bluuebunny/crossref_metadata_2025 huggingface dataset:
Intracavitary electrocardiography-guided positioning of central vascular access device can spare unnecessary ionizing radiation exposure in pediatric patients
Authors: Raffaele Alessandro , Segal Aviad , Romano Piero , Vatta Fabrizio , Boghen Stella , Bonetti Federico , Parigi Gian Battista , Avolio Luigi
Published: May 2020

Background:

Most hospital protocols—including those of our own institute—require the use of radiography to validate tip position in every central vascular access device placement. This study evaluated whether unnecessary ionizing radiation exposure could be spared in the pediatric population when intracavitary electrocardiography is used to guide catheter placement.

Material and methods:

Retrospective study of intracavitary electrocardiography-guided central vascular access device placements in our pediatric surgery department between 2013 and 2018. We evaluated the operating time, success in positioning the catheter, and accuracy of final tip position. We also assayed the effects of catheter type and of catheter access point on operating time, success, accuracy, and complications. We applied the chi-square test for statistical analysis.

Results:

In total, 622 interventions of central vascular access device placements were evaluated; 340 intracavitary electrocardiography-guided central vascular access device placements were included in the study. The electrocardiography method successfully positioned the tip of the catheter in 316/340 (92.94%) of placements. Where intracavitary electrocardiography placement was successful, radiography confirmed accuracy of tip position in 314/316 (99.41%) of placements.

Conclusion:

When electrocardiography-guided positioning is uneventful and a valid P-Wave pattern is seen, postprocedure radiograph imaging for verification is unnecessary. Any effort should be made to upgrade hospital policies according to evidences and newest guidelines to spare pediatric patients harmful exposure to radiation by limiting the use of radiography only to selected cases.
Cumulative Contexts of Vulnerability to Intimate Partner Violence Among Women With Disabilities, Elderly Women, and Immigrant Women: Prevalence, Risk Factors, Explanatory Theories, and Prevention
Authors: Sasseville Nathalie , Maurice Pierre , Montminy Lise , Hassan Ghayda , St-Pierre Émilie
Published: May 2020

Some groups of women are more vulnerable to intimate partner violence (IPV) due to particular risks and/or experiences: women with disabilities, elderly women, and immigrant women (DEI). Too often, their reality goes unnoticed, especially for those belonging to more than one of these groups. In this literature review, researchers used an intersectional approach to document the similarities and differences in how DEI women experience IPV, in terms of forms and consequences, as well as related risk factors, explanatory theories, and prevention strategies. Researchers selected 56 articles for review based on the following inclusion criteria: studies on adults living in a situation of IPV, studies on one of the three demographics under study (DEI), studies about one or multiple research questions, and studies based on empirical data relying on research methodology in either French or English. Researchers evaluated each selected article for its quality according to a chart that was specially developed for this review. The results highlight existing “intersections” between these groups to help understand the influence of belonging to more than one vulnerability group on these women’s experiences with IPV. The importance to better training social workers and developing policies and programs that target the social determinants of health to prevent IPV experienced by DEI is also discussed.
The Effect of Priming on Outcomes of Task-Oriented Training for the Upper Extremity in Chronic Stroke: A Systematic Review and Meta-analysis
Authors: da Silva Erika Shirley Moreira , Ocamoto Gabriela Nagai , Santos-Maia Gabriela Lopes dos , de Fátima Carreira Moreira Padovez Roberta , Trevisan Claudia , de Noronha Marcos Amaral , Pereira Natalia Duarte , Borstad Alexandra , Russo Thiago Luiz
Published: May 2020

Background. Priming results in a type of implicit memory that prepares the brain for a more plastic response, thereby changing behavior. New evidence in neurorehabilitation points to the use of priming interventions to optimize functional gains of the upper extremity in poststroke individuals. Objective. To determine the effects of priming on task-oriented training on upper extremity outcomes (body function and activity) in chronic stroke. Methods. The PubMed, CINAHL, Web of Science, EMBASE, and PEDro databases were searched in October 2019. Outcome data were pooled into categories of measures considering the International Classification Functional (ICF) classifications of body function and activity. Means and standard deviations for each group were used to determine group effect sizes by calculating mean differences (MDs) and 95% confidence intervals via a fixed effects model. Heterogeneity among the included studies for each factor evaluated was measured using the I2 statistic. Results. Thirty-six studies with 814 patients undergoing various types of task-oriented training were included in the analysis. Of these studies, 17 were associated with stimulation priming, 12 with sensory priming, 4 with movement priming, and 3 with action observation priming. Stimulation priming showed moderate-quality evidence of body function. Only the Wolf Motor Function Test (time) in the activity domain showed low-quality evidence. However, gains in motor function and in use of extremity members were measured by the Fugl-Meyer Assessment (UE-FMA). Regarding sensory priming, we found moderate-quality evidence and effect size for UE-FMA, corresponding to the body function domain (MD 4.77, 95% CI 3.25-6.29, Z = 6.15, P < .0001), and for the Action Research Arm Test, corresponding to the activity domain (MD 7.47, 95% CI 4.52-10.42, Z = 4.96, P < .0001). Despite the low-quality evidence, we found an effect size (MD 8.64, 95% CI 10.85-16.43, Z = 2.17, P = .003) in movement priming. Evidence for action observation priming was inconclusive. Conclusion. Combining priming and task-oriented training for the upper extremities of chronic stroke patients can be a promising intervention strategy. Studies that identify which priming techniques combined with task-oriented training for upper extremity function in chronic stroke yield effective outcomes in each ICF domain are needed and may be beneficial for the recovery of upper extremities poststroke.
An Exploration of Precancer and Post-Cancer Diagnosis and Health Communication Among African American Prostate Cancer Survivors and Their Families
Authors: Dickey Sabrina L. , Matthews Caneisaya , Millender Eugenia
Published: May 2020

Prostate cancer is the second most common cancer among American men, with Black men at the highest risk for the disease. Few studies have been published on how communication between Black prostate cancer survivors and their family members affect health outcomes and subsequent health communication. The purpose of this study was to understand cancer and health communication among Black prostate cancer survivors and their families before and after disclosing their diagnosis. Through a mixed method design, 11 Black prostate cancer survivors participated from the Southeastern region of the United States, completed questionnaires, and took part in a focus group. The study utilized 4 focus groups of Black prostate cancer survivors ranging in age from 51 to 76 years. Descriptive statistics revealed 91% ( n = 10) of participants indicated they could openly discuss health issues in their family and 82% ( n = 9) indicated a female relative as the person responsible for teaching about health. An analysis of the transcripts revealed four themes utilizing thematic network: (a) communication over the life course of the prostate cancer survivor, (b) parents’ communication with family, (c) disclosing prostate cancer diagnosis, and (d) treatment options for prostate cancer. Results suggested the participants recognized the importance of discussing prostate cancer with their families to reduce fears and misconceptions about the disease. Through the exploration of cancer and health communication within Black families, solutions can be derived for increasing health behaviors and health knowledge among men.
More than a trivial pursuit: Public order policing narratives and the ‘social media test’
Authors: Ellis Justin R
Published: May 2020

Social media has transformed public discourse on policing and the contest of control over the police image. This article draws on original, empirical research to conceptualise the phenomenon of the ‘social media test’ – the evolution of social media into a legitimate measure of police performance. Through in-depth interviews with police and non-police respondents the article maps the genealogy of, and provides perspective on, one of the first viral cases of bystander video of police excessive force in Australia filmed and uploaded to YouTube. The study shows the video’s impact on hegemonic mainstream and police news media narratives, processes of criminalisation and police accountability and the merit of narrative criminology in unpacking these phenomena. Police alluding to the ‘social media test’ in in-depth interviews shows that digital media in general and social media in particular can no longer be dismissed as peripheral or subsidiary to public discourse on policing in a digital society.
Introduction to the special issue: Why the coronavirus crisis is also a crisis of leadership
Authors: Tourish Dennis
Published: May 2020

This editorial introduction argues that the coronavirus crisis is also a crisis of leadership theory and practice. Decision making is particularly hazardous when we have poor evidence to guide us and face unpredictable outcomes. Mainstream leadership theories are of little help, since an environment of radical uncertainty means that leaders have less information, expertise and resources to guide them than is often assumed. Undaunted, populist leaders exploit uncertainty to suggest that simple solutions will work. I suggest that the responses of such leaders have been characterised by incompetent leadership, denialist leadership, panic leadership, othering leadership and authoritarian leadership. I also consider the implications of the crisis for business leadership, suggesting that already strained relationships within organisations are likely to deteriorate still further. Critical leadership studies has an important contribution to make in challenging self-serving theories of business that have come to guide much leadership decision-making. We have an opportunity to do research that really matters, and participate in vital conversations about how the theory and practice of leadership can contribute to better outcomes from the coronavirus crisis, and others still to come.
Steroidal aromatase inhibitors have a more favorable effect on lipid profiles than nonsteroidal aromatase inhibitors in postmenopausal women with early breast cancer: a prospective cohort study
Authors: Wang Xue , Zhu Anjie , Wang Jiayu , Ma Fei , Liu Jing , Fan Ying , Luo Yang , Zhang Pin , Li Qing , Xu Binghe , Yuan Peng
Published: May 2020

Background:

Aromatase inhibitors (AIs) influence blood lipid profiles. However, relatively few studies have directly compared the treatment effects of steroidal and nonsteroidal AIs.

Methods:

A prospective single-center cohort study was conducted to investigate the effects of steroidal and nonsteroidal AIs on lipid profiles during the first 24 months of endocrine therapy in hormone receptor-positive postmenopausal patients with early breast cancer. The primary endpoint was the cumulative incidence of lipid events, while the secondary endpoints were changes in lipid profiles and lipid event-free survival.

Results:

Comparison of the lipid profiles of the two groups showed that triglycerides (TGs) and total cholesterol (TC) levels were significantly higher in the nonsteroidal AI group over 24 months ( p < 0.05), whereas low-density lipoprotein cholesterol (LDL-C) was significantly higher only at 3 months ( p = 0.017) and 6 months ( p = 0.026). High-density lipoprotein cholesterol (HDL-C) was significantly lower in the steroidal group at all time points ( p < 0.05), except at 18 months ( p = 0.085). The cumulative incidence of lipid events in the steroidal and nonsteroidal groups at 24 months was 25.3% and 37.0%, respectively. Multivariate analysis results indicated that TG, LDL-C, and steroidal AIs were independently associated with blood lipid events.

Conclusion:

This trial showed that a significantly higher cumulative incidence of lipid events occurred in the nonsteroidal AI group than in the steroidal AI group, which indicated that steroidal AIs exerted a protective effect against blood lipid events in postmenopausal women receiving an AI as adjuvant therapy for breast cancer.

ClinicalTrials.gov identifier:

NCT02765373
Is the era of sorafenib over? A review of the literature
Authors: Fan Guanghan , Wei Xuyong , Xu Xiao
Published: May 2020

Hepatocellular carcinoma (HCC) is one of the most severe diseases worldwide. For the different stages of HCC, there are different clinical treatment strategies, such as surgical therapy for the early stage, and transarterial chemoembolization (TACE) and selective internal radiation therapy (SIRT) for intermediate-stage disease. Systemic treatment, which uses mainly targeted drugs, is the standard therapy against advanced HCC. Sorafenib is an important first-line therapy for advanced HCC. As a classically effective drug, sorafenib can increase overall survival markedly. However, it still has room for improvement because of the heterogeneity of HCC and acquired resistance. Scientists have reported the acquired sorafenib resistance is associated with the anomalous expression of certain genes, most of which are also related with HCC onset and development. Combining sorafenib with inhibitors targeting these genes may be an effective treatment. Combined treatment may not only overcome drug resistance, but also inhibit the expression of carcinoma-related genes. This review focuses on the current status of sorafenib in advanced HCC, summarizes the inhibitors that can combine with sorafenib in the treatment against HCC, and provides the rationale for clinical trials of sorafenib in combination with other inhibitors in HCC. The era of sorafenib in the treatment of HCC is far from over, as long as we find better methods of medication.
Keeping a 2009 Design Award–Winning Intensive Care Unit Current: A 13-Year Case Study
Authors: Halpern Neil A. , Anderson Diana C.
Published: May 2020

In a complex medical center environment, the occupants of newly built or renovated spaces expect everything to “function almost perfectly” immediately upon occupancy and for years to come. However, the reality is usually quite different. The need to remediate initial design deficiencies or problems not noted with simulated workflows may occur. In our intensive care unit (ICU), we were very committed to both short-term and long-term enhancements to improve the built and technological environments in order to correct design flaws and modernize the space to extend its operational life way beyond a decade. In this case study, we present all the improvements and their background in our 20-bed, adult medical–surgical ICU. This ICU was the recipient of the Society of Critical Care Medicine’s 2009 ICU Design Award Citation. Our discussion addresses redesign and repurposing of ICU and support spaces to accommodate expanding clinical or entirely new programs, new regulations and mandates; upgrading of new technologies and informatics platforms; introducing new design initiatives; and addressing wear and tear and gaps in security and disaster management. These initiatives were all implemented while our ICU remained fully operational. Proposals that could not be implemented are also discussed. We believe this case study describing our experiences and real-life approaches to analyzing and solving challenges in a dynamic environment may offer great value to architects, designers, critical care providers, and hospital administrators whether they are involved in initial ICU design or participate in long-term ICU redesign or modernization.
Untreated Stroke as Collateral Damage of COVID-19: “Time Is Brain” Versus “Stay at Home”
Authors: Rose David Z. , Burgin W. Scott , Renati Swetha
Published: May 2020

For decades, neurologists have been advocating that anyone with acute focal deficits report immediately to the closest hospital’s emergency room. Major advancements in the hyperacute diagnosis and treatment of stroke have justified our call-to-action slogan of “Time is Brain”—faster therapy leads to superior outcomes. However, this mantra has been recently usurped by the catchphrase “Stay at Home” during the coronavirus disease 2019 (COVID-19) pandemic. Fewer patients are presenting to hospitals with acute stroke; our census is down. Presumably the etiology of this phenomenon is either strict “social distancing” that some people may misperceive to exclude even emergent situations, or fears of contracting the virus while hospitalized. In this Short Report, we describe the year-over-year drop in stroke volume (ischemic and hemorrhagic both) coinciding with a paradoxical rise in acute reperfusion therapies at our university hospital. These data imply that stroke patients with mild/moderate symptoms are most likely staying home, and not receiving urgent therapies, and correspondingly, only the most severely disabled stroke patients are ultimately seeking and receiving help. We must remind our patients and the general public that our services are essential and available, as stroke still remains a medical emergency, and carries a likely higher overall mortality risk than COVID-19. As neurologists, we also must be vigilant for the atypical presentations and varied etiologies of stroke associated with COVID-19 as well.
Variation in the use of pulmonary vasodilators in children and adolescents with pulmonary hypertension: a study using data from the MarketScan® insurance claims database
Authors: O'Byrne Michael L. , Faerber Jennifer A. , Katcoff Hannah , Frank David B. , Davidson Alex , Giglia Therese M. , Avitabile Catherine M.
Published: May 2020

Despite progress in pharmacotherapy in pediatric pulmonary hypertension, real‐world patterns of directed pulmonary hypertension therapy have not been studied in the current era. A retrospective observational study of children (≤18 years) with pulmonary hypertension was performed using data from the MarketScan® Commercial and Medicaid claims databases. Associations between etiology of pulmonary hypertension and pharmaceutical regimen were evaluated, as were the associations between subject social and geographic characteristics (insurance‐type, race, and/or census region) and regimen. Annualized costs of single‐ and multi‐class regimens were calculated. In total, 873 subjects were studied, of which 94% received phosphodiesterase‐5 inhibitors, 31% endothelin receptor antagonist, 9% prostacyclin analogs, and 7% calcium channel blockers. Monotherapy was used in 72% of subjects. Phosphodiesterase‐5 inhibitors monotherapy was the most common regimen (93%). Subjects with idiopathic pulmonary hypertension, congenital heart disease, and unclassified pulmonary hypertension receive more than one agent and were more likely to receive both endothelin receptor antagonist and prostacyclin analogs than other forms of pulmonary hypertension. Compared to recipients of public insurance, subjects with commercial insurance were more likely to receive more intense therapy (p = 0.003), which was confirmed in multivariable analysis (OR: 1.4, p = 0.03). Receipt of commercial insurance was also associated with increased annual costs across all subjects (p < 0.001) and for the most common specific regimens. The majority of children with pulmonary hypertension receive phosphodiesterase monotherapy, followed by phosphodiesterase–endothelin receptor antagonist two drug regimens, and finally the addition of prostacyclin analogs for three‐drug therapy. However, even after adjustment for measurable confounders, commercial insurance was associated with higher intensity care and higher costs (even within specific classes of pulmonary vasodilators). The effect of these associations on clinical outcome cannot be discerned from the current data set, but patterns of treatment deserve further attention.
Pulmonary hypertension with adult respiratory distress syndrome: prevalence, clinical impact, and association with central venous pressure
Authors: Li Dong‐Kai , Mao Jia‐Yu , Long Yun , Liu Da‐Wei , Wang Xiao‐Ting
Published: May 2020

Pulmonary hypertension (PH) occurs in patients with acute respiratory distress syndrome (ARDS); the most severe form comprises acute cor pulmonale (ACP). Here, we investigated the prevalence of PH in patients with ARDS to evaluate its correlation with ACP risk, ARDS severity and central venous pressure (CVP). We conducted a secondary analysis using data from the MIMIC‐III open‐source clinical database. The prevalence of PH associated with new‐onset ARDS during the first 72 h after intensive care unit admission was investigated; moreover, the association between ACP risk score and PH was validated. We also evaluated the association between elevated CVP (mean CVP > 10 mmHg) and PH and other clinical outcomes. Among 2434 patients who met the ARDS Berlin criteria and underwent echocardiography or pulmonary artery catheterization evaluation, a total of 583 (24.0%) patients were diagnosed with moderate or severe PH, of which 418 had low and 165 had high ACP risk. After adjustment for disease/ARDS severity, ACP risk score, and other demographic variables, elevated CVP was independently associated with the occurrence of PH (odds ratio, 2.239 (1.674, 2.993), p < 0.005). Among patients with PH, higher mean CVP was associated with prolonged hospital stay (13.4 vs. 15.2 days, p = 0.041) and duration of ventilation (116.5 vs. 150.5 h, p = 0.023). Incidence of PH was 24.0% in patients with new‐onset ARDS in this retrospective study. Elevated CVP is relevant with higher incidence of PH and worse clinical outcome; these highlighted the importance of hemodynamic monitoring in the management of ARDS.
The association of diabetes and admission blood glucose with 30-day mortality in patients with acute myocardial infarction complicated by cardiogenic shock
Authors: Thoegersen Michael , Josiassen Jakob , Helgestad Ole KL , Berg Ravn Hanne , Schmidt Henrik , Holmvang Lene , Jensen Lisette Okkels , Møller Jacob Eller , Hassager Christian
Published: May 2020

Background

Cardiogenic shock is the leading cause of death in patients with acute myocardial infarction, with short-term mortality of approximately 50%. Whether diabetes mellitus and high blood glucose levels are associated with mortality in contemporary patients with acute myocardial infarction complicated by cardiogenic shock is inadequately described.

Purpose

To investigate if diabetes mellitus and high admission blood glucose were associated with 30-day mortality in a large, contemporary population with acute myocardial infarction complicated by cardiogenic shock.

Methods

Patients with acute myocardial infarction complicated by cardiogenic shock admitted at two tertiary centres in Denmark from 2010 to 2017 were individually identified through patient charts, resulting in the inclusion of 1716 cardiogenic shock patients. Glucose level at admission to the intensive care unit was available in 1302 patients.

Results

There was no significant difference in 30-day mortality between diabetes mellitus types I and II (63% vs. 62%, NS). Thirty-day mortality was significantly higher in diabetes patients compared to non-diabetes patients (62% vs. 50%, P < 0.001). Increasing admission glucose was associated with increasing 30-day mortality in a dose-dependent manner in diabetes mellitus (4–8 mmol/L, 41%; 8–12 mmol/L, 49%; 12–16 mmol/L, 63%; >16 mmol/L, 67%; P = 0.028) and non-diabetes patients (4–8 mmol/L, 32%; 8–12 mmol/L, 43%; 12–16 mmol/L, 57%; >16 mmol/l; 68%; P < 0.001).

Conclusion

Patients with acute myocardial infarction complicated by cardiogenic shock and concomitant diabetes mellitus type I or II had a significantly higher 30-day mortality in comparison to patients without diabetes mellitus, whereas no difference was found between diabetes mellitus types I and II. High glucose levels on admission to the intensive care unit were associated with increased 30-day mortality in diabetes mellitus and non-diabetes mellitus patients.
Lost in Transition: Pharmacist Roles in Identifying and Evaluating Medication-Related Problems During Hospital Discharge Follow-up Visits in a Primary Care Setting
Authors: Dellogono Alexis , Dawson Aimee , Piers-Gamble Marisa , Varghese Jerril , Lewicki Lori
Published: May 2020

Objectives: The objective of this study was to identify and evaluate medication-related problems (MRPs) found during hospital discharge transitions of care visits in a primary care setting. Design, Settings, and Participants: This retrospective cohort took place within a federally qualified health center (FQHC) where pharmacists are part of the interprofessional transitions of care team to help patients transition back to primary care after being discharged from the hospital. Pharmacists utilized standardized forms to document MRPs, potential and adverse drug events, and interventions made during the visit. This study quantifies the role that pharmacists can have by conducting medication reconciliation during postdischarge primary care visits. Patients included in this study were 18 years and older with at least 5 medications. Outcome Measures: The outcomes of this study include the number and type(s) of MRPs, number and severity of potential adverse drug events (pADEs) and adverse drug events (ADEs) that were identified, as well as the number and type of recommendations or interventions made by the pharmacist. The MRP types and pADE/ADE severity were classified and stratified using predetermined definitions. Results: During the 4-month study period from October 1, 2018 to February 4, 2019, 134 visits were completed. Outcomes included a total of 454 MRPs, with an average of 3 identified per visit. The most common MRPs were medication list in electronic health record inaccurate (79.1% of visits), poor adherence (32.1% of visits), and refills needed (30.6% of visits). A total of 72 pADEs and 27 ADEs were identified, with 524 recommendations made. Conclusion: Pharmacists serve a unique role during transitions of care by identifying MRPs. Pharmacists are an integral part of a patient’s health care team by making recommendations or interventions related to these MRPs. FQHCs and other primary care settings should consider integrating pharmacists into a collaborative transitions of care team.
Implementation of a Personalized Care Plan for Patients With Type 2 Diabetes Is Associated With Improvements in Clinical Outcomes: An Observational Real-World Study
Authors: Vuohijoki Anni , Mikkola Ilona , Jokelainen Jari , Keinänen-Kiukaanniemi Sirkka , Winell Klas , Frittitta Lucia , Timonen Markku , Hagnäs Maria
Published: May 2020

Objective: To analyze the clinical outcomes of patients with type 2 diabetes (T2D) before and after implementation of a personalized care plan in the primary health care setting. Design: Observational, retrospective, real-world study. Setting: All T2D patients with a care plan in Rovaniemi Health Center, Rovaniemi, Finland, for whom data were available from a baseline visit (in 2013-2015 during which the care plan was written) and from a follow-up visit, including an updated care plan by the year 2017. Subjects: In total, 447 patients were included. Mean age was 66.9 (SD 10.1) years, 58.8% were male, 15.4% were smokers, 33.1% had vascular disease, and 17.0% were receiving insulin treatment. The mean follow-up time was 14.4 months. Main Outcome Measures: Glycosylated hemoglobin A1 (HbA1c), low-density lipoprotein (LDL), blood pressure (BP), and body mass index (BMI). Clinical values were taken at both baseline and follow-up. Results: LDL decreased by 0.2 mmol/L, systolic blood pressure by 2.2 mm Hg, diastolic blood pressure by 1.5 mm Hg, and BMI by 0.5 kg/m2 ( P < .05 for each). The decrease in HbA1c was 0.8 mmol/mol ( P = .07). Conclusion: We observed statistically significant decreases in LDL, BP, and BMI. Our results indicate that, over 14 months of follow-up, implementation of a written care plan was associated with small improvements in the clinical outcomes of T2D patients in a primary health care study population in a real-world setting.
Evaluation of Pharmacy Model in a Trial of Free Essential Medicine Access
Authors: Ally Muhamad Z. , Persaud Nav , Umali Norman
Published: May 2020

Background: In Canada, pharmacists accessing electronic health records (EHR) and mailing medications to patients are relatively uncommon. We evaluated a pharmacy model implemented in a clinical trial that combined allowing the pharmacist access to patients’ EHR and mailing medications to participants. Methods: We conducted thematic analysis of comments made by participants and prescribers, and chart stimulated recalls with the pharmacist involved with the novel pharmacy model implemented in a clinical trial. Results: Major themes from participant’s comments related to the ease of obtaining information about medications from the pharmacy and satisfaction with the delivery. Prescribers felt that this model facilitated collaboration with the pharmacist and welcomed suggestions regarding therapeutic medication changes. Major themes from the pharmacist’s chart stimulated recalls were that access to participants’ EHRs allowed for improved drug therapy management and participant experience, and this pharmacy model increased participant’s access to pharmacy services. Discussion: According to the pharmacist and prescribers, this pharmacy model facilitated their collaboration in prescribing appropriate medications and participants were generally satisfied with the delivery of medications. Conclusion: Participants and prescribers were generally supportive of a pharmacy model that combined allowing the pharmacist access to participants’ EHR and medication mailing. This allowed the pharmacist more opportunities for drug therapy management and collaboration with prescribers. It also improved the participant’s access to pharmacy services, although those services were not always fully utilized.
Philosophical Problems With the Gender-Critical Feminist Argument Against Trans Inclusion
Authors: Zanghellini Aleardo
Published: May 2020

The Reform of the Gender Recognition Act: Government Consultation (2018) catalyzed a heated debate on transgender rights and trans inclusion in the United Kingdom. I start by explaining what the reforms to the U.K. system of gender recognition propose, why gender-critical feminists oppose them, and how other feminist academics have responded to their arguments. I then offer a more detailed philosophical critique of gender-critical trans-exclusionary feminist arguments. I argue that the gender-critical feminist case against trans women’s access to women-only (or sex-segregated, or single-sex) spaces suffers from a number of fallacies, and introduces modes of argument that are at odds with well-established and sound uses of practical reason. I try to make sense of these problems with gender-critical feminist thought by appealing to the idea of presupposed paranoid structuralism. I also argue that gender-critical feminists’ enthusiastic use of social media and allied online platforms may be implicated in generating some of these problems.
Analysis of Innovation Performance for Retail Banking Industry With the Hybrid Fuzzy Decision-Making Approach
Authors: Wang Shubin , Liu Qilei , Dinçer Hasan , Yüksel Serhat
Published: May 2020

This study aims to evaluate the innovation performance of the Turkish banking industry. For this purpose, eight different financial and nonfinancial criteria are identified as a result of literature review. Moreover, five biggest Turkish deposit banks are selected as alternatives. Interval type 2 fuzzy decision-making trial and evaluation laboratory (IT2 FDEMATEL) is taken into account to weight the dimensions. On the other side, to rank the alternatives, interval type 2 fuzzy Vise Kriterijumska Optimizacija I Kompromisno Resenje (IT2 FVIKOR) approach is considered. The findings show that market share and return on investment are the most important factors in the innovation performance of retail banking services. This situation gives information that the when banks are more successful in the market, they can make investment to the innovation more effectively. The main reason is that these banks have enough capacity to make this kind of investments. Thus, it is recommended that Turkish banks should first make an efficiency analysis to increase their profit margin so that their capacities can be improved. For this purpose, many different factors should be taken into account by Turkish banks, such as personnel competency and technological development. Within this scope, these banks should make financial analysis of the innovation effectively by generating a qualified team. However, necessary research and development activities should be conducted to reach this objective. Hence, it can be possible to minimize ineffective innovation for the banks.
The Elusive Understanding of Lyme Disease in Non-Endemic Geographic Areas: An Exploratory Survey of Patients With Chronic Symptoms in Texas
Authors: Maxwell Sarah P
Published: May 2020

This study was designed to determine the quality of life, diagnostic, and illness-related experiences of patients who self-report a diagnosis with Lyme disease (LD) and/or who are experiencing chronic illness in Texas, a state considered non-endemic for tick-borne illness. This exploratory study found that self-reported LD respondents have multisystem health problems that result in very poor quality of life. Lyme disease respondents experience multiple and severe symptoms, particularly flu-like illness, extreme fatigue, back and neck pain, and anxiety and depression. These symptoms were present at similar levels among all LD respondents, whether their diagnosis was clinical or serological. For all LD respondents, this study points to quality of life experiences that are powerfully negative. Practitioners and disease surveillance experts may consider LD when multisystem symptoms are severe, other etiologies are ruled out, and quality of life is threatened.
Safety and immunogenicity of a seasonal trivalent inactivated split influenza vaccine: a double blind, phase III randomized clinical trial in healthy Serbian adults
Authors: Stevanovic Goran , Obradovic Aleksandar , Ristic Snezana , Petrovic Dragan , Milenkovic Branislava , Mitrovic Danilo , Vignjevic Svetlana Filipovic , Ilic Katarina , Stoiljkovic Vera , Lavadinovic Lidija , Pelemis Mijomir , Petrovic Svetlana , Vidmanic Ana , Popovic Olga , Eremic Natasa , Sparrow Erin , Torelli Guido , Socquet Muriel , Holt Renée , Ilieva-Borisova Yordanka , Tang Yuxiao , Scorza Francesco Berlanda , Flores Jorge , Rathi Niraj
Published: May 2020

This study was a phase III, multicenter, double-blind, randomized, placebo-controlled trial to evaluate the safety and immunogenicity of a seasonal trivalent split, inactivated influenza vaccine (TIV) in healthy Serbian adults between the ages of 18 and 65 years. This egg-based vaccine was manufactured by the Institute of Virology, Vaccines and Sera, Torlak, Belgrade, Serbia. A total of 480 participants were assigned randomly in a ratio of 2:1 to receive a single intramuscular dose (0.5 ml) of the vaccine (15 µg of hemagglutinin per strain) or placebo (phosphate-buffered saline). Participants were monitored for safety, including solicited and unsolicited adverse events (AEs) and serious adverse events (SAEs). No SAEs related to vaccination were reported. Injection site pain (51.3%), injection site tenderness (40.4%), tiredness (17.0%), and headache (15.1%) were the most commonly reported solicited events in the vaccine group. Incidence of related unsolicited AEs was low (1.3%) among vaccinees. Hemagglutinin inhibition (HAI) titers were measured before and 21 days after vaccination in 151 participants. Overall, HAI seroconversion rates to H1 and H3 were observed in 90.1% and 76.2% of vaccinees, respectively. For B antigen, it was 51.5%, likely due to high pre-vaccination titers. Post-vaccination seroprotection rates were in the range of 78.2–95.0% for the three antigens. Post-vaccination geometric mean titers (GMT) were at least 3.8 times higher than baseline levels for all the three strains among vaccinees. Overall, the study showed that the vaccine was safe and well tolerated, and induced a robust immune response against all three vaccine strains.

ClinicalTrials.gov identifier: NCT02935192, October 17, 2016
In vivo optical biopsy of choroidal osteoma: a swept source optical coherence tomography–based tumor characterization
Authors: Azad Shorya Vardhan , Kumar Vinod , Chawla Rohan , Kashyap Bibhuti , Temkar Shreyas , Kumar Atul , Venkatesh Pradeep , Vohra Rajpal , Molla Kabiruddin , Sharma Anu
Published: May 2020

Objective:

To study tumor characteristics of choroidal osteoma by swept source optical coherence tomography.

Methods:

A retrospective case series done at tertiary referral center in northern India. All patients diagnosed with choroidal osteoma examined on swept source optical coherence tomography were included. Swept source optical coherence tomography images were analyzed for integrity of retinal layers—intraretinal layers, outer retinal layers (photoreceptor), retinal pigment epithelium, and contour abnormalities. Choroidal changes assessed were tumor attributes such as shape, depth of choroidal involvement, tumor mass reflectivity pattern, tumor vascularity, and evolutionary structural abnormalities such as deossification, focal depressions, or choroidal neovascular membrane.

Results:

A total of 15 eyes of 11 patients were analyzed. Seven of 11 patients were females. Mean age of presentation was approximately 26 years. Tumor was large in nine cases (>7.5 mm). Deossification was seen in 12 eyes. Inner and outer retinal integrity was maintained in 7 and 2 eyes, respectively. Most common internal tumor reflectivity pattern seen was a lamellar appearance (12/15). Increased signal transmission to choroid and focal area of deep excavation was present in 11 and 4 eyes, respectively. Osteoclastic activity was noted in 12 eyes. Choroidal neovascular membrane was seen in 6 eyes. Small lesions showed lamellar pattern of tumor reflectivity with preservation of retinal pigment epithelium and overlying retina. Larger tumors were deossified with 6 irregular tumor contour, disorganization of the outer retina, increased signal transmission to choroid, and areas of osteoclastic activity.

Conclusion:

Swept source optical coherence tomography was helpful in assessing tumor attributes and predicting the different timelines in tumor evolution.
Evaluating second-order effects in rigid wall-flexible roof diaphragm buildings
Authors: Lawson John , Koliou Maria
Published: May 2020

When evaluating seismically induced second-order effects in buildings, engineers and researchers are most familiar with these concerns in the context of multistory buildings with rigid diaphragms. However, similar concerns are valid for short single-story concrete or masonry-walled buildings with larger flexible diaphragms, which is a significant portion of the building stock in the United States. These rigid wall-flexible diaphragm (RWFD) buildings may have significant diaphragm drifts causing induced second-order effects. The stability coefficient currently found in ASCE 7 has traditionally been used by practitioners to evaluate the relative risk of P-delta instability in multistory buildings, but this indicator can be adapted for use in RWFD buildings. Using numerical studies following the Federal Emergency Management Agency (FEMA) P-695 collapse assessment methodology to evaluate the risk of collapse for a set of RWFD archetype buildings, a modified stability coefficient for RWFD buildings is found to capture the trend toward P-delta collapse and can act as a reasonable indicator without the need for heavy computational efforts.
Paediatric cohort studies on lower respiratory diseases and their reporting quality: systematic review of the year 2018
Authors: Ardura-Garcia Cristina , Mozun Rebeca , Pedersen Eva S.L. , Otth Maria , Mallet Maria Christina , Goutaki Myrofora , Kuehni Claudia E.
Published: May 2020

The paediatric respiratory research community uses cohort studies extensively. However, the landscape of these studies and their quality of reporting has not been assessed.

We performed a systematic review of publications on cohort studies reporting on paediatric lower respiratory problems published in 2018. We searched MEDLINE and Embase and extracted data on study and journal characteristics. We assessed the number of items of the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) checklist that a random sample (100 papers) reported. We analysed factors associated with the STROBE score and with the most poorly reported items, using Poisson and logistic regression.

Of the 21 319 records identified, 369 full-text articles met our inclusion criteria. Most papers studied asthma aetiology through birth cohorts and were based in Europe or North America. The reporting quality was insufficient: 15% reported the 22 STROBE items; median (interquartile range) score 18 (16–21). The most poorly reported items were sources of bias, sample size, statistical methods, descriptive results and generalisability. None of the study or journal factors were associated with the STROBE score.

We need a joint effort of editors, reviewers and authors to improve the reporting quality of paediatric cohort studies on respiratory problems.
A helper-dependent adenoviral vector rescues CFTR to wild-type functional levels in cystic fibrosis epithelial cells harbouring class I mutations
Authors: Cao Huibi , Ouyang Hong , Laselva Onofrio , Bartlett Claire , Zhou Zhichang Peter , Duan Cathleen , Gunawardena Tarini , Avolio Julie , Bear Christine E. , Gonska Tanja , Hu Jim , Moraes Theo J.
Published: May 2020

Cystic fibrosis (CF) is a genetic disorder affecting multiple organs, including the pancreas, hepatobiliary system and reproductive organs; however, lung disease is responsible for the majority of morbidity and mortality. Management of CF involves CF transmembrane conductance regulator (CFTR) modulator agents including corrector drugs to augment cellular trafficking of mutant CFTR as well as potentiators that open defective CFTR channels. These therapies are poised to help most individuals with CF, with the notable exception of individuals with class I mutations where full-length CFTR protein is not produced. For these mutations, gene replacement has been suggested as a potential solution.

In this work, we used a helper-dependent adenoviral vector (HD-CFTR) to express CFTR in nasal epithelial cell cultures derived from CF subjects with class I CFTR mutations.

CFTR function was significantly restored in CF cells by HD-CFTR and reached healthy control functional levels as detected by Ussing chamber and membrane potential (FLIPR) assay. A dose–response relationship was observed between the amount of vector used and subsequent functional outcomes; small amounts of HD-CFTR were sufficient to correct CFTR function. At higher doses, HD-CFTR did not increase CFTR function in healthy control cells above baseline values. This latter observation allowed us to use this vector to benchmarkin vitroefficacy testing of CFTR-modulator drugs.

In summary, we demonstrate the potential for HD-CFTR to informin vitrotesting and to restore CFTR function to healthy control levels in airway cells with class I or CFTR nonsense mutations.
Persistence of chronic cough in a community-based population
Authors: Lätti Anne M. , Pekkanen Juha , Koskela Heikki O.
Published: May 2020

Chronic cough causes significant impairment in the quality of life and is often immune to treatment. Previous studies about its persistence have focused on patients managed in special cough clinics. Little is known about the persistence of chronic cough in unselected populations. In this prospective follow-up study, we investigated factors that predict the persistence of cough at 12-month follow-up in a community-based study of subjects with chronic cough.

The first e-mail survey in 2017 included a questionnaire about current cough and its risk factors. The 264 subjects who reported chronic cough were sent a follow-up questionnaire 12 months later.

The response rate was 77.7% (205 subjects), of whom 165 subjects (80.5%) still had cough in 2018. In multivariate analysis, the following baseline factors predicted the persistence of cough at 12 months; gastro-oesophageal reflux disease (adjusted OR (aOR) 5.02 (95% CI 1.10–22.83)), presence of a chemical trigger (aOR 2.88 (95% CI (1.20–7.00)), duration of cough more than 1 year (aOR 2.80 (95% CI 1.27–6.22)), frequent somatic symptoms (aOR 1.31 (95% CI 1.07–1.59)), and low number of family members (aOR 0.71 (95% CI 0.52–0.98)).

In conclusion, most patients with chronic cough still suffer from cough 1 year later. The presence of gastro-oesophageal reflux disease is the main predictor for the persistence of cough.
The role of interleukin-17 in asthma: a protective response?
Authors: Hynes Gareth M. , Hinks Timothy S.C.
Published: May 2020

While there now exist effective treatments for type 2 high, eosinophilic asthma, there are no specific therapies for 40–50% of people with asthma with other phenotypes, which result from poorly understood underlying pathological mechanisms. One such pathology is neutrophilic inflammation, which has been associated with interleukin (IL)-17 family cytokines. Human genetic studies identified IL-17 polymorphisms associated with asthma; in murine models of allergic airways disease, IL-17A contributes to airway hyperresponsiveness, and in humans, elevated airway IL-17A levels are repeatedly observed in severe asthma. However, the directionality of this association is unknown, and the assumption that IL-17 cytokines drive disease pathology remains speculative. Here, we explore the evidence underlying the relationship between IL-17 and asthma, we review lessons learned from investigating IL-17 in other inflammatory diseases, and discuss the possibility that IL-17 may even be protective in asthma rather than pathogenic. We also critically examine the newly proposed paradigm of a reciprocal relationship between type 2 and type 17 airways inflammation. In summary, we suggest an association between IL-17 and asthma, but research is needed examining the diverse functions of these cytokines, their longitudinal stability, their response to clinical interventions, and for mechanistic studies determining whether they are protective or pathogenic.