bluuebunny/crossref_metadata_2025 huggingface dataset:
Our Galaxy’s youngest disc
Authors: Li Chengdong , Binney James
Published: July 2022

We investigate the structure of our Galaxy’s young stellar disc by fitting the distribution functions (DFs) of a new family to 5D Gaia data for a sample of $47\, 000$ OB stars. Tests of the fitting procedure show that the young disc’s DF would be strongly constrained by Gaia data if the distribution of Galactic dust were accurately known. The DF that best fits the real data accurately predicts the kinematics of stars at their observed locations, but it predicts the spatial distribution of stars poorly, almost certainly on account of errors in the best-available dust map. We argue that dust models could be greatly improved by modifying the dust model until the spatial distribution of stars predicted by a DF agreed with the data. The surface density of OB stars is predicted to peak at $R\simeq 5.5\, \mathrm{kpc}$, slightly outside the reported peak in the surface density of molecular gas; we suggest that the latter radius may have been underestimated through the use of poor kinematic distances. The velocity distributions predicted by the best-fitting DF for stars with measured line-of-sight velocities v∥ reveal that the outer disc is disturbed at the level of $10\, \mathrm{km\, s}^{-1}$ in agreement with earlier studies, and that the measured values of v∥ have significant contributions from the orbital velocities of binaries. Hence the outer disc is colder than it is sometimes reported to be.
On the scale height of the molecular gas disc in Milky Way-like galaxies
Authors: Jeffreson Sarah M R , Sun (孙嘉懿) Jiayi , Wilson Christine D
Published: July 2022

We study the relationship between the scale height of the molecular gas disc and the turbulent velocity dispersion of the molecular interstellar medium within a simulation of a Milky Way-like galaxy in the moving-mesh code arepo. We find that the vertical distribution of molecular gas can be described by a Gaussian function with a uniform scale height of ∼50 pc. We investigate whether this scale height is consistent with a state of hydrostatic balance between gravity and turbulent pressure. We find that the hydrostatic prediction using the total turbulent velocity dispersion (as one would measure from kiloparsec-scale observations) gives an overestimate of the true molecular disc scale height. The hydrostatic prediction using the velocity dispersion between the centroids of discrete giant molecular clouds (cloud–cloud velocity dispersion) leads to more accurate estimates. The velocity dispersion internal to molecular clouds is elevated by the locally enhanced gravitational field. Our results suggest that observations of molecular gas need to reach the scale of individual molecular clouds in order to accurately determine the molecular disc scale height.
Radiogenic chromium isotope evidence for the earliest planetary volcanism and crust formation in the Solar system
Authors: Zhu Ke , Becker Harry , Li Shi-Jie , Fan Yan , Liu Xiao-Ning , Elliott Tim
Published: July 2022

Erg Chech (EC) 002 is a meteorite with andesitic composition, potentially recording the lava crystallization and crust formation of its parent body. Nucleosynthetic Cr isotope composition (ε54Cr = −0.35 ± 0.06) for EC 002 suggests a non-carbonaceous region of the Solar system, and possibly represents the crustal composition of the brachinite parent body. The 53Mn-to-53Cr decay system shows it crystallized at 4566.6 ± 0.6 Ma, i.e. 0.7 ± 0.6 Ma after Solar system formation (only considering the cogenetic matrix fractions with similar ε54Cr values). This age represents the earliest recorded evidence for planetary melting and volcanism in the Solar system, suggesting that the planetary crust formation occurred very early, only within the first few hundred thousand years of Solar system history. However, the 53Mn–53Cr age does not overlap with 26Al–26Mg dating results, which might indicate that non-carbonaceous achondrites have lower initial 26Al/27Al than the canonical value defined by refractory inclusions in carbonaceous chondrites.
Overnight Abstinence Is Associated With Smaller Secondary Somatosensory Cortical Volumes and Higher Somatosensory-Motor Cortical Functional Connectivity in Cigarette Smokers
Authors: Chen Yu , Dhingra Isha , Chaudhary Shefali , Fucito Lisa , Li Chiang-Shan R
Published: July 2022

Introduction

Abstinence symptoms present challenges to successful cessation of cigarette smoking. Chronic exposure to nicotine and long-term nicotine abstinence are associated with alterations in cortical and subcortical gray matter volumes (GMVs).

Aims and Methods

We aimed at examining changes in regional GMVs following overnight abstinence and how these regional functions relate to abstinence symptoms. Here, in a sample of 31 regular smokers scanned both in a satiety state and after overnight abstinence, we employed voxel-wise morphometry and resting-state functional connectivity (rsFC) to investigate these issues. We processed imaging data with published routines and evaluated the results with a corrected threshold.

Results

Smokers showed smaller GMVs of the left ventral hippocampus and right secondary somatosensory cortex (SII) after overnight abstinence as compared to satiety. The GMV alterations in right SII were positively correlated with changes in withdrawal symptom severity between states. Furthermore, right SII rsFC with the precentral gyrus was stronger in abstinence as compared to satiety. The inter-regional rsFC was positively correlated with motor impulsivity and withdrawal symptom severity during abstinence and negatively with craving to smoke during satiety.

Conclusions

These findings highlight for the first time the effects of overnight abstinence on cerebral volumetrics and changes in functional connectivity of a higher-order sensory cortex. These changes may dispose smokers to impulsive behaviors and aggravate the urge to smoke at the earliest stage of withdrawal from nicotine.

Implications

Overnight abstinence leads to changes in gray matter volumes and functional connectivity of the second somatosensory cortex in cigarette smokers. Higher somatosensory and motor cortical connectivity in abstinence is significantly correlated with trait motor impulsivity and withdrawal symptom severity. The findings add to the literature of neural markers of nicotine addiction.
Radical flanks of social movements can increase support for moderate factions
Authors: Simpson Brent , Willer Robb , Feinberg Matthew
Published: July 2022

Social movements are critical agents of social change, but are rarely monolithic. Instead, movements are often made up of distinct factions with unique agendas and tactics, and there is little scientific consensus on when these factions may complement—or impede—one another’s influence. One central debate concerns whether radical flanks within a movement increase support for more moderate factions within the same movement by making the moderate faction seem more reasonable—or reduce support for moderate factions by making the entire movement seem unreasonable. Results of two online experiments conducted with diverse samples (N = 2,772), including a study of the animal rights movement and a preregistered study of the climate movement, show that the presence of a radical flank increases support for a moderate faction within the same movement. Further, it is the use of radical tactics, such as property destruction or violence, rather than a radical agenda, that drives this effect. Results indicate the effect owes to a contrast effect: Use of radical tactics by one flank led the more moderate faction to appear less radical, even though all characteristics of the moderate faction were held constant. This perception led participants to identify more with and, in turn, express greater support for the more moderate faction. These results suggest that activist groups that employ unpopular tactics can increase support for other groups within the same movement, pointing to a hidden way in which movement factions are complementary, despite pursuing divergent approaches to social change.
COVID-19 Vaccination Status and Concerns Among People Who Use Drugs in Oregon
Authors: Stack Erin , Shin Sarah , LaForge Kate , Pope Justine , Leichtling Gillian , Larsen Jessica E. , Byers Mikaela , Leahy Judith M. , Hoover Daniel , Chisholm Laura , Korthuis P. Todd
Published: July 2022

Objectives

The objective of this study was to examine COVID-19 vaccination acceptance and explore reasons for COVID-19 vaccine hesitancy among people who use drugs (PWUDs), a population with increased COVID-19 transmission and morbidity.

Methods

We conducted semi-structured in-depth interviews with PWUDs in 7 Oregon counties from May 11 to June 25, 2021. Participants (n = 34) were recruited in partnership with syringe service programs and local community organizations staff, participant-referrals, and flyer advertising. Research staff conducted interviews via telephone to assess participants’ acceptance of the COVID-19 vaccine, find knowledge gaps where new educational information about vaccination would be helpful, and identify who would be perceived as a trustworthy source of information. Interviews were transcribed and coded using thematic analysis with a deductive approach.

Results

Most participants had not received the COVID-19 vaccine and were not planning on or were unsure about receiving it. Participants were mistrustful of the rapid COVID-19 vaccine development process, the agencies involved in the development, and vaccines in general. Participants shared varied and contrasting responses about who they would trust to provide information about the COVID-19 vaccine, including peer recovery support specialists, doctors, or other health care professionals, and specified federal agencies or media outlets.

Conclusions

As addiction medicine and public health staff continue to respond to the evolving impacts of COVID-19, vaccination planning should be tailored to the unique needs of PWUD to increase COVID-19 vaccine acceptance in this high-risk population.
Psychologically Informed Practice in Audiological Rehabilitation: Audiologist Perceived Barriers, Facilitators, and Preparedness
Authors: Laird Emma C. , Bryant Christina A. , Barr Caitlin M. , Bennett Rebecca J.
Published: July 2022

Objectives:

Psychological factors, such as mental illness, mental health, attitudes, emotions, and coping styles, are known to impact the success of audiological rehabilitation. However, evidence suggests that audiologists are not sufficiently addressing client psychological factors. Psychologically informed practice, implemented in other healthcare professions, is a framework that guides clinicians in addressing both the physical and psychological factors of a condition throughout rehabilitation. Psychologically informed practice may also be an appropriate framework to improve client outcomes in audiology. The objectives of this study were (1) to determine the barriers and facilitators to audiologists addressing client mental health, psychological symptoms, emotions, and feelings, and (2) to determine audiologists’ preparedness and willingness to implement aspects of psychologically informed practice in audiological rehabilitation.

Design:

A cross-sectional survey was conducted with a convenience sample of 118 Australian clinical audiologists (83.1%, n = 98 female) working in adult audiological rehabilitation.

Results:

Most participants (91.5%) reported at least one barrier to discussing mental health with clients, with the most common being insufficient knowledge and skills in mental health (39.8%). Applying the COM-B model of behavior change, audiologists reported that factors related to motivation were primarily facilitators, and factors related to opportunity (e.g., lack of time) and capabilities (e.g., insufficient knowledge) were barriers to discussing client mental health. Many participants (83.1%) reported willingness to incorporate a clear protocol, including when and how to refer to psychological services, within audiological rehabilitation.

Conclusions:

Audiologists were generally motivated to incorporate psychologically informed practice into audiological rehabilitation; however, lack of knowledge and organizational barriers would need to be overcome. The insights gained in this study provide a foundation for developing a viable approach to psychologically informed practice, which may ultimately encourage audiologists to engage in person-centered care more actively.
Multifidus Sarcopenia Is Associated With Worse Patient-reported Outcomes Following Posterior Cervical Decompression and Fusion
Authors: Pinter Zachariah W. , Salmons Harold I. , Townsley Sarah , Omar Adan , Freedman Brett A. , Currier Bradford L. , Elder Benjamin D. , Nassr Ahmad N. , Bydon Mohamad , Wagner Scott C. , Sebastian Arjun S.
Published: July 2022

Study Design.

Retrospective cohort study.

Objective.

The present study is the first to assess the impact of paraspinal sarcopenia on patient-reported outcome measures (PROMs) following posterior cervical decompression and fusion (PCDF).

Summary of Background Data.

While the impact of sarcopenia on PROMs following lumbar spine surgery is well-established, the impact of sarcopenia on PROMs following PCDF has not been investigated.

Materials and Methods.

We performed a retrospective review of patients undergoing PCDF from C2 to T2 at a single institution between the years 2017 and 2020. Two independent reviewers who were blinded to the clinical outcome scores utilized axial cuts of T2-weighted magnetic resonance imaging sequences to assess fatty infiltration of the bilateral multifidus muscles at the C5–C6 level and classify patients according to the Fuchs Modification of the Goutalier grading system. PROMs were then compared between subgroups.

Results.

We identified 99 patients for inclusion in this study, including 28 patients with mild sarcopenia, 45 patients with moderate sarcopenia, and 26 patients with severe sarcopenia. There was no difference in any preoperative PROM between the subgroups. Mean postoperative Neck Disability Index scores were lower in the mild and moderate sarcopenia subgroups (12.8 and 13.4, respectively) than in the severe sarcopenia subgroup (21.0, P<0.001). A higher percentage of patients with severe multifidus sarcopenia reported postoperative worsening of their Neck Disability Index (10 patients, 38.5%; P=0.003), Visual Analog Scale Neck scores (7 patients, 26.9%; P=0.02), Patient-Reported Outcome Measurement Information System Physical Component Scores (10 patients, 38.5%; P=0.02), and Patient-Reported Outcome Measurement Information System Mental Component Scores (14 patients, 53.8%; P=0.02).

Conclusion.

Patients with more severe paraspinal sarcopenia demonstrate less improvement in neck disability and physical function postoperatively and are substantially more likely to report worsening PROMs postoperatively.

Level of Evidence.

3.
Back to the Future: A Report From the 16th International Forum for Back and Neck Pain Research in Primary Care and Updated Research Agenda
Authors: Dionne Clermont E. , Rossignol Michel , Deyo Richard A. , Koes Bart , Schoene Mark , Battié Michele
Published: July 2022

Study Design.

The 16th meeting of the International Forum for Back and Neck Pain Research in Primary Care was held in Québec City in July 2019 under the theme of innovation. This paper addresses the state of research in the field.

Objective.

To ascertain the evolution of knowledge and clinical application in back and neck pain and identify shifting research priorities.

Materials and Methods.

After a brief presentation of the Forum and its history, the current state of the field was depicted from the scientific program and the recordings of the plenary and parallel oral and poster communications of Forum XVI. Research agendas established in 1995 and 1997 were updated from a survey of a multidisciplinary group of experts in the field. A discussion of the progress made and challenges ahead follows.

Results.

While much progress has been made at improving knowledge at managing back pain in the past 25 years, most research priorities from earlier decades are still pertinent. The need for integration of physical and psychological interventions represents a key challenge, as is the need to better understand the biological mechanisms underlying back and neck pain to develop more effective interventions. Stemming the tide of back and neck pain in low and middle-income countries and avoiding the adoption of low-value interventions appear particularly important. The Lancet Low Back Pain Series initiative, arising from the previous fora, and thoughts on implementing best practices were extensively discussed, recognizing the challenges to evidence-based knowledge and practice given competing interests and incentives.

Conclusion.

With the quantity and quality of research on back and neck pain increasing over the years, an update of research priorities helped to identify key issues in primary care.
Comparison of Spinopelvic Configuration and Roussouly Alignment Types Between Pediatric and Adult Populations
Authors: Charles Yann Philippe , Lamas Vincent , Ilharreborde Brice , Blondel Benjamin , Prost Solène , Bauduin Eloïse , Laouissat Féthi , Riouallon Guillaume , Wolff Stéphane , Challier Vincent , Obeid Ibrahim , Boissière Louis , Ferrero Emmanuelle , Solla Federico , Le Huec Jean-Charles , Bourret Stéphane , Faddoul Joe , Abi Lahoud Georges N. , Fière Vincent , Vande Kerckhove Michiel , Lebhar Jonathan , Giorgi Hadrien , Faure Aymeric , Sauleau Erik A. , Pesenti Sébastien ,   The French Spine Surgery Society (SFCR)
Published: July 2022

Study Design.

Retrospective cross-sectional study.

Objective.

The aim was to describe spinopelvic alignment types by pelvic incidence (PI) and age to compare the Roussouly classification between pediatric and adult populations.

Summary of Background Data.

The Roussouly classification was validated for adults. Alignment types may vary during growth.

Materials and Methods.

Radiographs of 1706 non pathologic individuals (5–49 yr) were analyzed. Individuals ≤19 years were stratified by chronological age and skeletal maturity (triradiate cartilage, Risser), and compared with adults. Global and spinopelvic alignment parameters were assessed. Roussouly Types 1, 2, 3, 3A (anteverted pelvis), and 4 were determined. The distribution of parameters was analyzed by Bayesian inference. The relationship between PI and age by Roussouly type was modeled by linear regression.

Results.

The Sagittal Vertical Axis C7 decreased during growth and was significantly smaller in adults (20–34 yr) (Pr>0.99). Thoracic kyphosis and lumbar lordosis increased during growth and were larger in adults (Pr<0.025). Lordosis increased mainly in the cranial arch (Pr<0.025). PI and pelvic tilt increased during growth and were larger in adults (Pr<0.025). In children and adolescents, PI<45° represented the largest proportion, significantly larger compared with adults (Pr>0.99). Proportions of Roussouly Types 1 and 2 were similar throughout ages. Types 3 and 4 were rarer during the prepubertal period (Pr<0.025). The proportion of Type 3A was significantly higher in children and adolescents (Pr>0.99). Linear regression showed that Type 4 had the largest PI increase with age, with significantly higher curve slope compared with other types (Pr>0.9999). Types 3, 3A and 2 had similar slopes and lowest PI increase with age.

Conclusion.

Global and spinopelvic alignment changed during childhood and adolescence, leading to different kyphosis and lordosis distribution compared with adults. Growth-related PI increase influenced Roussouly types with typical predominance of Type 3A in the pediatric population and larger PI increase in Type 4.

Level of Evidence.

Level III.
Age- and Gender-based Global Sagittal Spinal Alignment in Asymptomatic Adult Volunteers: Results of the Multiethnic Alignment Normative Study (MEANS)
Authors: Sardar Zeeshan M. , Cerpa Meghan , Hassan Fthimnir , Kelly Michael , Le Huec Jean-Charles , Bourret Stephane , Hasegawa Kazuhiro , Wong Hee-Kit , Liu Gabriel , Dennis Hey Hwee Weng , Riahi Hend , Lenke Lawrence
Published: July 2022

Study Design.

Multicenter Cohort.

Objective.

Assess normative values of sagittal spinal and lower extremity alignment in asymptomatic volunteers stratified by age and gender.

Summary of Background Data.

Our understanding of ideal sagittal alignment is still evolving. The Multiethnic Alignment Normative Study (MEANS) investigated skeletal alignment of the largest multiethnic cohort of asymptomatic adult volunteers. We aim to assess normative values of sagittal spinal and lower extremity alignment in asymptomatic volunteers stratified by age and gender.

Materials and Methods.

Asymptomatic volunteers between the ages of 18–80 years were enrolled prospectively and then analyzed retrospectively from six different centers. Volunteers included reported no significant neck or back pain, nor any known spinal disorder(s). All volunteers underwent a standing full-body or full-spine low-dose stereoradiograph.

Results.

MEANS consisted of 468 volunteers with a mean age of 40.4±14.8 years. Thoracic kyphosis (TK) from T4 to T12 showed a mean of 37.4±10.9°. The average L1–S1 lumbar lordosis (LL) was −57.4±11.3°. LL did not show significant differences across the five age groups. TK showed a significant difference based on age (P<0.0001). Sagittal vertical axis increased across age groups from −14.2 mm in young adults to 17.0 mm in patients >64. Similar trend was seen for T1 pelvic angle with a mean of 5.0° in young adults and 13.7° in those older than age 64. Knee flexion increased across age groups without a significant change in odontoid-knee distance which is a surrogate for the center of the head aligned over the knees.

Conclusions.

In asymptomatic volunteers, sagittal alignment parameters showed a slow and steady change across age groups exemplified by an increase in TK. However, LL did not show a significant decrease across age groups. Volunteers used compensatory mechanisms such as slight pelvis retroversion, knee flexion, and neck extension to maintain an aligned sagittal posture with their head centered over their knees (odontoid-knee).

Level of Evidence.

3
Technique for Reconstruction of Midcarpal Instability Associated with Lunotriquetral Coalition
Authors: Hall Shannon M. , Lee Frank G. , Wallace Sean J. , Miller Nathan F.
Published: July 2022

Carpal coalition is a rare congenital presentation of 2 or more fused carpal bones due to a failure of apoptotic segmentation during development. The most common subtype is lunotriquetral coalition (LTC). Most cases are asymptomatic and found incidentally on imaging; however, a few symptomatic cases requiring treatment have been reported. Surgical intervention of arthrodesis and proximal row carpectomy in adults have been reported where conservative management of splinting, physiotherapy, anti-inflammatory medication, or steroid injections have failed. We report a unique case of Minnaar type 2 LTC in a 20-year-old man with a 6-year history of daily right wrist pain and symptomatic wrist instability whose previous conservative therapies failed. Midcarpal instability and volar intercalated segment instability—volar flexion of the lunate—were present. A novel technique using the palmaris longus tendon to reconstruct the triquetrohamate, triquetrocapitate, and dorsal radiolunate ligaments was performed. The graft was secured dorsally to the hamate, triquetrum, and capitate. An additional graft from the lunate to distal radius acted as a biomechanical checkrein. There were no complications. Temporary Kirschner wires were removed 2 months postoperatively, followed by occupational hand therapy. At 1-year follow-up, the patient no longer reported pain or lunotriquetral tenderness. Midcarpal instability and volar intercalated segment instability resolved. Postoperative right wrist flexion and extension were 40 and 75 degrees, respectively. We discuss the successful outcome of this novel technique as an alternative to arthrodesis in the surgical management of LTC.
Insights into the pleiotropic relationships between chronic back pain and inflammation-related musculoskeletal conditions: rheumatoid arthritis and osteoporotic abnormalities
Authors: Kasher Melody , Williams Frances M.K. , Freidin Maxim B. , Cherny Stacey S. , Malkin Ida ,   CHARGE Inflammation Working Group, Livshits Gregory
Published: July 2022

The ageing process includes the development of debilitating musculoskeletal (MSK) conditions, including chronic back pain (CBP), rheumatoid arthritis (RA), and osteoporosis (OP). The mechanisms involved in the genetic–epidemiological relationships between these MSK phenotypes are controversial and limited and thus require clarification, in particular, between CBP and the other MSK phenotypes. A cross-sectional statistical analysis was conducted using Europeans from the UK Biobank data collection, including 73,794 CBP, 4883 RA, and 7153 OP cases as well as 242,216 calcaneus bone mineral density scores. C-reactive protein (CRP) was measured for 402,165 subjects in this sample. Genetic correlations were assessed to evaluate shared genetic background between traits. Mendelian randomization was performed to assess a causal relationship between CBP and RA and OP along with other risk factors, such as CRP. Colocalization analysis was conducted to identify shared pleiotropic regions between the examined traits. Bayesian modelling was performed to determine a potential pathway that may explain the interrelationships among these traits. Mendelian randomization analyses revealed that CRP causally predicts CBP only (β = 0.183, 95% CI = 0.077-0.290, P-value = 0.001). Horizontally pleiotropy appeared to explain the relationship between CBP and RA and OP. Through colocalization analysis, several genomic regions emerged describing common genetic influences between CBP and its proposed risk factors, including HLA-DQA1/HLA-DQB1, APOE, SOX5, and MYH7B as well as Histone 1 genes. We speculate that among other factors, CBP and its MSK comorbidities may arise from common inflammatory mechanisms. Colocalized identified genes may aid in advancing or improving the mode of treatment in patients with CBP.
Assessing the Performance Value of the Baldrige Journey: A Comparison of Baldrige Applicants and Nonapplicants
Authors: Strahan Jennifer O. , Hearld Larry R. , Carroll Nathan W. , McWhorter John , Szychowski Jeff M.
Published: July 2022

Goal:

The national Baldrige program has supported performance excellence in healthcare since 1999. Previous studies have compared the performance of Baldrige hospital recipients to nonrecipients. This study, however, sought to address the question of whether the mere pursuit of the Baldrige award provides value.

Methods:

This study used propensity score matching with linear and quantile regression techniques to understand the impact of hospitals applying the Baldrige Excellence Framework across a comprehensive set of standardized industry performance measures, regardless of award recognition.

Principal Findings:

The analysis demonstrated that Baldrige applicants outperformed non-Baldrige applicants in select operational measures of efficiency (such as inpatient average length of stay), patient experience, and financial measures (including return on net assets, days in accounts receivable, and expenses as a percentage of patient revenues). However, there was no statistically significant difference in clinical performance between Baldrige applicants and nonapplicants.

Practical Applications:

The findings from this study suggest that hospital leaders can realize significant gains with select operational and financial measures without compromising clinical outcomes when applying the Baldrige Excellence Framework to their organizations.
The Contribution of First-name Information to the Accuracy of Racial-and-Ethnic Imputations Varies by Sex and Race-and-Ethnicity Among Medicare Beneficiaries
Authors: Haas Ann , Adams John L. , Haviland Amelia M. , Dembosky Jacob W. , Morrison Peter A. , Gaillot Sarah , Fremont Allen M. , Gildner Jennifer L. , Tamayo Loida , Elliott Marc N.
Published: July 2022

Background:

Data on race-and-ethnicity that are needed to measure health equity are often limited or missing. The importance of first name and sex in predicting race-and-ethnicity is not well understood.

Objective:

The objective of this study was to compare the contribution of first-name information to the accuracy of basic and more complex racial-and-ethnic imputations that incorporate surname information.

Research Design:

We imputed race-and-ethnicity in a sample of Medicare beneficiaries under 2 scenarios: (1) with only sparse predictors (name, address, sex) and (2) with a rich set (adding limited administrative race-and-ethnicity, demographics, and insurance).

Subjects:

A total of 284,627 Medicare beneficiaries who completed the 2014 Medicare Consumer Assessment of Healthcare Providers and Systems survey and reported race-and-ethnicity were included.

Results:

Hispanic, non-Hispanic Asian/Pacific Islander, and non-Hispanic White racial-and-ethnic imputations are more accurate for males than females under both sparse-predictor and rich-predictor scenarios; adding first-name information increases accuracy more for females than males. In contrast, imputations of non-Hispanic Black race-and-ethnicity are similarly accurate for females and males, and first names increase accuracy equally for each sex in both sparse-predictor and rich-predictor scenarios. For all 4 racial-and-ethnic groups, incorporating first-name information improves prediction accuracy more under the sparse-predictor scenario than under the rich-predictor scenario.

Conclusion:

First-name information contributes more to the accuracy of racial-and-ethnic imputations in a sparse-predictor scenario than in a rich-predictor scenario and generally narrows sex gaps in accuracy of imputations.
Clinical action plans make a difference at point-of-care
Authors: Reeves Patrick T.
Published: July 2022

Purpose of review

The purpose of this review is to provide an update to and roadmap for the practical implementation of various point-of-care clinical action plans for primary care providers.

Recent findings

Clinical action plans were first developed to address unmet, home preventive needs for the management of asthma. Over the past 10 years, the advancement of mobile health technologies, the recognition of at-risk populations, and the development of evidence-based concepts to guide the creation of patient education tools have expanded the implementation of clinical action plans for many diagnoses (e.g., functional constipation, atopic dermatitis, and headache migraines). Poor patient-related clinical outcomes have been linked with low health literacy for many chronic diseases of childhood. This has served as a call to action to improve patient education. Clinical action plans address this gap by facilitating superior knowledge transfer from the medical team in the clinic to the patient/caregiver. The use of clinical action plans can serve as clinical decision support tools for the medical team and has been demonstrated to improve patient adherence to complex therapy regimens.

Clinical action plans have the potential to improve disease-related self-management confidence, increase pharmacotherapy adherence, and enhance guideline-concordant care. These clinical decision support tools are safe, inexpensive, and represent an advancement in the high-value care model in pediatric medicine.
Exploring Nurses' Attitudes, Skills, and Beliefs of Medication Safety Practices
Authors: Arkin Laura , Schuermann Andrea , Penoyer Daleen , Loerzel Victoria
Published: July 2022

Background:

Medication errors exist within health care systems despite efforts to reduce their incidence. These errors may result in patient harm including morbidity, mortality, and increased health care costs.

Purpose:

The purpose of this study was to explore direct care nurses' attitudes, skills, and beliefs about medication safety practice.

Methods:

Researchers conducted a descriptive exploratory study using the Nurses' Attitudes and Skills around Updated Safety Concepts (NASUS) scale and the Nurse Beliefs about Errors Questionnaire (NBEQ).

Results:

Responses from 191 surveys were analyzed. Of the participants, 70% were bachelor's prepared registered nurses and 88% were female. Results of the NASUS scale revealed the median of means of the Perceived Skills subscale was 79.2 out of 100 and the Attitudes subscale was 65.8 out of 100. The mean of the belief questions related to severity of error was 7.66 out of 10; most participants agreed with reporting of severe errors, reporting errors with moderate or major adverse events, and reporting of incorrect intravenous fluids.

Conclusions:

Understanding direct care nurses' attitudes, skills, and beliefs about medication safety practices provides a foundation for development of improvement strategies.
Associations Between Gut Microbes and Social Behavior in Healthy 2-Year-Old Children
Authors: Delgadillo Desiree R. , Pressman Sarah D. , Christian Lisa M. , Galley Jeffrey D. , Bailey Michael T.
Published: July 2022

Objective

Emerging research has connected abundances of specific bacteria to differences in psychosocial behaviors in animals and adult humans. However, research assessing mind-microbiome associations in children is sparse with extant work primarily focused on populations with autism, making it unclear whether links are also present in typically developing children. The current study fills this gap by examining associations between prosocial–self-regulating temperaments (effortful control; EC) and the gut microbiome in typically developing children.

Methods

Maternal ratings of temperament were assessed in 77 toddlers 18 to 27 months of age (46.7% female, mean age = 23.14 months). Next-generation pyrosequencing of the V1–V3 region of the 16S rRNA gene was used to classify children’s gut microbial composition from fecal samples. EC included the following subcategories: cuddliness, attentional focusing, attentional shifting, inhibitory control, and low-intensity pleasure.

Results

After adjusting for covariates, EC was positively associated with relative abundances of Akkermansia (ΔR
2 = 0.117, b = 0.022, SE = 0.007, p = .002), with cuddliness (i.e., joy and ease of being held) driving the relation. Furthermore, attentional focusing was negatively associated with Alistipes (ΔR
2 = 0.062, b = −0.011, SE = 0.005, p = .028). Permutational analysis of variance revealed no significant differences in community structure between high and low EC groups on the phylum level (R
2 = 0.00372, p = .745) or the genus level (R
2 = 0.01559, p = .276).

Conclusions

Findings suggest that certain microbes may be linked to prosocial behaviors used to regulate emotion in typically developing children. Further research is needed to test whether these observations replicate in larger samples.
Brief Report: Role of Gender-Affirming Hormonal Care in HIV Care Continuum Outcomes When Comparing Transgender Women With Cisgender Sexual Minority Men
Authors: Chyten-Brennan Jules , Patel Viraj V. , Anastos Kathryn , Hanna David B.
Published: July 2022

Background:

Transgender women (transwomen) are frequently conflated with cisgender sexual minority men (cis-SMM) in HIV research. We examined the impact of socioeconomic and health conditions, and gender-affirming hormones in comparing HIV-related outcomes between cis-SMM and transwomen.

Setting:

Large tertiary care health system in the Bronx, NY.

Methods:

Retrospective cohort study of people with HIV receiving care in 2008–2017. We compared retention in care, antiretroviral therapy (ART) prescription, and viral suppression between cis-SMM and transwomen, using modified Poisson regression, adjusting for demographic and clinical factors. Transwomen were further stratified by receipt of estrogen prescription.

Results:

We included 166 transwomen (1.4%), 1936 cis-SMM (17%), 4715 other cisgender men (41%), and 4745 cisgender women (41%). Transwomen were more likely to have public insurance (78% vs 65%) and mental health (49% vs 39%) or substance use (43% vs 33%) diagnoses than cis-SMM. Compared with cis-SMM, transwomen prescribed estrogen (67% of transwomen) were more likely to be retained [adjusted risk ratio (aRR) 1.15, 95% confidence interval (CI) 1.08 to 1.23), prescribed ART (aRR 1.06, CI 1.01 to 1.11), and virally suppressed (aRR 1.08, CI 1.01 to 1.16). Transwomen not prescribed estrogen were less likely to be retained (aRR 0.92, CI 0.83 to 1.02), prescribed ART (aRR 0.90, CI 0.82 to 0.98), or virally suppressed (aRR 0.85, CI 0.76 to 0.95).

Conclusions:

In the context of HIV, socioeconomic factors, comorbidities, and gender-affirming care distinguish transwomen from cis-SMM. Compared with cis-SMM, transwomen who were prescribed estrogen had better HIV care continuum outcomes; transwomen not prescribed estrogen had worse outcomes. These differences should be accounted for in HIV-related research.
Multicenter Experience with Neoadjuvant Therapy in Melanoma Highlights Heterogeneity in Contemporary Practice
Authors: Rhodin Kristen E. , Gaughan Elizabeth M. , Raman Vignesh , Salama April K. , Hanks Brent A. , Shah Riddhishkumar , Tyler Douglas S. , Slingluff Craig L. , Beasley Georgia M.
Published: July 2022

Objective:

To determine the feasibility and impact of neoadjuvant therapy (NT) in patients who present with advanced melanoma amenable to surgical resection.

Summary Background Data:

Given current effective systemic therapy for melanoma, the use of NT is being explored in patients with advanced melanoma with disease amenable to surgical resection.

Methods:

Prospective data from 3 institutions was obtained in patients with clinically evident Stage III/IV melanoma who underwent NT. The primary objective was to compare recurrence-free survival between patients who had pathologic complete response (pCR) to those with persistent disease.

Results:

NT was offered to 45 patients, with 43 patients initiating various NT regimens including PD-1 antagonist (PD-1) therapy (N = 16), PD-1 plus ipilimumab (N = 10), BRAF/MEK inhibitor therapy (N = 14), a combination of those three (N = 1), and talimogene laherparepvec (TVEC) (N = 2). Thirty-two (74.1%) patients underwent surgery whereas 11 patients did not undergo surgery for these reasons: clinical CR (N = 7), progressive disease not amenable to resection (N = 3), and ongoing therapy (N = 1). 12 of 32 patients (37.5%) had pCR with these therapies: PD-1 (N = 4), PD-1 plus ipilimumab (N = 2), BRAF/MEK (N = 4), combination (N = 1), and TVEC (N = 1). At median follow-up of 16.4 months there was only 1 recurrence in the pCR group and patients with a pCR had significantly improved recurrence-free survival compared to patients without pCR (p = 0.004).

Conclusions:

Despite variability in NT regimens across institutions, NT for melanoma is feasible and associated with improved prognosis in patients who achieve a pCR. Maximizing rates of pCR could improve prognosis for patients with advanced melanoma.
Determining a Method to Minimize Pain After Laparoscopic Cholecystectomy Surgery
Authors: Akturk Remzi , Serinsöz Serdar
Published: July 2022

Background:

Although many studies have investigated control of postoperative pain, inadequacy of treatment still remains. In this study, we aimed to identify a method with the capacity to minimize abdominal and right shoulder pain after laparoscopic cholecystectomy.

Materials and Methods:

A total of 684 subjects, 77% (n=527) female and 23% (n=157) male, were included in this study. A T-drain was prescribed for patients requiring bile duct exploration and patients with acute cholecystitis were excluded from the study. Subjects were classified into groups as follows: Group 1: control group without drain and intraperitoneal analgesics; Group 2: a drain was placed but no intraperitoneal analgesic was applied; Group 3: no drain was placed and intraperitoneal subhepatic bupivacaine was applied; and Group 4: drain was placed and intraperitoneal subhepatic bupivacaine was applied. Parietal pain and visceral pain were evaluated with visual analog scale (VAS).

Results:

A drain was present in 51.9% (n=355) of the cases. A statistically significant difference was found between the preoperative pulse rate measurements of the cases according to the groups (P=0.009; <0.01). Subhepatic bupivacaine was administered in 50.1% (n=355) of the cases. A statistically significant difference was found between the second, fourth, sixth, 12th, and 24th hour VAS scores of the cases according to the groups [2 h VAS scores (mean±SD): Group 1: 3.58±1.07, Group 2: 3.86±1.12, Group 3: 1.20±0.67, and Group 4: 1.50±1.21 (P<0.001)]; [4 h VAS scores (mean±SD): Group 1: 2.55±1.26, Group 2: 2.87±1.14, Group 3: 1.66±1.06, and Group 4: 2.02±1.23 (P<0.001)]; [6 h VAS scores (mean±SD): Group 1: 2.50±0.91, Group 2: 2.53±1.14, Group 3: 1.66±1.06, and Group 4: 2.02±1.23 (P<0.001)]; [12 h VAS scores (mean±SD): Group 1: 3.24±1.2, Group 2: 3.49±1.14, Group 3: 2.83±0.98, and Group 4 : 2.99±1.36 (P<0.001)]; and [24 h VAS scores (mean±SD): Group 1: 3.75±0.99, Group 2: 4.01±0.91, Group 3: 3.61±1.34, and Group 4: 4.01±1.08 (P<0.001)].

Conclusion:

Bupivacaine spraying reduces postoperative abdominal pain, while drain placement minimizes shoulder pain by reducing CO2 remaining under the diaphragm.
Current Knowledge on Potential Determinants of Mass Public Shooting Perpetration and Casualties: A Systematic Review
Authors: Wichaidit Wit
Published: July 2022

Background

In the United States, mass shootings can be regarded as a public health issue due to its ubiquitous and public nature. A systematic review of the literature with adoption of the social ecological model for interpretation of the evidence can help inform relevant stakeholders and the public regarding the coherence between proposed gun control legislations and the body of empirical evidence.

Aims

To conduct a systematic review of factors associated with: 1) perpetration of mass shooting events, and; 2) injuries and fatalities at mass shooting events.

Material and Methods

The author conducted a search of the literatures on PubMed using the term “mass shooting”, filtering manuscripts from 2017 to 2022. The author included only articles in peer-reviewed academic journals with primary data collection for the review.

Results

The author reviewed 36 of the 336 articles initially found from a search on PubMed. All but two studies focused on mass shootings in the United States. Factors associated with perpetration of mass shootings included having mental illness and experience of acute life stressors (intra-personal), relationship issues with family and friends (inter-personal), gun ownership and access (community), permissive firearm laws or lack of gun control (policy). Factors associated with injuries and fatalities at mass shootings included use of semi-automatic rifles (intrapersonal), targeting women (interpersonal), presence of armed officers at schools (organizational), and lack of gun control measures (policy).

Conclusion

The author found that easy access to high-power firearms and lack of gun control were associated with both mass shooting perpetration and casualty. However, caveats including a limited time frame, limited sources of publications, and subjectivity in building the model should be considered in the interpretation of the study findings.
Meta-analysis of metagenomes via machine learning and assembly graphs reveals strain switches in Crohn’s disease
Authors: Reiter Taylor E. , Irber Luiz , Gingrich Alicia A. , Haynes Dylan , Pierce-Ward N. Tessa , Brooks Phillip T. , Mizutani Yosuke , Moritz Dominik , Reidl Felix , Willis Amy D. , Sullivan Blair D. , Brown C. Titus
Published: July 2022

Microbial strains have closely related genomes but may have different phenotypes in the same environment. Shotgun metagenomic sequencing can capture the genomes of all strains present in a community but strain-resolved analysis from shotgun sequencing alone remains difficult. We developed an approach to identify and interrogate strain-level differences in groups of metagenomes. We use this approach to perform a meta-analysis of stool microbiomes from individuals with and without inflammatory bowel disease (IBD; Crohn’s disease, ulcerative colitis; n = 605), a disease for which there are not specific microbial biomarkers but some evidence that microbial strain variation may stratify by disease state. We first developed a machine learning classifier based on compressed representations of complete metagenomes (FracMinHash sketches) and identified genomes that correlate with IBD subtype. To rescue variation that may not have been present in the genomes, we then used assembly graph genome queries to recover strain variation for correlated genomes. Lastly, we developed a novel differential abundance framework that works directly on the assembly graph to uncover all sequence variants correlated with IBD. We refer to this approach as dominating set differential abundance analysis and have implemented it in the spacegraphcats software package. Using this approach, we identified five bacterial strains that are associated with Crohn’s disease. Our method captures variation within the entire sequencing data set, allowing for discovery of previously hidden disease associations.
Geometric changes to the central nervous system organs at risk during chemoradiotherapy for locally advanced nasopharyngeal carcinoma
Authors: Li Jing , Jiang Zeying , Tan Wenyong
Published: July 2022

Background

Considerable geometric changes to the organs at risk (OARs) have been reported during treatment with chemotherapy and intensity modulated radiotherapy (chemo-IMRT) for locally advanced nasopharyngeal carcinoma (LA-NPC). This study aimed to quantify geometric changes to the central nervous system-related OARs (CNS-OARs), during chemo-IMRT for LA-NPC.

Methods

This prospective study included 20 patients with LA-NPC, treated with chemo-IMRT. Patients underwent a planning computed tomography (CT-plan) scan with intravenous contrast, followed by six weekly scans without contrast (CT-rep). For CNS-OARs, including the spinal cord, brainstem, optic chiasm and nerves, the globes of the eye, lens, and inner ears, their volume loss, the center of mass (COM) displacement, and spatial deformation was compared among weeks, respectively. The correlation between organ volume reduction and patients’ weight loss was estimated.

Results

The volume of the brainstem, spinal cord, and the globe of left-and right-side eye averagely decreased by 2.6±2.3% (95% CI: 2.1%, 3.1%), 6.5±4.8% (5.6%,7.4%), 9.4±6.9% (8.1%, 10.6%) and 9.6±7.8% (8.2, 11.1%) respectively. The volume reduction of the spinal cord and that of the brainstem were significantly correlated with patients’ weight loss. For all OARs, the COM displacement was within 3 mm, except for the lower level of the spinal cord. The DSC value of the spinal cord, brainstem, and the globes of the eye was of >0.85 throughout treatment.

Conclusions

The volume and shape changes to the CNS-OARs during chemo-IMRT for NPC were quantifiable, which could be useful to refine radiation treatment protocols.