunities, parental capacity, and the social and built environment all impacted the movement behaviours of CYD.

Conclusions

Movement behaviours and health of CYD must be prioritized in COVID-19 recovery efforts through quality programming, highly trained instructors, accessible and inclusive infrastructure, and family-centred health.
OA25 Is it time for patient-initiated methotrexate monitoring?
Authors: Wood Natasha A. E , Farmer Leila , Manhas Roope , Lewis Tom , Kyle Stuart
Published: April 2022

Background/Aims

Regular blood monitoring is recommended to ensure safety in patients on methotrexate (MTX). During the COVID pandemic, British Society of Rheumatology (BSR) sanctioned a reduction in monitoring for patients stable on MTX for 12 months. In accordance Devon CCG approved changing local Shared Care Guidelines (SCG), reducing the frequency to six monthly in stable MTX patients. Our aim was to assess whether monitoring frequency changed during the pandemic, and if so whether any patients came to harm.

Methods

Patients stable on MTX monotherapy for at least a year to 31.3.2020 were identified via hospital pathology. 854 patients identified; the mean number of days between monitoring requests was calculated for the year to April 2020, and year to April 2021, respectively. A sub-analysis of 229 patients who had reduced from monthly to three monthly blood tests at similar time points was undertaken. Tests included: platelets (PLT), mean cell volume (MCV), neutrophils (NEUT), estimated glomerular filtration rate (eGFR), and alanine aminotransferase (ALT). Confidence intervals evaluated any differences in the results between monthly and three-monthly frequencies, in terms of overall distribution as well as at an individual patient level. Additionally, the numbers of ‘catastrophic' test results, as defined by the Royal College of Pathologists, were calculated for the higher frequency and reduced frequency years.

Results

Testing frequency in the year to April 2020 approximated to monthly, and three-monthly in the year to April 2021. Sub-analysis in 229 patients showed the overall distributions of PLT, MCV, NEUT, eGFR and ALT results were no more likely to be outside normal laboratory parameters when tested less frequently. Furthermore, individual patients were no more likely to have results outside normal laboratory parameters with less frequent testing. Overall, our analysis indicated that reduced monitoring did not lead to more abnormal results. Additionally, ‘catastrophic’ results were extremely uncommon, and did not increase with reduced testing. Routine MTX monitoring revealed no catastrophic results, these only occurred in patients being managed for co-existing morbidities.

Conclusion

MTX monitoring reduced during the pandemic but not in adherence to updated SCG. We evidence that reducing frequency of routine blood monitoring did not increase abnormal results or cause harm in stable MTX patients. Significant blood abnormalities were rare and universally occurred only with co-existing morbidities. Across primary and secondary care workloads are increasing, resources are limited, and cost efficiencies needed. These findings support a review of the frequency of routine blood monitoring; is now the time to shift to patient-initiated testing in those stable on MTX monotherapy?

Disclosure

N.A.E. Wood: None. L. Farmer: None. R. Manhas: None. T. Lewis: None. S. Kyle: None.
Musculoskeletal ultrasound may narrow the gap between patients and physicians in the assessment of rheumatoid arthritis disease activity
Authors: Floris Alberto , Rozza Davide , Zanetti Anna , Carrara Greta , Bellis Emanuela , Cauli Alberto , Iagnocco Annamaria , Scirè Carlo Alberto , Piga Matteo ,   STARTER investigators, Batticciotto Alberto , Bortoluzzi Alessandra , Gabba Alessandra , Gattamelata Angelica , Adinolfi Antonella , Raffeiner Bernd , Vinghitti Carlo , Mastaglio Claudio , Scioscia Crescenzio , Russi Daniela , Luccioli Filippo , Cavatorta Francesco , Ceccarelli Fulvia , Sakellariou Garifallia , Filippou Georgios , Cagnotto Giovanni , Farina Ilaria , Menza Luana , Idolazzi Luca , Canzoni Marco , Massarotti Marco , Focherini Maria , Caprioli Marta , Gutierrez Marwin , Draghessi Antonella , Muratore Maurizio , De Lucia Orazio , Rossini Paola , Macchioni Pierluigi , Ramonda Roberta , Rossi Silvia , Parisi Simone , Sabatino Valentina Di , Picerno Valentina
Published: April 2022

Objectives

To investigate the association between patient–physician discordance in the assessment of disease activity and residual US synovitis/tenosynovitis in a cohort of patients with RA in clinical remission.

Methods

A post hoc analysis of the STARTER study, promoted by the Musculoskeletal-US (MSUS) Study Group of the Italian Society for Rheumatology, was performed using data from 361 consecutive patients with RA in clinical remission. The global assessment of disease activity by each patient (PGA) and evaluator/physician (EGA) was recorded on a 100-mm visual analogue scale. The PGA-EGA discordance was classified as positive (PGA>EGA) or negative (PGA<EGA) using a cut-off of ±10 mm. The association of discordance with greyscale (GS) and power Doppler (PD) synovitis (S) and tenosynovitis (T) scores was evaluated through logistic regression analysis. The odds ratio for each point of the scores, adjusted for prespecified confounders (adjOR), was calculated.

Results

The mean (s.d.) PGA and EGA scores were 6.1 (7.1) and 8.8 (12) mm, respectively, with a median (IQR) absolute difference of 4 (0–10) mm. Positive and negative discordances were recorded in 39 (10.8%) and 65(18.0%) patients, respectively. The GS-S (adjOR 1.099) and PD-S (adjOR 1.167) scores were associated with positive discordance (P < 0.01), while the GS-T (adjOR 1.083), GS-S (adjOR 1.063) and PD-S (adjOR 1.089) scores were associated with negative discordance (P < 0.05). The PGA-EGA discordance did not predict flares at 6 and 12 months.

Conclusions

Patient–physician discordance is associated with the lack of US remission in patients with RA and may represent a further indication for MSUS.
Evaluation of left cardiac chamber function with cardiac magnetic resonance and association with outcome in patients with systemic sclerosis
Authors: Butcher Steele C , Vos Jacqueline L , Fortuni Federico , Galloo Xavier , Liem Sophie I E , Bax Jeroen J , Delgado Victoria , Vonk Madelon C , van Leuven Sander I , Snoeren Miranda , El Messaoudi Saloua , de Vries-Bouwstra Jeska K , Nijveldt Robin , Ajmone Marsan Nina
Published: April 2022

Objective

This study aimed to determine whether lower values of feature-tracking cardiovascular magnetic resonance (CMR)-derived left atrial reservoir strain (LARS) and impaired left ventricular (LV) global longitudinal strain (GLS) were associated with the presence of symptoms and long-term prognosis in patients with SSc.

Methods

A total of 100 patients {54 [interquartile range (IQR) 46–64] years, 42% male} with SSc who underwent CMR imaging at two tertiary referral centres were included. All patients underwent analysis of LARS and LV GLS using feature-tracking on CMR and were followed-up for the occurrence of all-cause mortality.

Results

The median LV GLS was –21.8% and the median LARS was 36%. On multivariable logistic regression, LARS [odds ratio (OR) 0.964 per %, 95% CI 0.929, 0.998, P = 0.049] was independently associated with New York Heart Association (NYHA) class II–IV heart failure symptoms. Over a median follow-up of 37 (21–62) months, a total of 24 (24%) patients died. Univariable Cox regression analysis demonstrated that LARS [hazard ratio (HR) 0.94 per 1%, 95% CI 0.91, 0.97, P < 0.0001) and LV GLS (HR 1.10 per %, 95% CI 1.03, 1.17, P = 0.005) were associated with all-cause mortality, while LV ejection fraction was not. Likelihood ratio tests demonstrated that LARS provided incremental value over prognostically important clinical and imaging parameters, including late gadolinium enhancement.

Conclusion

In patients with SSc, LARS was independently associated with the presence of NYHA class II–IV heart failure symptoms. Although both LARS and LV GLS were associated with all-cause mortality, only LARS provided incremental value over all evaluated variables known to be prognostically important in patients with SSc.
Systematic review: sleep health in the US Latinx population
Authors: Roncoroni Julia , Okun Michele , Hudson Amy
Published: April 2022

Sleep disturbances are a common and unmet health problem in Latinx. While Latinx report similar sleep disturbances as non-Hispanic Whites [NHW], Latinx suffer from these disturbances to a greater degree than their NHW counterparts. Sleep disturbances are associated with increased risk of chronic health conditions, which Latinx experience at high rates. Research also points to significant sleep differences within Latinx. Given that Latinx are a rapidly growing population in the United States, sleep disparities between Latinx and NHWs and sleep differences within Latinx warrant further investigation. While research on Latinx sleep is growing, the last narrative review on US Latinx sleep health was published by Loredo and colleagues in 2010. Our narrative review expands on Loredo et al.’s work, adding the literature on Latinx sleep published since 2010 (N = 70). A total of 78 peer-reviewed articles related to young to middle-aged (i.e., 18–65 years) healthy Latinx adult sleep were identified in three databases—PsycInfo, PubMed/Medline, and Web of Science. With the socioecological model as framework, this review (1) summarizes current evidence pertaining to sleep health in healthy, community dwelling, urban Latinx adults; (2) discusses measurement challenges related to investigating Latinx sleep disparities and differences; and (3) discusses potential contributors to Latinx sleep. The prevalence of short sleep duration, long sleep duration, and poor sleep quality is high among Latinx; there are differences by Latinx subgroup. Our review identifies several multi-level influences associated with poor sleep: SES, sexual minority status, racial discrimination, access to care, neighborhood environment, and shift work. N = 250/250.
Measles
Authors: Feutz Kristi , Shirey Deborah
Published: April 2022

Measles is a vaccine-preventable, highly contagious virus once considered eradicated in the US. It is still a significant source of morbidity and mortality for children under 5 years of age worldwide. Advanced practice registered nurses are on the frontlines of reducing the spread of disease and educating the community on measles prevention.
Preparing for the Future
Authors: Hoelscher Stephanie H. , McBride Susan , Bumpus Serena
Published: April 2022

Clinicians across the globe face overwhelming dissatisfaction and burden with electronic health records due to poor usability and the sheer volume of data collection requirements. In the United States, electronic health records are noted to be a principal source of distress, dissatisfaction, and endless workarounds, leading to poor clinician performance and, ultimately, poor patient outcomes.

The purpose of this article is to present a detailed review of a 2020 Texas pilot study. The study's focus was the engagement of nursing informatics experts from around the state to gain consensus on nursing documentation's current status and if plans were being developed to modify or decrease documentation, specifically to alleviate burden during a time of crisis. The study consisted of subject matter expert focus groups, a high-level Delphi for instrument development, and the implementation of the statewide instrument to gain consensus. Ultimately, the research team learned that there were gaps in not only what documentation could be removed (either temporarily or permanently) but also what standards dictate the use of crisis documentation (ie, “surge” criteria). The study findings discussed in this article will inform improvement strategies and policy recommendations to increase the value and usability of crisis nursing documentation requirements.
Evaluation of the Effectiveness of Digital Game-Based Learning Given to Nursing Students for the Developmental Care of Infants in Neonatal Intensive Care Unit
Authors: Erdoğan Çiğdem , Turan Türkan
Published: April 2022

Although simulation laboratories are widely used in today's nursing education programs, it is becoming more and more difficult to find adequate physical space, equipment, and instructors for laboratory practices in schools. With increasing access to quality technology, schools prefer Web-based education or virtual games as another way of learning through simulation laboratories. This study was carried out to evaluate the effect of digital game–supported teaching activity given to nursing students for the developmental care of infants in neonatal ICU on learning. This study is a quasi-experimental study with a control group. Within the scope of the study, the researchers, together with the technical team, developed a digital game in accordance with the purpose of the study. The study was conducted in a health sciences faculty, nursing department, between September 2019 and March 2020. Sixty-two students were included in the study, which were divided into two groups, with 31 students in the experimental group and 31 students in the control group. The study data were collected using a personal information tool and a developmental care information tool. Whereas the digital game learning method was used for the students in the experimental group, the traditional teaching method was used for the students in the control group. No significant difference has been found between the pretest knowledge scores of the students in the experimental and control groups (P > .05). A statistically significant difference has been found in the rates of giving correct answers between the groups in the posttest and retention test (P < .05). The students in the experimental group gave more correct answers in the posttest and retention test than the students in the control group. In line with these results, the learning method with digital games is effective in increasing the knowledge level of nursing undergraduate students. Therefore, it is recommended to integrate digital games into education.
Developing a Multimodal Monitoring System for Geriatric Depression
Authors: Cho Youngshin , Lim Kyuhee , Lee Sunghee , Kim Yuntae , Kim Mijung , Kim Chang Oh , Kim Youkyung , Kim Heejung
Published: April 2022

The Internet of Medical Things is promising for monitoring depression symptoms. Therefore, it is necessary to develop multimodal monitoring systems tailored for elderly individuals with high feasibility and usability for further research and practice. This study comprised two phases: (1) methodological development of the system; and (2) system validation to evaluate its feasibility. We developed a system that includes a smartphone for facial and verbal expressions, a smartwatch for activity and heart rate monitoring, and an ecological momentary assessment application. A sample of 21 older Koreans aged 65 years and more was recruited from a community center. The 4-week data were collected for each participant (n = 19) using self-report questionnaires, wearable devices, and interviews and were analyzed using mixed methods. The depressive group (n = 6) indicated lower user acceptance relative to the nondepressive group (n = 13). Both groups experienced positive emotions, had regular life patterns, increased their self-interest, and stated that a system could disturb their daily activities. However, they were interested in learning new technologies and actively monitored their mental health status. Our multimodal monitoring system shows potential as a feasible and useful measure for acquiring mental health information about geriatric depression.
Individual and Team Factors Influencing the Adoption of Information and Communication Technology by Nurses
Authors: Coffetti Elvira , Paans Wolter , Roodbol Petrie F. , Zuidersma Jelly
Published: April 2022

The aim of this review was to explore which factors influence nurses' adoption of information and communication technology. A systematic review was conducted using qualitative and quantitative studies. The authors performed the search strategy in the databases of PubMed, CINAHL, and IEEE and included articles published between January 2011 and July 2021. This review explores the following factors: collaboration, leadership, and individual and team factors—that, according to qualitative and quantitative research, seem to influence nurses' adoption of information and communication technology. A gradual implementation process of the information and communication technology, involvement from care professionals in the implementation process, and team functioning are important factors to consider when adopting information and communication technology. In addition to these, individual factors such as age, experience, attitude, and knowledge are also influencing factors. The review suggests that collaboration is important within the implementation of information and communication technology in care and that it positively influences nurses' adoption of it. Individual factors are researched more extensively than collaboration, leadership, and team factors. Although they also appear to influence the adoption of information and communication technology, there is insufficient evidence to convincingly substantiate this.
An Open-Label Randomized Controlled Trial Comparing Effectiveness of Aggressive Hydration Versus High-dose Rectal Indomethacin in the Prevention of Postendoscopic Retrograde Cholangiopancreatographic Pancreatitis (AHRI-PEP)
Authors: Guha Pradipta , Patra Partha S. , Misra Debashis , Ahammed Sk Mahiuddin , Sarkar Rajib , Dhali Gopal K. , Ray Sukanta , Das Kshaunish
Published: April 2022

Background:

Although rectal administration of nonsteroidal anti-inflammatory drugs is recommended as the standard pharmacologic modality to prevent postendoscopic retrograde cholangiopancreatography (ERCP) post-ERCP pancreatitis (PEP), vigorous periprocedural hydration (vHR) with lactated Ringer’s solution (LR) is emerging as an effective prophylaxis modality for PEP. There has been no head-to-head comparison between these 2.

Study:

This was a single-center, randomized, open-label, noninferiority, parallel-assigned, equal allocation, controlled clinical trial in a tertiary care hospital. Consecutive adults referred for ERCP, satisfying predefined inclusion criteria, underwent simple randomization and blinded allocation into 2 groups. Those allocated to vHR received intravenous LR at 3 mL/kg/h during procedure, 20 ml/kg bolus immediately afterward, and then at 3 mL/kg/h for another 8 hours. Those randomized to rectal Indomethacin received only per-rectal 100 mg suppository immediately post-ERCP. Assuming PEP of 9% in Indomethacin arm and noninferiority margin of 4%, we calculated sample size of 171 patients in each arm for 80% power and α-error 5%. Primary outcome was incidence of PEP, within 1 week, as defined by Cotton’s criteria. All analysis were done by intention-to-treat.

Results:

Between October, 2017 to February, 2018, 521 patients were assessed. In all, 352 were enrolled, 178 randomized to vHR, and 174 to per-rectal Indomethacin. Baseline details and ERCP outcomes were not different between 2 groups. PEP occurred in 6 (1.7%) overall, with 1 (0.6%) in hydration arm, and 5 (2.9%) in indomethacin arm; an absolute risk reduction of 2.3% (95% confidence interval: 0.9%-3.5%) and odds ratio of 0.19 (95% confidence interval: 0.02-1.65). Three patients developed severe PEP, all receiving indomethacin.

Conclusions:

vHR with LR is noninferior to postprocedure per-rectal Indomethacin for PEP prevention (ClinicalTrials.govID:NCT03629600).
Effects of Classical Music Virtual Reality on Pediatric Healthcare Worker Compassion Fatigue
Authors: Hayakawa Jennifer , Barrows Jennifer , See Susan , Schomberg John
Published: April 2022

OBJECTIVE

The aim of this study was to explore the impact of classical music virtual reality (VR) on burnout, secondary traumatic stress, anxiety, and capacity for developing caring relationships with patients among healthcare workers (HCWs).

BACKGROUND

COVID-19 accentuated the importance of promoting the well-being of frontline workers. Efforts to address the mental health needs of HCWs are likely to positively impact patient outcomes.

METHODS

Healthcare workers completed 3 sessions of VR. A Wilcoxon rank-sum test was used to compare premeasure versus postmeasure on the Professional Quality of Life (ProQOL), State Trait Anxiety Inventory, and Caring Ability Inventory. Analysis of variance was performed to identify associations between the intervention and differences in scores for each ProQOL domain. Bonferroni correction adjusted for multiple comparisons. Fisher's t test was used for categorical analysis.

RESULTS

Seventy-one HCWs completed the study. There was a significant reduction in burnout after the experience, compared with baseline.

CONCLUSIONS

This study provides evidence that classical music VR may reduce burnout in HCWs.
Nursing Professional Development in Ambulatory Care
Authors: Fritz Elizabeth , Despins Laurel , Vogelsmeier Amy
Published: April 2022

Nursing professional development (NPD) practitioners play an important role in ensuring the quality and safety of nursing care and in guiding nurses through practice transitions. Recently, increasing numbers of NPD practitioners have been employed in ambulatory care settings, yet little is known about how the ambulatory practice setting affects or is affected by NPD practice. The aim of this descriptive phenomenology was to describe how the NPD role is experienced in the ambulatory care setting.
“Just-in-Time” COVID-19 Education
Authors: Joseph Letha M. , Therady Agnes M. , Rahman Alphonsa , Varghese Reenu M.
Published: April 2022

The pandemic jolted our healthcare professionals like none other in modern history. Though it was a crisis of unparalleled proportion, it brought out the best in the nursing professional development unit of a minority nurses association. In this article, the authors describe the journey of a professional development unit that empowered nurses with “just-in-time” education for knowledge and competence to manage the pandemic.
Preparing Staff Nurses to Be Preceptors on a Dedicated Education Unit Through an Interactive Bulletin Board
Authors: Dalbey Susan , Zenoni Lisa , Donnelly Lillian
Published: April 2022

Nursing professional development (NPD) specialists are tasked with providing pertinent education to staff members. Many barriers exist in providing education to nurses. Through an academic–practice partnership, an interactive bulletin board was trialed to provide staff education with overwhelmingly positive results. An increased percentage of staff participated in this learning activity. In addition, the mean score from the content knowledge quiz was 88%. NPD specialists may increase staff participation employing interactive bulletin boards as an educational method.
Presence and absence of type VI secretion systems in bacteria
Authors: Unni Rahul , Pintor Katherine L. , Diepold Andreas , Unterweger Daniel
Published: April 2022

The type VI secretion system (T6SS) is a molecular puncturing device that enables Gram-negative bacteria to kill competitors, manipulate host cells and take up nutrients. Who would want to miss such superpowers? Indeed, many studies show how widespread the secretion apparatus is among microbes. However, it is becoming evident that, on multiple taxonomic levels, from phyla to species and strains, some bacteria lack a T6SS. Here, we review who does and does not have a type VI secretion apparatus and speculate on the dynamic process of gaining and losing the secretion system to better understand its spread and distribution across the microbial world.