bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors predicting the effects of dysphagia rehabilitation on multidimensional functional status in elder outpatients: A prospective cohort study
Authors: Igarashi Kumi , Kikutani Takeshi , Tamura Fumiyo , Yajima Yuri , Tohara Takashi
Published: June 2020

Objective

This study aimed to clarify the relationship between the oral intake function and functional status, as well as to determine the aspects of functional status potentially predicting the effects of dysphagia rehabilitation in the maintenance stage, in elder outpatients.

Methods

This study was conducted in a clinic, specialised in rehabilitation of patients with dysphagia. The participants were 93 non–tube‐fed patients 65 years of age or older. The participants were scheduled to undergo the initial examination for oral intake function and functional status, and then to receive dysphagia rehabilitation for 1 year. After rehabilitation period, oral intake function was re‐evaluated, and the elements of functional status potentially related to the effects of dysphagia rehabilitation were determined.

Results

It was found that the lower the participants’ oral intake function levels, the higher the prevalence of reduced parameters of functional status. After 1‐year dysphagia rehabilitation, the oral intake function was maintained or improved in 70 (75.3%) participants, but had diminished in 23 (24.7%). Our analysis revealed that participants with higher Vitality Index scores and MMSE at the time of initial examination were significantly more likely to show maintained or improved oral intake function at 1 year (odds ratio[OR], 1.76; 95% confidence interval [CI], 1.14‐2.71; OR, 1.17; 95% CI, 1.06‐1.28, respectively).

Conclusions

It became apparent that the lower the oral intake function level at the initial examination, the higher the prevalence of reduced multidimensional functional status. Mental function was found to predict the effects of dysphagia rehabilitation in the maintenance stage.
Thrombopoietin receptor agonist is more effective than platelet transfusion for chronic liver disease with thrombocytopenia, shown by propensity score matching
Authors: Furuichi Yoshihiro , Takeuchi Hirohito , Yoshimasu Yuu , Kasai Yoshitaka , Abe Masakazu , Itoi Takao
Published: June 2020

Aim

The thrombopoietin receptor agonist, lusutrombopag, was recently adapted for treatment of thrombocytopenia in chronic liver disease. However, no studies have compared the effects of lusutorombopag and platelet transfusion. Therefore, we aimed to clarify the efficacy and proportion of responders of lusutrombopag compared with platelet transfusion, by propensity score matching.

Methods

A total of 200 patients (90 lusutrombopag, 110 platelet transfusion) with thrombocytopenia were enrolled, and matched for age, liver function, renal function, platelet count, peripheral blood count, and spleen size, using the propensity score‐matching method. Finally, 52 patients (26 lusutrombopag, 26 platelet transfusion) were included. The primary end‐point was an increase in platelet count. Secondary end‐points were the proportion of responders, duration of the sustained effect, incidence of adverse events, and predictors associated with an increase in platelet count.

Results

The median increase in platelets from baseline was 48 × 103/μL versus 9.5 × 103/μL (lusutrombopag vs. transfusion, P < 0.0001). The proportion of responders (increase of >10 × 103/μL) was 100% versus 50.0% (P < 0.0001). Median duration of the sustained effect (increase of >50 × 103/μL) was 10 versus 2 days (P < 0.0001). The incidence of adverse events was 7.7% versus 50.0% (P = 0.036). Predictors associated with an increase in platelets were hemoglobin and spleen size by multiple regression analysis.

Conclusion

Lusutrombopag was more effective in chronic liver disease patients than platelet transfusion. The proportion of responders, effect duration, and non‐incidence rate of adverse events were higher in the lusutrombopag group.
The assessment of commercial beef and chicken bouillons in terms of heterocyclic aromatic amines and some of their precursors
Authors: Elbir Zeynep , Oz Fatih
Published: June 2020

Herein, the assessment of commercial beef and chicken bouillons in terms of heterocyclic aromatic amines (HAAs) and some of their precursors was evaluated. Creatine and creatinine levels were ranged between 0.57–0.80 and 0.28–0.94 mg g−1, respectively. Glutamic acid was found to be the most abundant amino acid in both bouillons. 2‐amino‐3,7,8‐trimethylimidazo[4,5‐ƒ]quinoxaline (7,8‐DiMeIQx, up to 0.03 ng g−1) was the only quantified analyte in beef bouillons, whereas it (up to 0.08 ng g−1) was determined in addition to 2‐amino‐3‐methylimidazo[4,5‐ƒ]quinoxaline (IQx, up to 0.08 ng g−1) in chicken bouillons. Creatine, creatinine and free amino acid composition did not have the capacity to initiate the formation of HAAs. Therefore, bouillons do not pose risk in terms of HAAs. However, it should be noted that multiple factors, such as the substrate amount and production conditions, may affect the results. Glutamic acid content is remarkable in commercial bouillons sold in Turkey.
Effectiveness of postpartum sexual health education programme structured according to Levine's conservation model: An interventional study
Authors: Evcili Funda , Demirel Gulbahtiyar , Bekar Mine , Guler Handan
Published: June 2020

Aim

This study aimed to determine the effects of a postpartum sexual health education programme structured according to Levine's conservation model on postpartum women.

Methods

The interventional study was completed with 67 postpartum women. The intervention group was given the postpartum sexual health education programme structured according to Levine's conservation model. The control group received routine discharge training. The data were collected using a personal information form, The Index of Female Sexual Function, Arizona Sexual Experience Scale and Golombok–Rust Inventory of Sexual Satisfaction.

Results

It has been determined that the decrease in sexual arousal and desire is the first among postpartum sexual problems experienced by women. This study demonstrated that sexual function, sexual satisfaction and sexual response were higher in nonbreastfeeding women, women who had sexual intercourse one to three times a week and women who could talk to health care professionals on sexual matters. After the programme, the intervention group had more adequate sexual function, and they developed a strong, easy and satisfactory sexual response than the control group (p < 0.05).

Conclusion

This programme was effective in increasing the sexual functions and satisfaction of the postpartum women. Models provide guidance to nurses for provision of care in a systematic manner.
Osteopontin, GLUT1 and Ki‐67 expression in malignant peritoneal mesothelioma: prognostic implications
Authors: Liu Yingying , Zheng Guoqi , Yang Dongliang , Guo Xiaozhong , Tian Liang , Song Hui , Liang Yufei
Published: June 2020

Background

Malignant peritoneal mesothelioma is the most common primary peritoneal neoplasm. The only universally recognised pathological prognostic factor is histopathological subtype. Prognostic markers based on patient features and clinical stages have been disappointing.

Aims

To assess the prognostic role of several clinicopathological features in a retrospective cohort of 60 patients diagnosed with peritoneal mesothelioma.

Methods

Sixty patients were centrally collected and were immunohistochemically analysed for the expression of osteopontin (OPN), GLUT1 and Ki‐67. Labelling was assessed by two pathologists. Complete clinical information and follow‐up were obtained from patients' records.

Results

OPN expression was identified in 52 (86.6%) of 60 specimens, and GLUT1 in 39 (65%) of 60 specimens. Univariate Cox regression analysis showed that a lower peritoneal carcinomatosis index (PCI), tumour‐directed treatment (chemotherapy or surgery alone or in any combination), lower Ki‐67, GLUT1 and lower OPN expression had a statistically significant positive effect on overall survival (OS). PCI (hazard ratio (HR) = 1.032 (95% confidence interval (CI): 1.000–1.067); P = 0.054) and tumour‐directed treatment (HR = 0.211 (95% CI: 0.104–0.430); P < 0.001), Ki‐67 (HR = 22.326 (95% CI: 3.523–141.498); P = 0.003) and OPN (HR = 7.268 (95% CI: 1.771–29.811); P = 0.009) retained independent prognostic significance in the multivariate analysis, all with a positive effect on OS with the exception of GLUT1.

Conclusions

OPN, Ki‐67, treatment and PCI were independent indicators for OS, and a higher level of OPN expression correlated significantly with poorer OS.
Uncertainty Estimation for Pseudo‐Bayesian Inference Under Complex Sampling
Authors: Williams Matthew R. , Savitsky Terrance D.
Published: June 2020

Social and economic studies are often implemented as complex survey designs. For example, multistage, unequal probability sampling designs utilised by federal statistical agencies are typically constructed to maximise the efficiency of the target domain level estimator (e.g. indexed by geographic area) within cost constraints for survey administration. Such designs may induce dependence between the sampled units; for example, with employment of a sampling step that selects geographically indexed clusters of units. A sampling‐weighted pseudo‐posterior distribution may be used to estimate the population model on the observed sample. The dependence induced between coclustered units inflates the scale of the resulting pseudo‐posterior covariance matrix that has been shown to induce under coverage of the credibility sets. By bridging results across Bayesian model misspecification and survey sampling, we demonstrate that the scale and shape of the asymptotic distributions are different between each of the pseudo‐maximum likelihood estimate (MLE), the pseudo‐posterior and the MLE under simple random sampling. Through insights from survey‐sampling variance estimation and recent advances in computational methods, we devise a correction applied as a simple and fast postprocessing step to Markov chain Monte Carlo draws of the pseudo‐posterior distribution. This adjustment projects the pseudo‐posterior covariance matrix such that the nominal coverage is approximately achieved. We make an application to the National Survey on Drug Use and Health as a motivating example and we demonstrate the efficacy of our scale and shape projection procedure on synthetic data on several common archetypes of survey designs.
A robust biobjective optimization approach for operating a shared energy storage under price uncertainty
Authors: Dai Rui , Charkhgard Hadi , Rigterink Fabian
Published: June 2020

Energy storage (ES) is acknowledged to play an important role in modern energy technologies due to its potential to reduce operational costs, enhance the resilience, and level energy load for energy systems. Efficient ES management can achieve cost savings, also known as energy arbitrage, by charging at off‐peak prices and discharging at peak prices. This arbitrage can be further boosted by allowing the ES to be shared by multiple users/buildings. However, since energy arbitrage relies on the variation of energy prices, it is hard to achieve this arbitrage if the prices are uncertain. To address this challenge, we present a robust optimization approach to fairly and efficiently operate an ES shared between two users under price uncertainty. This sharing strategy is formulated as a biobjective mixed integer bilinear programming model. To facilitate solution efficiency, we propose a binary formulation for piecewise McCormick relaxations to approximate the bilinear model by a tractable linear model. A computational study demonstrates the effectiveness of our robust sharing strategy for managing ES sharing under price uncertainty. Also, it shows that the proposed binary formulation for piecewise McCormick relaxations reduces the runtime by around 80% compared to the traditional unary formulation.
Psychometric properties of the Five‐item World Health Organization Well‐being Index used in mental health services: Protocol for a systematic review
Authors: Lara‐Cabrera Mariela L. , Bjørkly Stål , De las Cuevas Carlos , Pedersen Sindre Andre , Mundal Ingunn Pernille
Published: June 2020

Aims

To synthesize evidence of the psychometric properties of the Five‐item World Health Organization Well‐being Index in mental health settings and critically appraise the methodologies of the included studies.

Design

Protocol for a systematic psychometric review.

Methods

The review protocol has been registered in the International Prospective Register for Systematic Reviews. The bibliographic databases MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Library, and Web of Science will be searched for relevant studies. The psychometric properties of each study will be evaluated according to the Consensus‐based Standards for the Selection of Health Measurements Instruments.

Discussion

The results of our psychometric review will synthesize the psychometric properties of the Five‐item World Health Organization Well‐being Index in mental health settings and identify possible gaps in the literature regarding methodological quality and its reliability, validity, and responsiveness to change.

Impact

The evaluation of patient well‐being is important, and the Five‐item World Health Organization Well‐being Index is an increasingly used patient‐reported outcome measure. It is simple to collect, free to use, and consists of five questions using positive health statements. Although the number of studies assessing the validity, reliability, and responsiveness of the questionnaire is increasing worldwide, there is a need to summarize the existing evidence of the psychometric properties of this questionnaire. The proposed study's findings will contribute to future research recommendations and help midwives and nurses in different settings pick an effective, appropriate questionnaire to evaluate patient well‐being.
Avian egg collections: museum collection bias driven by shape and size
Authors: Thompson Jamie E. , Birkhead Tim R.
Published: June 2020

Avian eggs exhibit substantial intra‐ and interspecific variation in shape, size and colour. Considerable efforts have been made to better understand the evolutionary drivers behind such variation, often using museum egg collections. Usually it is assumed that museum collections accurately represent the variation seen in natural populations, but this may not be the case if there is collection bias. Collection bias may lead to the over‐representation of certain egg traits in collections, due to the aesthetic (or other) preferences of collectors. The aim of this study is to begin to look for the occurrence of potential collection bias in museum egg collections by comparing three shape indices (pointedness/asymmetry, elongation and polar asymmetry) and egg volume between subsets of eggs in museum collections with those of recently sampled eggs in the field for three different bird species: common guillemotUria aalge, razorbillAlca tordaand northern fulmarFulmarus glacialis. We found no evidence of collection bias in our sampled razorbill and northern fulmar museum collection eggs, but some evidence for a bias in sampled museum collection eggs of common guillemots. Since the guillemot's egg differs from most bird eggs in being pyriform, we suggest that collection bias by historic egg collectors may be more prevalent in species with extreme egg traits. Researchers using museum egg collections to examine questions relating to egg shape should be aware of collection bias risks and consider how to minimise the effect of these possible biases on accumulated datasets.
Increased number and activation of peripheral basophils in adult‐onset minimal change disease
Authors: Han Huanqin , Xu Yong‐Zhi , Liao Shuzhen , Xiao Haiyan , Chen Xiaoqun , Lu Xing , Wang Shujun , Yang Chen , Liu Hua‐feng , Pan Qingjun
Published: June 2020

Nowadays, the pathogenesis of minimal change disease (MCD) is still not well‐known, and the current understanding on MCD is mainly based on data derived from children, and very few adults. Here, we comprehensively analysed the correlation between the changes of peripheral basophils and the incidence rate and relapse of adult‐onset MCD. The results showed that in patients at the onset of MCD, the ratio and activation of basophils were all higher than those of healthy controls (all P < .05). In vitro test results showed that basophils from healthy controls can be activated by the serum taken from patients with MCD. Among 62 patients at the onset of MCD, with complete remission after treatment and 1 year of follow‐up, the relative and absolute basophil counts before treatment were higher in the long‐term remission group (n = 33) than that of the relapse group (n = 29). The basophil counts were significantly higher in the infrequent relapse group (n = 13) than that of the frequent relapse group (n = 16; P < .05). These findings suggested that basophil may play a pathogenic role in adult‐onset MCD, and the increased number and activation of peripheral basophils could predict recurrence in adult MCD.
Sleep Quality as a Mediator of the Relationship Between Cyber Victimization and Depression
Authors: Kwon Misol , Seo Young S. , Nickerson Amanda B. , Dickerson Suzanne S. , Park Eunhee , Livingston Jennifer A.
Published: June 2020

Purpose

Cyber victimization is a national mental health concern, especially among adolescents who are digital natives. The current study examined sleep quality as a mediator of the association between cyber victimization and depressive symptoms among adolescents.

Design and Method

A prospective study design was utilized with a community sample of adolescents (N = 801; 57% female; mean age = 14.45, SD = .85) from the eastern United States. Participants completed (a) the Pittsburgh Sleep Quality Index; (b) the Cyber Victimization Scale; and (c) the Center for Epidemiologic Studies Depression Scale Revised via online surveys at baseline and 6‐month follow‐up. The inter‐relationship between variables was analyzed by Hayes’ mediation approach.

Findings

Cyber victimization was not directly associated with having depressive symptoms 6 months later when controlling for adolescents’ poor sleep quality, sex, and age (direct effect [c’] = .012, t(676) = 1.12, p < .05, confidence interval [CI] ‐.008, .036). The mediation analysis indicated a significant indirect effect of poor sleep quality on the relationship between cyber victimization and depressive symptoms (ab = .005, bootstrapped standard error [SE] = .003, bootstrapped CI .001, .011; a is the effect of cyber victimization on poor sleep quality; b is the effect of poor sleep quality on depressive symptoms). Specifically, adolescents’ cyber victimization led to poor sleep quality (a = .039, SE = .041, p < .05), which also led to increased depressive symptoms (b = .116, SE = .019, p < .001), after controlling for depressive symptoms at baseline, sex, and age. The indirect effect of cyber victimization on depressive symptoms was estimated through poor sleep quality (a*b = .039(.116) = .0045).

Conclusions

The findings suggest that poor sleep quality may be a mechanism through which cyber bullying is related prospectively to depressive symptoms. Interventions for cyber‐victimized adolescents should include assessment of sleep quality and incorporate sleep hygiene education.

Clinical Relevance

Adolescents should be screened for cyber victimization and sleep quality. Moreover, promotion of sleep hygiene among cyber‐victimized adolescents may help to reduce depression.
Personality trait change at work: Associations with organizational socialization and identification
Authors: Alessandri Guido , Perinelli Enrico , Robins Richard W. , Vecchione Michele , Filosa Lorenzo
Published: June 2020

Objective

This study investigates associations between Big Five personality trait change, organizational socialization, and organizational identification during a 3‐year police officer training program (N = 416 police officer cadets).

Method

Participants completed a questionnaire measuring the Big Five personality traits when they entered the training academy, and then, completed the same personality questionnaire, along with measures of organizational socialization and identification, during their 2nd (n = 360) and 3rd (n = 397) year of training.

Results

Results corroborated the hypotheses that (a) the Big Five traits can show systematic changes even across a relatively short time period and (b) this change is functional, given that the latent difference scores of all Big Five traits significantly predicted increases in organizational socialization and identification.

Conclusion

The Big five personality traits showed significant mean level changes across the 3‐year training program. Although these changes were not fully consistent with theoretical expectations, they did predict two aspects of organizational adjustment (socialization and identification). The theoretical and practical implications of these findings were discussed.
Confidence is sexy and it can be trained: Examining male social confidence in initial, opposite‐sex interactions
Authors: Li Norman P. , Yong Jose C. , Tsai Ming‐Hong , Lai Mark H. C. , Lim Amy J. Y. , Ackerman Joshua M.
Published: June 2020

Objective

We investigated whether men's social confidence in an initial, opposite‐sex chatting context can be improved through a video tutorial and the extent to which being perceived as socially confident results in being seen as more romantically desirable and worthy of future contact.

Method

Women chatted with men who had received or not received a tutorial on how to handle speed‐dating chats (Study 1: N = 129; Study 2: N = 60) or with male targets selected for having high versus moderate confidence in handling initial, opposite‐sex encounters (Study 3: N = 46).

Results

Tutorial‐trained men felt more confident going into the chats and they, as well as male targets selected for their confidence, were perceived by female chat partners to be higher in social confidence, status, and dominance. However, only perceptions of social confidence were further associated with being perceived as more romantically desirable (as a short‐term mate) and worthy of future contact.

Conclusions

Findings indicate that social confidence is trainable and that other‐perceived social confidence can impact the outcomes of social interactions.
Getting the first job: Size and quality of ethnic enclaves and refugee labor market entry
Authors: Klaesson Johan , Öner Özge , Pennerstorfer Dieter
Published: June 2020

We analyze the relationship between residence in an ethnic enclave and immigrants' labor market integration with respect to finding a first job in the receiving country. The analysis distinguishes between the size and the quality of the ethnic enclaves, where quality is measured in terms of employment rate among ethnic peers in the same neighborhood. We use longitudinal geo‐coded registry data for two distinct groups of immigrants arriving in the Stockholm metropolitan area to investigate their initial labor market contact. The first group of immigrants moved from the Balkans in the early 1990s following the Yugoslavian war, and the second group arrived from the Middle East following the second Iraq War in 2006. We estimate the probability of finding a first job using probit regressions and complement the analysis with additional duration models. To draw causal inference, we use instrumentation that combines initial neighborhood variables with citywide variation over time. We provide empirical evidence that the employment rate of the respective immigrant group in the vicinity facilitates labor market integration of new immigrants. The influences of the overall employment rate and the share of conationals in the neighborhood tend to be positive, but less robustly so. Our results are consistent with the notion that the qualitative nature of an enclave is at least as important as the sheer number of ethnic peers in helping new immigrants find jobs.
Influence of breakfast and meal frequency in calcium intake among pregnant adolescents
Authors: Pinho‐Pompeu Maira , Paulino Daiane Sofia Morais , Surita Fernanda Garanhani
Published: June 2020

Calcium is an essential micronutrient that plays a role in growing and pregnancy, and its necessity is increased during pregnancy in adolescence. Thus, the aim of the study is to describe the daily calcium intake and its associations with dietetic habits, sociodemographic data and perinatal outcomes among pregnant adolescents. A prospective cohort study was conducted among primiparous adolescents who started prenatal care before 20 weeks of gestation. Sociodemographic data, weight and height, 24‐h dietary recall (24hRec) and perinatal outcomes were collected over four meetings (three during pregnancy and one in puerperium). All 24hRecs were analysed by the Nutrition Data System for Research (NDSR)® programme, and descriptive analysis and univariate and multivariate logistic regression were done. A total of 150 pregnant adolescents were included, with a mean of daily calcium intake of 659.9 mg (50% of recommended intake). Adolescents who ate more than three meals per day (89.3%), and ate breakfast every day (69.3%), were shown to have higher daily calcium intake, odds ratio (OR CI 95%) of 3.4 (1.0, 11.0) and 16.8 (1.0, 302.1), respectively. No correlation was observed between calcium daily intake and sociodemographic data or perinatal outcomes. Dairy products were the foods that mostly contributed to achieving recommended daily calcium intake. In our cohort, pregnant adolescents had a low daily calcium intake. They should be advised to eat more than three meals per day, eat breakfast in particular, increase the consumption of calcium rich‐foods, such as dairy products and green leafy vegetables, and consider calcium supplementation.
How do nutrition professionals working in low‐income countries perceive and prioritize actions to prevent wasting? A mixed‐methods study
Authors: Ickes Scott B. , Craig Christina , Heidkamp Rebecca A.
Published: June 2020

Despite a shared commitment to achieving global nutrition targets, development and emergency‐humanitarian actors tend to prioritize different nutrition outcomes and actions. New approaches are needed to bridge the divide between these communities and to strengthen the overall evidence base for prevention of wasting. To better understand how these different groups perceive and prioritize actions for wasting prevention, key informant interviews (n = 21) were conducted, and an online survey was fielded among nutrition professionals working in low‐income countries (n = 107). Additionally, nutrition policy and strategy documents for select global and country institutions (n = 12) were analysed to identify interventions and approaches for addressing different forms of undernutrition. The findings of this study suggest that at both global and country levels, development actors tend to prioritize stunting prevention, and emergency‐humanitarian actors tend to prioritize treatment of acute malnutrition. It was less common for wasting prevention to be mentioned as an explicit priority. Many interventions were perceived by respondents to influence both stunting and wasting despite limited published evidence of effectiveness on wasting for water, sanitation and hygiene, growth monitoring and promotion, breastfeeding promotion and micronutrient supplementation. To help unify the nutrition community around prevention of wasting, the discourse about priority interventions should shift from ‘stunting versus wasting’ and ‘prevention versus treatment’ to a life‐course framing around child survival, growth and development. Respondents identified a need for more programme and research funding that prioritizes both wasting and stunting as outcomes. They also suggest leveraging existing national coordination bodies that bring development and emergency‐humanitarian partners together.
Effects of antifungal stewardship using therapeutic drug monitoring in voriconazole therapy on the prevention and control of hepatotoxicity and visual symptoms: A multicentre study conducted in Japan
Authors: Hamada Yukihiro , Ueda Takashi , Miyazaki Yoshitsugu , Nakajima Kazuhiko , Fukunaga Keiko , Miyazaki Taiga , Nakada‐Motokawa Nana , Nagao Miki , Kawamura Hideki , Shigemi Akari , Ebihara Fumiya , Kimura Toshimi , Ikegame Kazuhiro , Uchino Motoi , Ikeuchi Hiroki , Takesue Yoshio
Published: June 2020

Background

Hepatotoxicity and visual symptoms are common adverse effects (AEs) of voriconazole therapy.

Objective

To retrospectively evaluate the effects of treatment modification based on therapeutic drug monitoring on AEs in patients undergoing voriconazole therapy.

Methods

The target voriconazole trough concentration (Cmin) was 1‐5 µg/mL. Receiver operating characteristic curves were used to determine Cmin cut‐offs for AEs.

Results

A total of 401 patients were included. Among 108 patients with high initial Cmin, voriconazole was discontinued in 32 and the dose was reduced in 71. Among 44 patients with low initial Cmin, voriconazole was discontinued in 4 and the dose was increased in 19. Hepatotoxicity occurred in 6.0% of patients, after a median of 10 days. Visual symptoms were evident in 9.5% of patients after a median of 4 days. Initial Cmin was significantly associated with visual symptoms but not hepatotoxicity, which suggested the effect of treatment modification on hepatotoxicity. However, both hepatotoxicity and visual symptoms were significantly correlated with Cmin at the onset of AEs, and the Cmin cut‐offs were 3.5 μg/mL for hepatotoxicity and 4.2 μg/mL for visual symptoms. Voriconazole was discontinued after the occurrence of AEs in 62.5% of patients with hepatotoxicity but only 26.3% of patients with visual symptoms. With dose adjustment, treatment was completed in 8/9 patients with hepatotoxicity and 27/28 patients with visual symptoms.

Conclusions

A significant preventive effect was demonstrated on hepatotoxicity, but not on visual symptoms because of earlier occurrence. With treatment modification after the occurrence of AEs, most patients completed therapy.
Jackhammer esophagus: Clinical presentation, manometric diagnosis, and therapeutic results—Results from a multicenter French cohort
Authors: Philonenko Sara , Roman Sabine , Zerbib Frank , Gourcerol Guillaume , Gault Nathalie , Ropert Alain , Bruley des Varannes Stanislas , Barret Maximilien , Vitton Veronique , Bouchoucha Michel , Billard Nicolas , Gorbatchef Caroline , Duboc Henri , Coffin Benoit
Published: June 2020

Background/aims

Jackhammer esophagus (JE) is a hypercontractile esophageal motor disorder defined by at least two swallows with a distal contractile integral (DCI) >8000 mm Hg.s.cm during high‐resolution manometry (HRM). The relationship between symptoms and hypercontractility and the response to therapies have been poorly evaluated. The aim of this study was to determine the clinical presentation, manometric diagnosis, and therapeutic results in a large cohort of JE patients.

Methods

Patients with JE diagnosed among the HRM tests performed in nine academic French centers from 01/01/2010 to 08/31/2016 were included. Patient charts were reviewed to collect clinical and therapeutic data.

Results

Among the 16 264 HRM tests performed during this period, 227 patients (60.8 ± 13.8 years, 151 male) had JE (1.7%). Dysphagia was the most frequent symptom (74.6%), followed by regurgitation (37.1%) and chest pain (36.6%); 4.7% of the patients were asymptomatic. The diagnostic workup was heterogeneous, and only a minority of patients had esophageal biopsies. None of the individual symptoms were significantly associated with any of the manometric parameters defined, except for dysphagia, which was significantly associated with the mean of all DCIs >8000 mm Hg.s.cm (P = .04). Additionally, the number of symptoms was not associated with any manometric parameter. Medical treatment and endoscopic treatments had poor efficacy and a high relapse rate.

Conclusion

Jackhammer esophagus is a rare motility disorder. Diagnostic workup is heterogeneous and should be standardized. Symptoms are poorly associated with manometric parameters. The medical treatments and endoscopic therapies currently used are inefficient.
Direct Anterior Approach in Crowe Type III‐IV Developmental Dysplasia of the Hip: Surgical Technique and 2 years Follow‐up from Southwest China
Authors: Liu Zai‐yang , Zhang Jun , Wu Song‐tao , Li Zi‐qiang , Xu Zhong‐hua , Zhang Xia , Zhou Yue , Zhang Yuan
Published: June 2020

Objectives

To summarize our pioneering surgical practice and clinical outcome of Crowe type III‐IV developmental dysplasia of the hip (DDH) with a direct anterior approach total hip arthroplasty in a single teaching hospital in Southwest China.

Methods

Fourteen patients (15 hips) diagnosed with Crowe type III‐IV developmental dysplasia of the hip were involved in this single‐center retrospective study between 2016 and 2018. A comprehensive surgical procedure, including preoperative planning and algorithms for leg length equalization, intraoperative stepwise soft tissue release, bone defect reconstruction, and an innovative subtrochanteric osteotomy, was described. Furthermore, advancements in intraoperative CT guidance, computer navigation, and nerve monitoring were available for specific demands. The short‐term clinical outcome was evaluated at the endpoint of follow‐up by three patient‐reported functional scales (Harris, WOMAC, and SF‐12 scores), and objective data collected at the clinic, including functional recovery (muscle strength of hip flexor and abductor, correction of the pelvic tilt, leg length discrepancy, and limp), radiographic analysis, and complication occurrence.

Results

The intraoperative variables were carefully recorded. The mean operating times in Crowe type III and IV groups were 115.8 min and 156.2 min, and the median blood loss volumes were 520.5 mL and 810.2 mL, respectively. The general changes in the Harris, SF‐12, and WOMAC scores of the two groups were 46.2, 8.7 and 134.3, respectively, at a mean follow‐up of 25.4 months. Enhanced recovery of hip abductor muscle strength was identified in 85.7% of the population at the third postoperative month. The equalization of leg length and correction of the pelvic tile were observed at the sixth postoperative month, with a 36‐mm decrease in leg length discrepancy. No radiographic evidence of the loosening or migration of the components was observed. A self‐innovated subtrochanteric shortening osteotomy was performed in five patients, and they healed after 6 months. Specific complications included two cases of distal femoral cracks and one case of a periprosthetic fracture needing internal fixation. Two patients received a late iliotibial band release at the 3rd month postoperatively due to progressive genu valgum. No records of infection, dislocation, nerve palsy, bone non‐union, or revision surgery were identified.

Discussion

The direct anterior approach total hip arthroplasty showed potential advantages, including optimum component positioning, improved hip stability, steerable complication rate, and enhanced functional recovery with Crowe type III‐IV DDH. The short‐term outcome is comparable to that of the traditional posterolateral approach.
Cryoballoon or radiofrequency ablation? Alternating technique for repeat procedures in patients with atrial fibrillation
Authors: Verlato Roberto , Pieragnoli Paolo , Iacopino Saverio , Rauhe Werner , Molon Giulio , Stabile Giuseppe , Rebellato Luca , Allocca Giuseppe , Arena Giuseppe , Rovaris Giovanni , Sacchi Riccardo , Catanzariti Domenico , Pepi Patrizia , Tondo Claudio
Published: June 2020

Background

Which technique is better for repeat ablation in patients with atrial fibrillation (AF) remains unclear. The aim of the study was to compare long‐term efficacy of repeat ablation using the alternative technique for the first redo ablation procedure: (a) cryoballoon (CB) re‐ablation after a failed index pulmonary vein isolation (PVI) with radiofrequency (RF) ablation, RF‐then‐CB group or (b) RF repeat ablation following a failed CB ablation, CB‐then‐RF group.

Methods

Within the 1STOP Italian Project, consecutive patients undergoing repeat ablation with a different technique from the index procedure were included.

Results

We studied 474 patients, 349 in RF‐then‐CB and 125 in CB‐then‐RF group. Less women (21% vs 30%; P = .041), more persistent AF (33% vs 22%; P = .015), longer duration of AF (60 vs 31 months; P < .001), and more hypertension (50% vs 36%; P = .007) were observed in the RF‐then‐CB cohort as compared with the CB‐then‐RF group. The number of reconnected PVs was 3.7 ± 0.7 and 1.4 + 1.3 in RF‐then‐CB and CB‐then‐RF group, respectively (P < .001). During the follow‐up, significantly less AF recurrence occurred in the CB‐then‐RF group (22% vs 8%, HR = 0.46; 95% CI: 0.24‐0.92; P = .025). Cohort designation was the only independent predictor of AF recurrence.

Conclusion

Alternation of energy source for repeat ablation was safe and effective, regardless the energy used first. However, patients initially treated with CB PVI undergoing repeat ablation with RF current had less AF recurrence at long‐term follow‐up as compared with those originally treated by RF ablation receiving a CB repeat ablation.
Personal brand equity: Scale development and validation
Authors: Gorbatov Sergey , Khapova Svetlana N. , Oostrom Janneke K. , Lysova Evgenia I.
Published: June 2020

Crafting a personal brand has become an important factor for career success. Despite the growing literature on topics associated with personal brands, the conceptualization and measurement of personal brand equity (PBE) have received little attention. By drawing upon and integrating the marketing and careers literatures on branding, we reconceptualized the definition of PBE and delineated its dimensions and conceptual boundaries. Furthermore, we developed a 12‐item scale to measure PBE. Among seven different samples (total N = 3,273), including two samples of employees, this study tested the construct and criterion‐related validity of the PBE scale. First, exploratory and confirmatory factor analyses supported a three‐dimensional structure of PBE (brand appeal, brand differentiation, and brand recognition). In two samples, the convergent and discriminant validity of the PBE scale was established. Finally, this study showed that PBE predicts perceived employability, career success, and job performance. The PBE scale offers new opportunities to understand and measure career behaviors by considering individuals’ personal brand positioning.
Hyponatremia: A possible immuno‐neuroendocrine interface with COVID‐19 in a kidney transplant recipient
Authors: Tantisattamo Ekamol , Reddy Uttam G. , Duong Dang K. , Ferrey Antoney J. , Ichii Hirohito , Dafoe Donald C. , Kalantar‐Zadeh Kamyar
Published: June 2020

There is fast‐emerging, cumulative clinical data on coronavirus disease 2019 (COVID‐19) in kidney transplant recipients. Although respiratory tract symptoms are often the initial presentation among kidney transplant recipients who contract COVID‐19, other clinical features which may indicate underlying SARS‐CoV‐2‐related inflammation, such as gastrointestinal symptoms, are not uncommon. Hyponatremia can develop and may reflect underlying inflammation. Interferon‐6 is an important pro‐inflammatory cytokine involved in the pathogenesis of severe COVID‐19 complications and may play a role in the inappropriately higher secretion of antidiuretic hormone leading to hyponatremia. This pathway is the so‐called immuno‐neuroendocrine interface. Hyponatremia in COVID‐19 has been reported in a few case series of non‐kidney transplant patients and only one reported kidney transplant recipient. However, the clinical course and prognostic value of hyponatremia in this population are not described in detail. We report a kidney transplant recipient who was infected with COVID‐19 and exhibited severe hyponatremia secondary to the syndrome of inappropriate antidiuretic hormone secretion. Hyponatremia is one of the clinical presentations of COVID‐19, although less common, and may occur more frequently in kidney transplant recipients. Thus, the possible underlying immuno‐neuroendocrine relationship related to the inflammatory process of COVID‐19 leading to hyponatremia and its prognostic value are reviewed.
COVID‐19 in lung transplant recipients: A case series from Milan, Italy
Authors: Morlacchi Letizia Corinna , Rossetti Valeria , Gigli Lorenzo , Amati Francesco , Rosso Lorenzo , Aliberti Stefano , Nosotti Mario , Blasi Francesco
Published: June 2020

Limited data are currently available regarding the course of COVID‐19 in lung and solid organ transplant recipients. We hereby present four cases of SARS‐CoV‐2 pneumonia in lung transplant recipients from our center, set in Milan, Italy. We reduced immunosuppressive regimen in all these patients, typically holding the antiproliferative agent and augmenting steroids; everybody received hydroxychloroquine, initial empiric antibiotic treatment with piperacillin/tazobactam, and high‐dose low molecular weight heparin. Clinical course seemed favorable in three of our patients, but one of them deteriorated after 10 days of hospitalization, probably due to an acute form of graft dysfunction triggered both by COVID‐19 and a nosocomial bacterial infection, and eventually died. Although short‐term prognosis could be considered benign in the majority of our patients, we should carefully monitor these individuals in order to detect early sign of clinical deterioration and graft dysfunction in the next few months.
Tuberculosis transmission across three states: The story of a solid organ donor born in an endemic country, 2018
Authors: Jones Jefferson M. , Vikram Holenarasipur R. , Lauzardo Michael , Hill Amy , Jones Jeffrey , Haley Clinton , Seaworth Barbara , Oldham Sara , Brown Marcus , Gutierrez Felipe , Basavaraju Sridhar V.
Published: June 2020

Transmission of tuberculosis (TB) from a deceased solid organ donor to recipients can result in severe morbidity and mortality. In 2018, four solid organ transplant recipients residing in three states but sharing a common organ donor were diagnosed with TB disease. Two recipients were hospitalized and none died. The organ donor was born in a country with a high incidence of TB and experienced 8 weeks of headache and fever prior to death, but was not tested for TB during multiple hospitalizations or prior to organ procurement. TB isolates of two organ recipients and a close contact of the donor had identical TB genotypes and closely related whole‐genome sequencing results. Donors with risk factors for TB, in particular birth or residence in countries with a higher TB incidence, should be carefully evaluated for TB.
An open‐label dose escalation study evaluating tolerability and safety of a single 5‐days course of temozolomide in dogs with advanced cancer
Authors: Marconato Laura , Rohrer Bley Carla , Leone Vito F. , Finotello Riccardo
Published: June 2020

Temozolomide is a novel oral alkylating agent that has schedule‐dependent clinical activity in human malignant glioma and metastatic melanoma. Little is known about the efficacy of temozolomide in the treatment of canine solid cancers, where broad range of dosages have been used but no maximally tolerated dose (MTD) had been established. The aim of this this open‐label, dose‐escalating study was to determine MTD and dose‐limiting toxicity (DLT) of a single temozolomide cycle in dogs with advanced solid tumours. Temozolomide was administered as a 5‐days course starting at 70 mg/m2, using escalation of 10 mg/m2 increments with 3 dogs per dose level. MTD was established based on the number of dogs experiencing DLT assessed after 1 cycle. Safety evaluation was performed 10 days after dosing. Thirty‐three client‐owned dogs were enrolled. MTD was established at 150 mg/m2 and the most frequent adverse events (AEs) were hematologic and hepatic, followed by gastrointestinal, with the majority being self‐resolving and of mild grade. VCOG grade 3 hepatic toxicity and grade 4 thrombocytopenia were defined as DLTs at 160 mg/m2. A subcohort of dogs received multiple temozolomide doses on a 4‐week cycle and no cumulative toxicity was documented. Conclusions of this study define temozolomide MTD at 150 mg/m2 when given once daily over 5 days. Future trials on the efficacy of temozolomide administered at its MTD are warranted.
Evaluation of the short‐ and long‐term complications and outcomes of phacoemulsification surgery in alpacas
Authors: Ledbetter Eric C. , Irby Nita L.
Published: June 2020

Objective

To describe the complications and determine the visual outcomes associated with phacoemulsification surgery in alpacas.

Animals

Five alpacas (nine operated eyes).

Procedures

Medical records of alpacas with a clinical diagnosis of cataracts that received elective phacoemulsification surgery at Cornell University over a 15 year period were reviewed.

Results

The mean (± standard deviation) age of the five operated alpacas was 104 days (±64 days). The cataracts were suspected to be congenital in all alpacas. Concurrent congenital ocular abnormalities were common in the operated eyes and included microphakia, persistent patent hyaloid arteries, and persistent patent tunica vasculosa lentis. No significant intraoperative complications were identified in any cases. In the immediate postoperative period, uveitis was mild‐to‐moderate in most operated eyes, ocular hypertension was not detected, and clinically significant corneal edema did not occur in any eyes. The mean (± standard deviation) duration of clinical follow‐up after surgery was 32 months (±25 months). A peri‐incisional corneal stromal ulcer associated with fibrinous uveitis was identified in a single eye during recheck examination 4 weeks postoperative that resolved with medical therapy. Long‐term complications included unilateral glaucoma in two alpacas that resulted in vision loss. On the final recheck ophthalmic examination, 78% (7 of 9) of operated eyes were visual and all operated alpacas had vision in at least one operated eye.

Conclusions and clinical relevance

In this series, the visual outcomes associated with elective phacoemulsification surgery in alpacas were good. Glaucoma was the most common vision‐threatening long‐term postoperative complication.
Integration of Modeling Capabilities in CATHENA for Supercritical Water Reactors
Authors: Beuthe T. , Vasić A. , Zahlan H. , Nava Domínguez A.
Published: June 2020

CATHENA has been successfully employed to simulate accident and startup transients in the development of the Canadian supercritical water reactor concept. This success is attributed to the implementation of a novel method to integrate supercritical modeling elements into the code. A supercritical water properties scheme was used that does not rely on the use of pseudo-phases and treats the supercritical regime as a single uninterrupted phase. The development of a robust numerical strategy manages the transitions that can occur in accident scenarios. Finally, the utilization of an expanded transcritical heat transfer look-up-table that smoothly transitions across the near-critical and supercritical regions over a wide temperature range ensures consistent, stable simulation results.