bluuebunny/crossref_metadata_2025 huggingface dataset:
Insights into the use of social comparisons within an advanced cancer setting
Authors: Starkings Rachel , Jenkins Valerie , Shilling Valerie
Published: November 2020

Background:

The PROACT (Patient Reported Outcomes in cancer, impact of Age and Carer role demands associated with Treatment) study had the primary aim of developing 2 scales measuring the impact of cancer on wellbeing and caregiving responsibilities, for people with cancer and the individuals supporting them. The project consisted of 4 consecutive studies; the first stage was the collection of qualitative narratives to understand the patient/caregiver experience. This article reports on an incidental finding from these narratives.

Methods:

The researchers conducted semistructured interviews exploring participants’ views on the impact cancer had on their quality of life. They interviewed 24 people with stage III/IV cancer from 3 tumor groups, lung (n = 6), melanoma (n = 9), and ovarian (n = 9), and 23 informal caregivers. Interviews were recorded and transcribed verbatim and a framework was developed through open coding. A framework approach to thematic analysis was employed.

Results:

Twenty themes and 33 subthemes were identified including topics such as impact for caregiving and employment. There was an unplanned finding of participants recurrently using concepts of “luck” or good fortune when describing their situations. Although not a theme itself, this narrative was present across the framework, occurring when individuals made comparisons to “other” groups of people perceived as facing more difficulties.

Conclusions:

This analysis provides insight into the use of language by both patients and informal caregivers in the advanced disease setting, laying the foundation for future research exploring any effects this has on dyadic wellbeing. These interpretations form a basis to explore whether this language can be harnessed by healthcare professionals to deliver information in line with an individual's conceptualization of their situation.
Relationship intimacy processes during treatment for couple-focused interventions for prostate cancer patients and their spouses
Authors: Manne Sharon L. , Kashy Deborah A. , Kissane David , Zaider Talia , Heckman Carolyn J. , Penedo Frank J. , Myers Shannon
Published: November 2020

Objective:

In a previously published trial, we compared the effect of an intimacy-enhancing therapy (IET) and a General Health and Wellness intervention (GHW) on psychological and relationship outcomes among men diagnosed with localized prostate cancer and their partners. Results suggested partial effects of IET on psychological adjustment and relationship satisfaction. To understand these partial effects, the first aim of this study was to evaluate self-disclosure, perceived partner disclosure, perceived partner responsiveness, and levels of intimacy rated after sessions, and the second aim of this study was to examine the role of pre-treatment holding back on these intimacy processes.

Methods:

A total of 156 couples who participated in treatment reported on self- and perceived partner disclosure, responsiveness, and intimacy during sessions. Participants rated levels of holding back before treatment. Linear growth models were estimated using multilevel modeling. Each intimacy process variable was predicted to be a function of time, role, condition, and all interactions among these variables. The effects of own and partner pretreatment holding back on average intimacy process and change in intimacy process were tested in moderated growth models.

Results:

Self- and perceived partner disclosure were significantly higher during IET sessions than GHW sessions. Self-disclosure, perceived partner disclosure, and perceived partner responsiveness increased in both IET and GHW. Intimacy was not higher and did not increase more in IET compared with GHW. Participants who held back reported that their partner disclosed less to them during sessions, perceived that their partner was less responsive to them during sessions, and reported less intimacy during sessions. Partners of participants who held back were seen as less responsive and their interactions were seen as less intimate.

Conclusions:

Although IET focused on enhancing couples’ responsiveness and intimacy, it did not have a stronger effect on these processes during sessions than GHW. The lack of an effect may, in part, be because of the fact that IET did not help those couples who may have been in the greatest need for it because they held back more.
Building the capacity for psycho-Oncology research: a survey of the research barriers and training needs within the International Psycho-Oncology Society
Authors: Lambert Sylvie D. , Coumoundouros Chelsea , Hulbert-Williams Nick J. , Shaw Joanne , Schaffler Jamie
Published: November 2020

Background:

The International Psycho-Oncology Society (IPOS) is a multidisciplinary professional network that aims to improve psychosocial care for individuals impacted by cancer. IPOS encourages research activity, recognizing that a high-quality evidence base is essential to provide best-practice, data-driven clinical care. This study aimed to determine the barriers to research involvement and the training needs and priorities of IPOS members, with the goal of facilitating the development of training resources tailored to the needs of IPOS members.

Methods:

A link to an online, cross-sectional survey was disseminated to all registered members of IPOS via email. The online survey platform SimpleSurvey was used, and questions included demographic characteristics and items related to research interests, involvement, and training needs. High priority research training needs were identified as research tasks respondents rated as highly important, yet possessed a low perceived skill level in.

Results:

Thirty-two percent of IPOS members (n = 142) completed the survey. Participants represented 49 countries and were at a variety of career stages. Overall, participants reported spending an average of 17.3 hours per week on research (range 0–80 hours per week), with 69% of respondents wanting to increase their research involvement. The main barriers to research participation included lack of research funding (80%) and lack of protected time (63%). IPOS members identified 5 high-priority training needs: preparing successful grant applications; preparing research budgets; community-based participatory research; working with decision makers; and finding collaborators or expert consultants. Participants suggested funding access, statistical advisors, and networking and mentorship opportunities as ways to enhance research involvement. Members preferred online training modules (39%) and mentorship programs (19%) as methods by which IPOS could provide research support. IPOS was viewed as being able to contribute to many aspects of research capacity building such as networking, training, and dissemination of research findings.

Conclusions:

IPOS has an important role in encouraging research capacity building among members. This survey provides an agenda for workshops and training opportunities. Mainly, for respondents it was less about training in research methods and more about training in how to prepare successful grant applications, including budgets, and receiving mentorship on this as well as having opportunities to collaborate with other researchers.
Post-traumatic stress in parents of long-term childhood cancer survivors compared to parents of the Swiss general population
Authors: Baenziger Julia , Roser Katharina , Mader Luzius , Harju Erika , Ansari Marc , Waespe Nicolas , Scheinemann Katrin , Michel Gisela
Published: November 2020

Background:

We describe post-traumatic stress symptoms (PTSS) and post-traumatic stress disorder (PTSD) in parents of long-term childhood cancer survivors (CCS-parents) and compare them to parents of similar-aged children (comparison-parents) of the Swiss general population (SGP). We compare type of reported stressful event, prevalence of PTSS and PTSD, and psychosocial and cancer-related characteristics associated with PTSS. We further describe the respective normative data for the SGP.

Methods:

We conducted a nationwide cross-sectional questionnaire survey in a population-based sample of long-term CCS-parents (survivors aged ≤16 years at diagnosis, ≥20 years at study, >5 years post-diagnosis) and in the SGP. Using the Impact of Event Scale-Revised, we measured PTSS regarding the most stressful event experienced, and computed probable cases of PTSD.

Results:

Participants included 663 CCS-parents (39.4% fathers) and 1035 individuals of the SGP (40.0% male), of which we identified 391 comparison-parents (41.2% fathers). Illness was most often indicated as stressful event (CCS-parents: 49.5%, comparison-parents: 27.6%, SGP: 25.3%). Prevalence of PTSS and PTSD (CCS-parents: 4.8%, comparison-parents: 6.7%, SGP: 5.6%) did not significantly differ. Lower education was associated with higher intrusion, avoidance, and hyperarousal in all samples (all P ≤ .003). Parents of children with a chronic illness reported higher intrusion (all P ≤ .004). We found no associations with cancer-related characteristics.

Conclusions:

No increased risk for PTSS or PTSD was found among CCS-parents. Individuals with lower education and those with a chronically ill child might benefit from additional support to help manage and resolve the stress symptoms in the long term.
Single cases from multiple perspectives: a qualitative study comparing the experiences of patients, patients’ caregivers, surgeons, and nurses when bad news is delivered about cancer
Authors: Matthews Tamyra , Baken Donald , Ross Kirsty
Published: November 2020

Background:

Qualitative literature on the experiences of those delivering and receiving bad news about cancer has revealed what these parties consider important during the process across many different patient cases. The current study aims to add to this understanding by employing a “linked case" study design to directly compare the perspectives of patients, their caregivers, and health care professionals (HCPs) involved in a series of single-patient cases of breaking bad news.

Method:

Semistructured interviews were conducted with 13 participants (5 patients, 4 caregivers, 2 surgeons, and 2 nurses) who formed 5 linked cases. Interviews were analyzed using interpretative phenomenological analysis and directly compared within each linked case.

Results:

Analyses identified 2 main superordinate themes. The first labeled “accurately perceiving and responding to needs," included HCPs recognizing and responding to patients’ and caregivers’ individual emotional and informational needs. The second labeled “carers fulfilling necessary roles," identified the various roles HCPs and patients’ caregivers took to satisfactorily meet patients’ needs.

Conclusions:

The findings suggest the importance of HCPs accurately perceiving and responding to patients’ and caregivers’ various needs and caregivers ability and willingness to fulfilling support roles in a way that aligns with their own resources and patients’ needs. This highlights the value of HCPs developing and applying interpersonal skills within bad news encounters, working as a team, and exploring caregivers’ resources for patient support.
Cytokine Panels and Pediatric Acute Respiratory Distress Syndrome: A Translational Investigation*
Authors: McKeone Daniel J. , Mathewson Margaret , Dalal Priti G. , Spear Debbie , Umstead Todd M. , Hicks Steven D. , Chroneos Zissis C. , Wang Ming , Thomas Neal J. , Halstead E. Scott
Published: November 2020

Objectives:

To identify and compare serum and lower respiratory tract fluid biomarkers of lung injury using well-characterized mouse models of lung injury. To explore the relationship between these preclinical biomarkers and clinical outcomes in a discovery cohort of pediatric patients with acute respiratory failure from pneumonia.

Design:

Prospective, observational cohort study.

Setting:

A basic science laboratory and the PICU of a tertiary-care children’s hospital.

Patients:

PICU patients intubated for respiratory failure from a suspected respiratory infection.

Interventions:

Prospective enrollment and collection of lower respiratory tract fluid samples.

Measurements and Main Results:

C57BL6/J mice were intranasally inoculated with escalating doses of influenza A virus or toll-like receptor agonists to simulate varying degrees of lung injury. Serum and bronchoalveolar lavage fluid were measured for the presence of cytokines using commercially available multiplex cytokine assays. Elevated levels of C-C motif chemokine ligand 7 at the peak of inflammation in both bronchoalveolar lavage fluid and serum correlated with lethality, with the bronchoalveolar lavage fluid ratio of C-C motif chemokine ligand 7:C-C motif chemokine ligand 22 providing the best prediction in the mouse models. These preclinical biomarkers were examined in the plasma and lower respiratory tract fluid of a discovery cohort of pediatric patients with acute respiratory failure from pneumonia. The primary clinical outcome measure was ventilator-free days, with secondary outcomes of pediatric acute respiratory distress syndrome severity and mortality. Elevation in peak lower respiratory tract fluid C-C motif chemokine ligand 7:C-C motif chemokine ligand 22 ratios demonstrated a significant negative correlation with ventilator-free days (r = –0.805; p < 0.02).

Conclusions:

This study provides evidence that lung immune profiling via lower respiratory tract fluid cytokine analysis is feasible and may provide insight into clinical outcomes. Further validation of markers, including the C-C motif chemokine ligand 7:C-C motif chemokine ligand 22 ratio in this limited study, in a larger cohort of patients is necessary.
Increased FAPI Uptake in Brain Metastasis From Lung Cancer on 68Ga-FAPI PET/CT
Authors: Fu Wenhui , Liu Lin , Liu Huipan , Zhou Zhijun , Chen Yue
Published: November 2020

A 51-year-old woman with newly diagnosed lung cancer experienced progressive left hip pain for 1 month. 18F-FDG PET/CT showed multiple hypermetabolic lesions throughout the body, including a suspicious lesion in the brain. Elevated FDG activity in select muscles was visualized, which was attributed to altered weight bearing. Unexpectedly, 68Ga-fibroblast activation protein inhibitor PET/CT showed the FDG-avid lesion in the brain with excellent imaging contrast. Brain metastasis was confirmed by a cerebral MRI.
Potential Utilization of Lymphoscintigraphy in Patients With Klippel-Trenaunay Syndrome
Authors: Wen Zhe , Tong Guansheng , Liu Yong
Published: November 2020

Purpose

Klippel-Trenaunay syndrome (KTS) is a rare disease that was characterized by vascular malformation. Lymphatic malformation was also commonly associated with KTS. However, the application of lymphoscintigraphy in the management of patients with KTS was rarely described. The purpose of this study is to assess whether the findings of lymphoscintigraphy can aid the management of the patients with KTS.

Methods

A total of 28 patients with known KTS who underwent 99mTc-dextran lymphoscintigraphy with lower extremity tracer injection were included in this retrospective analysis. The images from lymphoscintigraphy were reviewed for any abnormalities in the body with the attention on the region of left subclavian-jugular venous angle.

Results

In addition to abnormal activity in the other regions, abnormal activity in the left subclavian-jugular venous angle was visualized in over half of the patients (53.6%, 15/28). Based on the findings of the lymphoscintigraphy, 7 patients with left subclavian-jugular venous angle activity underwent thoracic duct decompression. In 4 patients with postsurgery follow-up, 3 achieved significant, measurable symptomatic relief.

Conclusions

Lymphoscintigraphy can be used to assess potential candidates for thoracic duct decompression to alleviate the symptoms in patients with KTS.
Solitary 68Ga-PSMA–Avid Proximal Tibial Prostatic Adenocarcinoma Metastasis Mimicking Enthesopathy
Authors: Hilliar Luke , Yip Joshua Wei Liang , Le Ken , Loh Han , Mansberg Robert
Published: November 2020

A 76-year-old man with previously treated prostatic adenocarcinoma (Gleason 8) was referred for a 68Ga–prostate-specific membrane antigen PET/CT scan due to a rising serum PSA level. An intensely PSMA-avid focus was demonstrated in the left proximal tibia with no evidence of local recurrence or metastatic disease elsewhere. This was diagnosed and managed as enthesopathy. A 99mTc-MDP bone scan with SPECT/CT performed 9 months later confirmed an intensely osteoblastic mixed lytic/sclerotic metastasis at the left proximal tibia.
Influence of Asthma Onset on Airway Dimensions on Ultra–high-resolution Computed Tomography in Chronic Obstructive Pulmonary Disease
Authors: Tanabe Naoya , Sato Susumu , Oguma Tsuyoshi , Shima Hiroshi , Kubo Takeshi , Kozawa Satoshi , Koizumi Koji , Sato Atsuyasu , Togashi Kaori , Matsumoto Hisako , Hirai Toyohiro
Published: November 2020

Purpose:

Asthma onset before the age of 40 years is associated with distinct clinical manifestations in chronic obstructive pulmonary disease (COPD) patients, but its morphologic features remain unestablished. This study aimed to explore airway morphology in COPD patients with asthma onset before 40 years of age using ultra–high-resolution computed tomography (U-HRCT), which allows a more accurate quantitation of the lumen and the wall in smaller airways than using conventional CT.

Materials and Methods:

Clinical data of 500 consecutive patients undergoing full inspiratory U-HRCT (1024×1024 matrix and 0.25 mm slice thickness) were retrospectively analyzed. COPD patients without asthma, COPD patients with asthma onset at age below or 40 years and above, and non-COPD smoker controls (N=137, 29, 34, and 22, respectively) were enrolled. The length, lumen area (LA), wall thickness and area (WA), and wall area percent (WA%) of the segmental (third-generation) to sub-subsegmental (fifth-generation) bronchus and the low attenuation volume percent (LAV%) were measured.

Results:

LA and WA were smaller in the fourth and fifth generation in COPD patients than in non-COPD controls, regardless of the age of asthma onset. LA was smaller and WA% was larger in the fourth-generation and fifth-generation airways in COPD with asthma onset before 40 years than COPD without asthma, whereas WA did not differ between them. In multivariate analyses, asthma onset before 40 years was associated with smaller LA in COPD patients independent of demographics, use of inhaled corticosteroids and long-acting bronchodilators, airflow limitation, and LAV%.

Conclusions:

Asthma onset before 40 years of age could be associated with greater lumen narrowing of the airways in COPD.
Orbitofrontal Reconstruction With a Three-Dimensional Titanium Patient-Specific Implant After Intraosseous Haemangioma Resection
Authors: Sesqué Alexandre , Dang Nathalie Pham , Coste Aurélien , Barthélémy Isabelle , Depeyre Arnaud
Published: November 2020

Background:

Intraosseous hemangiomas are rare benign tumors that can develop in the skull. Orbitofrontal localization is uncommon. The complexity of orbitofrontal anatomy results in difficult reconstruction following trauma or tumoral resection.

Case presentation:

A 50-year-old woman with a right orbitofrontal intraosseous hemangioma was referred to our department. The authors decided to perform tumoral bone resection and orbitofrontal reconstruction using virtual surgical planning in collaboration with Materialize engineers (Materialise, Leuven, Belgium). Three cutting guides and a patient-specific 3-dimensional (3D) titanium implant were designed and manufactured in 3 weeks. Surgery was performed with a double surgical team composed of maxillofacial surgeons and neurosurgeons. No perioperative or post-operative complications occurred. Post-operatively, the patient was completely asymptomatic and clinical examination showed symmetrical and satisfactory facial morphology.

Conclusion:

Virtual surgical planning, design of patient-specific guides and manufacturing of implants make surgery easier and increase surgical precision. This technique is recommended for wide use in cases of oncological or complex trauma craniomaxillofacial reconstruction.
Zygoma Fractures Are Associated With Increased Morbidity and Mortality in the Pediatric Population
Authors: Elzanie Ashraf S. , Park Kitae E. , Irgebay Zhazira , Choi James , Zellner Elizabeth G.
Published: November 2020

Background:

Trauma involving the facial bones has been shown to be associated with high severity in previous studies. Characteristics of facial fractures in adults have been well described in the adult population, less so in the pediatric literature. Our investigation aims to define these epidemiological measures and risk factors for poor outcomes using the most recent data.

Methods:

The 2016 Trauma Quality Improvement Program data bank was examined to study facial fracture pattern, mechanism of injury, and demographic descriptive data to characterize pediatric trauma patients. Multivariable regression analysis was performed to assess risk factors for morbidity and mortality in pediatric facial fracture patients.

Results:

Of 51,168 total pediatric trauma patients, 2917 (5.7%) presented with facial fractures. Motor vehicle trauma was the most common mechanism of injury. Maxillary/malar fractures was the most common fracture type overall. Mandibular fractures were most common in the 0 to 1 age category while nasal bone fractures were more common in older patients. Patients with mandible fractures experienced the highest rate of operative management. Zygoma fracture was highly associated with concomitant traumatic brain injury. Multivariable regression analysis showed that fracture of the zygoma, concomitant traumatic brain injury, and cervical spine injury were risk factors for increased mortality.

Conclusion:

Facial fractures are a rare but significant form of trauma in the pediatric population. Our data suggests a slight change in fracture patterns compared to previous studies. Zygoma fractures, traumatic brain injury, and cervical spine injury are risk factors of increased mortality that clinicians should be aware of.
Management of Unicistic Ameloblastoma in a Young Patient: Reducing Social Consequences
Authors: Mendes Bruno Coelho , Maia Rafael Alberto dos Santos , Santos Anderson Maikon de Souza , Moura Kaline da Silva , Araújo-Filho Nilton Pires de , Aburad Arlindo Tadeu Teixeira , Faverani Leonardo Perez , Borba Alexandre Meireles
Published: November 2020

Ameloblastoma is an odontogenic tumor of significant clinical relevance, aggressive and locally invasive. Although the posterior region of the mandible is more frequently affected, lesions observed in the maxilla should receive special attention due to the risk of expansion to the nasal, paranasal and orbital structures. This report shows a successful case of a maxillary ameloblastoma treated by combining therapies in a young patient. The treatment strategy adopted to reduce and redefine the lesion dimensions enabled enucleation in a safe way, without destruction of adjacent noble structures. It also allowed complementary approach with peripheral ostectomy and sclerosing agent, efficiently, without evidence of recurrence or complications after 2 years.
Technical Strategy Using Piezosurgery to Correct Flattened Supraorbital Rim in Unilateral Coronal Craniosynostosis
Authors: Furtado Leopoldo Mandic Ferreira , da Costa Val Filho José Aloysio , de Guimarães Mourão Rômulo Tscherbakowski Nunes , dos Santos Júnior Luiz Carlos , de Macedo Machado Filho Guaracy , Pedrosa Lucas Dantas
Published: November 2020

The surgical correction of orbital deformities in patients with unilateral coronal craniosynostosis is challenging. Traditional techniques have shown the persistence of orbital flattening. This study presents a new strategy for remodeling the compromised orbit, using the piezosurgery technique, which improves the orbital curvature.
Complications Due to Cranial Distraction for Craniosynostosis
Authors: Noto Mariko , Imai Keisuke , Masuoka Takeshi , Sakahara Daisuke , Kunihiro Noritsugu
Published: November 2020

Background:

Complications of cranial distraction techniques can arise perioperatively. This study assessed long-term clinical outcomes following cranial distraction for craniosynostosis. We analyzed factors involved in those complications.

Methods:

We retrospectively assessed outcomes from 120cases treated with cranial distraction for craniosynostosis between 1997 and 2019. Age at surgery, type of craniosynostosis, length of advancement, and complications were reviewed. We analyzed cases in which clinical characteristics and medical data appeared to increase the risk of complications.

Results:

Of the 120 patients (65 males, 55 females), 79 had syndromic craniosynostosis and 41 had nonsyndromic craniosynostosis. Type of craniosynostosis was scaphocephaly in 17 patients, trigonocephaly in 4, plagiocephaly in 15, brachycephaly in 57, oxycephaly in 14, cloverleaf in 10, and others in 3. Mean age at surgery was 18.6 months (range, 3–525 months). Mean total length of advancement was 32.3 mm (range, 5.5–62.0 mm). No deaths were encountered. Complications included cerebrospinal fluid leaks in 5 patients, epidural abscess in 1, local infections in 33, device problems in 20, erosions and/or ulcers in 23 and decubitus ulcers in 8.

Comparisons of complications and factors: Local infection showed no significant correlation with type of craniosynostosis, nor with the total length of advancement. Plate displacement showed significant relationships with total length of advancement, or with age at surgery (P < 0.01)

Conclusion:

These results suggested that local infection occurred independent of the type of craniosynostosis. Plate displacement and ulcers appear to occur more easily among patients with longer lengths of advancement or with surgery at a younger age, due to the weakness of the cranial bones.
Defining Microbiome Readiness for Surgery: Dietary Prehabilitation and Stool Biomarkers as Predictive Tools to Improve Outcome
Authors: Keskey Robert , Papazian Emily , Lam Adam , Toni Tiffany , Hyoju Sanjiv , Thewissen Renee , Zaborin Alexander , Zaborina Olga , Alverdy John C.
Published: November 2020

Objectives:

Determine whether preoperative dietary prehabilitation with a low-fat, high-fiber diet reverses the impact of Western diet (WD) on the intestinal microbiota and improves postoperative survival

Background:

We have previously demonstrated that WD fed mice subjected to an otherwise recoverable surgical injury (30% hepatectomy), antibiotics, and a short period of starvation demonstrate reduced survival (29%) compared to mice fed a low-fat, high-fiber standard chow (SD) (100%).

Methods:

Mice were subjected to 6 weeks of a WD and underwent dietary pre-habilitation (3 days vs 7 days) with a SD prior to exposure to antibiotics, starvation, and surgery. 16S rRNA gene sequencing was utilized to determine microbiota composition. Mass spectrometry measured short chain fatty acids and functional prediction from 16S gene amplicons were utilized to determine microbiota function.

Results:

As early as 24 hours, dietary prehabilitation of WD mice resulted in restoration of bacterial composition of the stool microbiota, transitioning from Firmicutes dominant to Bacteroidetes dominant. However, during this early pre-habilitation (ie, 3 days), stool butyrate per microbial biomass remained low and postoperative mortality remained unchanged from WD. Microbiota function demonstrated reduced butyrate contributing taxa as potentially responsible for failed recovery. In contrast, after 7 days of prehabilitation (7DP), there was greater restoration of butyrate producing taxa and survival after surgery improved (29% vs 79% vs 100%: WD vs 7DP vs SD, P < 0.001).

Conclusions:

The deleterious effects of WD on the gut microbiota can be restored after 7 days of dietary prehabilitation. Moreover, stool markers may define the readiness of the microbiome to withstand the process of surgery including exposure to antibiotics and short periods of starvation.
Risk of Acquiring Perioperative COVID-19 During the Initial Pandemic Peak: A Retrospective Cohort Study
Authors: Axiotakis Lucas G. , Youngerman Brett E. , Casals Randy K. , Cooke Tyler S. , Winston Graham M. , Chang Cory L. , Boyett Deborah M. , Lalwani Anil K. , McKhann Guy M.
Published: November 2020

Objective:

To determine the risk of acquiring perioperative COVID-19 infection in previously COVID-19 negative patients.

Summary of Background Data:

During the initial peak of the COVID-19 pandemic, there was significant concern of hospital acquired COVID-19 infections. Medical centers rapidly implemented systems to minimize perioperative transmission, including routine preoperative testing, patient isolation, and enhanced cleaning.

Methods:

In this retrospective cohort study, medical records of all adult patients who underwent surgery at our quaternary, acute care hospital between March 15 and May 15, 2020 were reviewed. The risk of preoperatively negative patients developing symptomatic COVID-19 within 2–14 days postoperatively was determined. Surgical characteristics, outcomes, and complications were compared between those with and without acquired perioperative COVID-19 infection.

Results:

Among 501 negative patients undergoing index surgeries, 9 (1.8%) developed symptomatic COVID-19 in the postoperative period; all occurred before implementation of routine preoperative testing [9/243, 3.7% vs 0/258, 0%, odds ratio (OR): 0.048, P = 0.036]. No patient who was polymerase-chain-reaction negative on the day of surgery (n = 170) developed postoperative infection. Perioperative infection was associated with preoperative diabetes (OR: 3.70, P = 0.042), cardiovascular disease (OR: 3.69, P = 0.043), angiotensin receptor blocker use (OR: 6.58, P = 0.004), and transplant surgery (OR: 11.00, P = 0.002), and multiple complications, readmission (OR: 5.50, P = 0.029) and death (OR: 12.81, P = 0.001).

Conclusions:

During the initial peak of the COVID-19 pandemic, there was minimal risk of acquiring symptomatic perioperative COVID-19 infection, especially after the implementation of routine preoperative testing. However, perioperative COVID-19 infection was associated with poor postoperative outcome.
A Single Institution Multi-disciplinary Approach to Power-assisted Liposuction for the Management of Lymphedema
Authors: Granoff Melisa D. , Johnson Anna Rose , Shillue Kathy , Fleishman Aaron , Tsai Leo , Carroll Brett , Donohoe Kevin , Lee Bernard T. , Singhal Dhruv
Published: November 2020

Objective:

To implement and evaluate outcomes from a comprehensive, multi-disciplinary debulking program in the United States.

Summary of Background Data:

Interest in and access to surgical treatment for chronic lymphedema (LE) in the United States have increased in recent years, yet there remains little attention on liposuction, or debulking, as an effective treatment option. In some other countries, debulking is a common procedure for the surgical treatment of LE, is covered by insurance, and has demonstrated excellent, reproducible outcomes. In this study we describe our experience implementing a debulking technique from Sweden in the United States.

Methods:

Patients who presented with chronic LE followed a systematic multi-disciplinary work-up. For debulking with power assisted liposuction, the surgical protocol was modeled after that developed by Håkan Brorson. A retrospective review of consecutive patients who underwent debulking at our institution was conducted.

Results:

Between December 2017 and January 2020, 39 patients underwent 41 debulking procedures with power assisted liposuction, including 23 upper and 18 lower extremities. Mean patient age was 58 years and 85% of patients had LE secondary to cancer, the majority of which (64%) was breast cancer. Patients experienced excess volume reductions of 116% and 115% in the upper and lower extremities, respectively, at 1 year postoperatively. Overall quality of life (LYMQOL) improved by a mean of 33%. Finally, patients reported a decreased incidence of cellulitis and decreased reliance on conservative therapy modalities postoperatively.

Conclusions:

Debulking with power assisted liposuction is an effective treatment for patients with chronic extremity LE. The operation addresses patient goals and improves quality of life, and additionally reduces extremity volumes, infection rates and reliance on outpatient therapy. A comprehensive, multi-disciplinary debulking program can be successfully implemented in the United States healthcare system.
Utilization of MEG Among the US Epilepsy Centers: A Survey-Based Appraisal
Authors: Bagić Anto I. , Burgess Richard C.
Published: November 2020

Purpose:

The purported underutilization of magnetoencephalography (MEG) among the USA epilepsy centers has never been studied, and any evidence-based understanding of its magnitude is lacking.

Methods:

Two hundred twenty-five National Association of Epilepsy Centers centers (2016) were invited to participate anonymously in a 13-question web-based survey of clinical practice focused on MEG use.

Results:

On average, centers (N = 70; 61 of which were level 4) reported <6 epileptologists, >7 dedicated epilepsy monitoring unit beds, 206 phase 1 studies, 15 phase 2 studies, 10 direct resections, and 9 indirect resections; 27% owned MEG. On average, 11.2 MEGs per year were ordered for epilepsy localization and 7.6 for any presurgical mapping modalities. Wada test aka the intracarotid sodium amobarbital procedure (ISAP) (43%) and functional MRI (29%) were preferred over MEG (4%) for language mapping. The number of epileptologists and the number of epilepsy monitoring unit beds correlated positively with the most clinical volumes. The centers who own a MEG had surgical volumes significantly higher than those without. The number and complexity of patients as well as the proximity of a MEG were perceived as significant contributors/obstacles to increased MEG use.

Conclusions:

Only the centers with larger surgical volumes incorporate MEG regularly in presurgical evaluation of patients with drug-resistant epilepsy. A reversal of the pervasive underutilization of epilepsy surgery can benefit from MEG, but this requires a sustained concerted promotion by the epilepsy and MEG communities.
The 10 Common Evidence-Supported Indications for MEG in Epilepsy Surgery: An Illustrated Compendium
Authors: Bagić Anto I. , Funke Michael E. , Kirsch Heidi E. , Tenney Jeffrey R. , Zillgitt Andrew J. , Burgess Richard C.
Published: November 2020

Unfamiliarity with the indications for and benefits of magnetoencephalography (MEG) persists, even in the epilepsy community, and hinders its acceptance to clinical practice, despite the evidence. The wide treatment gap for patients with drug-resistant epilepsy and immense underutilization of epilepsy surgery had similar effects. Thus, educating referring physicians (epileptologists, neurologists, and neurosurgeons) both about the value of epilepsy surgery and about the potential benefits of MEG can achieve synergy and greatly improve the process of selecting surgical candidates. As a practical step toward a comprehensive educational process to benefit potential MEG users, current MEG referrers, and newcomers to MEG, the authors have elected to provide an illustrated guide to 10 everyday situations where MEG can help in the evaluation of people with drug-resistant epilepsy. They are as follows: (1) lacking or imprecise hypothesis regarding a seizure onset; (2) negative MRI with a mesial temporal onset suspected; (3) multiple lesions on MRI; (4) large lesion on MRI; (5) diagnostic or therapeutic reoperation; (6) ambiguous EEG findings suggestive of “bilateral” or “generalized” pattern; (7) intrasylvian onset suspected; (8) interhemispheric onset suspected; (9) insular onset suspected; and (10) negative (i.e., spikeless) EEG. Only their practical implementation and furtherance of personal and collective education will lead to the potentially impactful synergy of the two—MEG and epilepsy surgery. Thus, while fulfilling our mission as physicians, we must not forget that ignoring the wealth of evidence about the vast underutilization of epilepsy surgery - and about the usefulness and value of MEG in selecting surgical candidates - is far from benign neglect.
Hymenobacter terrestris sp. nov. and Hymenobacter lapidiphilus sp. nov., isolated from regoliths in Antarctica
Authors: Sedláček Ivo , Pantůček Roman , Zeman Michal , Holochová Pavla , Šedo Ondrej , Staňková Eva , Švec Pavel , Králová Stanislava , Vídeňská Petra , Micenková Lenka , Urvashi  , Korpole Suresh , Lal Rup
Published: November 2020

A group of four psychrotrophic bacterial strains was isolated on James Ross Island (Antarctica) in 2013. All isolates, originating from different soil samples, were collected from the ice-free northern part of the island. They were rod-shaped, Gram-stain-negative, and produced moderately slimy red-pink pigmented colonies on R2A agar. A polyphasic taxonomic approach based on 16S rRNA gene sequencing, whole-genome sequencing, MALDI-TOF MS, rep-PCR analyses, chemotaxonomic methods and extensive biotyping was used to clarify the taxonomic position of these isolates. Phylogenetic analysis based on 16S rRNA gene sequences showed that the isolates belonged to the genusHymenobacter. The closest relative wasHymenobacter humicolaCCM 8763T, exhibiting 98.3 and 98.9% 16S rRNA pairwise similarity with the reference isolates P5342Tand P5252T, respectively. Average nucleotide identity, digital DNA–DNA hybridization and core gene distances calculated from the whole-genome sequencing data confirmed that P5252Tand P5342Trepresent two distinctHymenobacterspecies. The menaquinone systems of both strains contained MK-7 as the major respiratory quinone. The predominant polar lipids for both strains were phosphatidylethanolamine and one unidentified glycolipid. The major components in the cellular fatty acid composition were summed feature 3 (C16:1ω7c/C16:1ω6c), C16:1ω5c, summed feature 4 (anteiso-C17:1B/iso-C17:1I), anteiso-C15:0and iso-C15 : 0for all isolates. Based on the obtained results, two novel species are proposed, for which the namesHymenobacter terrestrissp. nov. (type strain P5252T=CCM 8765T=LMG 31495T) andHymenobacter lapidiphilussp. nov. (type strain P5342T=CCM 8764T=LMG 30613T) are suggested.
Alteromonas ponticola sp. nov., a gammaproteobacterium isolated from seawater
Authors: Kim Young-Ok , Park In-Suk , Park Sooyeon , Yoon Jung-Hoon
Published: November 2020

A Gram-stain-negative, aerobic, non-spore-forming, non-motile and ovoid or rod-shaped bacterial strain, MYP5T, was isolated from seawater in Jeju island of South Korea. MYP5T grew optimally at 30–35 °C and in the presence of 2.0 % (w/v) NaCl. A neighbour-joining phylogenetic tree based on 16S rRNA gene sequences revealed that MYP5T fell within the clade enclosed by the type strains of species of the genus

Alteromonas

, clustering with the type strains of

Alteromonas confluentis

and

Alteromonas halophila

. MYP5T exhibited the highest 16S rRNA gene sequence similarity value (98.0 %) to the type strain of

A. confluentis

and similarities of 95.1–97.9 % to the type strains of the other species of the genus

Alteromonas

. ANI and dDDH values of genomic sequences between MYP5T and the type strains of 22 species of the genus

Alteromonas

were 66.8–70.5 % and 18.6–27.5 %, respectively. The DNA G+C content of MYP5T, determined from the genome sequence, was 46.1 %. MYP5T contained Q-8 as the predominant ubiquinone and C18 : 1 ω7c, summed feature 3 (C16 : 1 ω7c and/or C16 : 1 ω6c), C16 : 0 and 10-methyl C17 : 0 as the major fatty acids. The major polar lipids of MYP5T were phosphatidylethanolamine and phosphatidylglycerol. Distinguishing phenotypic properties, along with the phylogenetic and genetic distinctiveness, revealed that MYP5T is separated from species of the genus

Alteromonas

. On the basis of the data presented, MYP5T is considered to represent a novel species of the genus

Alteromonas

, for which the name Alteromonas ponticola sp. nov. is proposed. The type strain is MYP5T (=KCTC 82144T=NBRC 114354T).
The psychological distress of parents is associated with reduced linear growth of children: evidence from a nationwide population survey
Authors: Susiloretni Kun A , Smith Emily R , Suparmi  , Marsum  , Agustina Rina , Shankar Anuraj H
Published: November 2020

Background

Stunting, an indicator of restricted linear growth, has become a primary measure of childhood undernutrition due to its persistent high prevalence globally, and importance for health and development. Although the etiology is recognized to be complex, most analyses have focused on biomedical determinants, with limited attention to social factors affecting care and nurturing in the home.

Objectives

To identify the association between parental distress and linear growth and stunting and to examine z score loss due to any parental distress and socioeconomic, behavioral, and physiologic risk factors on for linear growth

Design

Cross sectional study

Participants

54,261 households from the Indonesia National Health Survey 2013. Main outcome measures. Multivariate linear, logistic, and multilevel multinomial logistic regression, using survey weights, were used to assess the relationship between parental distress, as assessed by the WHO Self Reporting Questionnaire, with height-for-age z score (HAZ), stunting, and behavioral risk factors for stunting.

Results

Maternal, paternal and parental distress (i.e. both maternal and paternal distress) were associated with reduced linear growth of the children by 0.091, 0.13 and 0.21 z-scores, respectively. Maternal and paternal distress increased the risk of mild stunting (HAZ < -1) by 38% and 39%, and the risk of moderate stunting (HAZ < -2) by 41% and 23%, respectively. Parental stress increased the risk of moderate and severe stunting by 67% and 41%. Any parental distress accounted for 5.6% of the modeled overall loss of HAZ-score due to interactions with socioeconomic status (low maternal occupational status, low wealth, low maternal occupation) and behavioral (poor garbage sanitation) factors, rendering it amongst the more influential factors on linear growth. The modeled overall loss of HAZ-score incorporating any parental distress was associated with socioeconomic factors (26.1%) including, in descending order, low maternal occupational status, low wealth, low maternal education, low paternal occupational status, rural residence; behavioral factors (15.3%) including open garbage disposal, unimproved water disposal, paternal smoking, not using iodized salt; physiological factors (13.5%) including low maternal height, female child, paternal height, maternal mid-upper arm circumference.

Conclusions

These findings highlight the complex etiology of stunting, and suggest nutritional and other biomedical interventions are insufficient, and that promotion of mental and behavioral health programs for parents are essential to achieve child growth and development, and would likely foster taller, healthier, smarter, and thriving populations.
One year cross-sectional study in adult and neonatal intensive care units reveals the bacterial and antimicrobial resistance genes profiles in patients and hospital surfaces
Authors: Christoff Ana Paula , Rodrigues Sereia Aline Fernanda , Flores Cruz Giuliano Netto , de Bastiani Daniela Carolina , Silva Vanessa Leitner , Hernandes Camila , Metran Nascente Ana Paula , dos Reis Ana Andrea , Gonçalves Viessi Renata , Pereira Marques Andrea dos Santos , Braga Bianca Silva , Lovizio Raduan Telma Priscila , Valle Martino Marines Dalla , de Menezes Fernando Gatti , de Oliveira Luiz Felipe Valter
Published: November 2020

Several studies have shown the ubiquitous presence of bacteria in the hospital environmental surfaces, staff, and patients. Frequently, these bacteria are related to HAI (healthcare-associated infections) and carry antimicrobial resistance (AMR). These HAI-related bacteria contributes to a major public health issue by increasing patient morbidity and mortality during or after hospital stay. Bacterial high-throughput amplicon gene sequencing along with AMR genes identification and whole genome sequencing (WGS) are new biotechnological tools that allow multiple-sample screening for a diversity of bacteria. In this paper, we used these methods to perform an one-year cross sectional profiling of bacteria and AMR genes in adult and neonatal intensive care units (ICU and NICU) in a Brazilian public hospital. Our results showed high abundances of HAI-related bacteria as S. epidermidis, S. aureus, K. pneumoniae, A. baumannii complex, E. coli, E. faecalis and P. aeruginosa in patients and hospital surfaces. Most abundant AMR genes detected throughout ICU and NICU were mecA, blaCTX-M-1 group, blaSHV-like and blaKPC-like. We found that NICU environment and patients were more widely contaminated with pathogenic bacteria than ICU. Patient samples, despite the higher bacterial load, have lower bacterial diversity than environmental samples in both units. Finally, we also identified contamination hotspots in the hospital environment showing constant frequencies of bacterial and AMR contamination throughout the year. WGS sequencing, 16S rRNA oligotypes and AMR identification allowed a high-resolution data analysis for bacterial characterization and its distributions along the hospital microbiome profile.
Ancestral ecological regime shapes reaction to food limitation in the Least Killifish,Heterandria formosa
Authors: Felmy Anja , Leips Jeff , Travis Joseph
Published: November 2020

In populations with contrasting densities of conspecifics, we often see genetically-based differences in life histories. The divergent life histories could be driven by several distinct agents of selection, including, amongst other factors, variation in per-capita food levels, the intensity of crowding-induced stress, rates of pathogen transmission, mate encounter rates, and the rates with which waste products accumulate. Understanding which selective agents act in a particular population is important as the type of agents can affect both population dynamics and evolutionary responses to density-dependent selection. Here we used a full-factorial laboratory experiment to examine whether two populations of a small live-bearing freshwater fish, characterised by high-density/low-predation or low-density/high-predation conditions, are adapted to different per-capita food levels. As expected, fish from the higher density regime handled food limitation better than those from the lower density regime. Although the lower food level resulted in slower growth, smaller body size, delayed maturation and reduced survival in both populations, especially survival to maturity showed a highly significant population x food-level interaction. At low food, 75% of fish from the low-density population died, compared to only 15% of fish from the high-density population. This difference was much smaller at high food (15% vs. 0% mortality), and was mediated, at least partly, through a larger size at birth of fish from the high-density regime. While we cannot preclude other agents of selection from operating differently in the study populations, we demonstrate that selection at higher density confers a greater ability to cope with low per-capita food availability.