bluuebunny/crossref_metadata_2025 huggingface dataset:
Survey of off-label prescribing in a university paediatric outpatient in Brazil
Authors: Monteiro Francelle A. S. G. , Soares Cristina N. , Chaveiro Letícia G. , Cabral Valeska A. , Lima Paulo M. A.
Published: January 2022

Ours is a cross-sectional, descriptive, retrospective study evaluating the extent of off-label prescribing for patients attending a university paediatric outpatient department in Goiás, Brazil. 391 patients were treated in the outpatient, and 668 medicines were prescribed. Of these, 70.4% followed the terms of the marketing authorization; 0.3% were unlicenced, and 11% were off-label. Dose was the main factor in off-label prescribing. Infants (0–2 years) received 37.8% of the off-label prescriptions. Vitamins and drugs for the treatment of respiratory diseases were the most prevalent culprits. Of the total prescriptions, 23 different drugs were defined as off-label. Salbutamol was the most prescribed (41.9%). Owing to practical and legal difficulties in carrying out clinical trials, medicines are inadequately studied in children; cooperation between industry, regulatory authorities, and healthcare professionals is required to improve treatment safety. Our results may help guide clinical researcher on off-label prescripting in future trials.
Segmentation Enhanced Elastic Image Registration for 2D Speckle Tracking Echocardiography—Performance Study In Silico
Authors: Wilczewska Aleksandra , Cygan Szymon , Żmigrodzki Jakub
Published: January 2022

Although the two dimensional Speckle Tracking Echocardiography has gained a strong position among medical diagnostic techniques in cardiology, it still requires further developments to improve its repeatability and reliability. Few works have attempted to incorporate the left ventricle segmentation results in the process of displacements and strain estimation to improve its performance. We proposed the use of mask information as an additional penalty in the elastic image registration based displacements estimation. This approach was studied using a short axis view synthetic echocardiographic data, segmented using an active contour method. The obtained masks were distorted to a different degree, using different methods to assess the influence of the segmentation quality on the displacements and strain estimation process. The results of displacements and circumferential strain estimations show, that even though the method is dependent on the mask quality, the potential loss in accuracy due to the poor segmentation quality is much lower than the potential accuracy gain in cases where the segmentation performs well.
Vanguard or business-as-usual? ‘New’ movement parties in comparative perspective
Authors: Vittori Davide
Published: January 2022

The recent success of new movement parties in Europe brought the attention of party politics scholars to this hybrid party type. There are still many under-analysed theoretical and empirical aspects related to their organization and this article aims to show that despite sharing older movement parties’ traits, these ‘new’ movement parties introduce for the first time a unique combination of plebiscitarian intra-party democracy and party leadership empowerment. The implications of these findings are twofold: first, despite promoting intra-party democracy mainly through new digital tools, the main function of party membership is that of cheerleading; second, the leadership exercises strict control over the organization, thus restricting bottom-up ‘voice’ from the rank-and-file.
‘There’s this big fear around palliative care because it’s connected to death and dying’: A qualitative exploration of the perspectives of undergraduate students on the role of the speech and language therapist in palliative care
Authors: Collins Claire A
Published: January 2022

Background:

Speech and language therapy in palliative care is a developing discipline of clinical practice. Research literature has highlighted that undergraduate palliative care education in speech and language therapy is inconsistent and inadequate. However, limited research has been carried out to date in relation to student speech and language therapists and palliative care.

Aim:

To explore the role of speech and language therapists in palliative care from the perspective of speech and language therapy students in Ireland.

Design:

A qualitative descriptive research study was conducted, involving focus group interviews.

Setting/participants:

Purposive sampling was used to recruit 12 student speech and language therapists from one university site for this study. Undergraduate second, third and fourth year students were eligible for inclusion.

Results:

This study revealed that undergraduate student speech and language therapists collectively agree that there is a role for speech and language therapy in palliative care. Although students acknowledged that speech and language therapists can make a positive difference to patients’ lives, and academic lectures were positively received, insufficient exposure to palliative care has resulted in fear, uncertainty and a lack of confidence amongst student speech and language therapists.

Conclusions:

A greater emphasis on palliative care is needed in undergraduate speech and language therapy education to ensure confidence and competency development. An exploration of student speech and language therapists’ experiences in a specialist palliative care unit would be advantageous to determine the appropriateness of this setting for clinical placements.
Politics as Usual: Charles Edward Trevelyan and the Irish and Scottish Fisheries Before and During the Great Famine
Authors: Leazer John
Published: January 2022

Since the Great Irish Famine a debate has raged concerning the culpability of the British government, especially in the person of Assistant Secretary of the Treasury Charles Edward Trevelyan, and its failure to come to the aid of the starving Irish. On one end of the debate, Trevelyan is accused of severe prejudice against the Irish, with some ultra-nationalists even accusing him of genocide. On the other end, Trevelyan is viewed simply as an ideologue intent on enforcing the Whig view of laissez-faire economics. However, a study of government involvement in the Irish and Scottish fishing industries shows that the political situation before and during the Famine was more complex than the traditional debate indicates. This paper argues that the government’s treatment of the Irish fisheries, which were in a dismal state compared to the Scots, had more to do with political realities that Trevelyan inherited and could not ignore.
The antecedents and consequences of organizational learning in the library: A systematic literature review
Authors: Srirahayu Dyah Puspitasari , Eliyana Anis , Anugrah Esti Putri
Published: January 2022

The aim of this study is to determine the developments and factors that affect organizational learning in libraries. The study uses a systematic literature review method by analysing 20 research articles. The results of the study indicate that there are antecedents and consequences of organizational learning in the library. The research offers a comprehensive framework of the antecedents and consequences of organizational learning in libraries. Library managers can use these results to improve organizational learning in their libraries in accordance with the conditions and environment. The results can also be used as material for consideration in making decisions about the application of organizational learning in the library. There are few systematic literature reviews of organizational learning in libraries; hence, this article can be used as an opening for further discussion.
Pediatric Critical Care Neurologists in the United States and Canada: A Survey of Clinical Practice Experience
Authors: Farias-Moeller Raquel , Jayakar Anuj , Guerriero Rejean M. , Carpenter Jessica L. , Wainwright Mark S. , Harrar Dana B.
Published: January 2022

Objective

To describe the characteristics of pediatric intensive care neurologists and their practice in the United States and Canada.

Methods

We performed a survey-based study of child neurologists who self-identify as ‘intensive care neurologists’. The survey included questions about demographics, training, pediatric neurocritical care service and job structure, teaching, academics, challenges, and views on the future of pediatric neurocritical care.

Results

We analyzed 55 surveys. Most respondents were 31-50 years of age with ≤10 years of practice experience. Fifty-four percent identified as female. Most completed subspecialty training after child neurology residency. The majority practice at highly resourced centers with >45 intensive care unit beds. Respondents cover a variety of inpatient (critical and noncritical care) services, at times simultaneously, for a median of 19.5 weeks/y and work >70 hours/wk when on service for pediatric neurocritical care. The top 3 challenges reported were competing demands for time, excess volume, and communication with critical care medicine. Top priorities for the “ideal pediatric neurocritical care service” were attendings with training in pediatric neurocritical care or a related field and joint rounding with critical care medicine.

Conclusion

We report a survey-based analysis of the demographics and scope of practice of pediatric critical care neurologists. We highlight challenges faced and provide a framework for the further development of this rapidly growing field.
How Socioeconomic Status and Acculturation Relate to Dietary Behaviors Within Latino Populations
Authors: Alegria Katie , Fleszar-Pavlović Sara , Hua Jacqueline , Ramirez Loyola Maria , Reuschel Hope , Song Anna V.
Published: January 2022

Purpose

Despite having lower socioeconomic status, Latinos in the US experience fewer adverse health outcomes than non-Latinos. However, they are disproportionately affected by diet-related diseases. Among other racial/ethnic groups, high acculturation and low socioeconomic status are associated with worse dietary intake, yet, few studies have investigated these relationships among Latinos.

Design

2013–2014 NHANES analyzed to examine pathways through which acculturation, income, nativity, and food security are associated with dietary behaviors.

Setting

U.S. population-based survey.

Sample

Survey respondents >18 years old and identified as Latino/Hispanic (N = 1197; 53.88% female; Mage = 44.61).

Measures

Primary language spoken (acculturation), total household income (income), place of birth (nativity), Food security, and the Flexible Consumer Behavior Survey (dietary behavior).

Analysis

Univariate and multivariate regressions in STATA. Covariates include length of time in the US, ethnicity/Hispanic origin (i.e., “Mexican American” or “Other Hispanic”), and gender.

Results

Nativity ( β = −1.16; SE = .19; P < .001) and income ( β = .39; SE = .07; P < .001) were significant predictors of dietary behavior. Foreign-born Latinos and those with lower income consumed significantly lower numbers of fast-food or pizza. Food security was not a significant predictor of dietary behavior ( β = .16; SE = .1; P > .05).

Conclusions

Results suggest that income is not a protective factor against unhealthy dietary behavior and a renewed importance of nativity as a predictor of health behavior among Latinos.
Key Points for Pharmacists From the ACC Expert Consensus Decision Pathway for Patients Hospitalized With Heart Failure
Authors: Tellor Katie B. , Armbruster Anastasia L.
Published: January 2022

Heart failure (HF) is a complex condition, and its clinical course often includes periods of decompensation that represent a deterioration in clinical status. During these periods, patients may experience worsening HF symptoms requiring hospitalization. Heart failure that necessitates hospitalization increases the risk of mortality and rehospitalization. In order to help facilitate appropriate care of patients hospitalized with HF, the American College Cardiology (ACC) published an expert consensus decision pathway (ECDP) that focuses on a multidisciplinary approach. The ECDP is divided into multiple nodes and pharmacists play integral roles in each one. There are many opportunities for pharmacists to optimize medical therapy, reinforce adherence, and provide medication and disease state education throughout hospitalization. This review article will highlight inpatient medication management of HF for hospital pharmacists.
Competing risks analysis with missing cause-of-failure—penalized likelihood estimation of cause-specific Cox models
Authors: Lô Serigne N , Ma Jun , Manuguerra Maurizio , Moreno-Betancur Margarita , Scolyer Richard A , Thompson John F
Published: January 2022

Competing risks models are attractive tools to analyze time-to-event data where several causes of an event are competing. However, a complexity may arise when, for instance, some subjects experience the event of interest but the causes are not known. Assuming that unknown causes of events are missing at random, we developed a novel constrained maximum penalized likelihood method for fitting semi-parametric cause-specific Cox regression models. Here, penalty functions were used to smooth the baseline hazards. An appealing feature of this approach is that all the relevant estimands in competing risks models are estimated including cause-specific hazard ratios, cause-specific baseline hazards, and cumulative incidence functions. Asymptotic results for these estimators were also developed, allowing for direct inferences. The proposed method was compared with some existing methods through a simulation study. A real data example was analyzed using the new method to evaluate the association of age at diagnosis with melanoma-death and non-melanoma-death in patients diagnosed with thin melanoma (tumour thickness [Formula: see text]1.0  mm). An R function for our proposed method is currently available on GitHub and will be included in the R package "survivalMPL" at CRAN.
Marijuana toxicosis in 2 donkeys
Authors: Fitzgerald Alyson H. , Magnin Geraldine , Pace Ellen , Bischoff Karyn , Pinn-Woodcock Toby , Vin Ron , Myhre Michael , Comstock Emily , Ensley Steve , Coetzee Johann F.
Published: January 2022

Marijuana toxicosis is typically seen by companion animal veterinarians. However, with increased marijuana availability, there is a greater potential for toxicosis in other species. Herein we describe a case of suspected marijuana toxicosis in a female and a male American Mammoth donkey, aged 8 y and 20 y, respectively, fed cannabis buds. Both cases were presented because of depression and lethargy. However, the jenny had ataxia, mild colic, tachycardia, tachypnea, and decreased tongue tone. Plasma samples from the jenny on presentation and 3 d following hospitalization were submitted to the Kansas State Veterinary Diagnostic Laboratory to be screened for cannabinoids using high-pressure liquid chromatography coupled with tandem mass spectroscopy (HPLC-MS/MS). A single serum sample from the jack was taken on presentation and submitted to the Animal Health Diagnostic Center at Cornell University for Δ9-tetrahydrocannabinol (THC) and cannabidiol analysis using HPLC-MS/MS. THC was detected in all samples. Clinical signs were noted 24–36 h after ingestion, which included mild-to-moderate neurologic deficits, mild colic, tachycardia, tachypnea, and decreased tongue tone. Both donkeys recovered uneventfully within 24 h of peak effects. Utilizing a cannabinoid screening assay in collaboration with a veterinary diagnostic laboratory may be useful when an equine practitioner suspects marijuana toxicosis in a patient.
Review of genome sequencing technologies in molecular characterization of influenza A viruses in swine
Authors: Chauhan Ravendra P. , Gordon Michelle L.
Published: January 2022

The rapidly evolving antigenic diversity of influenza A virus (IAV) genomes in swine makes it imperative to detect emerging novel strains and track their circulation. We analyzed in our review the sequencing technologies used for subtyping and characterizing swine IAV genomes. Google Scholar, PubMed, and International Nucleotide Sequence Database Collaboration (INSDC) database searches identified 216 studies that have utilized Sanger, second-, and third-generation sequencing techniques to subtype and characterize swine IAV genomes up to 31 March 2021. Sanger dideoxy sequencing was by far the most widely used sequencing technique for generating either full-length (43.0%) or partial (31.0%) IAV genomes in swine globally; however, in the last decade, other sequencing platforms such as Illumina have emerged as serious competitors for the generation of whole-genome sequences of swine IAVs. Although partial HA and NA gene sequences were sufficient to determine swine IAV subtypes, whole-genome sequences were critical for determining reassortments and identifying unusual or less frequently occurring IAV subtypes. The combination of Sanger and second-generation sequencing technologies also greatly improved swine IAV characterization. In addition, the rapidly evolving third-generation sequencing platform, MinION, appears promising for on-site, real-time sequencing of complete swine IAV genomes. With a higher raw read accuracy, the use of the MinION could enhance the scalability of swine IAV testing in the field and strengthen the swine IAV disease outbreak response.
Bilinear damage evolution in AA2011 wire drawing processes
Authors: González Álvaro A , Cruchaga Marcela A , Celentano Diego J
Published: January 2022

This paper presents an experimental and numerical analysis of damage evolution in AA2011 aluminum alloy wires drawn under different scenarios. To this end, load-unload tensile tests were firstly carried out in order to characterize the degradation of the mechanical response in every cycle where the experimental results show a bilinear damage relationship in terms of the effective plastic strain. Therefore, a modification of the classical Lemaitre model is proposed in this work in order to reproduce bilinear paths of damage with the addition of only two parameters that can be directly obtained from the material characterization. Then, the damage predictive capability of this new experimental-based model is assessed in numerical simulations of the drawing process in one and two passes (considering for this last case the sequential and tandem configurations) where the computed predictions are compared with the corresponding experimental data showing a good agreement between them.
Whole-Exome Sequencing Reveals Novel NDP Variants in X-Linked Familial Exudative Vitreoretinopathy
Authors: Peng Yujiao , Zhao Rulian , Dai Erkuan , Peng Li , He Yunqi , Li Shujin , Yang Mu
Published: January 2022

Purpose

To investigate causative variants in three Chinese families affected with familial exudative vitreoretinopathy (FEVR).

Methods

Three unrelated Chinese families were recruited in this study. The three probands and their family members experienced a comprehensive age-appropriate eye examination and genetic analysis. Luciferase assay was performed to evaluate impacts of variants on Norrin/β-catenin signaling activity.

Results

Here we report two novel NDP variants associated with FEVR in three families, including c.17T>C (p.Leu6Pro) in family 1 and c.58G>A (p.Gly20Arg) in family 2 and 3. These two variants were co-segregated with the disease phenotypes within each family. In addition, both variants resulted in compromised Norrin/β-catenin signaling activity.

Conclusion

Our study identified two FEVR-associated pathogenic variants in NDP, which expanded the variant spectrum and provided information for the genetic diagnosis of FEVR.
The effect of parental presence and dental anxiety on children’s fear during dental procedures: A randomized trial
Authors: Yigit Tugba , Gucyetmez Topal Burcu , Ozgocmen Esra
Published: January 2022

Objective: To evaluate the effect of anxiety of parent accompanying child on child’s anxiety during treatment. Methods: The study included two groups: one group with 80 children whose parents were anxious, and the other group with 80 children with non-anxious parents, totaling 160 children. Each group was further randomized into subgroups, with and without parents accompanying their children. The children’s heart rates were measured using a portable pulse oximeter during the treatment. The child’s perception was measured using the Wong–Baker Faces Rating Scale, and another pediatric dentist rated child’s behavior using the Frankl scale based on the treatment video that was limited to the child’s appearance. Results: The highest pulse rates were observed in children accompanied by an anxious parent ( p < .001). Values on the Wong–Baker scale did not differ according to parental anxiety and parental presence ( p > .05). According to the dentist, the presence of parents negatively affected the anxiety of the child ( p = .025), while the effect of parents’ anxiety was not statistically significant ( p = .514). Conclusions: The anxiety of parent accompanying the child affects child’s anxiety. Parents with high anxiety appeared to negatively affect their children’s behavior.
Flexural behavior analysis and strength prediction of steel fiber-and-nanosilica reinforced rubber concrete
Authors: Gao Danying , Zhang Tao , Pang Yuyang , Wang Yihong
Published: January 2022

In this study, a series of experiments were conducted to investigate the effects of the hook-shaped steel fiber (SF) and nanosilica (NS) on the flexural properties of the rubber concrete (RC), and the modification mechanisms of the NS on the flexural properties of steel fiber-and-nanosilica reinforced rubber concrete (SFNS-RC) were also revealed by using the X-ray diffraction (XRD) and scanning electron microscope. Based on the RC specimen with a rubber content of 5%, the experimental variables included the SF volume fractions (0%, 0.5%, 1.0%, and 1.5%) and NS replacement ratios (0%, 1%, and 2%). The results indicated that the NS could improve the microstructure of the RC, the peaks of Ca(OH)2, C3S, and C2S steadily reduced as the NS replacement ratio increased, respectively, and the microstructure of SFNS-RC became more compact and uniform because the NS could produce pozzolanic activity to fill the pores of the matrix and strengthen the bond behavior between the SF and matrix. In addition, the RC specimens containing the SF and NS displayed the excellent flexural behaviors, including the ductility and energy dissipation characteristics. Finally, the empirical formulae for predicting the first-peak flexural strength and peak flexural strength of SFNS-RC were proposed through the analysis of experimental data, respectively.
Between Wellness and Elegance: Yoga Consumption in China
Authors: Jingwei Li
Published: January 2022

Yoga has become prevalent as a fitness choice in China. Its commercial development is based on imported knowledge and is also constructed through a traditional way of interpretation, reflecting the localization of an “exotic” body technique. Although the related literature focuses primarily on Western and South Asian societies, the subjectivities of a new yoga “school” require examination for a better evaluation of present theory. By combining historical analysis, personal interviews, and auto-ethnography, this article investigates yoga from different perspectives to illustrate the practice’s social connotations. Particularly, this study shows how yoga has experienced continuous translation and transformation during the interaction of interpreters and learners, and eventually become a consumption category associated with “wellness” and “elegance.” Incorporating ontological anthropology and Pierre Bourdieu’s theory, this article defines yoga as a multi-faceted habitus mediated among scenarios constructed by different actors, which sets with the time lag between the Chinese present and the past originated from the west and India. In this process of cross-cultural practice, yoga reveals two sets of conflicting values that embody the particularities of Chinese discourse.
The Effect of the Crowd on Home Bias: Evidence from NBA Games During the COVID-19 Pandemic
Authors: Gong Hua
Published: January 2022

The present study examines a specific type of referee biases, home bias, and analyzes how the presence of fans affects home bias by using NBA games played in empty arenas during the COVID-19 pandemic in the 2020–2021 season and matches played before the pandemic from 2017 to 2020. This research also uses a unique data set from NBA Last Two Minute Reports to assess referees’ performance at the play level. The findings show crowd support does not cause referees to treat home and away teams differently in crucial situations during the NBA regular season, contrary to the results in most prior studies.
Triterpenoid CDDO-IM protects against lipopolysaccharide-induced inflammatory response and cytotoxicity in macrophages: The involvement of the NF-κB signaling pathway
Authors: Ahmed Hassan , Amin Urooj , Sun Xiaolun , Pitts Demetrius R , Li Yunbo , Zhu Hong , Jia Zhenquan
Published: January 2022

Lipopolysaccharide (LPS), also known as endotoxin, can trigger septic shock, a severe form of inflammation-mediated sepsis with a very high mortality rate. However, the precise mechanisms underlying this endotoxin remain to be defined and detoxification of LPS is yet to be established. Macrophages, a type of immune cells, initiate a key response responsible for the cascade of events leading to the surge in inflammatory cytokines and immunopathology of septic shock. This study was undertaken to determine whether the LPS-induced inflammation in macrophage cells could be ameliorated via CDDO-IM (2-cyano-3,12 dioxooleana-1,9 dien-28-oyl imidazoline), a novel triterpenoid compound. Data from this study show that gene expression levels of inflammatory cytokine genes such as interleukin-1 beta (IL-1β), interleukin-8 (IL-8), tumor necrosis factor alpha (TNF-α), and monocyte chemoattractant protein-1 (MCP-1) were considerably increased by treatment with LPS in macrophages differentiated from ML-1 monocytes. Interestingly, LPS-induced increase in expression of pro-inflammatory cytokine levels is reduced by CDDO-IM. In addition, endogenous upregulation of a series of antioxidant molecules by CDDO-IM provided protection against LPS-induced cytotoxicity in macrophages. LPS-mediated nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB) transcriptional activity was also noted to decrease upon treatment with CDDO-IM in macrophages suggesting the involvement of the NF-κB signaling. This study would contribute to improve our understanding of the detoxification of endotoxin LPS by the triterpenoid CDDO-IM.
Risk of Stroke with Impella Placement Is Not Associated with Access Vessel
Authors: Levine Dov , Volk Lindsay , Vagaonescu Tudor , Soto Cassandra , Ikegami Hirohisa , Ghaly Aziz , Lemaire Anthony
Published: January 2022

Objective: The Impella heart pump is an intravascular microaxial device that provides short-term mechanical circulatory support and can be placed through the femoral, axillary, or central vessels. One of the most feared complications is stroke. It is unclear if patient stroke risk varies based on access vessel. Methods: A retrospective review of consecutive patients who underwent Impella placement at an academic institution from January 1, 2007, through September 15, 2018, was performed. Four groups were compared: (1) minimally invasive Impella (femoral or axillary access), (2) minimally invasive Impella upgraded to another minimally invasive Impella, (3) minimally invasive Impella upgraded to a central Impella (ascending aorta), and (4) central Impella. Patient charts were reviewed to identify baseline characteristics. Outcome measures included length of stay, stroke, and mortality. Results: A total of 349 patients (or 407 Impellas) were identified, and the majority of the devices were inserted through a minimally invasive approach ( n = 248, 60.9%), while the remainder were implanted via central access ( n = 159, 39.1%). Minimally invasive Impellas were upgraded in 44 patients. The risk of stroke for the entire cohort was 10.3% ( n = 36), with no difference observed in any particular group. Overall mortality was 44.4% ( n = 155). Of the patients who initially received a minimally invasive Impella, those who were upgraded had higher rates of mortality (56.8% vs 39.4%, P = 0.03), postoperative dialysis (50.0% vs 27.4%, P < 0.01), and sepsis (43.2% vs 20.0%, P < 0.01). Conclusions: This study found no statistically significant difference in rates of postoperative stroke based on initial access vessel.
High shear stress attenuated arterial neointimal hyperplasia accompanied by changes in yes-associated protein/jun N-terminal kinase/vascular cell adhesion protein 1 expression
Authors: Chen Feng , Luo Jun Fu , Wan Rong
Published: January 2022

Background and objectives

Abnormal neointimal hyperplasia (NIH) is known as the predominant mechanism in the pathogenesis of arterial restenosis after balloon angioplasty. Low shear stress (SS) is known to augment balloon injury–induced NIH. The aim of this study is to study the effect and mechanisms of an increase of shear stress caused by arteriovenous fistula could alleviate arterial NIH caused by balloon injury.

Methods and results

Eighteen male rabbits were randomly divided into three groups: BI—the rabbits received a balloon injury to right common carotid artery (CCA). BI+AVF—the rabbits received a balloon injury to right CCA and a carotid–jugular AVF. Control—the animals received no surgery. After 21 days, CCA samples were harvested for histological staining, immunohistochemistry, and western blot analysis. The luminal shear stress of the BI+AVF group increased from 13.8 ± 1.0 dyn/cm2 before surgery to 30.9 ± 1.7 dyn/cm2 right after surgery ( p < 0.01). This value was higher than that of the BI or Control groups at any timepoint. The neointimal area and neointima/media area ratio in the BI+AVF group were significantly lower than those in the BI group. In the BI group, the cellular proliferation, the protein levels of yes-associated protein (YAP), connective tissue growth factor (CTGF), phospho-c-Jun N-terminal kinase (pJNK), and vascular cell adhesion protein 1 (VCAM1) increased, whereas the protein levels of SMCs specific genes decreased. In the BI+AVF group, the opposite effect was observed as cellular proliferation and the protein levels of YAP, CTGF, pJNK, and VCAM1 decreased, the protein levels of SMCs specific genes increased.

Conclusion

The arteriovenous fistula alleviated the balloon injury–induced arterial NIH. It elevated the luminal shear stress and inhibited SMCs phenotypic modulation to the synthetic state, as well as suppressing the over-activation of YAP, JNK, and VCAM1.
Simple endovascular coiling: An effective long-term solution for wide-necked ruptured middle cerebral artery aneurysms? A 10-years retrospective study
Authors: Xenofontos Andreas , Raffalli-Ebezant Helen , Madhavan Aparna , Khan Haroon , Mastan Aliya , Russell Ian , Dulhanty Louise , Patel Hiren C , Hilditch Christopher A
Published: January 2022

Background

Endovascular coiling is usually the first line treatment modality for most ruptured intracranial aneurysms. However, there is still some debate as to whether microsurgical clipping or coiling is the treatment of choice for complex wide-necked ruptured middle cerebral artery (MCA) aneurysms. Our aim was to assess the efficacy, safety and longevity of simple endovascular coiling for ruptured MCA aneurysms

Methods

This was a single-centre 10 years retrospective study (2008–2019) of all endovascularly treated patients with ruptured MCA aneurysms ( n = 148). Patients were treated with simple coiling ( n = 111), balloon-assisted coiling ( n = 13), dual micro-catheter coiling ( n = 19), balloon-assisted and dual micro-catheter coiling ( n = 4) and woven endobridge (WEB) device ( n = 1). The standard follow-up protocol consisted of Magnetic Resonance angiography at 6, 12 and 24 months. Our primary endpoints were mortality at 2, 12 and 24 months and dependency at discharge. Secondary endpoints included aneurysm occlusion, complications, re-canalisation, rebleeding and retreatment rates.

Results

All-cause mortality at 2, 12 and 24 months was 4.7% ( n = 7), 8.1% ( n = 12) and 10.8% ( n = 16), respectively. 81.3% of patients remained independent in activities of daily livings (ADLs) at the point of discharge. Over a mean follow-up period of 19.7 months, we demonstrated re-bleeding and re-treatment rates of 2.7% ( n = 4) and 4.1% ( n = 6) respectively. Complete occlusion was achieved in 54% ( n = 79) of aneurysms, with recanalisation observed in 18.2% ( n = 27) of the patients.

Conclusions

Our results demonstrate that simple endovascular coiling techniques offer a safe and effective solution in the management of ruptured MCA aneurysms without the requirement for re-treatment either surgically or endovascularly using endoluminal stents or other devices.
Physiotherapy Practice Pattern in the Adult Intensive Care Units of Singapore – A Multi-Centre Survey
Authors: Ou Gabriel Wai Mun , Ng Marcus Jun Hui , Ng Cindy Li Whye , Ong Hwee Kuan , Jayachandran Balachandran , Palanichamy Vimal
Published: January 2022

Background

The roles of physiotherapy in Intensive Care Unit (ICU) have significantly developed from the traditional management of respiratory conditions to early rehabilitation and mobilisation of patients on mechanical ventilation. Surveys of United Kingdom, Australia and regional ICU physiotherapy practice have been published but there are no local data sets. This study aims to report the physiotherapy practices across the adult ICUs of Singapore.

Methods

Twenty-nine item questionnaire was mailed to 90 physiotherapists working in 15 adult ICUs across restructured and private hospitals in Singapore. Data sets were summarised from the returned questionnaires. This includes identifying common physiotherapy techniques and exercise prescription protocols for both mechanically and non-mechanically ventilated patients in the ICU.

Results

A total of 63 (70%) questionnaires were returned. The most used physiotherapy interventions were airway secretion clearance, techniques to improve lung ventilation and mobilisation out of bed. Positioning was most used respiratory technique (60/61, 98%). Sitting on the edge of bed is the most preferred physical activity for ICU patients (43/44, 98%). Exercise was routinely prescribed (50/61, 83%) although only a minority (8/50, 16%) have established exercise prescription protocols. For mechanically ventilated patients, active/active assisted exercises were most used (40/44, 91%). 12% of ICU use either Chelsea Critical Care Physical Assessment Tool or the Functional Status Score for the Intensive Care Unit as routine outcome measures.

Conclusion

Airway clearance was stated as the most used physiotherapy technique. Exercise is routinely prescribed in ICU. Validated outcome measures are only used by few.
Interactive virtual 3D image reconstruction to assist renal surgery in patients with fusion anomalies of the kidney
Authors: Morka Naomi , Berger Lorenz , Hyde Eoin , Mumtaz Faiz , Barod Ravi , Patki Prasad , Graafland Niels , Hendricksen Kees , Tran Maxine , Bex Axel
Published: January 2022

Objective:

Renal fusion anomalies are rare and usually present as horseshoe kidneys or crossed fusion ectopia. The complex renal anatomy seen in patients with these anomalies can present a challenge. Pre-operative planning is therefore paramount in the surgical management of these cases. Herein we report the use of interactive virtual three-dimensional (3D) reconstruction to aid renal surgery in patients with fusion anomalies of the kidney.

Materials and Methods:

A total of seven cases were performed between May 2016 and October 2020. 3D reconstruction was rendered by Innersight Labs using pre-operative computed tomography (CT) scans.

Results:

Five patients had malignant disease and two patients had benign pathology. Robotic and open operations were performed in four and three patients, respectively.

Conclusion:

The use of 3D reconstruction in the cases reported in this series allowed for the identification of variations in renal vasculature, and this informed the choice of operative approach.

Oxford Centre for Evidence-Based Medicine Evidence Level:

4
Innovative Cohort Process to Minimize COVID-19 Infection for Migrant Farmworkers During Travel to Iowa
Authors: Johnson Caroline , Dukes Kimberly , Sinnwell Emily , Culp Kennith , Zinnel Daniel , Corwin Claudia
Published: January 2022

Background: Migrant and seasonal farmworkers (MSFW) experience disproportionate infection, severe disease and death from COVID-19. This report describes an innovative process to address the safety of MSFW that utilized cohorting that eventually allowed for safe release to work in the fields on a large family farm in Iowa. Methods: Upon worker departure from Mexico, the employer arranged for bus seat assignments, mask use, and hand hygiene practice during the 3-day trip to Iowa. Upon arrival at the farm, surveillance testing and low-density housing cohorting based upon travel seat assignments allowed for early identification of infected workers and appropriate quarantine as per CDC guidelines. Upon completion of isolation or quarantine as appropriate, workers were released to congregate housing and work in the fields. Findings: Compared to a migrant farmworker COVID-19 outbreak without travel pre-planning, the cohorting process produced a 3.5% positivity rate compared to an earlier season July farmworker group on the same farm with a 12.7% positivity rate. Conclusions/Application to Practice: The success of this model points to the power of collaboration between farm employer, health care providers and workers to minimize worker infection and enable safe work in the fields. Increased state and federal support for MSFW protections could support infrastructure to proactively plan for prevention mechanisms to prevent the spread of known communicable disease. With support in place from the top down, employers, workers, and health care providers will be able to prioritize the management of infectious diseases and the needs of essential workers.
Incidence and Severity of Concussions Among Young Soccer Players Based on Age, Sex, and Player Position
Authors: Weiner Alden R. , Durbin John R. , Lunardi Susie R. , Li Adam Y. , Hannah Theodore C. , Schupper Alexander J. , Gal Jonathan S. , Jumreornvong Oranicha , Spiera Zachary , Ali Muhammad , Marayati Naoum Fares , Gometz Alex , Lovell Mark R. , Choudhri Tanvir F.
Published: January 2022

Background:

Previously studied risk factors for sports-related concussion in soccer players include sex, age, and player position. However, prior studies were limited in number, they reported conflicting results, and most did not assess initial concussion severity.

Purpose/Hypothesis:

The purpose of this study was to conduct an in-depth analysis of soccer players across key demographic groups (sex, age, position) for both concussion incidence and severity. It was hypothesized that concussion incidence and severity would be higher among male players, players aged ≥17 years, and goalkeepers.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

The authors analyzed baseline and postinjury ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) scores for athletes aged 12 to 22 years between July 2009 and June 2019. Players were assigned to an age group based on when they had their most recent baseline test. Concussion incidence and concussion severity index were compared using t tests and multivariate logistic regression.

Results:

For 1189 individuals who reported soccer as their primary sport, 1032 contributed 1754 baseline ImPACT tests (some individuals had multiple baseline tests), whereas 445 individuals were suspected of sustaining a concussion and then referred for a postinjury 1 test. Of these players, 254 (24.6%) had both a baseline and a postinjury test and were analyzed for concussion severity. Linear regression showed that forwards had a lower incidence of ImPACT-proxied concussions than goalkeepers had ( P = .008). Female players had a significantly higher incidence of ImPACT concussions compared with male players (mean, 0.07 [female] vs 0.04 [male] concussions per person-year; P = .05). Players in the ≥17-year age group had a higher incidence of ImPACT concussions than players in the 15- to 16-year age group ( P = .04), although the 15- to 16-year age group had more severe concussions than the ≥17-year age group (mean severity index, 2.91 [age 15-16 years] vs 1.73 [age ≥17 years]; P = .001).

Conclusion:

Female soccer players experienced a higher incidence of concussion than did male players, and goalkeepers experienced a greater incidence of ImPACT concussions than did forwards. Players of both sexes and all positions in the 15- to 16-year age group showed increased initial concussion severity compared with the ≥17-year age group, despite a lower comparative incidence of ImPACT concussions. Further study is needed to understand whether sex and player position affect concussion severity.
From Yellow Peril to Model Minority and Back to Yellow Peril
Authors: Wu Lin , Nguyen Nhu
Published: January 2022

During the COVID-19 pandemic, some perceptions of Asian Americans in the United States shifted as anti-Asian hate crimes escalated. However, little is known about how these shifting views manifest in K–12 schools. This qualitative case study uses Asian critical race theory to examine how two Southeast Asian American students faced exclusion and erasure before and during the COVID-19 pandemic and how their Southeast Asian American teacher advocated for them at a public elementary school in the Pacific Northwest. Implications include how researchers can pursue inquiries about Asian American students’ holistic development and how in-service and pre-service teachers can address anti-Asian xenophobia.
Contribution of antimicrobial photo-sonodynamic therapy in wound healing: an in vivo effect of curcumin-nisin-based poly (L-lactic acid) nanoparticle on Acinetobacter baumannii biofilms
Authors: Pourhajibagher Maryam , Pourakbari Babak , Bahador Abbas
Published: January 2022

Background

The biofilm-forming ability of Acinetobacter baumannii in the burn wound is clinically problematic due to the development of antibiotic-resistant characteristics, leading to new approaches for treatment being needed. In this study, antimicrobial photo-sonodynamic therapy (aPSDT) was used to assess the anti-biofilm efficacy and wound healing activity in mice with established A. baumannii infections.

Methods

Following synthesis and confirmation of Curcumin-Nisin-based poly (L-lactic acid) nanoparticle (CurNisNp), its cytotoxic and release times were evaluated. After determination of the sub-significant reduction (SSR) doses of CurNisNp, irradiation time of light, and ultrasound intensity against A. baumannii, anti-biofilm activity and the intracellular reactive oxygen species (ROS) generation were evaluated. The antibacterial and anti-virulence effects, as well as, histopathological examination of the burn wound sites of treated mice by CurNisNp-mediated aPSDTSSR were assessed and compared with silver sulfadiazine (SSD) as the standard treatment group.

Results

The results showed that non-cytotoxic CurNisNp has a homogeneous surface and a sphere-shaped vesicle with continuous release until the 14th day. The dose-dependent reduction in cell viability of A. baumannii was achieved by increasing the concentrations of CurNisNp, irradiation time of light, and ultrasound intensity. There was a time-dependent reduction in biofilm growth, changes in gene expression, and promotion in wound healing by the acceleration of skin re-epithelialization in mice. Not only there was no significant difference between aPSDTSSR and SSD groups in antibacterial and anti-virulence activities, but also wound healing and re-epithelialization occurred more efficiently in aPSDTSSR than in the SSD group.

Conclusions

In conclusion, CurNisNp-mediated aPSDT might be a promising complementary approach to treat burn wound infections.
Genome-wide analysis of the NAAT, DMAS, TOM, and ENA gene families in maize suggests their roles in mediating iron homeostasis
Authors: Zhang Xin , Xiao Ke , Li Suzhen , Li Jie , Huang Jiaxing , Chen Rumei , Pang Sen , Zhou Xiaojin
Published: January 2022

Background

Nicotianamine (NA), 2′-deoxymugineic acid (DMA), and mugineic acid (MA) are chelators required for iron uptake and transport in plants. Nicotianamine aminotransferase (NAAT), 2′-deoxymugineic acid synthase (DMAS), transporter of MAs (TOM), and efflux transporter of NA (ENA) are involved in iron uptake and transport in rice (Oryza sativa), wheat (Triticum aestivum), and barley (Hordeum vulgare); however, these families have not been fully identified and comprehensively analyzed in maize (Zea mays L.).

Results

Here, we identified 5 ZmNAAT, 9 ZmDMAS, 11 ZmTOM, and 2 ZmENA genes by genome mining. RNA-sequencing and quantitative real-time PCR analysis revealed that these genes are expressed in various tissues and respond differently to high and low iron conditions. In particular, iron deficiency stimulated the expression of ZmDMAS1, ZmTOM1, ZmTOM3, and ZmENA1. Furthermore, we determined protein subcellular localization by transient expression of green fluorescent protein fusions in maize mesophyll protoplasts. ZmNAAT1, ZmNAAT-L4, ZmDMAS1, and ZmDMAS-L1 localized in the cytoplasm, whereas ZmTOMs and ZmENAs targeted to plasma and tonoplast membranes, endomembranes, and vesicles.

Conclusions

Our results suggest that the different gene expression profiles and subcellular localizations of ZmNAAT, ZmDMAS, ZmTOM, and ZmENA family members may enable specific regulation of phytosiderophore metabolism in different tissues and under different external conditions, shedding light on iron homeostasis in maize and providing candidate genes for breeding iron-rich maize varieties.
Delivering colon cancer survivorship care in primary care; a qualitative study on the experiences of general practitioners
Authors: Vos Julien A. M. , de Best Robin , Duineveld Laura A. M. , van Weert Henk C. P. M. , van Asselt Kristel M.
Published: January 2022

Background

With more patients in need of oncological care, there is a growing interest to transfer survivorship care from specialist to general practitioner (GP). The ongoing I CARE study was initiated in 2015 in the Netherlands to compare (usual) surgeon- to GP-led survivorship care, with or without access to a supporting eHealth application (Oncokompas).

Methods

Semi-structured interviews were held at two separate points in time (i.e. after 1- and 5-years of care) to explore GPs’ experiences with delivering this survivorship care intervention, and study its implementation into daily practice. Purposive sampling was used to recruit 17 GPs. Normalisation Process Theory (NPT) was used as a conceptual framework.

Results

Overall, delivering survivorship care was not deemed difficult and dealing with cancer repercussions was already considered part of a GPs’ work. Though GPs readily identified advantages for patients, caregivers and society, differences were seen in GPs’ commitment to the intervention and whether it felt right for them to be involved. Patients’ initiative with respect to planning, absence of symptoms and regular check-ups due to other chronic care were considered to facilitate the delivery of care. Prominent barriers included GPs’ lack of experience and routine, but also lack of clarity regarding roles and responsibilities for organising care. Need for a monitoring system was often mentioned to reduce the risk of non-compliance. GPs were reticent about a possible future transfer of survivorship care towards primary care due to increases in workload and financial constraints. GPs were not aware of their patients’ use of eHealth.

Conclusions

GPs’ opinions and beliefs about a possible future role in colon cancer survivorship care vary. Though GPs recognize potential benefit, there is no consensus about transferring survivorship care to primary care on a permanent basis. Barriers and facilitators to implementation highlight the importance of both personal and system level factors. Conditions are put forth relating to time, reorganisation of infrastructure, extra personnel and financial compensation.

Trial registration

Netherlands Trial Register; NTR4860. Registered on the 2nd of October 2014.