bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a new scale to explore the experience of living with chronic heart failure: the UNAV-ENF-CHF scale
Authors: Olano-Lizarraga M , Martin-Martin J , Cobo Sanchez J L , Perez Garcia S , Zaragoza-Salcedo A , De La Torre Lomas N , Simon-Ricart Cenizo A , Ara Lucea P , Jimeno San Martin L , Ducay Eguillor M , Saracibar Razquin M
Published: July 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Integrated in the State R&D&I Plan 2013-2016 of the Spanish Goverment and co-financed by the General Directorate of Evaluation and Promotion of Research and the European Regional Development Fund (ERDF).

Introduction

Chronic heart failure (CHF) is characterized by a progressive deterioration in the patient's health state that significantly impacts their whole life. Most of the scales available for its assessment show that the physical dimension is still given great prominence, even when they aim to address quality of life.

Purpose

This study aimed to design a scale to know the experience of living with CHF.

Methods

Methodologically, the design of the scale followed DeVellis. The development of the items was based on a hermeneutic phenomenological study and a systematic review of the literature conducted by the research team. In addition, feedback was received from a panel of six experts. The scale was administered to a sample of 17 patients with CHF recruited by purposive sampling. A sociodemographic questionnaire was administered previously (see Table 1), and an observational study was conducted during data collection. A cognitive interview followed this. Data were collected in June-September 2020 in three heart failure units in three Spanish regions. In addition to the psychometric study of the scale's feasibility, acceptability, and reliability, a descriptive analysis of sociodemographic variables and a content analysis of the cognitive interview and the observational study were performed.

Results

A 55-item scale divided into six domains was designed. The analysis of the study conducted with patients showed a Cronbach's Alpha of 0.72-0.92 in Domains 1, 3, 4, and 6, with lower scores for Domain 2 (0.65) and 5 (0.23). Most item-total correlations remained within the criterion values (r> 0.20), and the homogeneity index was acceptable for Domains 1, 4, and 6. In the cognitive interview, patients considered the scale relevant, and the majority (82.35%) thought it was complete. The observational study evidenced that the questions were straightforward; two questionable items were removed; two were modified, and the possibility of "does not apply" was added in two of them.

Conclusions

Analysis of the results indicates that a national validation of the scale in a large sample of patients is needed to assess construct validity, and its feasibility, acceptability and reliability.
Hemostasis of the radial artery after coronary angiography: a scoping review
Authors: Teixeira Rodrigues D , Teixeira C , Parola V , Marques P
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Background/Introduction

Nowadays, most interventional cardiology procedures are made via radial artery. There is significant variability of haemostasis methods, devices, and protocols. All of them try to avoid radial artery occlusion while maintaining patent haemostasis. Summarizing the available evidence about haemostasis of the radial artery after coronary angiography will allow us to challenge our current practice.

Purpose

The focus of this scoping review is to map the literature on haemostasis of the radial artery after coronary angiography. To date, no previous reviews addressing this purpose have been found.

Methods

This review follows the Joanna Briggs Institute methodology for scoping reviews. Two reviewers will independently perform the study selection regarding their eligibility. Data extraction will be accomplished using a researcher's developed tool to address the objectives and reviews questions. Any disagreements arisen between the reviewers will be resolved by discussion or consulting a third reviewer. Data synthesis will be presented in tabular form and a narrative summary that align with the review's objective. Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension to scoping reviews guidelines will be used to report the results. A set of relevant electronic databases and grey literature will be searched.

Results

Twenty-four studies were included, of various types: randomized clinical trials, case-reports, case series, narrative reviews. Three methods were described: compression devices, compression band and haemostatic patch. Sometimes more than one method is used, and there are various protocols that vary according to the institutional practice.

Conclusion

There are multiple radial artery haemostasis methods and protocols currently in use after a coronary angiography with no method overwhelmingly predominant. Few were associated with clearly defined haemostasis protocols, even though these protocols exist, often associated with compression devices. The institutional practice plays a decisive role on the use and modification of these protocols, with no clear evidence to support it. Such variability in protocols might have a detrimental effect in having a standardized one that can be used across various institutions/countries, facilitating broader multicentric studies.
Co-designing an online support program for and with informal carers of people with heart failure
Authors: Allemann H , Andreasson F , Hanson E , Magnusson L , Jaarsma T , Thylen I , Stromberg A
Published: July 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Swedish research council for health, working life and welfare

Background

Informal care is increasing due to societal challenges such as ageing populations, more non-communicable diseases in combination with lack of health care personnel. Informal carers, namely family members, friends and neighbours, are important actors in the care and support of people with heart failure. To support them in their caring, information and communication technology has shown to be promising. The mentioned challenges have also put pressure on digitalising health care. The COVID 19 pandemic has further highlighted the need to provide and receive support through digital services. There is currently a lack of support interventions for carers of people with heart failure that are directly integrated within the health care system. To develop relevant support carers should be involved in the process.

Purpose

The aim of the study was to describe the co-design process in the development of an online support program for carers of people with heart failure.

Methods

Informal carers, researchers and practitioners were involved in the co-design process. In the first phase an assessment of carers’ needs and preferences was performed based on a literature search, focus group interviews (n=23 carers), individual interviews and user group sessions (n= 7 carers). Phase two continued with the actual development of the support program prototype, based on the results of phase one. This phase included 13 carers and 18 researchers and practitioners. In the final phase, the program was reviewed and refined by carers, practitioners, and researchers. The project group coordinated the co-design process and took part in the development of the support program.

Results

The co-design process resulted in an online support program consisting of 15 modules with the aim to increase carers’ preparedness to care for a person with heart failure. Each module focused on different topics such as "About heart failure" and "To be a carer". The support program was designed and integrated within the Swedish national e-health platform "1177" in a section called "support and treatment". During the co-design process, various challenges arose, which included the choice of platform itself which then influenced the further co-design process. This process involved balancing implementation and sustainability requirements, against carers’ needs and preferences regarding the program itself.

Conclusions

To conduct a co-design process involving carers and other actors means to navigate diverse interests, goals and pay due attention to regulations. It is an explorative process in which researchers need to be flexible. The effects of the program will now be tested via a randomized controlled trial, and the results will also illuminate the co-design process further.
Museum Genomics Provide Evidence for Persistent Genetic Differentiation in a Threatened Seabird Species in the Western Atlantic
Authors: Byerly Paige A , Chesser R Terry , Fleischer Robert C , McInerney Nancy , Przelomska Natalia A S , Leberg Paul L
Published: July 2022

Connectivity among wildlife populations facilitates exchange of genetic material between groups. Changes to historical connectivity patterns resulting from anthropogenic activities can therefore have negative consequences for genetic diversity, particularly for small or isolated populations. DNA obtained from museum specimens can enable direct comparison of temporal changes in connectivity among populations, which can aid in conservation planning and contribute to the understanding of population declines. However, museum DNA can be degraded and only available in low quantities, rendering it challenging for use in population genomic analyses. Applications of genomic methodologies such as targeted sequencing address this issue by enabling capture of shared variable sites, increasing quantity and quality of recovered genomic information. We used targeted sequencing of ultra-conserved Elements (UCEs) to evaluate potential changes in connectivity and genetic diversity of roseate terns (Sterna dougallii) with a breeding distribution in the northwestern Atlantic and the Caribbean. Both populations experienced range contractions and population declines due to anthropogenic activity in the 20th century, which has the potential to alter historical connectivity regimes. Instead, we found that the two populations were differentiated historically as well as contemporaneously, with little evidence of migration between them for either time period. We also found no evidence for temporal changes in genetic diversity, although these interpretations may have been limited due to sequencing artifacts caused by the degraded nature of the museum samples. Population structuring in migratory seabirds is typically reflective of low rates of divergence and high connectivity among geographically segregated subpopulations. Our contrasting results suggest the potential presence of ecological mechanisms driving population differentiation, and highlight the value of targeted sequencing on DNA derived from museum specimens to uncover long-term patterns of genetic differentiation in wildlife populations.
Ultrastructural examination of mouse kidney glomerular capillary loop by sandwich freezing and freeze-substitution
Authors: Yamaguchi Masashi , Takahashi-Nakaguchi Azusa , Uematsu Katsuyuki , Yamada Hiroyuki , Sato-Okamoto Michiyo , Chibana Hiroji
Published: July 2022

Sandwich freezing is a method of rapid freezing by sandwiching specimens between two metal disks and has been used for observing exquisite the close-to-native ultrastructure of living yeast and bacteria. Recently, this method has been found to be useful for preserving cell images of glutaraldehyde-fixed animal and human tissues. In the present study, this method was applied to observe the fine structure of mouse glomerular capillary loops. Morphometry was then performed, and the results were compared with the data obtained by an in vivo cryotechnique, which may provide the closest ultrastructure to the native state of living tissue. The results show that the ultrastructure of glomerular capillary loops obtained by sandwich freezing–freeze-substitution after glutaraldehyde fixation was close to that of the ultrastructure obtained by in vivo cryotechnique not only in the quality of cell image but also in quantitative morphometry. They indicate that the ultrastructure obtained by sandwich freezing–freeze-substitution after glutaraldehyde fixation may more closely reflect the living state of cells and tissues than conventional chemical fixation and dehydration at room temperature and conventional rapid freezing–freeze-substitution of excised tissues without glutaraldehyde fixation. Sandwich freezing–freeze-substitution techniques should be used routinely as a standard method for observing the close-to-native ultrastructure of biological specimens.
Apolipoprotein E ε4 Mediates Myelin Breakdown by Targeting Oligodendrocytes in Sporadic Alzheimer Disease
Authors: Cheng Gerald Wai-Yeung , Mok Kingston King-Shi , Yeung Sunny Hoi-Sang , Kofler Julia , Herrup Karl , Tse Kai-Hei
Published: July 2022

White matter degradation in the frontal lobe is one of the earliest detectable changes in aging and Alzheimer disease. The ε4 allele of apolipoprotein E (APOE4) is strongly associated with such myelin pathology but the underlying cellular mechanisms remain obscure. We hypothesized that, as a lipid transporter, APOE4 directly triggers pathology in the cholesterol-rich myelin sheath independent of AD pathology. To test this, we performed immunohistochemistry on brain tissues from healthy controls, sporadic, and familial Alzheimer disease subjects. While myelin basic protein expression was largely unchanged, in frontal cortex the number of oligodendrocytes (OLs) was significantly reduced in APOE4 brains independent of their Braak stage or NIA-RI criteria. This high vulnerability of OLs was confirmed in humanized APOE3 or APOE4 transgenic mice. A gradual decline of OL numbers was found in the aging brain without associated neuronal loss. Importantly, the application of lipidated human APOE4, but not APOE3, proteins significantly reduced the formation of myelinating OL in primary cell culture derived from Apoe-knockout mice, especially in cholesterol-depleted conditions. Our findings suggest that the disruption of myelination in APOE4 carriers may represent a direct OL pathology, rather than an indirect consequence of amyloid plaque formation or neuronal loss.
Secondary Syphilis Presentation and Urticarial Eruption After Moderna COVID-19 Vaccination
Authors: Brockshus Aaron , Evans Martin O , Punch Chandra
Published: July 2022

The diversity of the cutaneous manifestations of syphilis and the ability of the spirochete to evade diagnosis have been well documented by medical literature. However, what triggers the onset of secondary syphilis is not yet clear because of difficulties studying the bacterium. Our case describes the onset of a heterogeneous rash (or coexisting rashes) that presented the day after vaccination with the Moderna mRNA-1273 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. The potential etiologies of the patient’s rash: A vaccine reaction, reactivation of chronic spontaneous urticaria, or a physical sign of syphilis itself are then reviewed. The potential for the Moderna coronavirus disease 2019 (COVID-19) vaccine to be the catalyst of this patient’s cutaneous manifestations of his immune system responses is also hypothesized.
From Ancient to Modern: Identifying Anglicanism in an Anglo-Jewish Hymnal
Authors: Padley Danielle
Published: July 2022

In 1899, Francis L. Cohen and David M. Davis published Kol Rinnah U’Tefillah: The Voice of Prayer and Praise. This pioneering ‘Handbook of Synagogue Music for Congregational Singing’ standardized the body of liturgical music used in Anglo-Jewish worship to this day. Early references to the volume as a ‘hymnal’ highlight parallels with Anglican music publications of the period, notably Hymns, Ancient and Modern (1861), the unofficial hymnbook of the Church of England. Published over thirty years apart, there are nonetheless striking correlations between the purpose, reception, and content of the two collections. This article explores these correlations, tracing the histories of Hymns Ancient and Modern and The Voice of Prayer and Praise in relation to two other prominent volumes published in mid-century: John Mason Neale and Thomas Helmore’s Hymnal Noted (1851) and Emanuel Aguilar and David Aaron De Sola’s The Ancient Melodies of the Spanish and Portuguese Jews (1857).
Physical properties of near-Earth asteroid (2102) Tantalus from multiwavelength observations
Authors: Rożek Agata , Lowry Stephen C , Rozitis Benjamin , Dover Lord R , Taylor Patrick A , Virkki Anne , Green Simon F , Snodgrass Colin , Fitzsimmons Alan , Campbell-White Justyn , Sajadian Sedighe , Bozza Valerio , Burgdorf Martin J , Dominik Martin , Figuera Jaimes R , Hinse Tobias C , Hundertmark Markus , Jørgensen Uffe G , Longa-Peña Penélope , Rabus Markus , Rahvar Sohrab , Skottfelt Jesper , Southworth John
Published: July 2022

Between 2010 and 2017, we have collected new optical and radar observations of the potentially hazardous asteroid (2102) Tantalus from the ESO NTT and Danish telescopes at the La Silla Observatory, and from the Arecibo planetary radar. The object appears to be nearly spherical, showing a low-amplitude light-curve variation and limited large-scale features in the radar images. The spin-state is difficult to constrain with the available data; including a certain light-curve subset significantly changes the spin-state estimates, and the uncertainties on period determination are significant. Constraining any change in rotation rate was not possible, despite decades of observations. The convex light curve-inversion model, with rotational pole at λ = 210° ± 41° and β = −30° ± 35°, is more flattened than the two models reconstructed by including radar observations: with prograde (λ = 36° ± 23°, β = 30° ± 15°), and with retrograde rotation mode (λ = 180° ± 24°, β = −30 ± 16°). Using data from WISE, we were able to determine that the prograde model produces the best agreement in size determination between radar and thermophysical modelling. Radar measurements indicate possible variation in surface properties, suggesting one side might have lower radar albedo and be rougher at the centimetre-to-decimetre scale than the other. However, further observations are needed to confirm this. Thermophysical analysis indicates a surface covered in fine-grained regolith, consistent with radar albedo, and polarisation ratio measurements. Finally, geophysical investigation of the spin-stability of Tantalus shows that it could be exceeding its critical spin-rate via cohesive forces.
Bayesian control variates for optimal covariance estimation with pairs of simulations and surrogates
Authors: Chartier Nicolas , Wandelt Benjamin D
Published: July 2022

Predictions of the mean and covariance matrix of summary statistics are critical for confronting cosmological theories with observations, not least for likelihood approximations and parameter inference. Accurate estimates require running costly N-body and hydrodynamics simulations. Approximate solvers, or surrogates, greatly reduce the computational cost but introduce biases, especially in the non-linear regime of structure growth. We propose ‘CARPool Bayes’ to solve the inference problem for both the means and covariances using a combination of simulations and surrogates. Our approach allows incorporating prior information for the mean and covariance. We derive closed-form solutions for maximum a posteriori covariance estimates that are efficient Bayesian shrinkage estimators, guarantee positive semidefiniteness, and can optionally leverage analytical covariance approximations. We discuss choices of the prior and propose a procedure for obtaining optimal prior hyperparameter values with a small set of test simulations. We test our method by estimating the covariances of clustering statistics of gadget-iiiN-body simulations at redshift z = 0.5 using surrogates from a 100–1000× faster particle-mesh code. Taking the sample covariance from 15 000 simulations as the truth, and using an empirical Bayes prior with diagonal blocks, our estimator produces nearly identical Fisher matrix contours for ΛCDM parameters using only 15 simulations of the non-linear dark matter power spectrum. In this case, the number of simulations is so small that the sample covariance is degenerate. We show cases where even with a naïve prior our method improves the estimate. Our framework is applicable to a wide range of cosmological problems where fast surrogates are available.
2001 SN263 – the contribution of their irregular shapes on the neighbourhood dynamics
Authors: Valvano G , Winter O C , Sfair R , Machado Oliveira R , Borderes-Motta G
Published: July 2022

The first proposed Brazilian mission to deep space, the ASTER mission, has the triple asteroid system (153591) 2001 SN263 as a target. One of the mission’s main goals is to analyse the physical and dynamical structures of the system to understand its origin and evolution. This work aims to analyse how the asteroid’s irregular shape interferes with the stability around the system. The results show that the irregular shape of the bodies plays an important role in the dynamics nearby the system. For instance, the perturbation due to the (153591) 2001 SN263 Alpha’s shape affects the stability in the (153591) 2001 SN263 Gamma’s vicinity. Similarly, the (153591) 2001 SN263 Beta’s irregularity causes a significant instability in its nearby environment. As expected, the prograde case is the most unstable, while the retrograde scenario presents more stability. Additionally, we investigate how the solar radiation pressure perturbs particles of different sizes orbiting the triple system. We found that particles with a 10–50 cm radius could survive the radiation pressure for the retrograde case. Meanwhile, to resist solar radiation, the particles in prograde orbit must be larger than the particles in retrograde orbits, at least one order of magnitude.
WS-Snapshot: an effective algorithm for wide-field and large-scale imaging
Authors: Xie Yang-Fan , Wang Feng , Deng Hui , Mei Ying , Lü Ying-He Celeste , Hodosán Gabriella , Stolyarov Vladislav , Smirnov Oleg , Li Xiao-Feng , Cornwell Tim
Published: July 2022

The Square Kilometre Array (SKA) is the largest radio interferometer under construction in the world. The high accuracy, wide-field, and large size imaging significantly challenge the construction of the Science Data Processor (SDP) of SKA. We propose a hybrid imaging method based on improved W-Stacking and snapshots. The w-range is reduced by fitting the snapshot uv plane, thus effectively enhancing the performance of the improved W-Stacking algorithm. We present a detailed implementation of WS-Snapshot. With full-scale SKA1-LOW simulations, we present the imaging performance and imaging quality results for different parameter cases. The results show that the WS-Snapshot method enables more efficient distributed processing and significantly reduces the computational time overhead within an acceptable accuracy range, which would be crucial for subsequent SKA science studies.
Prevalence and risk factors of monoclonal gammopathy in patients with autoimmune inflammatory rheumatic disease: A systematic review and meta-analysis
Authors: Bai Zhiqian , Hu Chuanyu , Zhong Jixin , Dong Lingli
Published: July 2022

Objective

To systemically investigate the prevalence and risk factors of monoclonal gammopathy (MG) in patients with autoimmune inflammatory rheumatic disease (AIIRD).

Methods

A literature search was conducted using databases of PubMed, EMBASE, and Web of Science for relevant studies from inception to 31 July 2021. The pooled prevalence, odds ratio (OR), weighted mean difference (WMD), and 95% confidence interval (CI) were calculated with Stata 16.0 using a random or fixed effects model.

Results

In 17 included studies involving 6667 AIIRD patients, the pooled prevalence of MG in AIIRD patients was 7% (95%CI: 0.06–0.09). Compared to general populations, patients with Sjögren’s syndrome (SS) possessed the highest risk for MG (OR 4.51; 95%CI: 3.39–5.74), followed by systemic lupus erythematosus (OR 3.99; 95%CI: 2.84–5.14), ankylosing spondylitis (OR 2.04; 95%CI: 1.11–2.97), and rheumatoid arthritis (OR 2.00; 95%CI: 1.79–2.22). Older age (WMD = 5.17 years; 95%CI: 0.68–9.66), higher erythrocyte sedimentation rate (WMD = 14.04 mm/H; 95%CI: 7.77–20.30), higher serum gammaglobulins level (WMD = 1.92 mg/dl, 95%CI: 0.51–3.32) were associated with a greater risk of MG in AIIRD patients.

Conclusions

MG prevalence was higher in AIIRD patients, especially in SS patients. Older age, higher erythrocyte sedimentation rate, and hypergammaglobulins were risk factors for MG in AIIRD patients.
A Cross-sectional Analysis of Socio-spatial Patterning of Tobacco Retail in Shanghai, China
Authors: Zheng Chunyu , Feng Zhiqiang , Pearce Jamie
Published: July 2022

Introduction

International evidence from high-income countries demonstrates that the availability of tobacco tends to be greater in more urban and more deprived neighborhoods. However, little is known about the socio-spatial disparities in other settings, including megacities in China. This study investigated the patterning of tobacco retailers across Shanghai by types of tobacco retailers, including the relationship with levels of urbanity and neighborhood deprivation.

Aims and Methods

Tobacco retailer data (n = 19 413) was extracted from a web-scraped Points-of-Interest database. For all communities (n = 5432) across Shanghai, neighborhood tobacco retail availability was calculated using population-weighted kernel density estimation and grouped by quintiles of neighborhood deprivation and a 3-level urban classification. Associations were analyzed using the Kruskal–Wallis tests and epsilon squared.

Results

Across Shanghai, tobacco retail availability decreased from more urbanized areas to less urbanized areas. There was a statistical difference (p < .001) in the availability of tobacco retail across quintiles of deprivation, with the highest availability in the less deprived neighborhoods, and the lowest availability in the most deprived neighborhoods. However, this trend was reversed in the urban center, where retail availability was greatest in the most deprived areas. Convenience stores were the most common type of tobacco retailer across the city, while tobacco-only outlets were most strongly associated with levels of neighborhood deprivation.

Conclusions

The results show an association between tobacco retail availability and neighborhood deprivation, which varied with levels of urbanity and types of tobacco retailers. These findings provide supportive evidence for further interventions that target reducing inequalities in exposure to tobacco retail.

Implications

This is the first study to examine the relationship between tobacco retail availability and neighborhood deprivation in the context of Chinese megacities. Using data from Shanghai, China, we found a significant non-linear association between tobacco retail availability and neighborhood deprivation across the city. It is plausible that the socio-spatial disparities in tobacco retail availability at the neighborhood level may be a key factor explaining differences in smoking behaviors between sociodemographic groups. The findings emphasize the need for greater efforts in regulating neighborhood-level tobacco retailing in China.
ROP Interactive Partners are Involved in the Control of Cell Division Patterns in Arabidopsis Leaves
Authors: Hasi Qimuge , Kakimoto Tatsuo
Published: July 2022

Animal Rho GTP-binding proteins and their plant counterparts, Rho of plants (ROPs), regulate cell polarity, but they do so through different effector proteins. A class of ROP effectors, interactor of constitutive active ROPs (ICRs)/ROP interactive partners (RIPs), has been implicated in diverse biological processes; however, there are limited analyses of RIP loss-of-function mutants. Here, we report an analysis of the functions of the Arabidopsis thaliana RIPs in the leaf epidermis. Green Fluorescent Protein (GFP) fusion proteins of all the RIPs colocalized to cortical microtubules. RIP1, RIP3 and RIP4, but not RIP2 and RIP5, colocalized with the preprophase band (PPB), spindles and phragmoplasts. RIP2 and RIP5 did not colocalize with the PPB, spindles or phragmoplasts even when they were expressed under a promoter active in proliferative cells, indicating that there are differences among RIP protein properties. The overexpression of RIP1 or RIP4 resulted in the fragmentation of cortical microtubules, and the rip1 2 3 4 5 quintuple mutant showed increased growth rate of microtubules at their plus ends compared with the wild type. The rip1 2 3 4 5 mutant leaves and petals were narrow, which was explained by the decreased cell number along the transverse axis compared with that of the wild type. The rip1 2 3 4 5 mutant leaf epidermis possessed fewer PPBs oriented close to the long axis of the leaf compared with wild type, indicating the involvement of RIPs in cell division plane regulation and leaf shape determination.
Impact of Personalized Outcomes Forecasts on Clinical Reasoning of Physical Therapists in Intermittent Claudication: A Vignette Study
Authors: Sinnige Anneroos , Teijink Joep A W , Spruijt Steffie , Kittelson Andrew J , Oude Bos Anita , Van der Wees Philip J , Hoogeboom Thomas J
Published: July 2022

Objective

Guidelines recommend supervised exercise therapy and lifestyle counseling by a physical therapist as initial treatment for patients with intermittent claudication. However, guidelines provide only a crude estimate of the outcomes that therapists and patients might expect from treatment. The purpose of this study was to explore the impact of personalized outcomes forecasts (POFs) on the decision-making process of physical therapists and to learn lessons on facilitating the use of forecasts in daily practice.

Methods

A vignette-based, think-aloud interview study design was used. The participants were physical therapists trained in treating patients with intermittent claudication. Vignettes described fictitious patients diagnosed with intermittent claudication and included POFs. A directed approach was used to code, organize, and describe the data. Transcripts were analyzed using a thematic approach.

Results

Sixteen therapists participated in the study. Three themes were identified: (1) setting and contextualizing treatment expectations, (2) setting (shared) goals and (de)motivating the patient, and (3) establishing and monitoring the treatment plan. Therapists mentioned that POFs could be useful for setting expectations and realistic treatment goals, contextualizing expected treatment response, stimulating patients to achieve their goals, and deciding on treatment frequency and treatment timing. Therapists thought POFs would be of less use for changing treatment goals during follow-up visits or for establishing intensity or type of training.

Conclusion

To overcome challenges that may arise when adopting POFs in daily practice, adequate training of physical therapists should be conducted. Potential areas to address with training include statistical and data literacy as well as guidance on integrating POFs with existing treatment protocols.

Impact

The use of POFs by physical therapists might contribute to a more person-centered care approach. The insights provided by this study on the first use of POFs by physical therapists can serve as an example and lesson on how to optimally implement such supporting tools into daily practice.
Leptin-mediated neural targets in obesity hypoventilation syndrome
Authors: Amorim Mateus R , Aung O , Mokhlesi Babak , Polotsky Vsevolod Y
Published: July 2022

Obesity hypoventilation syndrome (OHS) is defined as daytime hypercapnia in obese individuals in the absence of other underlying causes. In the United States, OHS is present in 10%–20% of obese patients with obstructive sleep apnea and is linked to hypoventilation during sleep. OHS leads to high cardiorespiratory morbidity and mortality, and there is no effective pharmacotherapy. The depressed hypercapnic ventilatory response plays a key role in OHS. The pathogenesis of OHS has been linked to resistance to an adipocyte-produced hormone, leptin, a major regulator of metabolism and control of breathing. Mechanisms by which leptin modulates the control of breathing are potential targets for novel therapeutic strategies in OHS. Recent advances shed light on the molecular pathways related to the central chemoreceptor function in health and disease. Leptin signaling in the nucleus of the solitary tract, retrotrapezoid nucleus, hypoglossal nucleus, and dorsomedial hypothalamus, and anatomical projections from these nuclei to the respiratory control centers, may contribute to OHS. In this review, we describe current views on leptin-mediated mechanisms that regulate breathing and CO2 homeostasis with a focus on potential therapeutics for the treatment of OHS.
Xylella fastidiosa Outbreak in Israel: Population Genetics, Host Range, and Temporal and Spatial Distribution Analysis
Authors: Zecharia Noa , Krasnov Helena , Vanunu Miri , Siri Andreina Castillo , Haberman Ami , Dror Orit , Vakal Lera , Almeida Rodrigo P. P. , Blank Lior , Shtienberg Dani , Bahar Ofir
Published: July 2022

Diseases caused by the insect-transmitted bacterium Xylella fastidiosa have been reported in the Americas since the 19th century, causing diseases such as Pierce's disease of grapevine, almond leaf scorch (ALS), and citrus variegated chlorosis. In the last decade X. fastidiosa was reported from different parts of the world, most notably from southern Italy, infecting olives. In 2017, X. fastidiosa was reported to be associated with ALS symptoms in Israel. Here, we investigated the causal agent of ALS in Israel, its genetic diversity, and host range, and we characterized the temporal and spatial distribution of the disease. X. fastidiosa subsp. fastidiosa sequence type 1 was isolated from symptomatic almond trees and was used to infect almond and grapevine by mechanical inoculation. The pathogen, however, did not infect olive, peach, cherry, plum, nectarine, clementine, and grapefruit plants. Genomic analysis of local isolates revealed that the local population is derived from a single introduction and that they are closely related to X. fastidiosa strains from grapevines in California. Distribution analyses revealed that ALS did not expand from 2017 to 2019; however, since 2020, newly symptomatic trees appeared in the tested orchards. Symptomatic trees were located primarily in clusters, and symptoms tended to spread within rows. Our study confirms that X. fastidiosa is the causal agent of ALS in Israel and describes its genetic and host range characteristics. Although there is no clear evidence yet for the identity of the vectors in Israel, ALS spread continues to threat the almond and grapevine industries in Israel.
Severe asthma and personalized approach in the choice of biologic
Authors: Di Bona Danilo , Spataro Federico , Carlucci Palma , Paoletti Giovanni , Canonica Giorgio W.
Published: July 2022

Purpose of review

Severe asthma requires intensive pharmacological treatment to achieve disease control. Oral corticosteroids are effective, but their use is burdened with important side effects. Biologics targeting the specific inflammatory pathways underpinning the disease have been shown to be effective but not all patients respond equally well. As we treat more patients than those who can respond, our inability to predict responders has important healthcare costs considering that biologics are expensive drugs. Thus, a more precise choice of the ‘right patients’ to be prescribed with the ‘right biologics’ would be desirable.

Recent findings

Machine learning techniques showed that it is possible to increase our ability to predict outcomes in patients treated with biologics. Recently, we identified by cluster analysis four different clusters within the T2 high phenotype with differential benralizumab response. Two of these clusters, characterized by higher levels of inflammatory markers, showed the highest response rate (80–90%).

Machine learning holds promise for asthma research enabling us to predict which patients will respond to which drug. These techniques can facilitate the diagnostic workflow and increase the chance of selecting the more appropriate treatment option for the individual patient, enhancing patient care and satisfaction.
Management of endothelial disease without keratoplasty
Authors: Hakim Farida E. , He P. Cody , Veldman Peter B.
Published: July 2022

Purpose of review

Currently, the most widely used treatment for endothelial disease is endothelial replacement via endothelial keratoplasty. Increasingly selective techniques have allowed for increased safety and faster visual recovery. However, alternative treatment options that are lower in cost, require less surgical expertise, and rely less on tissue availability are needed. This review discusses established and emerging therapies for endothelial disease without keratoplasty.

Recent findings

Regenerative therapies that have been successful include Descemet stripping only and Descemet membrane transplants. Rho-kinase inhibitors promote cell proliferation, adhesion, and migration and appear to have a role in these treatments and possibly in the prevention of endothelial disease. Cell-based therapies and the development of an artificial endothelial implant have also demonstrated promising results.

There are numerous emerging treatments for endothelial disease that have proven successful. Advances in our understanding of disease pathogenesis on a cellular level will continue to expand possibilities for therapeutics.
Impact of vaccination on keratoplasty
Authors: Dugan Sarah P. , Mian Shahzad I.
Published: July 2022

Purpose of review

Corneal graft rejection has been reported after coronavirus disease 2019 (COVID-19) vaccination. The purpose of this review is to evaluate the literature regarding corneal graft rejection after vaccination, including rejection rates and risk factors. We aim to create a framework to identify patients who are at higher risk for graft rejection and may warrant consideration of prophylactic interventions.

Recent findings

Graft rejection has been reported following administration of mRNA, viral vector, and inactivated whole-virion COVID-19 vaccines. Most cases had additional risk factors associated with rejection. Vaccination increases circulation of proinflammatory cytokines, CD4+ and CD8+ T-cell responses, and antispike neutralizing antibody, all of which may contribute to graft rejection. Two prospective studies have found no relationship between recent vaccination and rejection but 20% of cornea specialists report to have seen a vaccine-associated rejection and 22% recommend delaying vaccination in certain circumstances. Many specialists recommend prophylactic topical corticosteroids before and after vaccination to mitigate rejection risk but there is no evidence to support this practice on a wider scale.

Our framework identified 96.8% of penetrating keratoplasty patients with vaccine-associated rejection as higher risk. Further research is needed in order to develop evidence-based guidelines.
Therapy for contact lens-related ulcers
Authors: Jeang Lauren , Tuli Sonal S.
Published: July 2022

Purpose of review

The current review covers the current literature and practice patterns of antimicrobial therapy for contact lens-related microbial keratitis (CLMK). Although the majority of corneal ulcers are bacterial, fungus, and acanthamoeba are substantial contributors in CLMK and are harder to treat due to the lack of commercially available topical medications and low efficacy of available topical therapy.

Recent findings

Topical antimicrobials remain the mainstay of therapy for corneal ulcers. Fluoroquinolones may be used as monotherapy for small, peripheral bacterial ulcers. Antibiotic resistance is a persistent problem. Fungal ulcers are less responsive to topical medications and adjunct oral or intrastromal antifungal medications may be helpful. Acanthamoeba keratitis continues to remain a therapeutic challenge but newer antifungal and antiparasitic agents may be helpful adjuncts. Other novel and innovative therapies are being studied currently and show promise.

Contact lens-associated microbial keratitis is a significant health issue that can cause vision loss. Treatment remains a challenge but many promising diagnostics and procedures are in the pipeline and offer hope.
Advances in eye banking and corneal tissue processing
Authors: Li Jennifer Y.
Published: July 2022

Purpose of review

Eye bank processing of donor corneal tissue has helped to revolutionize and popularize newer corneal transplantation surgeries. In particular, Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK) have benefited from eye banks preparing donor corneal tissue in advance of the surgery. As a result of these eye banking advances, surgeons have been able to rapidly adopt these new techniques.

Recent Findings

This article reviews the techniques that are now being utilized to prepare donor tissue for endothelial keratoplasty (EK) with a focus on Ultrathin-DSAEK, prestamped, prestained, preloaded DMEK tissue, and advancements to improve the safety of donor corneal tissue.

Collaborative efforts between surgeons and eye banks have been at the core of advances that have been made in EK over the past decade. Corneal surgery starts in the eye bank, and it is important for corneal surgeons to understand the process and appreciate the efforts that have been made to provide them with suitable and safe donor corneal tissue.
Translating guidelines into practice via implementation science: an update in lipidology
Authors: Jones Laney K. , Sturm Amy C. , Gionfriddo Michael R.
Published: July 2022

Purpose of review

Guidelines provide recommendations for clinicians based on the best available evidence and informed by clinical expertise. These recommendations often fail to be utilized by clinicians hindering the translation of evidence into practice. The purpose of this review is to describe novel ways in which implementation science has been used to improve translation of guidelines into clinical practice in the field of lipidology.

Recent findings

We searched PubMed for articles related to guideline implementation in lipidology published in 2021 and 2022. Identified articles were categorized into three domains: first, poor uptake of guideline recommendations in practice; second, implementation science as a solution to improve care; and third, examples of how implementation science can be incorporated into guidelines.

The field of lipidology has identified that many guideline recommendations fail to be translated into practice and has started to utilize methods from implementation science to assess ways to shrink this gap. Future work should focus on deploying tools from implementation science to address current gaps in guideline development. Such as, developing a systematic approach to restructure guideline recommendations so they are implementable in practice and aid in clinicians’ ability to easily translate them into practice.
Navigating End-of-Life Needs for a Person With Intellectual Disabilities and Their Caregivers
Authors: Moore Caitlyn M. , Kates Jeannette
Published: July 2022

People with intellectual disabilities (IDs) are living longer, with many experiencing significant barriers to accessing palliative care and hospice services. Families, caregivers, and direct support professionals comprise essential portions of the community of support often surrounding a person with IDs. For a variety of reasons, including clinician bias and communication difficulties, many people with IDs are excluded from critical conversations regarding their health and life. This article uses a blended case study to explore the complexities and unique considerations in ensuring ethical and practical end-of-life care for people with IDs. Decision-making must center on the person with ID and include them in ways they can understand, thus facilitating their right to autonomy. A collaborative approach to care with shared expertise between caregivers and hospice and palliative care services is key to providing effective, patient-centered care at the end of life. There are tremendous areas of opportunity to improve end-of-life care for this population by partnering with people with IDs, their families, and caregivers.
Deep Learning for Fully Automated Prediction of Overall Survival in Patients Undergoing Resection for Pancreatic Cancer
Authors: Yao Jiawen , Cao Kai , Hou Yang , Zhou Jian , Xia Yingda , Nogues Isabella , Song Qike , Jiang Hui , Ye Xianghua , Lu Jianping , Jin Gang , Lu Hong , Xie Chuanmiao , Zhang Rong , Xiao Jing , Liu Zaiyi , Gao Feng , Qi Yafei , Li Xuezhou , Zheng Yang , Lu Le , Shi Yu , Zhang Ling
Published: July 2022

Objective:

To develop an imaging-derived biomarker for prediction of overall survival (OS) of pancreatic cancer by analyzing preoperative multiphase contrast-enhanced computed topography (CECT) using deep learning.

Background:

Exploiting prognostic biomarkers for guiding neoadjuvant and adjuvant treatment decisions may potentially improve outcomes in patients with resectable pancreatic cancer.

Methods:

This multicenter, retrospective study included 1516 patients with resected pancreatic ductal adenocarcinoma (PDAC) from 5 centers located in China. The discovery cohort (n=763), which included preoperative multiphase CECT scans and OS data from 2 centers, was used to construct a fully automated imaging-derived prognostic biomarker—DeepCT-PDAC—by training scalable deep segmentation and prognostic models (via self-learning) to comprehensively model the tumor-anatomy spatial relations and their appearance dynamics in multiphase CECT for OS prediction. The marker was independently tested using internal (n=574) and external validation cohorts (n=179, 3 centers) to evaluate its performance, robustness, and clinical usefulness.

Results:

Preoperatively, DeepCT-PDAC was the strongest predictor of OS in both internal and external validation cohorts [hazard ratio (HR) for high versus low risk 2.03, 95% confidence interval (CI): 1.50–2.75; HR: 2.47, CI: 1.35–4.53] in a multivariable analysis. Postoperatively, DeepCT-PDAC remained significant in both cohorts (HR: 2.49, CI: 1.89–3.28; HR: 2.15, CI: 1.14–4.05) after adjustment for potential confounders. For margin-negative patients, adjuvant chemoradiotherapy was associated with improved OS in the subgroup with DeepCT-PDAC low risk (HR: 0.35, CI: 0.19–0.64), but did not affect OS in the subgroup with high risk.

Conclusions:

Deep learning-based CT imaging-derived biomarker enabled the objective and unbiased OS prediction for patients with resectable PDAC. This marker is applicable across hospitals, imaging protocols, and treatments, and has the potential to tailor neoadjuvant and adjuvant treatments at the individual level.