bluuebunny/crossref_metadata_2025 huggingface dataset:
Antisocial Personalities
Authors: Gabbard Glen O.
Published: February 2022

Antisocial personalities can be conceptualized as a group of disorders that reside on a continuum from least pathological to most disturbed. The top of this continuum are antisocial features shared by other personality disorders. The next step down includes many cases of narcissistic personality disorder that feature antisocial behavior as a major problem. These individuals can be ruthlessly exploitative of others but have the capacity to experience guilt and concern. Further down the continuum are malignant narcissists who have a paranoid orientation and ego-syntonic sadism, who differ from true antisocial personality disorder patients and cases of psychopathy in that they have some capacity for loyalty and concern for others. Finally, one encounters true psychopathy, featuring individuals who cannot imagine altruism of any sort and are incapable of investing themselves in nonexploitative relationships. The epidemiology of these disorders, including their life course, is discussed, as well as common comorbidities found with people who have antisocial personalities. Diagnostic considerations in this cohort are complicated by their propensity to falsify their histories. In this overview, the full spectrum of antisocial behavior is considered, with relevant differential diagnostic material that helps the clinician identify what sort of disorder is being treated and the nature of the individual with the diagnosis. The biological/genetic underpinnings of these disorders, their psychosocial contributions, and typical countertransference reactions will also be covered, along with treatment strategies designed to help manage the spectrum of antisocial features and other difficulties presented by patients who may not be seriously invested in treatment.
Personality disorders
Authors: O'Dwyer Anne-Marie , Campion Mariel
Published: February 2022

This chapter explains the concepts of personality and personality disorders. The term personality refers to enduring patterns of behaviour, deeply ingrained attitudes and responses, typically present from adolescence, persisting throughout adult life, and manifesting across different situations. It defines our interests, how we interact with others and how we respond to stress. Every presentation occurs in a person with a pre-existing, ‘premorbid’, personality. This personality has a profound impact on both the way in which a patient presents and on the impact of any intervention. The concepts of personality and personality disorder, in particular, are difficult areas in mental health.
This chapter provides knowledge about:
• Definitions of personality and personality disorder.
• Limitations of the concept.
• The main personality categories, including paranoid, schizoid, dissocial, emotionally unstable, histrionic, anxious, anankastic, and dependant.
• A clinical approach that incorporates advantages, as well as disadvantages, of particular personality traits.
Practical tips include:
• Key points to define personality disorder.
• A mnemonic to aid memory for each personality category.
• A grid that highlights ‘helpful’ aspects of specific personality traits.
Mood disorders
Authors: O'Dwyer Anne-Marie , Campion Mariel
Published: February 2022

Mood disorders are so called because the core feature is an abnormality of mood that is persistent and pervasive. The terminology of mood disorders can be confusing, partly because of differences within the classification systems. The term mood refers to a sustained emotional state that defines the person’s experience. There are two major disorders of mood: depressive disorder (also termed unipolar depression) and bipolar affective disorder. The key difference between the two is the occurrence of both elevated (mania) and depressed mood in bipolar disorder. Two other mood disorders, cyclothymia and dysthymia, will also be discussed. Mildly elevated mood is called hypomania.This chapter presents the key features of mood disorders, highlighting key points in diagnosing depression, mania, and bipolar disorder. The text includes how to identify, investigate, and manage each of the disorders, highlighting clinical features, course, and treatment.
This chapter provides knowledge about:
• Symptoms of depression and mania.
• How to categorize the disorders with respect to severity.
• Key facts about aetiology.
• Factors to consider in making the diagnosis and matching interventions to the specific presentation.
• Guiding principles in assessment of hopelessness and suicide risk.
Practical tips include:
• What students must know about mood disorders.
• Simplified representation of categories for depression.
• Basic guidelines for diagnosis and management of depression.
The NewHorizon simulation – to bar or not to bar
Authors: Reddish J , Kraljic K , Petersen M S , Tep K , Dubois Y , Pichon C , Peirani S , Bournaud F , Choi H , Devriendt J , Jackson R , Martin G , Park M J , Volonteri M , Yi S K
Published: February 2022

We use the NewHorizon simulation to study the redshift evolution of bar properties and fractions within galaxies in the stellar masses range M⋆ = 107.25–1011.4$\, \rm {M}_\odot$ over the redshift range of z = 0.25–1.3. We select disc galaxies using stellar kinematics as a proxy for galaxy morphology. We employ two different automated bar detection methods, coupled with visual inspection, resulting in observable bar fractions of fbar = 0.070$_{{-0.012}}^{{+0.018}}$ at z ∼ 1.3, decreasing to fbar = 0.011$_{{-0.003}}^{{+0.014}}$ at z ∼ 0.25. Only one galaxy is visually confirmed as strongly barred in our sample. This bar is hosted by the most massive disc and only survives from z = 1.3 down to z = 0.7. Such a low bar fraction, in particular amongst Milky Way-like progenitors, highlights a missing bars problem, shared by literally all cosmological simulations with spatial resolution <100 pc to date. The analysis of linear growth rates, rotation curves, and derived summary statistics of the stellar, gas and dark matter components suggest that galaxies with stellar masses below 109.5−1010$\, \rm {M}_\odot$ in NewHorizon appear to be too dominated by dark matter relative to stellar content to form a bar, while more massive galaxies typically have formed large bulges that prevent bar persistence at low redshift. This investigation confirms that the evolution of the bar fraction puts stringent constraints on the assembly history of baryons and dark matter on to galaxies.
DNAcycP: a deep learning tool for DNA cyclizability prediction
Authors: Li Keren , Carroll Matthew , Vafabakhsh Reza , Wang Xiaozhong A , Wang Ji-Ping
Published: February 2022

DNA mechanical properties play a critical role in every aspect of DNA-dependent biological processes. Recently a high throughput assay named loop-seq has been developed to quantify the intrinsic bendability of a massive number of DNA fragments simultaneously. Using the loop-seq data, we develop a software tool, DNAcycP, based on a deep-learning approach for intrinsic DNA cyclizability prediction. We demonstrate DNAcycP predicts intrinsic DNA cyclizability with high fidelity compared to the experimental data. Using an independent dataset from in vitro selection for enrichment of loopable sequences, we further verified the predicted cyclizability score, termed C-score, can well distinguish DNA fragments with different loopability. We applied DNAcycP to multiple species and compared the C-scores with available high-resolution chemical nucleosome maps. Our analyses showed that both yeast and mouse genomes share a conserved feature of high DNA bendability spanning nucleosome dyads. Additionally, we extended our analysis to transcription factor binding sites and surprisingly found that the cyclizability is substantially elevated at CTCF binding sites in the mouse genome. We further demonstrate this distinct mechanical property is conserved across mammalian species and is inherent to CTCF binding DNA motif.
Perspective on COVID-19 vaccination in patients with immune-mediated kidney diseases: consensus statements from the ERA-IWG and EUVAS
Authors: Stevens Kate I , Frangou Eleni , Shin Jae I l , Anders Hans-Joachim , Bruchfeld Annette , Schönermarck Ulf , Hauser Thomas , Westman Kerstin , Fernandez-Juarez Gema M , Floege Jürgen , Goumenos Dimitrios , Turkmen Kultigin , van Kooten Cees , McAdoo Stephen P , Tesar Vladimir , Segelmark Mårten , Geetha Duvuru , Jayne David R W , Kronbichler Andreas ,   Immunonephrology Working Group (IWG) of the European Renal Association (ERA) and the European Vasculitis Society (EUVAS)
Published: February 2022

Patients with immune-mediated kidney diseases are at increased risk of severe coronavirus disease 2019 (COVID-19). The international rollout of COVID-19 vaccines has provided varying degrees of protection and enabled the understanding of vaccine efficacy and safety. The immune response to COVID-19 vaccines is lower in most patients with immune-mediated kidney diseases; either related to immunosuppression or comorbidities and complications caused by the underlying disease. Humoral vaccine response, measured by the presence of antibodies, is impaired or absent in patients receiving rituximab, mycophenolate mofetil (MMF), higher doses of glucocorticoids and likely other immunosuppressants, such as cyclophosphamide. The timing between the use of these agents and administration of vaccines is associated with the level of immune response: with rituximab, vaccine response can only be expected once B cells start to recover and patients with transient discontinuation of MMF mount a humoral response more frequently. The emergence of new COVID-19 variants and waning of vaccine-induced immunity highlight the value of a booster dose and the need to develop mutant-proof vaccines. COVID-19 vaccines are safe, exhibiting a very low risk of de novo or relapsing immune-mediated kidney disease. Population-based studies will determine whether this is causal or coincidental. Such cases respond to standard management, including the use of immunosuppression. The Immunonephrology Working Group and European Vasculitis Society recommend that patients with immune-mediated kidney diseases follow national guidance on vaccination. Booster doses based on antibody measurements could be considered.
Variability in Urinary Nicotine Exposure Biomarker Levels Between Waves 1 (2013–2014) and 2 (2014–2015) in the Population Assessment of Tobacco and Health Study
Authors: Ashley David L , Zhu Wanzhe , Wang Lanqing , Sosnoff Connie , Feng Jun , Del Valle-Pinero Arseima Y , Cheng Yu-Ching , Chang Cindy M , van Bemmel Dana , Borek Nicolette , Kimmel Heather L , Silveira Marushka L , Blount Benjamin C
Published: February 2022

Introduction

To date, no studies have evaluated the consistency of biomarker levels in people who smoke over a long-time period in real-world conditions with a large number of subjects and included use behavior and measures of nicotine metabolism. We evaluated the variability of biomarkers of nicotine exposure over approximately a 1-year period in people who exclusively smoke cigarettes, including intensity and recency of use and brand switching to assess impact on understanding associations with product characteristics.

Aims and Methods

Multivariate regression analysis of longitudinal repeated measures of urinary biomarkers of nicotine exposure from 916 adults in the Population Assessment of Tobacco and Health (PATH) Study with demographic characteristics and use behavior variables. Intraclass correlation coefficients (ICCs) were calculated to examine individual variation of nicotine biomarkers and the uncertainty of repeat measures at two time points (Waves 1 and 2).

Results

Age, race, and urinary creatinine were significant covariates of urinary cotinine. When including use behavior, recency, and intensity of use were highly significant and variance decreased to a higher extent between than within subjects. The ICC for urinary cotinine decreased from 0.7530 with no use behavior variables in the model to 0.5763 when included. Similar results were found for total nicotine equivalents.

Conclusions

Urinary nicotine biomarkers in the PATH Study showed good consistency between Waves 1 and 2. Use behavior measures such as time since last smoked a cigarette and number of cigarettes smoked in the past 30 days are important to include when assessing factors that may influence biomarker concentrations.

Implications

The results of this study show that the consistency of the nicotine biomarkers cotinine and total nicotine equivalents in spot urine samples from Waves 1 to 2 of the PATH Study is high enough that these data are useful to evaluate the association of cigarette characteristics with biomarkers of exposure under real-world use conditions.
A phytoplasma effector acts as a ubiquitin-like mediator between floral MADS-box proteins and proteasome shuttle proteins
Authors: Kitazawa Yugo , Iwabuchi Nozomu , Maejima Kensaku , Sasano Momoka , Matsumoto Oki , Koinuma Hiroaki , Tokuda Ryosuke , Suzuki Masato , Oshima Kenro , Namba Shigetou , Yamaji Yasuyuki
Published: February 2022

Plant pathogenic bacteria have developed effectors to manipulate host cell functions to facilitate infection. A certain number of effectors use the conserved ubiquitin–proteasome system in eukaryotic to proteolyze targets. The proteasome utilization mechanism is mainly mediated by ubiquitin interaction with target proteins destined for degradation. Phyllogens are a family of protein effectors produced by pathogenic phytoplasmas that transform flowers into leaves in diverse plants. Here, we present a noncanonical mechanism for phyllogen action that involves the proteasome and is ubiquitin-independent. Phyllogens induce proteasomal degradation of floral MADS-box transcription factors (MTFs) in the presence of RADIATION-SENSITIVE23 (RAD23) shuttle proteins, which recruit ubiquitinated proteins to the proteasome. Intracellular localization analysis revealed that phyllogen induced colocalization of MTF with RAD23. The MTF/phyllogen/RAD23 ternary protein complex was detected not only in planta but also in vitro in the absence of ubiquitin, showing that phyllogen directly mediates interaction between MTF and RAD23. A Lys-less nonubiquitinated phyllogen mutant induced degradation of MTF or a Lys-less mutant of MTF. Furthermore, the method of sequential formation of the MTF/phyllogen/RAD23 protein complex was elucidated, first by MTF/phyllogen interaction and then RAD23 recruitment. Phyllogen recognized both the evolutionarily conserved tetramerization region of MTF and the ubiquitin-associated domain of RAD23. Our findings indicate that phyllogen functionally mimics ubiquitin as a mediator between MTF and RAD23.
Mendelian and non-Mendelian genetics in model plants
Authors: Mittelsten Scheid Ortrun
Published: February 2022

The “Mendelian Rules” of inheritance are cornerstones of genetics, described in Mendel’s seminal publication from 1866. The experimental results and their interpretation have been discussed in numerous ways. This perspective emphasizes the contribution of Mendel’s preparations prior to his crossing experiments to the discovery of Mendelian genetics. This thoughtful experimental design, and some fortune, avoided pitfalls that could have resulted in non-Mendelian inheritance.
Physical Therapy Is an Important Component of Postpartum Care in the Fourth Trimester
Authors: Critchley Claire J C
Published: February 2022

The objectives of this Perspective paper are to educate physical therapists on their important role in assessing and treating common pregnancy- and delivery-related health conditions and to advocate for their routine inclusion in postpartum care during the fourth trimester. Pelvic floor dysfunction (PFD) and diastasis recti abdominis (DRA) are 2 examples of musculoskeletal disorders associated with pregnancy and childbirth that can have negative physical, social, and psychological consequences. This paper reviews evidence from 2010 through 2021 to discuss the efficacy of physical therapist intervention in the fourth trimester for PFD and DRA. The role of physical therapy in the United States is compared with its role in other developed nations, with the intent of illustrating the potential importance of physical therapy in postpartum care. Evidence shows physical therapy is an effective, low-risk, therapeutic approach for PFD and DRA; however, physical therapists in the United States currently have a peripheral role in providing postpartum care. Lack of awareness, social stigma, and policy barriers prevent women from receiving physical therapist care. Recommendations are made regarding ways in which physical therapists can increase their involvement in the fourth trimester within their community, stimulate policy change, and promote improved postpartum care practices.

Impact

This Perspective highlights the valuable role of physical therapist assessment and treatment during the postpartum period for some common musculoskeletal conditions associated with pregnancy and delivery.
Volunteer Leadership in the American Physical Therapy Association: A Phenomenological Study of Early Career Physical Therapists
Authors: Bordenave Lori M , Tovin Melissa Moran , Blackinton Mary , Canbek Jennifer
Published: February 2022

Objective

Professional associations rely on the work of volunteer leaders to serve their members. Little is known about the experiences of individuals who choose to seek and participate in these volunteer roles in the American Physical Therapy Association (APTA). The purpose of this qualitative study was to understand the lived experience of early career professionals engaged in volunteer leadership in APTA.

Methods

The study used a phenomenological design to explore the experience of volunteer leadership by novice physical therapists. Physical therapists holding a volunteer leadership position in APTA and in the first 7 years of clinical practice were recruited using purposeful sampling. One-on-one semistructured interviews were conducted. Following transcription, interviews were analyzed and coded using the constant comparison method.

Results

Thirteen physical therapists participated. Eleven themes emerged: (1) internal factors that facilitated volunteerism—Passion, Internal drive, Always involved, Protect and advance the profession; (2) external forces that facilitated and sustained volunteer leadership—Professional role models, Meeting the leaders, Someone asked, Support of others; and (3) behaviors that sustained their involvement—Learning while doing, Future plans, and Encouraging others’ involvement.

Conclusions

Novice physical therapists who volunteer for leadership roles within APTA have a passion for protecting and advancing the profession that leads to their decision to volunteer. Other members including faculty and experienced leaders in the association facilitate their initial volunteerism and help to sustain their engagement. Support from employers, including time off and flexible schedules, and making plans for future involvement were crucial to their continued volunteer activity.

Impact Statement

Changing demographics and a limited understanding of volunteer leadership could leave APTA with a limited pool of leaders into the future. Understanding the reasons early career professionals volunteer in APTA can help develop more effective strategies to recruit and retain these leaders.
The OXTR rs53576 impacts moral permissibility of attempted but failed harms in populations of students and prisoners
Authors: He Linlin , Liu Jinting , Fan Yuhe , Leng Junhui , Wang Quanhe , Yang Cuimei , Zhang Rui , Guo Wenxuan , Zhang Jieting , Gong Pingyuan
Published: February 2022

Previous research has highlighted the roles of oxytocin in empathy and altruistic behaviors. Based on these findings, recent studies have examined the association between the oxytocin receptor gene (OXTR) and outcome-based moral judgment with sacrificial dilemmas (e.g. runaway trolley case). However, little is known about the relationships between OXTR polymorphisms and intent-based moral judgment of harms (e.g. attempted but failed harm or intentionally committed harm). This study investigated the association between the OXTR rs53576 and intent-based moral judgment in college students (N = 544) and prisoners (N = 540). Results indicated that both students and prisoners with the GG genotype of OXTR rs53576 rated attempted but failed harm as less permissible than those with the AA and AG genotypes. These findings highlight the role of the OXTR gene in intent-based moral judgment.
Cerium oxide nanoparticles attenuate the renal injury induced by cadmium chloride via improvement of the NBN and Nrf2 gene expressions in rats
Authors: Bashandy, PhD Mostafa M , Saeed Hanan E , Ahmed Walaa M S , Ibrahim Marwa A , Shehata Olfat
Published: February 2022

Background

Cadmium (Cd) is a highly toxic heavy metal that adversely affects both human and animal health. Chronic cadmium exposure causes serious kidney damage. The current study investigated the protective role of cerium oxide nanoparticles (CeO2NPs) against cadmium chloride (CdCl2)-induced renal injury.

Method

One hundred and twenty male albino rats were divided into 6 equal groups. Group (C): considered as control group which was given distilled water orally. Group (NC.1 and NC.5): rats were injected i.p. with nanoceria at a dose of (0.1 and 0.5 mg/kg b.wt), respectively, twice a week for 2 weeks starting at the 15th day of the study. Group (Cd): rats were received CdCl2 orally (10 mg/kg b.wt) daily for 28 days. Groups (Cd + NC.1 and Cd + NC.5): rats were given CdCl2 orally (10 mg/kg b.wt) for 28 days and CeO2NPs by i.p. injection at a dose of (0.1 and 0.5 mg/kg b.wt), respectively, twice a week for 2 weeks started at the 15th day of the experiment.

Results

The Cd group exhibited a significant increase in the serum levels of IL-1β, KIM-1, Cys-C, and β2-MG, downregulation of the antioxidant initiator genes such as Nrf-2, and up-regulation of apoptosis markers such as nibrin gene (NBN). Urine examination showed a high level of microalbuminuria, abnormal physical, chemical, and microscopical changes in comparison with control groups.

Conculsion

Remarkably, posttreatment with CeO2NPs showed significant improvement in kidney histopathological picture and relieved the alterations in kidney biomarkers, inflammatory markers, urine abnormalities, and expressions of different genes as Nrf-2 and NBN.
Ionized Blood Magnesium in Sick Children: An Overlooked Electrolyte
Authors: Dabla Pradeep Kumar , Sharma Shikha , Dabas Aashima , Tyagi Vernika , Agrawal Shipra , Jhamb Urmila , Begos Dennis , Upreti Kamal , Mir Rashid
Published: February 2022

Introduction

Magnesium is a less frequently monitored electrolyte in critically ill patients. Hypomagnesemia is associated with increased need for mechanical ventilation, mortality and prolonged ICU stay. The present study was undertaken to identify the proportion of children with abnormal magnesium levels and correlate it with disease outcome.

Methods

This observational study included children aged 1 month to 12 years hospitalized at the emergency room. Heparinized blood was collected for determination of ionized magnesium, ionized calcium, sodium, potassium and lactate using Stat Profile Prime Plus (Nova Biomedical, Waltham, MA, USA). Clinical outcomes for duration of hospitalization, and death or discharge were recorded.

Results

A total of 154 (102 males) children with median (IQR) age of 11 (4, 49.75) months were enrolled. Sixty one (39.6%) had ionized magnesium levels below 0.42 mmol/l, 63 (40.9%) had normal levels and 30 (19.4%) had hypermagnesemia (>0.59 mmol/l). Hypomagnesemia was associated with hypocalcemia (p < 0.001), hyponatremia (p < 0.001) and hypokalemia (p < 0.02). A higher proportion of children with hypermagnesemia required ventilation than hypomagnesemia (26% vs. 9%) and succumbed (35% vs. 20%), respectively; p > 0.05. Ninety-three (60.3%) had hypocalcemia and 10 (6.5%) children had hypercalcemia. There was good correlation between ionized calcium and magnesium values (r = 0.72, p < 0.001).

Conclusion

Both hypomagnesemia and hypermagnesemia were seen in critically ill children. Patients with hypomagnesemia had significantly higher proportion of other electrolyte abnormalities.
High nerve density in breast cancer is associated with poor patient outcome
Authors: Li Dong , Hu Li Na , Zheng Si Min , La Ting , Wei Li Yuan , Zhang Xiao Jun , Zhang Zhen Hua , Xing Jun , Wang Li , Li Ruo Qi , Zhu Qin , Thorne Rick F. , Feng Yu Chen , Hondermarck Hubert , Zhang Xu Dong , Li Li , Gao Jin Nan
Published: February 2022

Active crosstalk between the nervous system and breast cancer cells has been experimentally demonstrated in vitro and in animal models. However, low frequencies of peripheral nerve presence in human breast cancers reported in previous studies (~30% of cases) potentially negate a major role of the nervous system in breast cancer development and progression. This study aimed to clarify the incidence of nerves within human breast cancers and to delineate associations with clinicopathological features. Immunohistochemical staining was conducted in formalin‐fixed paraffin‐embedded breast cancer tissue sections using antibodies against the pan‐neuronal markers protein gene product 9.5 and growth‐associated protein 43, and the sympathetic nerve‐specific marker tyrosine hydroxylase. Nerve trunks and isolated nerve fibers were quantitated. The chi‐squared test was used to determine the associations between nerve counts and clinicopathological parameters. The log‐rank test was used to compare differences in patient progression‐free survival (PFS) and overall survival (OS). The overall frequency of peripheral nerves in breast cancers was 85%, a markedly higher proportion than reported previously. Of note, most nerves present in breast cancers were of the sympathetic origin. While high density of nerve trunks or isolated nerve fibers was associated with poor PFS and OS of patients, high nerve trunk density appeared also to predict poor patient PFS independently of lymph node metastasis. Innervation of breast cancers is a common event correlated with poor patient outcomes. These findings support the notion that the nervous system plays an active role in breast cancer pathogenesis.
New Treatment for Polycythemia Vera
Authors: Aschenbrenner Diane S.
Published: February 2022

Ropeginterferon alfa-2b-njft (Besremi) is the first interferon for treating polycythemia vera and the first approved medication for this condition that can be taken regardless of the patient's treatment history. It is administered subcutaneously every two weeks.

Like other interferon alfa products, ropeginterferon alfa-2b-njft has a boxed warning that it can cause or aggravate neuropsychiatric, autoimmune, ischemic, and infectious disorders, which can be life-threatening or fatal. Nurses should closely monitor patients for any persistently severe or worsening signs or symptoms of these adverse effects.
Nurse-Led Intervention Improves Tuberculosis Treatment Completion in Homeless Population
Authors: Rosenberg Karen
Published: February 2022

According to this study:

A nurse-led community health worker program resulted in a high rate of treatment completion among adults who were homeless and had latent tuberculosis infection.
Health Care Innovation: Embracing the Nurse–Engineer Partnership
Authors: Giuliano Karen K. , Landsman Kelly
Published: February 2022

This article introduces a series on nurse innovators, focusing whenever possible on nurse–engineer partnerships and outlining working, replicable models of collaboration between the two disciplines. This first column highlights the similarities between nursing and engineering, provides a case example, and discusses barriers to nurse–engineer partnerships as well as recommendations for success. Listen to a podcast with the authors at www.ajnonline.com.
Using a Generous Leadership Model to Promote Evidence-Based Practice
Authors: Staffileno Beth A. , Heitschmidt Mary , Tucker Sharon J.
Published: February 2022

This article is part of a series about evidence-based practice (EBP) that builds on AJN's award-winning previous series—Evidence-Based Practice, Step by Step—published between 2009 and 2011 (to access the series, go to https://links.lww.com/AJN/A133). This follow-up series features exemplar success stories, in which authors describe how initiatives using an implementation framework or evidence-based strategy resulted in a successful practice or program change. Column coordinators Sharon J. Tucker and Lynn Gallagher-Ford alternate in providing commentary at the end.
Returning Home from COVID Island
Authors: McNally Deirdre
Published: February 2022

As the pandemic abates, an ICU nurse struggles to understand what she's experienced.
Hold the Antibiotics: Are Preoperative Antibiotics Unnecessary in the Treatment of Pediatric Supracondylar Humerus Fractures?
Authors: Bloomer Ainsley K. , Coe Kelsie M. , Brandt Aaron M. , Roomian Tamar , Brighton Brian , Scannell Brian P.
Published: February 2022

Background:

Supracondylar humerus (SCH) fracture is the most common elbow injury in children and often treated with closed reduction and percutaneous pinning (CRPP). There is little published evidence supporting or refuting the use of perioperative prophylactic antibiotics for SCH CRPP in the pediatric population. The purpose of this study is to evaluate the rate of surgical site infection for patients with and without preoperative antibiotics.

Methods:

A retrospective chart review was conducted of patients less than or equal to 16 years from 2012 to 2018 who underwent primary CRPP. Open fractures, multilimbed polytraumas, and immunodeficient patients were excluded. Infection rates were compared using a noninferiority test assuming a 3% infection rate and a predefined noninferiority margin of 4%. A total of 255 patients were needed to adequately power the study.

Results:

Of the 1253 cases identified, 845 met eligibility criteria. A total of 337 received antibiotics, and 508 did not. Preoperative nerve injury (P=0.0244) and sterilization technique (P<0.0001) were associated with antibiotic use: 4 patients developed an infection; there were successfully treated superficial infections, and 1 was a deep infection requiring a formal debridement. There were 8 patients that had a recorded mal-union, and 6 patients required additional procedures; 1 patient had a postoperative compartment syndrome on postoperation day 1. The infection rates among patients treated with and without antibiotics were 0.60% and 0.40%, respectively. The absence of antibiotics was not clinically inferior to using antibiotics (P=0.003).

Conclusions:

Infection remains a rare complication following CRPP of SCH fractures. According to our current data, not giving perioperative antibiotics was not inferior to using perioperative antibiotics for preventing superficial or deep infection in patients undergoing CRPP of SCH fractures. With the increase in attention to antibiotic stewardship, it is important to eliminate unnecessary antibiotic use while continuing to maintain a low rate of surgical site infection.

Level of Evidence:

Level IV—case series. This is a therapeutic study that investigates the results from a case series.
UTILITY OF OCULAR β-d-GLUCAN TESTING IN PATIENTS WITH FUNGAL ENDOPHTHALMITIS
Authors: Xia Tian , Finkelman Malcolm , Kolomeyer Anton , Ying Gui-Shuang , Bracha Peter , Miller Charles G. , Elnahry Ayman G. , Carroll Robert , Zhang Yonglong , Saluadades Adrienne , Brucker Alexander J. , Kim Benjamin J.
Published: February 2022

Purpose:

To assess the diagnostic utility of (1→3)-β-d-glucan (BDG) in ocular fluid of patients with fungal endophthalmitis.

Methods:

This prospective pilot single-center study evaluated aqueous and vitreous humor BDG levels of suspected fungal endophthalmitis, bacterial endophthalmitis, and noninfectious controls with the standard Fungitell assay and the Fungitell STAT assay. β-d-Glucan levels were compared using generalized linear models followed by post hoc pairwise comparisons.

Results:

Seven fungal endophthalmitis, 6 bacterial endophthalmitis, and 17 noninfectious ocular samples were evaluated. Mean aqueous BDG concentrations were 204, 11.0, and 9.6 pg/mL for fungal endophthalmitis, bacterial endophthalmitis, and noninfectious controls, respectively (P = 0.01, fungal vs. bacterial; P = 0.0005, fungal vs. noninfectious controls). Mean vitreous BDG concentrations were 165, 30.3, and 5.4 pg/mL, respectively (P = 0.001 for fungal vs. bacterial; P < 0.0001 for fungal vs. noninfectious controls). Mean vitreous BDG index (Fungitell STAT) values were 1.7, 0.4, and 0.3, respectively (P = 0.001, fungal vs. bacterial; P = 0.0004, fungal vs. noninfectious controls). The Pearson correlation between BDG levels and BDG index was high (correlation coefficient = 0.99, P < 0.001).

Conclusion:

Significantly elevated ocular BDG levels were found in fungal endophthalmitis compared with bacterial endophthalmitis and noninfectious controls. Our study suggests a potential utility for BDG testing in the diagnosis of fungal endophthalmitis, and a larger study is warranted.
The Association of COVID-19 on Organizational Attitudes in Primary Care Among Interprofessional Practice Clinics
Authors: Fifolt Matthew , White-Williams Connie , Shirey Maria R. , Su Wei , Talley Michele
Published: February 2022

This article describes the association of COVID-19 on organizational attributes in primary care among 2 academic-practice partnership interprofessional collaborative practice (IPCP) clinics. Our team used a concurrent, triangulation repeated-measures study design to examine responses to the Survey of Organizational Attitudes of Primary Care (SOAP-C) instrument between January and December 2020. Analysis revealed statistically nonsignificant change over 12 months across all 4 subscales. Study results suggest that IPCP teams can function effectively through adversity. The IPCP model seemed to bolster resilience making it a viable model for ambulatory practices caring for vulnerable populations.
Acculturative Stress and Postpartum Depressive Symptoms among Immigrant Arab American Couples
Authors: Khalil Dalia , Giurgescu Carmen , Misra Dawn P. , Javanbakht Arash , Templin Thomas , Jenuwine Elizabeth
Published: February 2022

Purpose:

The purpose of this study was to examine the relationships between acculturative stress, perceived stress, social support, and postpartum depression (PPD) symptoms among immigrant Arab American couples.

Methods:

Using a cross-sectional design, 30 Arab American immigrant couples were enrolled. During home visits, couples completed the demographic information, the Multi-Dimensional Acculturative Stress Inventory, Perceived Stress, the Multidimensional Scale of Perceived Social Support among Arab Women, and the Edinburgh Postnatal Depression Scale. Data were analyzed using bivariate linear regression and Pearson correlation.

Results:

In bivariate regressions, paternal and maternal acculturative stress was moderately associated with maternal PPD symptoms (r = .39, and .46, respectively; p < .05). Maternal perceived stress (r = .70, P < .01) was strongly associated with PPD and maternal perceived social support was moderately associated with PPD (r = -.42, p < .05). Maternal and paternal acculturative stress was strongly correlated (r = .61, p < .001).

Conclusion:

Couple's acculturative stress and mother's perceived stress were positively associated with mother's PPD symptoms. Our findings suggest the need to develop a culturally appropriate procedure to assess couple's stress that may affect immigrant women at high risk for PPD.
Reconstruction of Mandibular Contour Defect Using Patient-Specific Titanium Implant Manufactured by Selective Laser Melting Method
Authors: Yang Hoon Joo , Oh Ji Hye
Published: February 2022

The purpose of this study was to evaluate the surgical accuracy and postoperative stability of patient-specific titanium implants (PSTIs) manufactured by the selective laser melting method and applied for mandibular contour reconstruction. For 2 patients who showed asymmetry of the mandibular angle after mandibuloplasty, including angle reduction, reconstructive surgeries of the mandibular contour defects were performed using PSTI. Patient-specific titanium implant was three-dimensional designed using a mirror image similar to the shape of the contralateral side, and 3 screw holes were formed, avoiding the inferior alveolar nerve. Patient-specific titanium implant was applied intraorally, and screw fixation was performed via a transbuccal approach. Surgical accuracy and postoperative stability were evaluated by comparing preoperative three-dimensional design with immediate postoperative computed tomography (CT), and immediate postoperative CT with postoperative 6-month CT, respectively. Both patients were satisfied with the surgical results, and no complications were observed. Surgical accuracy was defined as a mean Hausdorff distance <0.4mm, and postoperative stability was defined as a mean Hausdorff distance <0.3mm. Our results suggest that PSTI by the selective laser melting method for augmentation of the mandibular border is useful as an additional cosmetic surgery.
The effectiveness of Non Pharmaceutical Interventions in reducing the outcomes of the COVID-19 epidemic in the UK, an observational and modelling study
Authors: Galanis G. , Di Guilmi C. , Bennett D.L. , Baskozos G.
Published: February 2022

Epidemiological models used to inform government policies aimed to contain the contagion of COVID-19, assume that the reproduction rate is reduced through Non-Pharmaceutical Interventions (NPIs) leading to physical distancing. Available data in the UK show an increase in physical distancing before the NPIs were implemented and a fall soon after implementation. We aimed to estimate the effect of people’s behaviour on the epidemic curve and the effect of NPIs taking into account this behavioural component. We have estimated the effects of confirmed daily cases on physical distancing and we used this insight to design a bevavioural SEIR model (BeSEIR), simulated different scenaria regarding NPIs and compared the results to the standard SEIR. Taking into account behavioural insights improves the description of the contagion dynamics of the epidemic significantly. The BeSEIR predictions regarding the number of infections without NPIs were several orders of magnitude less than the SEIR. However, the BeSEIR prediction showed that early measures would still have an important influence in the reduction of infections. The BeSEIR model shows that even with no intervention the percentage of the cumulative infections within a year will not be enough for the epidemic to resolve due to a herd immunity effect. On the other hand, a standard SEIR model significantly overestimates the effectiveness of measures. Without taking into account the behavioural component the epidemic is predicted to be resolved much sooner than when taking it into account.
Undergraduate Pharmacology Written Question Papers of Different Universities of Bangladesh: Analysis of One Decade
Authors: Johora Fatema , Abbasy Asma Akter , Mahboob Sabiha , Jeenia Fatiha Tasmin , Ferdoush Jannatul , Rahman Md Sayedur
Published: February 2022

Background

It is expected that pharmacology education should prepare students as rational prescriber. Credibility of undergraduate pharmacology curricula is rather questionable in this aspect. As assessment shapes learning priorities, it is crucial to design assessment methods of pharmacology in right way to achieve the expected learning outcomes of future physicians.

Materials and Methods

This descriptive cross-sectional study was conducted to compare the reflection of curricular objectives, content coverage and national health priorities in undergraduate pharmacology written question papers (SAQ) of different universities of Bangladesh in last 10 years (January 2010 to November 2019). Total 131 question papers were collected, and reflection of curricular objectives, content coverage and selective disease burdens were evaluated and compared.

Result

One objective regarding factual knowledge (pharmacological effects, mechanisms of action, pharmacokinetic characteristics and adverse reactions of drugs) had significant higher weightage throughout the decade in all universities. There were statistically significant differences in weightage of reflection of five curricular objectives (p value <0.00001, 0.001, 0.003, 0.004, 0.02) among different universities. There was not a single question reflecting the ethical and legal issues involved in drug prescribing, development, manufacture and marketing in the decade in any university. Chemotherapy was the highest covered area (19.4±3.3), followed by central nervous system (16.0±3.4) and general principles of pharmacology (1 4.3±3.2) throughout the last ten years in all universities. There was statistically also significant difference among different universities in weightage of all content areas except Gastrointestinal pharmacology. Statistically significant difference (p value < 0.00001) among different universities in cardiovascular diseases burden was observed.

Conclusion

Current study found variation in pharmacology written question papers of different universities in the aspects of reflection of curricular objectives, content coverage and cardiovascular disease burden.
The effect of digital-enabled multidisciplinary therapy conferences on efficiency and quality of the decision making in prostate-cancer care
Authors: Rönmark Erik , Hoffmann Ralf , Skokic Viktor , de Klerk-Starmans Maud , Jäderling Fredrik , Vos Pieter , Gayet Maudy C.W. , Hofstraat Hans , Janssen Marco , Akre Olof , Vincent Per H
Published: February 2022

Objectives

To investigate the impact on efficiency and quality of pre-prostatectomy multidisciplinary therapy conferences (MDT) at Karolinska University Hospital related to the use of a digital solution compared to standard of care. Further, to explore whether gains in MDT efficiency and quality impact oncological or functional patient outcomes.

Methods

We conducted a prospective, observational study of preoperative prostate-cancer MDT at Karolinska between February 2017 and March 2021. We compared efficiency and quality of the standard MDT and the MDT using the digital solution IntelliSpace Precision Medicine Multidisciplinary Team Orchestrator (ISPM) based on the previously used MDT-MODe approach. Clinical and patient-reported functional outcomes were derived from the medical records and the Swedish National Prostate Cancer Register (NPCR).

Results

While ISPM was used during the multidisciplinary therapy conference, the time spent per patient was reduced by 24 % (p<0.001) and most of the MDT-MODe items were scored significantly higher. There was a reduction in pelvic lymph-node dissection procedures in the ISPM cohort (p=0.001) and an increased proportion of unilateral nerve-sparing procedures (p=0.005), while all other outcome-related measures were not significantly different between the two patient groups.

Discussion & Conclusion

To increase the value of the MDT, all data relevant for treatment decision need to be purposefully presented and compiled, which also enables secondary use of the data.

The use of a digital solution during preoperative MDTs for prostate-cancer decision-making at Karolinska University Hospital improved the efficiency and quality of this multidisciplinary team meeting without impacting patient outcomes.

What is already known?

Multidisciplinary therapy conferences are widely used in modern cancer care.

Patients discussed in a multidisciplinary therapy conference are more likely to receive appropriate staging and treatment.

The multidisciplinary therapy conference is time consuming and rarely digitalized or adequately structured.

What does this paper add?

The use of a digital clinical decision support system during preoperative prostate-cancer multidisciplinary therapy conferences improved the efficiency and quality of the meetings.

The introduction of this digital clinical decision support system was not associated with changes in oncological and functional outcomes after surgery.
Rap1 regulates TIP60 function during fate transition between two-cell-like and pluripotent states
Authors: Barry Raymond Mario , Sacco Olivia , Mameri Amel , Stojaspal Martin , Kartsonis William , Shah Pooja , De Ioannes Pablo , Hofr Ctirad , Côté Jacques , Sfeir Agnel
Published: February 2022

In mammals, the conserved telomere binding protein Rap1 serves a diverse set of nontelomeric functions, including activation of the NF-kB signaling pathway, maintenance of metabolic function in vivo, and transcriptional regulation. Here, we uncover the mechanism by which Rap1 modulates gene expression. Using a separation-of-function allele, we show that Rap1 transcriptional regulation is largely independent of TRF2-mediated binding to telomeres and does not involve direct binding to genomic loci. Instead, Rap1 interacts with the TIP60/p400 complex and modulates its histone acetyltransferase activity. Notably, we show that deletion of Rap1 in mouse embryonic stem cells increases the fraction of two-cell-like cells. Specifically, Rap1 enhances the repressive activity of Tip60/p400 across a subset of two-cell-stage genes, including Zscan4 and the endogenous retrovirus MERVL. Preferential up-regulation of genes proximal to MERVL elements in Rap1-deficient settings implicates these endogenous retroviral elements in the derepression of proximal genes. Altogether, our study reveals an unprecedented link between Rap1 and the TIP60/p400 complex in the regulation of pluripotency.
Why are college sports tourists traveling long distance? Antecedents of destination and team loyalty
Authors: Min Jae Han , Chang Hyo Jung , Fowler Deborah , Blum Shane
Published: February 2022

Purpose

On a home game weekend of collegiate football, thousands of fan visitors spend their weekend participating in college football games, showing significant potential of sports tourism businesses in the USA. Understanding the original personality of sport tourists and their travel motivation factors is imperative to develop appealing tourist attractions at the destinations of sports team fandoms. The purpose of the study is to examine the relationships among tourists' personality characteristics, their push and pulls motivations, satisfaction with travel experience, and loyalty toward destination and team using structural equation modeling.

Design/methodology/approach

The author collected information from a total of 301 sports tourists who had traveled to a college football game within the past year, staying at least one night in a hotel or other lodging place. This study employed PASW Statistics 25.0 and structural equation modeling using LISREL 9.30 for data analyses.

Findings

Personality has a significant relationship with push factors, especially for socialization motivation, and pull factors (i.e. access and affordability, other attractions) had more significant effects on sports tourists' satisfaction than push factors. The findings indicate the key roles for the entertainment motivation in generating tourists' satisfaction and destination loyalty and important roles of destination loyalty in building team loyalty.

Originality/value

The present study provides an approach of sports tourists' travel behaviors and experiences in the sporting event tourism. The outcome of this research can help both sports event organizers and destination marketers to understand the motivations for sports game attendance and to develop marketing strategies and products/services for attracting various types of sports tourists to games.