bluuebunny/crossref_metadata_2025 huggingface dataset:
DESI and DECaLS (D&D): galaxy–galaxy lensing measurements with 1 per cent survey and its forecast
Authors: Yao Ji , Shan Huanyuan , Zhang Pengjie , Jullo Eric , Kneib Jean-Paul , Yu Yu , Zu Ying , Brooks David , de la Macorra Axel , Doel Peter , Font-Ribera Andreu , Gontcho Satya Gontcho A , Kisner Theodore , Landriau Martin , Meisner Aaron , Miquel Ramon , Nie Jundan , Poppett Claire , Prada Francisco , Schubnell Michael , Vargas Magana Mariana , Zhou Zhimin
Published: August 2023

The shear measurement from the Dark Energy Camera Legacy Survey (DECaLS) provides an excellent opportunity for galaxy–galaxy lensing study with the Dark Energy Spectroscopic Instrument (DESI) galaxies, given the large (∼9000 deg2) sky overlap. We explore this potential by combining the DESI 1 per cent survey and DECaLS Data Release 8 (DR8). With ∼106 deg2 sky overlap, we achieve significant detection of galaxy–galaxy lensing for Bright Galaxy Survey (BGS) and luminous red galaxy (LRG) as lenses. Scaled to the full BGS sample, we expect the statistical errors to improve from $18(12)\,{\rm per \ cent}$ to a promising level of $2(1.3)\,{\rm per \ cent}$ at $\theta \gt 8\,\mathrm{ arcmin} \, (\lt 8\,\mathrm{ arcmin})$. This brings stronger requirements for future systematics control. To fully realize such potential, we need to control the residual multiplicative shear bias |m| < 0.006 and the bias in the mean redshift |Δz| < 0.008, requiring the introduced bias in the measurement is <0.31σ. We also expect significant detection of galaxy–galaxy lensing with DESI LRG/emission line galaxy (ELG) full samples as lenses, and cosmic magnification of ELG through cross-correlation with low-redshift DECaLS shear. If such systematical error control can be achieved, we find the advantages of DECaLS, comparing with the Kilo Degree Survey (KiDS) and the Hyper Suprime-Cam (HSC), are at low redshift, large scale, and in measuring the shear ratio (to σR ∼ 0.04) and cosmic magnification.
Statistical analysis of the onset temperature of solar flares in 2010–2011
Authors: da Silva Douglas Félix , Hui Li , Simões Paulo J A , Valio Adriana , Costa Joaquim E R , Hudson Hugh S , Fletcher Lyndsay , Hayes Laura A , Hannah Iain G
Published: August 2023

Understanding the physical processes that trigger solar flares is paramount to help with forecasting space weather and mitigating the effects on our technological infrastructure. A previously unknown phenomenon was recently identified in solar flares: the plasma temperature, derived from soft X-ray (SXR) data, at the onset of four flares, was revealed to be in the range 10–15 MK, without evidence of gradual heating. To investigate how common the hot-onset phenomenon may be, we extend this investigation to solar flares of B1.2–X6.9 classes recorded by the X-ray Sensor (XRS) onboard the GOES-14 and GOES-15 satellites between 2010 and 2011. For this statistical study, we employed the same methodology as in recent work, where the pre-flare SXR flux of each flare is obtained manually, and the temperature and emission measure values are obtained by the flux ratio of the two GOES/XRS channels using the standard software. From 3224 events listed in the GOES flare catalogue for 2010–2011, we have selected and analysed 745 events for which the flare heliographic location was provided in the list, to investigate centre-to-limb effects of the hot-onset phenomenon. Our results show that 559 out of 745 flares (75 per cent) exhibit an onset temperature above 8.6 MK (the first quartile), with respective log10 of the emission measure values between 46.0–47.25 cm−3, indicating that small amounts of plasma are quickly heated to high temperatures. These results suggest that the hot-onset phenomenon is very common in solar flares.
A conditional abundance matching method of extending simulated halo merger trees to resolve low-mass progenitors and subhalos
Authors: Chen Yangyao , Mo H J , Li Cheng , Wang Kai , Wang Huiyuan , Yang Xiaohu
Published: August 2023

We present an algorithm to extend subhalo merger trees in a low-resolution dark-matter-only simulation by conditionally matching them to those in a high-resolution simulation. The algorithm is general and can be applied to simulation data with different resolutions using different target variables. We instantiate the algorithm by a case in which trees from ELUCID, a constrained simulation of $(500\, h^{-1}\, {\rm Mpc})^3$ volume of the local universe, are extended by matching trees from TNGDark, a simulation with much higher resolution. Our tests show that the extended trees are statistically equivalent to the high-resolution trees in the joint distribution of subhalo quantities and in important summary statistics relevant to modelling galaxy formation and evolution in halos. The extended trees preserve certain information of individual systems in the target simulation, including properties of resolved satellite subhalos, and shapes and orientations of their host halos. With the extension, subhalo merger trees in a cosmological scale simulation are extrapolated to a mass resolution comparable to that in a higher resolution simulation carried out in a smaller volume, which can be used as the input for (sub)halo-based models of galaxy formation. The source code of the algorithm, and halo merger trees extended to a mass resolution of $\sim 2 \times 10^8 \, h^{-1}\, {\rm M_\odot}$ in the entire ELUCID simulation, are available.
On the spatial distribution of electron energy loss due to gyro-cooling in hot star magnetospheres
Authors: Das B , Owocki S P
Published: August 2023

Hot magnetic stars often exhibit incoherent circularly polarized radio emission thought to arise from gyro-synchrotron emission by energetic electrons trapped in the circumstellar magnetosphere. Theoretical scalings for electron acceleration by magnetic reconnection driven by centrifugal breakout match well the empirical scalings for observed radio luminosity with both the magnetic field strength and the stellar rotation rate. This paper now examines how energetic electrons introduced near the top of closed magnetic loops are subsequently cooled by the energy loss associated with their gyro-synchrotron radio emission. For sample assumed distributions for energetic electron deposition about the loop apex, we derive the spatial distribution of the radiated energy from such ‘gyro-cooling’. For sub-relativistic electrons, we show explicitly that this is independent of the input energy, but also find that even extensions to the relativistic regime still yield a quite similar spatial distribution. However, cooling by Coulomb collisions with even a modest ambient density of thermal electrons can effectively quench the emission from sub-relativistic electrons, indicating that the observed radio emission likely stems from relativistic electrons that are less affected by such collisional cooling. The overall results form an initial basis for computing radio emission spectra in future models that account for such cooling and multimode excitation about the fundamental gyro-frequency. Though motivated in the context of hot stars, the basic results here could also be applied to gyro-emission in any dipole magnetospheres, including those of ultra-cool dwarfs and even (exo)-planets.
A 2-step prediction model for diagnosis of germinomas in the pineal region
Authors: Yu Yang , Lu Xiaoli , Yao Yidi , Xie Yongsheng , Ren Yan , Chen Liang , Mao Ying , Yao Zhenwei , Yue Qi
Published: August 2023

Background

Germinomas are sensitive to radiation and chemotherapy, and their management distinctly differs from other kinds of pineal region tumors. The aim of this study was to construct a prediction model based on clinical features and preoperative magnetic resonance (MR) manifestations to achieve noninvasive diagnosis of germinomas in pineal region.

Methods

A total of 126 patients with pineal region tumors were enrolled, including 36 germinomas, 53 nongerminomatous germ cell tumors (NGGCTs), and 37 pineal parenchymal tumors (PPTs). They were divided into a training cohort (n = 90) and a validation cohort (n = 36). Features were extracted from clinical records and conventional MR images. Multivariate analysis was performed to screen for independent predictors to differentiate germ cell tumors (GCTs) and PPTs, germinomas, and NGGCTs, respectively. From this, a 2-step nomogram model was established, with model 1 for discriminating GCTs from PPTs and model 2 for identifying germinomas in GCTs. The model was tested in a validation cohort.

Results

Both model 1 and model 2 yielded good predictive efficacy, with c-indexes of 0.967 and 0.896 for the diagnosis of GCT and germinoma, respectively. Calibration curve, decision curve, and clinical impact curve analysis further confirmed their predictive accuracy and clinical usefulness. The validation cohort achieved areas under the receiver operating curves of 0.885 and 0.926, respectively.

Conclusions

The 2-step model in this study can noninvasively differentiate GCTs from PPTs and further identify germinomas, thus holding potential to facilitate treatment decision-making for pineal region tumors.
Performance pay and work hours: US survey evidence
Authors: Artz Benjamin , Heywood John S
Published: August 2023

Using US survey data, we show that those on performance pay work substantially longer hours. This remains in worker fixed-effect estimates and in worker with employer fixed-effect estimates. The magnitudes confirm increased hours as a dimension of the anticipated effort response and long hours as a potential intermediary between performance pay and reduced worker health. Despite managers being the most likely to both receive performance pay and work long hours, this association largely reflects sorting and not the behavioral response evident for other workers.
Development, Acceptability, and Usability of a Virtual Intervention for Vertebral Fractures
Authors: Ponzano Matteo , Tibert Nicholas , Brien Sheila , Funnell Larry , Gibbs Jenna C , Keller Heather , Laprade Judi , Morin Suzanne N , Papaioannou Alexandra , Weston Zachary J , Wideman Timothy H , Giangregorio Lora M
Published: August 2023

Objective

This project aimed to develop a virtual intervention for vertebral fractures (VIVA) to implement the international recommendations for the nonpharmacological management of osteoporotic vertebral fractures and to test its acceptability and usability.

Methods

VIVA was developed in accordance with integrated knowledge translation principles and was informed by the Behavioral Change Wheel, the Theoretical Domains Framework, and the affordability, practicability, effectiveness and cost-effectiveness, acceptability, side effects/safety, and equity (APEASE) criteria. The development of the prototype of VIVA involved 3 steps: understanding target behaviors, identifying intervention options, and identifying content and implementation options. The VIVA prototype was delivered to 9 participants to assess its acceptability and usability.

Results

VIVA includes 7 1-on-1 virtual sessions delivered by a physical therapist over 5 weeks. Each session lasts 45 minutes and is divided in 3 parts: education, training, and behavioral support/goal setting. Four main themes emerged from the acceptability evaluation: perceived improvements in pain, increased self-confidence, satisfaction with 1-on-1 sessions and resources, and ease of use. All of the participants believed that VIVA was very useful and were very satisfied with the 1-on-1 sessions. Four participants found the information received very easy to practice, 4 found it easy to practice, and 1 found it somewhat difficult to practice. Five participants were satisfied with the supporting resources, and 4 were very satisfied. Potential for statistically significant improvements was observed in participants’ ability to make concrete plans about when, how, where, and how often to exercise.

Conclusion

VIVA was acceptable and usable to the participants, who perceived improvements in pain and self-confidence.

Impact

The virtual implementation of the recommendations for the nonpharmacological management of vertebral fractures showed high acceptability and usability. Future trials will implement the recommendations on a larger scale to evaluate their effectiveness.
Drawing a veil? Privacy and anonymity in trusts and capacity proceedings
Authors: Bedworth Georgia , Kirby James
Published: August 2023

The open justice principle enshrined 110 years ago as a fundamental right at common law by the House of Lords judgment in Scott v Scott [1913] AC 417 remains as central as ever to civil proceedings in England and Wales. However, its precise ambit and content continue to provoke discussion. Where the court is not adjudicating on rival claims in hostile litigation, but is instead administering the affairs of an individual who lacks capacity or a trust, or an estate, this causes particular difficulty. To what extent, if any, does the open justice principle apply to such proceedings? This article will examine how the courts—not only in England and Wales but also by way of comparison in offshore jurisdictions—have answered this question in recent years.
Prevalence of trachoma in the non-indigenous Baixo Jaguaribe micro-region, Ceará State, Northeast Brazil
Authors: Maciel Adjoane Maurício Silva , Ramos Junior Alberto Novaes , Ferreira Anderson Fuentes , de Almeida Nádia Maria Girão Saraiva , de Almeida Paulo César , Szwarcwald Célia Landmann , Favacho Joana da Felicidade Ribeiro , Franco Filho Luciano Chaves , Gomes Vivian da Silva , Damasceno Lisandra Serra , Maciel Manuella Maurício Silva , Delerino Antônio Lucas , Pires Neto Roberto da Justa
Published: August 2023

Background

The aim of the current study was to estimate the population prevalence of trachoma in non-indigenous populations in the Baixo Jaguaribe micro-region, in the state of Ceará, northeast region of Brazil, 2021–2022.

Methods

A population-based prevalence survey focusing on detecting cases of trachomatous inflammation-follicular (TF) in children aged 1−9 y and trachomatous trichiasis (TT) ‘unknown to the health system’ in people aged ≥15 y, was conducted in rural areas of the Baixo Jaguaribe micro-region in the state of Ceará. Indigenous populations will be further researched.

Results

There was no detection of cases of TF and TT. In 900 households, 2234 people were examined. In the Baixo Jaguaribe micro-region, females (54.6%; 1219/2234) and the mixed/Pardo-Brazilian ethnicity (68.1%; 1521/2234) predominated. The most commonly reported educational level was elementary and middle school (41.8%; 702/1679). In 56.2% (506/900) of households, there was a source of water within the household. The monthly income range of 50%−100% of the minimum wage predominated in the families of the Baixo Jaguaribe micro-region (43.1%; 388/900).

Conclusions

Although no cases of TF and TT were detected in the Baixo Jaguaribe micro-region in the state of Ceará during the study period, considering the historical endemicity, we emphasise the need for monitoring and sustainability of surveillance actions in areas at risk for trachoma, common contexts for neglected populations.
The Social Protection Engel Curve
Authors: Lokshin Michael , Ravallion Martin , Torre Iván
Published: August 2023

Why do richer countries spend a higher share of their income on social protection than poor countries? A newly assembled dataset on social protection spending for 142 countries since 1995 allows an exploration of alternate hypotheses, treating the pandemic period separately, as it entailed a large expansion in social protection efforts. While the mean income share devoted to social protection rises with income, this is attributable to multiple confounders, including relative prices, weak governance in low-income countries, and access to information-communication technologies. Controlling for these, social protection spending is similar between rich and poor countries. This was also true during the pandemic.
Soil Census of Kentucky High Tunnels Reveals Statewide Distribution of Two Meloidogyne Species
Authors: Bajek Victoria , Munir Misbakhul , Rudolph Rachel E.
Published: August 2023

High tunnels are passively heated and cooled structures used for specialty crop production that can increase marketable yields, extend the growing season, and protect crops from harsh weather. Kentucky has more than 1,500 high tunnels, and although there are many benefits, production still has several challenges. High soil temperatures, lack of rotation and sanitation, and intensive and continuous cropping make high tunnels hospitable environments for the root-knot nematode (RKN; Meloidogyne spp.). This plant parasite infects roots, causing chlorosis, wilting, stunting, and yield loss. Determining the presence, population density, and species of RKN is important to inform management strategies. To our knowledge, this is the first research aimed at determining the presence and distribution of RKN across Kentucky. From 2019 to 2022, we sampled the soil in 175 high tunnels in 62 counties. The characteristics of production system, soil type, crop rotation, and high tunnel age were collected to analyze with RKN presence, species, and soil population density. Of the soil samples collected, 45% had no presence of RKN. Among those samples where RKNs were observed, 55% were identified as M. incognita, 39% as M. hapla, and 4% as M. arenaria. RKN presence was dependent on production system and crop rotation, whereas RKN species was dependent on production system and soil type. With over half of the sampled high tunnels infested with RKN, this project justifies further research for management strategies for RKN, especially those that are sustainable species-specific options and appropriate for commercial high tunnels.
Phloem and Xylem Responses Are Both Implicated in Huanglongbing Tolerance of Sugar Belle
Authors: Robledo Jacobo , Welker Stacy , Shtein Ilana , Bernardini Chiara , Vincent Christopher , Levy Amit
Published: August 2023

Although huanglongbing (HLB) is a devastating citrus disease, improved tolerant cultivars, such as Sugar Belle (SB) mandarin, have been identified. To understand the responses that HLB-affected SB undergoes, we compared 14CO2 fixation, carbohydrate export, phloem callose accumulation, relative expression of plant defense activators, and anatomical changes between healthy and infected SB trees versus susceptible Pineapple (PA) sweet orange. Eight- to ten-week-old leaves of infected SB showed a 2.5-fold increase in 14CO2 fixation and a 13% decrease in 14C-carbohydrate export, whereas HLB-affected PA presented a decrease of 33 and 50%, respectively. The mean distance of a callose deposit to its closest neighbor was 36% smaller in infected SB versus healthy, whereas in HLB-affected PA, it was 33% higher. Expression of papain-like cysteine proteases (PLCPs) was upregulated in SB but downregulated in PA. Infected SB showed minor alterations in the number of xylem vessels, a 16% larger xylem vessel lumen area, and a 14% increase in the proportional area of the xylem. In contrast, PA showed a 2.4-fold increase in the xylem vessel number and a 2% increase in the proportional xylem area. Three complementary mechanisms of tolerance in SB are hypothesized: (i) increased carbohydrate availability induced by greater CO2 fixation, mild effect in carbohydrate export, and local accumulation of callose in the phloem; (ii) activation of defense response via upregulation of PLCPs, and (iii) increased investment in the xylem structure. Thus, phloem and xylem modifications seem to be involved in SB tolerance.
Multiorgan talks in the presence of brain injury
Authors: Farag Ehab , Machado Sandra , Argalious Maged
Published: August 2023

Purpose of review

The brain is the command center of the rest of the body organs. The normal multiorgan talks between the brain and the rest of the body organs are essential for the normal body homeostasis. In the presence of brain injury, the disturbed talks between the brain and the rest of body organs will result in several pathological conditions. The aim of this review is to present the most recent findings for the pathological conditions that would result from the impaired multiorgan talks in the presence of brain injury.

Recent findings

The brain injury such as in acute ischemic stroke, subarachnoid hemorrhage and traumatic brain injury will result in cascade of pathological talks between the brain and the rest of body organs. These pathological talks could result in pathological conditions such as cardiomyopathy, acute lung and kidney injuries, impaired liver functions, and impaired gut barrier permeability as well.

Better understanding of the pathological conditions that could result from the impaired multiorgan talks in the presence of brain injury will open the doors for precise targeted therapies in the future for myriad of pathological conditions.
Modulating anesthetic emergence with pathway-selective dopamine signaling
Authors: Vincent Kathleen F. , Solt Ken
Published: August 2023

Purpose of review

To summarize the recent preclinical findings investigating dopaminergic circuits for their involvement in reversing anesthetic-induced unconsciousness.

Recent findings

The release of dopamine from the ventral tegmental area onto dopamine D1 receptor-expressing neurons in the nucleus accumbens promotes emergence following general anesthesia. Two relevant targets of dopamine D1 receptor-expressing neurons in the nucleus accumbens include the lateral hypothalamus and ventral pallidum. Activating mesocortical dopaminergic projections from the ventral tegmental area to the prelimbic cortex has also been shown to hasten emergence from general anesthesia. In contrast, the nigrostriatal dopamine pathway is not involved in regulating anesthetic emergence. The role of the tuberoinfundibular endocrine dopamine pathway remains to be tested; however, recent studies have identified an important function of neuroendocrine signaling on modulating general anesthesia.

Potential avenues for accelerating anesthetic emergence may be found through targeting specific arousal-promoting pathways in the brain. Accumulating evidence from rodent studies manipulating cell type- and circuit-specific signaling pathways have identified dopamine as a potent modulator of general anesthesia. Specifically, dopamine signaling along the mesolimbic and mesocortical pathways plays a fundamental role in regulating consciousness.
Management strategies for patients with neurologic stimulators during nonneurologic surgery: an update and review
Authors: Morano Jacqueline M. , Uejima Jamie L. , Tung Avery , Rosenow Joshua M.
Published: August 2023

Purpose of review

The goal of this review is to summarize the perioperative management of noncardiac implanted electrical devices (NCIEDs) and update the anesthesiologist on current recommendations for management when a NCIED is encountered during a nonneurosurgical procedure.

Recent findings

Indications for NCIEDs continue to expand, and increasing numbers of patients with NCIEDs are presenting for nonneurosurgical procedures. Recent case reports demonstrate that NCIEDs may meaningfully affect perioperative management including use of electrocautery and neuromonitoring. This review highlights the importance of evaluating NCIED function (including lead impedance) prior to surgery, provides an update on the MRI compatibility and safety of these devices, and reviews the management of patients with altered respiratory drive because of vagal nerve stimulators.

As the prevalence of NCIEDs in patients presenting for surgery increases, anesthesiologists will likely encounter these devices more frequently. To provide a well tolerated anesthetic, anesthesiologists should recognize the concerns associated with NCIEDs and how best to address them perioperatively.
Making chronic pain count: empirical support for the ICD-11 classification of chronic pain
Authors: Barke Antonia , Korwisi Beatrice
Published: August 2023

Purpose of review

The purpose is to review the evidence that has been collected with regard to the new classification of chronic pain. In 2022, the World Health Assembly endorsed the 11th revision of the International Classification of Diseases and Related Health Problems (ICD-11), and with it a new classification of chronic pain.

Recent findings

The evidence from the formative field testing indicated that the categories were clearly delineated and the coverage of chronic pain excellent (<3% in remainder categories). Official WHO field tests showed that the classification works well within the technical parameters WHO classifications must conform to and outperformed the ICD-10 diagnoses in all respects. International field tests, in which clinicians diagnosed consecutive patients in settings of medium and high resources, showed substantial interrater reliability (κ = 0.596 to κ = 0.783) for the diagnoses and the clinicians rated their clinical utility as very high. Studies using complete hospital records demonstrated that with the information they contain, retrospective coding of the new diagnoses is possible and provides much more meaningful information than the ICD-10 diagnoses.

The evidence supports the use of the new classification and highlights its informational gains – using it will contribute to making chronic pain count in many contexts.
Prognostic models for chronic postsurgical pain-Current developments, trends, and challenges
Authors: Segelcke Daniel , Rosenberger Daniela C. , Pogatzki-Zahn Esther M.
Published: August 2023

Purpose of review

Prognostic models for chronic postsurgical pain (CPSP) aim to predict the likelihood for development and severity of CPSP in individual patients undergoing surgical procedures. Such models might provide valuable information for healthcare providers, allowing them to identify patients at higher risk and implement targeted interventions to prevent or manage CPSP effectively. This review discusses the latest developments of prognostic models for CPSP, their challenges, limitations, and future directions.

Recent findings

Numerous studies have been conducted aiming to develop prognostic models for CPSP using various perioperative factors. These include patient-related factors like demographic variables, preexisting pain conditions, psychosocial aspects, procedure-specific characteristics, perioperative analgesic strategies, postoperative complications and, as indicated most recently, biomarkers. Model generation, however, varies and performance and accuracy differ between prognostic models for several reasons and validation of models is rather scarce.

Precise methodology of prognostic model development needs advancements in the field of CPSP. Development of more accurate, validated and refined models in large-scale cohorts is needed to improve reliability and applicability in clinical practice and validation studies are necessary to further refine and improve the performance of prognostic models for CPSP.
Update on bi-specific monoclonal antibodies for blood cancers
Authors: Shouse Geoffrey
Published: August 2023

Purpose of review

The purpose of this review is to present updates in the field of bispecific antibodies focusing on those agents that have been recently approved for multiple myeloma, follicular lymphoma and diffuse large B cell lymphoma.

Recent findings

Teclistamab, the β-cell maturation antigen -targeted bispecific antibody has shown efficacy and tolerability in the fourth line setting for multiple myeloma. Mosunetuzumab, the CD20-targeted bispecific antibody has shown excellent response rates and durability in third line and beyond follicular lymphoma. Epcoritamab and glofitamab have both shown excellent response rates in heavily pretreated patients with diffuse large B cell lymphoma including those with prior chimeric antigen receptor T cell therapy. The toxicity is significant but manageable for both agents. Epcoritamab is approved by the FDA in the United States, while glofitamab is approved for use in Canada for patients with diffuse large B cell lymphoma refractory to 2 or more prior lines of therapy.

Bispecific antibodies represent a novel therapeutic resource that is poised to dramatically change the treatment landscape of many hematologic malignancies, but so far, initial successes include multiple myeloma, follicular lymphoma, and diffuse large B cell lymphoma, where several agents have been recently approved.
Do Externalizing and Internalizing Symptoms Moderate Medication Response in Preschool Attention-Deficit/Hyperactivity Disorder? A DBPNet Study
Authors: Blum Nathan J. , Shults Justine , Barbaresi William , Bax Ami , Cacia Jaclyn , Deavenport-Saman Alexis , Friedman Sandra , Loe Irene M. , Mittal Shruti , Vanderbilt Douglas , LaRosa Angela , Harstad Elizabeth
Published: August 2023

Objectives:

This study aimed to determine whether parent ratings of attention-deficit/hyperactivity disorder (ADHD) symptom severity or externalizing symptoms (EXT) or internalizing symptoms (INT) moderate response to stimulants (STIM) and alpha-2 adrenergic agonists (A2As) in preschool ADHD.

Methods:

Health records for children treated with medication for ADHD and with parent rating scale data available (N = 309; age <72 months) were reviewed at 7 Developmental-Behavioral Pediatric Research Network sites. Severity of ADHD was defined as the number of ADHD symptoms occurring often or very often on DSM-IV–based parent rating scales. EXT or INT from standardized rating scales were categorized as T score <60, 60 to <70, or ≥70. Ordinal logistic regression models predicting response to medication were calculated.

Results:

The median (interquartile range) age at ADHD diagnosis was 59 (54–65) months. One hundred eighty-three participants had ADHD symptom severity, and 195 had EXT or INT data. ADHD severity was not associated with medication response. Both EXT and INT were associated with medication response but with significant medication class by EXT/INT interactions. Children with higher EXT were less likely to respond to STIM, with percentage of nonresponders for T-score categories <60, 60 to <70, and ≥70 being 3.6%, 25.7%, and 33.3% (p = 0.016) and, for A2As, being 60%, 50%, and 33.3% (p = 0.55), respectively. A similar pattern was observed for INT categories: STIM 19.4%, 22.5%, and 50.0% (p = 0.002) and A2As 42.3%, 30%, and 42.3% (p = 0.48), respectively.

Conclusion:

For preschool ADHD, low ratings of EXT or INT are associated with a high likelihood of response to STIM. By contrast, response rates to STIM and A2As are more similar for children with high levels of EXT or INT.
A phase 1/2, open-label, parallel group study to evaluate the preliminary efficacy and usability DARE-HRT1 (80 μg estradiol/4 mg progesterone and 160 μg estradiol/8 mg progesterone intravaginal RinGSM) over 12 weeks in healthy postmenopausal women
Authors: Thurman Andrea , Hull M. Louise , Stuckey Bronwyn , Hatheway Jessica , Zack Nadene , Mauck Christine , Friend David
Published: August 2023

Objectives

The exploratory objectives of this study were to evaluate the usability and acceptability and to conduct a preliminary evaluation of the efficacy of DARE-HRT1. DARE-HRT1 is an intravaginal ring (IVR) that releases 17β2-estradiol (E2) with progesterone (P4) over 28 days. It is the first combination E2 and P4 IVR being developed for the treatment of vasomotor symptoms (VMS) in healthy postmenopausal women with an intact uterus.

Methods

This was a randomized, open-label, 2-arm, parallel group study in 21 healthy postmenopausal women. Women were randomized (1:1) to either DARE-HRT1 IVR1 (E2 80 μg/d with P4 4 mg/d) or DARE-HRT1 IVR2 (E2 160 μg/d with P4 8 mg/d). They used the assigned IVR for three 28-day cycles, inserting a new IVR monthly. Preliminary genitourinary syndrome of menopause (GSM) treatment efficacy was estimated by measuring changes from baseline in vaginal pH, vaginal maturation index (VMI), and changes in the severity of GSM symptoms. Preliminary systemic VMS efficacy was measured by changes in responses to the Menopause-Specific Quality of Life (MENQOL) questionnaire. Acceptability was assessed by product experience surveys.

Results

Preliminary local GSM treatment efficacy was supported by significant decreases in vaginal pH and % parabasal cells, and significant increases in the overall VMI and % superficial cells for both IVR groups (all P values <0.01). Preliminary VMS efficacy was supported by significant decreases in all domains of the MENQOL questionnaire from baseline for both dosing groups (all P values <0.01).

Conclusions

Data from this study support further development of DARE-HRT1 for the treatment of menopausal symptoms.
Periocular Mass Due to Persistent Secretion Within a Transplanted Parotid Duct
Authors: Sansom Luke T. , Verity David H. , Rose Geoffrey E.
Published: August 2023

A male patient underwent microvascular transplantation of an autologous submandibular gland and its associated (Wharton’s) duct for management of very severe right keratoconjunctivitis sicca due to Stevens-Johnson syndrome; due to hypersecretion, the gland was later removed in toto. Twenty-two years later, he presented with a nontender, sausage-like mass lying subcutaneously in the right temple. Intraoperatively a fluctuant tubular mass passing from the temporalis fossa to the superotemporal conjunctiva was identified and excised intact. Histology showed a slightly proteinaceous fluid within a duct lined with cuboidal epithelium, this being compatible with Wharton’s duct. This case highlights that iatrogenic causes should be considered with any history of periocular injury or surgery.
Effective VTE prophylaxis with enoxaparin after elective THR or TKR: a retrospective observational study
Authors: Nóbrega Catelas Diogo , Cordeiro Filipa , Loureiro Luís , Vilaça Adélio , Silva Ivone
Published: August 2023

Background:

Orthopedic patients are at the highest risk for venous thromboembolism (VTE). Nowadays, with VTE prophylaxis as a routine in patients undergoing total hip replacement (THR) and total knee replacement (TKR), fatal pulmonary embolism (PE) is rare and the rates of symptomatic VTE within 3 months dropped to 1.3%–10%, compared with the rates of 50%–70% before VTE prophylaxis implementation. In this study, we aim to evaluate the VTE prophylaxis and incidence in patients who underwent THR and TKR in Centro Hospitalar Universitário de Santo António (CHUdSA).

Methods:

We included 483 patients who underwent elective THR or TKR in CHUdSA from March 2019 to February 2020 and who were under enoxaparin as a VTE prophylaxis drug. All data related to prescribed enoxaparin were collected from the nationwide common electronic drug prescription system (PEM).

Results:

Of the 483 eligible patients, 192 (39.75%) underwent elective THR and 291 (60.25%) underwent TKR. Enoxaparin was prescribed for 31.86 ± 5.98 and 30.28 ± 5.97 days, on average, for the THR and TKR groups, respectively (P = .005). Patients completed, on average, 29.38 ± 8.12 days and 28.20 ± 7.32 days of VTE prophylaxis with enoxaparin in the THR and TKR groups, respectively (P = .098). The incidence of VTE was approximately 3.13% and 0.69% in the THR and TKR groups, respectively (P = .064).

Conclusion:

In CHUdSA, we usually prescribe enoxaparin 40 mg once daily for up to 35 days for VTE prophylaxis after THR or TKR. High therapeutic compliance rates resulted in very few events.
Scoping Review of Measures of Comorbidities in Heart Failure
Authors: Lee Jihyang , Oh Oonjee , Park Da-In , Nam Gyumi , Lee Kyoung Suk
Published: August 2023

Background

Comorbidities are risk factors for poor clinical outcomes in patients with heart failure. However, no consensus has been reached on how to assess comorbidities related to clinical outcomes in patients with heart failure.

Objective

The aims of this study were to review (1) how comorbidities have been assessed, (2) what chronic conditions have been identified as comorbidities and (3) the rationale for choosing the comorbidity instruments and/or specific comorbidities when exploring clinical outcomes in patients with heart failure.

Methods

The clinical outcomes of interest were mortality, hospitalization, quality of life, and self-care. Three electronic databases and reference list searches were used in the search.

Results

In this review, we included 39 articles using 3 different ways to assess comorbidities in the relationship with clinical outcomes: using an instrument (ie, Charlson Comorbidity Index), disease count, and including individual comorbidities. A total of 90 comorbidities were investigated in the 39 articles; however, definitions and labels for the diseases were inconsistent across the studies. More than half of the studies (n = 22) did not provide a rationale for selecting the comorbidity instruments and/or all of the specific comorbidities. Some of the rationale for choosing the instruments and/or specific comorbidities was inappropriate.

Conclusions

We found several issues related to measuring comorbidities when examining clinical outcomes in patients with heart failure. Researchers need to consider these methodological issues when measuring comorbidities in patients with heart failure. Further efforts are needed to develop guidelines on how to choose proper measures for comorbidities.
The Influence of Caregiver Contribution to Self-care on Symptom Burden in Patients With Heart Failure and the Mediating Role of Patient Self-care
Authors: Locatelli Giulia , Iovino Paolo , Jurgens Corrine Y. , Alvaro Rosaria , Uchmanowicz Izabella , Rasero Laura , Riegel Barbara , Vellone Ercole
Published: August 2023

Background

Patients with heart failure experience high symptom burden, which can be mitigated with adequate self-care. Caregiver contribution to self-care has been theorized to improve patient symptom burden. The mediating role of patient self-care in this relationship has not been tested yet.

Objectives

The aim of this study was to test whether (a) caregiver contribution to self-care influences patient self-care, (b) patient self-care influences symptom burden, and (c) patient self-care mediates the relationship between caregiver contribution to self-care and symptom burden.

Methods

In this study, the authors conducted a secondary analysis of the baseline and 3-month data from the MOTIVATE-HF trial, which enrolled 510 dyads (patient with heart failure and caregiver) in Italy. Multigroup confirmatory factor analysis was used to test measurement invariance. Autoregressive longitudinal path analysis with contemporaneous mediation was used to test our hypotheses.

Results

On average, caregivers were 54 years old and mainly female, whereas patients were 72.4 years old and mainly male. Better caregiver contribution to self-care maintenance was associated with better patient self-care maintenance (β = 0.280, P < .001), which, in turn, was associated with lower symptom burden (β = −0.280, P < .001). Patient self-care maintenance mediated the effect of caregiver contribution to self-care maintenance on symptom burden (β = −0.079; 95% bias-corrected bootstrapped confidence interval, −0.130 to −0.043). Better caregiver contribution to self-care management was associated with better patient self-care management (β = 0.238, P = .006). The model significantly accounted for 37% of the total variance in symptom burden scores (P < .001).

Conclusions

This study expands the situation-specific theory of caregiver contribution to heart failure self-care and provides new evidence on the role of caregiver contribution to self-care and patient self-care on symptom burden in heart failure.
Hearing Rehabilitation in Patients With Neurofibromatosis Type 2: The Quebec's Experience With Auditory Implants
Authors: Khneisser Edwina , Bussieres Richard , Côté Mathieu , Philippon Daniel , Fradet Gaétan , Côté Martin , Lessard Nathalie , Champagne Pierre-Olivier , Trudel Mathieu
Published: August 2023

Objective

To review a single-center experience with hearing rehabilitation in patients with neurofibromatosis type 2 (NF2) and to describe the auditory outcomes of cochlear implants (CIs) and auditory brainstem implants (ABI) in this population.

Study design

Retrospective case series.

Setting

Tertiary referral center.

Patients

Twelve adult patients with NF2 who received a CI (n = 10) and/or an ABI (n = 5) between 2000 and 2021.

Interventions

Insertion of a CI and/or an ABI in NF2 patients with bilateral vestibular schwannomas (VSs).

Main outcome measures

Patients' demographic data, treatment history, hearing evolution, hearing rehabilitation methods, implant details, and auditory outcomes after implantation.

Results

Among those who received a CI, five patients had a stable untreated VS, one patient underwent a cochlear nerve preserving surgery, and four patients received radiotherapy treatments. Six patients became regular users of their device. The median open-set sentence recognition scores were as follows: 0.5% preoperatively, 60% at 1 year postoperatively, and 80% on the most recent audiological evaluation. All patients with an ABI were implanted concomitantly with VS surgical excision, and three of them also received radiotherapy treatments. The median open-set sentence recognition scores were as follows: 4% preoperatively, 26% at 1 year postoperatively, and 0% on the most recent evaluation. Three patients became regular ABI users.

Conclusion

Despite major technological advances, auditory outcomes with ABIs remain deceiving. Considering the overall improvement in postoperative auditory performances provided by CIs compared with ABIs, cochlear implantation standouts as a primary mean of hearing rehabilitation in NF2 patients.
The Effect of Repositioning Maneuver Applied with the TRV Chair on Residual Dizziness after Benign Paroxysmal Positional Vertigo
Authors: Soylemez Emre , Bolat Kubra Binay , Karakoc Kursad , Can Mehmet , Basak Hazan , Aydogan Zehra , Tokgoz-Yilmaz Suna
Published: August 2023

Objective

This study aims to investigate the effect of TRV chair on residual dizziness (RD) after idiopathic posterior semicircular canal benign paroxysmal positional vertigo (BPPV) successfully treated with canalith repositioning maneuver (CRM).

Study Design

Prospective case–control study.

Setting

Hospital.

Patients

Thirty-three patients with posterior canal BPPV were included in the study. These patients were divided into two identical groups. CRM was applied to the first group with a TRV chair (TRV group) and manually to the second group (manual group).

Interventions

Dizziness Handicap Inventory (DHI), Beck Anxiety Inventory (BAI), and video head impulse test were applied to the patients. Patients in both groups were asked to report the RD developed after successful CRM daily by visual analog scale (VAS).

Results

The TRV group’s first-day RD rate was 94.1% with VAS, and the RD duration was 2.47 ± 1.77 (0–7) days. The manual group’s first-day RD rate was 100%, and the RD duration was 3.38 ± 1.70 (1–7) days. There was no difference between the groups in terms of RD duration (p > 0.05). Mean RD severity and severity in the first 3 days were lower in the TRV group compared with the manual group (p < 0.05). There was no difference between the groups on other days (p > 0.05). In addition, there was a positive correlation between RD and DHI and BPPV duration (p < 0.05).

Conclusion

RD is a multifactorial symptom associated with how the repositioning maneuver is performed, BPPV duration, and DHI. Performing the repositioning maneuver with the TRV chair can reduce the severity of RD.
Professional Standards and the Role of the Advanced Practice Registered Nurse in Hospice and Palliative Care
Authors: Battista Vanessa , Sciacca Kate
Published: August 2023

Palliative care aims to optimize quality of life and reduce physical, psychological, social, and spiritual suffering for people living with serious and life-threatening illness throughout the life span. There are different educational pathways to becoming an advanced practice registered nurse (APRN) and a range of areas in which APRNs may specialize, including hospice and palliative care. National guidelines and professional standards have been developed to guide the delivery of high-quality palliative care and to demonstrate the need for all nurses to be competent in providing primary palliative care. Advanced practice registered nurses are well poised to integrate palliative care standards into their practice in a variety of settings and in myriad ways including clinical care, program development, leadership, education, and advocacy. This article is the first in a series that will highlight the different roles of the hospice and palliative care APRN, including the doctor of nursing practice, clinical nurse specialist, pediatric APRN, adult/gerontology APRN, and community-based APRN in a variety of settings throughout the country.
Postmortem Computed Tomography Is a Reliable, Reproducible, and Accurate Method in Measuring Body Length
Authors: Martin Jeremy , Gadsby Zeena , Jeremic Philip , Thompson Melissa , Tse Rexson
Published: August 2023

Currently, traditional body length measurement at postmortem analysis involves processes, which are susceptible to human error and not reviewable or reproducible in case of data loss. Many facilities are now adopting routine postmortem computed tomography (PMCT) scanning, which provides a permanent and reviewable radiological record of body dimensions. Previous literature has validated the use of PMCT in estimating body and organ weights, but not in body length measurement. This retrospective study aimed to determine whether body length can be accurately and reliably measured when compared with traditional measurements in 50 consecutive adult cases. Our findings revealed that body length measured using PMCT had high intrarater and interrater reliability across different experience levels in raters (Pearson correlation coefficient and interclass correlation: >0.99, P < 0.01). Although body lengths measured using PMCT were significantly shorter (mean, −1.2 cm; 95% confidence interval, −1.75 to −0.65 cm; P < 0.05), it was deemed clinically insignificant and correlated well with those measured at postmortem examination (Pearson correlation coefficient and interclass correlation, >0.97; P < 0.01). While care will need to be taken to ensure the body in the body bag is in reasonable anatomical position for scanning purposes, overall, body length measured uniform PMCT is reliable, reproducible, and accurate.