bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding comorbidities and health disparities related to COVID-19: a comprehensive study of 776 936 cases and 1 362 545 controls in the state of Indiana, USA
Authors: Zidan Nader , Dey Vishal , Allen Katie , Price John , Zappone Sarah Renee , Hebert Courtney , Schleyer Titus , Ning Xia
Published: February 2023

Objective

To characterize COVID-19 patients in Indiana, United States, and to evaluate their demographics and comorbidities as risk factors to COVID-19 severity.

Materials and Methods

EHR data of 776 936 COVID-19 cases and 1 362 545 controls were collected from the COVID-19 Research Data Commons (CoRDaCo) in Indiana. Data regarding county population and per capita income were obtained from the US Census Bureau. Statistical analysis was conducted to determine the association of demographic and clinical variables with COVID-19 severity. Predictive analysis was conducted to evaluate the predictive power of CoRDaCo EHR data in determining COVID-19 severity.

Results

Chronic obstructive pulmonary disease, cardiovascular disease, and type 2 diabetes were found in 3.49%, 2.59%, and 4.76% of the COVID-19 patients, respectively. Such COVID-19 patients have significantly higher ICU admission rates of 10.23%, 14.33%, and 11.11%, respectively, compared to the entire COVID-19 patient population (1.94%). Furthermore, patients with these comorbidities have significantly higher mortality rates compared to the entire COVID-19 patient population. Health disparity analysis suggests potential health disparities among counties in Indiana. Predictive analysis achieved F1-scores of 0.8011 and 0.7072 for classifying COVID-19 cases versus controls and ICU versus non-ICU cases, respectively.

Discussion

Black population in Indiana was more adversely affected by COVID-19 than the White population. This is consistent to findings from existing studies. Our findings also indicate other health disparities in terms of demographic and economic factors.

Conclusion

This study characterizes the relationship between comorbidities and COVID-19 outcomes with respect to ICU admission across a large COVID-19 patient population in Indiana.
Mesh-free least-squares reverse-time migration
Authors: Deng Xiaofan , Wu Han , Sun Chengyu , Gao Rui
Published: February 2023

The reflectivity of the subsurface can be precisely determined using least-squares reverse-time migration (LSRTM). As LSRTM necessitates solving the wave equation, the numerical solution method of the wavefield directly determines the quality of the migration image. The conventional LSRTM method usually uses the finite difference method based on a regular grid to calculate the wavefield. Due to the stepwise approximation of an irregular surface with a regular grid, scattering noise may occur in the propagation of the wavefield, which affects the quality of the image. In addition, the conventional LSRTM cannot effectively handle the models with rugged topography. The finite difference method generated by radial basis functions (FD-RBF) is a mesh-free method and can construct interpolation functions to solve the wave equations numerically according to arbitrarily distributed spatial coordinate points. Therefore, we use the FD-RBF method to develop a mesh-free LSRTM approach to eliminate the influence of the inherent limitation of a regular grid on the imaging. Numerical examples show that the mesh-free LSRTM method can better represent the curved or steep interface within the model and is also suitable for models with rugged topography. The LSRTM method can provide higher-quality images and effectively reduce the memory required for calculations.
Immunities of Foreign Officials for International Crimes: The Dilemmas of Strategic Litigation
Authors: Mégret Frédéric
Published: February 2023

This article analyses the elusive search to restrict immunities for foreign officials accused of international crimes as a form of strategic litigation. It emphasizes how litigation ‘constitutes’ legal reality beyond particular victories. Problematizing ‘success’ in litigation makes it possible to pay attention to unintended effects and even perverse outcomes of certain strategic routes. A proper understanding of success as more than victory is then used to assess three routes that have been used to try and limit, circumvent or oppose functional immunities of former officials. These routes are found not to be of even value for human rights, independently of their legal validity or their odds of success: the idea that international crimes are not committed as part of state functions trivializes the ‘public’ character of most international crimes; the argument that the jus cogens norm that prohibits international crimes trumps immunities either constantly needs to be finessed or sets up too dramatic a showdown; the idea that immunities offend human rights finds some favour as the one that is closest to the heart of human rights, although its tendency to symbolically sanctify the right to prosecutions could also have problematic ripple effects. Offered as a contribution to thinking through the rights implications of litigation, the article insists on the responsibility of human rights lawyers in creating legal worlds of their own making.
Hibiscus Mealybug (Hemiptera: Pseudococcidae) – Biology, Host Plants, Current Management Practices, and a Field Guide for North America
Authors: Olabiyi David , Middleton Eric , Ahmed Muhammad Z , Osborne Lance S , McKenzie Cindy L , Diepenbrock Lauren
Published: February 2023

Hibiscus mealybug, Nipaecoccus viridis (Newstead), is an invasive, highly polyphagous pest that has recently established in Florida. This pest is historically known to heavily effect citrus production in other citrus-producing regions and has similarly negatively impacted citrus groves in several counties. Hibiscus mealybug was first found infesting citrus in one county in 2019 and has rapidly spread across counties and onto additional hosts in only a few years. Here we review the known distribution and biology of hibiscus mealybug, including a description of life stages, known host plants in Florida, and management options. Additionally, a field diagnostics guide is presented to assist in early detection and prevent the spread of N. viridis in other regions. We anticipate that information shared here will help in slowing its spread in the United States.
Water channel aquaporin 4 is required for T cell receptor mediated lymphocyte activation
Authors: Nicosia Michael , Lee Juyeun , Beavers Ashley , Kish Danielle , Farr George W , McGuirk Paul R , Pelletier Marc F , Lathia Justin D , Fairchild Robert L , Valujskikh Anna
Published: February 2023

Aquaporins are a family of ubiquitously expressed transmembrane water channels implicated in a broad range of physiological functions. We have previously reported that aquaporin 4 (AQP4) is expressed on T cells and that treatment with a small molecule AQP4 inhibitor significantly delays T cell mediated heart allograft rejection. Using either genetic deletion or small molecule inhibitor, we show that AQP4 supports T cell receptor mediated activation of both mouse and human T cells. Intact AQP4 is required for optimal T cell receptor (TCR)-related signaling events, including nuclear translocation of transcription factors and phosphorylation of proximal TCR signaling molecules. AQP4 deficiency or inhibition impairs actin cytoskeleton rearrangements following TCR crosslinking, causing inferior TCR polarization and a loss of TCR signaling. Our findings reveal a novel function of AQP4 in T lymphocytes and identify AQP4 as a potential therapeutic target for preventing TCR-mediated T cell activation.
Superficial acral fibromyxoma: a case of missed diagnosis
Authors: Debordes Pierre-Antoine , Hamoudi Ceyran , Weingertner Noelle , Di Marco Antonio
Published: February 2023

Superficial acral fibromyxoma (SAFM) is a rare, benign, slow-growing fibroblastic tumour of the soft tissue that is part of the group of myxoid soft-tissue neoplasms. It is a rare entity and usually occurs in the acral regions. We report the case of a 64-year-old man who presented to the emergency room for a lesion expected to have occurred as a result of an ingrown toenail. Because this patient had a history of repeated recurrences despite multiple surgical wedge excisions, we performed a complete surgical excision, and the pathological analysis confirmed the suspected diagnosis of SAFM. There was no recurrence at the 6-month follow-up. This case highlights the fact that this tumour is still misunderstood and underrecognized by surgeons and this often leads to delayed diagnosis. Although it is a rare entity, clinicians should be aware of this tumour in cases of recurring ingrown toenails.
Fragility fracture of talar neck in an osteoporotic patient treated by posterior-to-anterior screw fixation under hindfoot endoscopy: a case report
Authors: Morio Futoshi , Morimoto Shota , Tachibana Toshiya , Iseki Tomoya
Published: February 2023

Fragility fractures of the talar neck are extremely rare. Here, we describe a case of fragility fracture of the talar neck associated with osteoporosis in a 76-year-old female, who was treated by posterior-to-anterior screw fixation under hindfoot endoscopy. A 76-year-old female cleaner with a history of osteoporosis complained of pain in her right ankle when going downstairs. Radiological findings revealed a fragility fracture of the talar neck associated with osteoporosis. Because the patient was elderly and it was difficult to treat using a prolonged non-weight-bearing cast, we performed a posterior-to-anterior parallel dual screw fixation under hindfoot endoscopy for this case. As a result, the patient was able to return to work 8 weeks after surgery without pain, dysfunction or complication. Osteosynthesis with posterior-to-anterior screw fixation under hindfoot endoscopy successfully treated a rare case of fragility fracture of the talar neck in a 76-year-old female cleaner.
Same-sex families’ rights and the European Union: incompatible or promising relationship?
Authors: Křičková Lenka
Published: February 2023

This article deals with the role of the European Union (EU) in enhancing rights of same-sex couples and their children (‘rainbow families’). It describes EU actions in this area and examines what influence they can have within the Member States, using the Czech Republic as a case study. The article argues that, despite the EU’s general lack of competence in family law matters, the relationship between the EU and rainbow families’ rights, in theory, no longer appears incompatible, but rather promising, as the EU bodies have found ways to address these issues. In practical terms. However, the question raised in this article’s title cannot be definitively answered without data from the Member States. Here, the findings from the Czech Republic demonstrate that the EU law’s potential has not been fulfilled in practice yet. Therefore, it would be too soon to celebrate the EU as a significant player in the rainbow families’ rights arena. As the Czech example suggests, if the EU wants to truly enhance rainbow families’ rights, it will probably need to be more explicit about that because the Member States, particularly their national courts, may not find or pave the way to utilize EU law themselves.
A Principle-based Account of Self-attacking Arguments in Gradual Semantics
Authors: Beuselinck Vivien , Delobelle Jérôme , Vesic Srdjan
Published: February 2023

The issue of how a semantics should deal with self-attacking arguments was always a subject of debate among argumentation scholars. A consensus exists for extension-based semantics because those arguments are always rejected (as soon as the semantics in question respects conflict-freeness). In case of gradual semantics, the question is more complex, since other criteria are taken into account. In this paper, we check the impact of those arguments by using a principle-based approach. Principles like self-contradiction and strong self-contradiction prescribe how to deal with self-attacking arguments. We show that they are incompatible with the well-known equivalence principle (which is satisfied by almost all the existing gradual semantics), as well as with some other principles (e.g. counting). This incompatibility was not studied until now and the class of semantics satisfying self-contradiction is under-explored. In the present paper, we explore that class of semantics. We show links and incompatibilities between several principles. We define a new general oriented argumentation semantics that satisfies (strong) self-contradiction and a maximal number of compatible principles. We introduce an iterative algorithm to calculate our semantics and prove that it always converges. We also provide a characterization of our semantics. Finally, we experimentally show that our semantics is computationally efficient.
Application of radiomics to meningiomas: A systematic review
Authors: Patel Ruchit V , Yao Shun , Huang Raymond Y , Bi Wenya Linda
Published: February 2023

Background

Quantitative imaging analysis through radiomics is a powerful technology to non-invasively assess molecular correlates and guide clinical decision-making. There has been growing interest in image-based phenotyping for meningiomas given the complexities in management.

Methods

We systematically reviewed meningioma radiomics analyses published in PubMed, Embase, and Web of Science until December 20, 2021. We compiled performance data and assessed publication quality using the radiomics quality score (RQS).

Results

A total of 170 publications were grouped into 5 categories of radiomics applications to meningiomas: Tumor detection and segmentation (21%), classification across neurologic diseases (54%), grading (14%), feature correlation (3%), and prognostication (8%). A majority focused on technical model development (73%) versus clinical applications (27%), with increasing adoption of deep learning. Studies utilized either private institutional (50%) or public (49%) datasets, with only 68% using a validation dataset. For detection and segmentation, radiomic models had a mean accuracy of 93.1 ± 8.1% and a dice coefficient of 88.8 ± 7.9%. Meningioma classification had a mean accuracy of 95.2 ± 4.0%. Tumor grading had a mean area-under-the-curve (AUC) of 0.85 ± 0.08. Correlation with meningioma biological features had a mean AUC of 0.89 ± 0.07. Prognostication of the clinical course had a mean AUC of 0.83 ± 0.08. While clinical studies had a higher mean RQS compared to technical studies, quality was low overall with a mean RQS of 6.7 ± 5.9 (possible range −8 to 36).

Conclusions

There has been global growth in meningioma radiomics, driven by data accessibility and novel computational methodology. Translatability toward complex tasks such as prognostication requires studies that improve quality, develop comprehensive patient datasets, and engage in prospective trials.
Epidemiology and Clinical Outcomes of Non-HACEK Gram-Negative Infective Endocarditis
Authors: Shah Sunish , Clarke Lloyd G , Shields Ryan K
Published: February 2023

Background

The objectives of this study were to describe the changing epidemiology of gram-negative infective endocarditis (GNIE) and to identify factors associated with treatment failure and death.

Methods

Adult patients with GNIE were included if they met modified Duke criteria for definitive infective endocarditis (IE) between April 2010 and December 2021. Patients were identified using Boolean search terms. Clinical failure was a defined as a composite of all-cause 42-day mortality or microbiologic failure. All analyses were performed using Stata, version 15.1.

Results

One-hundred twenty-three patients were included. The most common pathogens were Serratia spp. (43%), Pseudomonas aeruginosa (21%), and Klebsiella spp. (14%). Fifty-two percent of cases were among persons who injection drugs (PWID; n = 64), for whom Serratia spp. (70%) was the most common cause of GNIE. Overall, patients infected with P. aeruginosa had higher microbiologic failure rates than other patients (23% vs 6%; P = .004). Patients who received combination therapy (n = 53) had comparable median lengths of stay (23 vs 19.5 days; P = .412), microbiologic failure rates (11.3% vs 7.1%; P = .528), clinical failure rates (18.9% vs 22.9%; P = .592), and 90-day mortality rates (13.2% vs 25.7%; P = .088) as those treated with monotherapy. After applying stepwise logistic regression, male gender, Pitt Bacteremia Score, and not receiving surgical intervention despite a surgical indication were associated with clinical failure.

Conclusions

This is the first study to identify Serratia spp. as the most common etiology of GNIE, which was particularly true among PWID. Microbiologic failures occurred most commonly among P. aeruginosa, and use of combination antimicrobial therapy did not improve clinical outcomes.
Managing Ibrutinib-Intolerant Patients With B-Cell Malignancies
Authors: Muñoz Javier , Sarosiek Shayna , Castillo Jorge J
Published: February 2023

Ibrutinib is a first-generation inhibitor of Bruton tyrosine kinase (BTK) that is currently approved to treat patients with B-cell malignancies, including Waldenström macroglobulinemia (WM), relapsed/refractory (R/R) mantle cell lymphoma (MCL), R/R marginal zone lymphoma (MZL), and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). Off-target adverse effects, such as atrial fibrillation, hypertension, and bleeding, have been observed and may limit a patient’s tolerance for treatment. Currently, there is no well-established treatment regimen for patients who cannot tolerate ibrutinib. Approaches to address such patients include managing ibrutinib side effects with supportive care or dose reductions, switching to an alternative covalent BTK inhibitor, or abandoning covalent BTK inhibitors for alternative forms of treatment. Here we review the literature and provide guidance on treating ibrutinib-intolerant patients with B-cell malignancies.
Prevalence and Associations of Beta2-Microglobulin Mutations in MSI-H/dMMR Cancers
Authors: Liu Fangcen , Zhong Fangfang , Wu Huan , Che Keying , Shi Jiaochun , Wu Nandie , Fu Yao , Wang Yue , Hu Jing , Qian Xiaoping , Fan Xiangshan , Wang Weifeng , Wei Jia
Published: February 2023

Microsatellite instability (MSI) has emerged as an important predictor of sensitivity for immunotherapy-based strategies. β-2-Microglobulin (B2M) contains microsatellites within the coding regions and is prone to somatic changes in MSI/mismatch repair deficiency (MSI/dMMR) tumors. To delineate prevalence and associations of B2M mutations in MSI-H/dMMR cancers, we investigated the mutational profile of B2M and clinical and pathological features in gastric cancer (GC), colorectal cancer (CRC), and endometrial cancer (EC) with a high incidence of microsatellite instability-high (MSI-H)/dMMR. Formalin-fixed paraffin-embedded (FFPE) tumor tissues along with matched normal tissues were collected from 108 MSI/dMMR patients with GC, CRC, and EC. Genomic profiling of tissue and blood samples were assessed next-generation sequencing (NGS). Immunohistochemistry (IHC) was used to examine the presence or absence of B2M protein. Alternations in the exonic microsatellite regions of B2M were observed at various but high frequencies (57.5% in CRC, 23.9% in GC, and 13.6% in EC) and in different forms. NGS assay revealed that genes involved in chromatin regulation, the PI3K pathway, the WNT pathway, and mismatch repair were extensively altered in the MSI-H cohort. Signature 6 and 26, 2 of 4 mutational signatures associated with defective DNA mismatch repair, featured with high numbers of small insertion/deletions (INDEL) dominated in all 3 types of cancer. Alternations in the exonic microsatellite regions of B2M were observed at various but high frequencies (57.5% in CRC, 23.9% in GC, and 13.6% in EC) and in different forms. Tumor mutational burden (TMB) was significantly higher in the patients carrying MSI-H/dMMR tumors with B2M mutation than that in patients with wild-type B2M (P = .026).The frame shift alteration occurring at the exonic microsatellite sties caused loss of function of B2M gene. In addition, a case with CRC carrying indels in B2M gene resisted the ICI treatment was reported. In conclusion, patients carrying MSI-H/dMMR tumors with B2M mutation showed significantly higher TMB. Prescription of ICIs should be thoroughly evaluated for these patients.
Galaxy clusters at z ∼ 1 imaged by ALMA with the Sunyaev–Zel’dovich effect
Authors: Kitayama Tetsu , Ueda Shutaro , Okabe Nobuhiro , Akahori Takuya , Hilton Matt , Hughes John P , Ichinohe Yuto , Kohno Kotaro , Komatsu Eiichiro , Lin Yen-Ting , Miyatake Hironao , Oguri Masamune , Sifón Cristóbal , Takakuwa Shigehisa , Takizawa Motokazu , Tsutsumi Takahiro , van Marrewijk Joshiwa , Wollack Edward J
Published: February 2023

We present high angular resolution measurements of the thermal Sunyaev–Zel’dovich effect (SZE) toward two galaxy clusters, RCS J2319+0038 at $z$ = 0.9 and HSC J0947−0119 at $z$ = 1.1, by the Atacama Large Millimeter/submillimeter Array (ALMA) in Band 3. They are supplemented with available Chandra X-ray data, optical data taken by Hyper Suprime-Cam on Subaru, and millimeter-wave SZE data from the Atacama Cosmology Telescope. Taking into account departures from spherical symmetry, we have reconstructed non-parametrically the inner pressure profile of two clusters as well as electron temperature and density profiles for RCS J2319+0038. This is one of the first such measurements for an individual cluster at $z \gtrsim 0.9$. We find that the inner pressure profile of both clusters is much shallower than that of local cool-core clusters. Our results consistently suggest that RCS J2319+0038 hosts a weak cool core, where radiative cooling is less significant than in local cool cores. On the other hand, HSC J0947−0119 exhibits an even shallower pressure profile than RCS J2319+0038 and is more likely to be a non-cool-core cluster. The SZE centroid position is offset by more than 140 $h_{70}^{-1}$ kpc from the peaks of galaxy distribution in HSC J0947−0119, suggesting a stronger influence of mergers in this cluster. We conclude that these distant clusters are at a very early stage of developing the cool cores typically found in clusters at lower redshifts.
Ingestion rate estimated from food concentration and predatory role of copepod nauplii in the microbial food web of temperate embayment waters
Authors: Sugai Youta , Natori Noriaki , Tsuchiya Kenji , Nakagawa Megumi , Honda Makio C , Shimode Shinji , Toda Tatsuki
Published: February 2023

To quantitatively evaluate the role of copepod nauplii as predators in the microbial food web, the ingestion rate (IR) of copepod nauplii and the food requirement (FR) of microzooplankton were estimated monthly for 3 consecutive years in temperate embayment waters. The IR of dominant copepod nauplii (Acartia spp. nauplii) was estimated from water temperature, individual carbon weight and food concentration and peaked (>0.50 μgC ind−1 d−1) with relatively high food concentration (>57.5 μgC L−1). This result suggests that food concentration should be considered to estimate copepod naupliar IR in marine environments, especially where biological conditions fluctuate largely. The comparison of copepod naupliar and microprotozoan FR showed the dominance of naked ciliate FR (77.0–90.2%) during the study period except in spring when comparable values were observed between the FR of naked ciliates (41.6%) and copepod nauplii (33.6%). During spring, transfer efficiency (10.5%) from primary production (PP) to microzooplankton production was lower than in other seasons (16.2–17.1%). This study indicates that copepod nauplii are seasonally important micro-sized predators in the microbial food web of temperate embayment waters and that carbon flow through copepod nauplii is a pathway which inefficiently transfers PP to higher trophic levels.
The role of sleep and heart rate variability in metabolic syndrome: evidence from the Midlife in the United States study
Authors: Nevels Torrance L , Wirth Michael D , Ginsberg J P , McLain Alexander C , Burch James B
Published: February 2023

Study Objectives

Poor sleep and autonomic dysregulation can both disrupt metabolic processes. This study examined the individual and combined effects of poor sleep and reduced heart rate variability (HRV) on metabolic syndrome among 966 participants in the Midlife in the United States II (MIDUS II) study.

Methods

Self-reported sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI). HRV was acquired from 11-minute resting heart rate recordings. Spearman correlations, general linear regression, and logistic regression models were used to examine the study hypotheses.

Results

Poor sleep quality was associated with metabolic syndrome when global PSQI scores were evaluated as a continuous (odds ratio [OR]: 1.07, 95% confidence interval [CI]: 1.03 to 1.11) or categorical measure (cutoff > 5, OR: 1.58, 95% CI: 1.19 to 2.10), after adjustment for confounding. There also was an association between reduced HRV and metabolic syndrome (ln [HF-HRV] OR: 0.89, 95% CI: 0.80 to 0.99; ln [LF-HRV] OR: 0.82, 95% CI: 0.72 to 0.92; ln [SDRR] OR: 0.59, 95% CI: 0.43 to 0.79; ln [RMSSD] OR: 0.75, 95% CI: 0.60 to 0.94). When the combined effects of poor sleep and low HRV were examined, the association with metabolic syndrome was further strengthened relative to those with normal sleep and HRV.

Conclusions

To the best of the author’s knowledge, this is the first study to suggest a combined effect of poor sleep and low HRV on the odds of metabolic syndrome.
Counternarratives: An Antiracist Approach in Social Work Education, Practice, and Research
Authors: Berrett-Abebe Julie , Reed Sarah C , Burrell Storms Stephanie
Published: February 2023

Given renewed attention to racial equity in the social work profession, the authors suggest the use of counternarratives, an established tool of critical race theory, as an accessible method to challenge racism and examine privilege in social work education, practice, and research. Counternarratives use the technique of storytelling to elevate the lived experiences of marginalized individuals and communities and invite the listener into critical reflection about dominant, privileged discourses. The ultimate goal of counternarratives is the achievement of racial equity. The authors provide context about how counternarratives can align with social work education, practice, and research, and then use specific, illustrative examples from their own work to bring this method and its application to life. The authors also share their own processes of reflection and dialogue across disciplines and social locations in the use of counternarratives. The reflections of an experienced social justice educator provide additional insights on the use of counternarratives in the field of social work.
HexSE: Simulating evolution in overlapping reading frames
Authors: Muñoz-Baena Laura , Wade Kaitlyn E , Poon Art F Y
Published: February 2023

Gene overlap occurs when two or more genes are encoded by the same nucleotides. This phenomenon is found in all taxonomic domains, but is particularly common in viruses, where it may provide a mechanism to increase the information content of compact genomes. The presence of overlapping reading frames (OvRFs) can skew estimates of selection based on the rates of non-synonymous and synonymous substitutions, since a substitution that is synonymous in one reading frame may be non-synonymous in another and vice versa. To understand the impact of OvRFs on molecular evolution, we implemented a versatile simulation model of nucleotide sequence evolution along a phylogeny with any distribution of open reading frames in linear or circular genomes. We use a custom data structure to track the substitution rates at every nucleotide site, which is determined by the stationary nucleotide frequencies, transition bias and the distribution of selection biases (dN/dS) in the respective reading frames. Our simulation model is implemented in the Python scripting language. All source code is released under the GNU General Public License version 3 and are available at https://github.com/PoonLab/HexSE.
Graduate Nurse Educator Students’ Perceptions of the Use of Narrative Pedagogy in Online Learning
Authors: Kim-Godwin Yeoun Soo , Matthias April D. , Dieckman Laura P.
Published: February 2023

This pilot study explored graduate nurse educator students’ perceptions of the application of narrative pedagogy in an online environment. Four major themes were identified in 15 student discussion posts: adapting challenges, increasing digital human interactions, enabling strategies, and creating a partnership for learning. Results illustrate how integrating narrative pedagogy into online classes enables a transformation of student thinking and learning by providing alternate ways for nurse educators to promote active learning.
Telepresence: An Innovative Teaching Modality to Enrich Simulation and Remote Learning
Authors: Want David R. , Cieslowski Bethany J.
Published: February 2023

The COVID-19 pandemic magnified the need for simulation and necessitated a radical change in how educators execute simulation-based learning (SBL), highlighting new and emerging technologies. Student evaluations noted a lack of realism with screen-based and telesimulations, and faculty reported students’ decreased engagement. This project enhanced SBL using robot telepresence to provide an immersive and interactive environment. Student comments supported the positive experience, expressing greater engagement and indicating that the experience closely mirrored clinical practice. Telepresence removes barriers to distance learning, augments the potential of SBL, and broadens the understanding of how to deliver engaging SBL experiences to remote learners.
Virtual Suturing Lab: A Practical and Innovative Approach in Nursing Education
Authors: McClinton Tracy D.
Published: February 2023

Competency in a variety of skills is necessary for undergraduate and advanced practice nursing students prior to entering the clinical setting. Basic suturing is traditionally taught in skills labs in advanced practice programs globally. However, when in-person teaching is not an option, nurse educators must be innovative in meeting clinical course outcomes. A virtual suturing skills lab proved to be beneficial in meeting the needs of advanced practice nursing students when in-person teaching was not feasible. Students demonstrated competency using an innovative method of teaching a hybrid program through distance learning.
Socialization of Master's-Prepared Novice Nurse Faculty
Authors: Nicholls Lakeisha N. , Kelman Glenda B.
Published: February 2023

AIM

The aim of this study was to explore the lived experience of novice nurse faculty's socialization to academia.

BACKGROUND

Socialization is a process that enables individuals to acquire the inherent roles, standards, rules, and values inherent of a group. Given the complexity of the faculty role, socialization is essential for novice nurse educators.

METHOD

A descriptive, qualitative study was conducted employing Colaizzi's phenomenological method of data analysis.

RESULTS

Eight themes emerged: lack of structure, the blind spot, distinctive experiences, acceptance and validation, continually evolving—learning as you go, the wish list, new role challenges, and self-revelation.

CONCLUSION

These findings increase our understanding of the challenges experienced by novice nursing faculty as they are socialized to their new roles. The findings can inform strategies to improve the socialization experience and faculty retention.
Updates in school-based asthma management
Authors: Lowe Ashley A. , Onge Ina St , Trivedi Michelle
Published: February 2023

Purpose of review

School-based asthma management is an important component of pediatric asthma care that has the potential to provide more universal evidence-based asthma care to children and mitigate asthma-related health inequities. The purpose of this review is to highlight relevant developments in school-based asthma management over the past 2 years.

Recent findings

There have been considerable recent scientific advances in school-based asthma management including robust clinical trials of environmental interventions in the classroom setting, school-nurse led interventions, stock albuterol policy changes, school-based telemedicine approaches and innovative methods to engage community stakeholders in research that have pushed the frontiers of school-based asthma care.

Recent scientific work in school-based asthma management demonstrates the potential power of schools in providing access to guideline-based asthma care for all children with asthma and in improving their health outcomes. Future work should focus on the evaluation of methods to promote the adoption of school-based asthma management strategies in real-world practice and support evidence-based policy change and strategic partnerships to improve asthma health outcomes and produce meaningful public health impact for diverse children and families.
Update on irritant-induced occupational asthma
Authors: Ronsmans Steven , Le Moual Nicole , Dumas Orianne
Published: February 2023

Purpose of review

In this narrative review, we aim to highlight novel research findings on both acute/subacute irritant-induced asthma (IIA) and chronic exposure IIA (also called ‘low dose’ IIA).

Recent findings

Novel case series showed that acute and subacute IIA cases had similar causal agents (e.g., acid or base aerosols/fumes, dusts, mixtures) but had occurred in different circumstances (accidents vs. regular work). Acute and subacute IIA cases had similar clinical characteristics but poorer short-term outcomes than sensitizer-induced occupational asthma patients. Novel large epidemiological studies reported associations between chronic occupational exposure to irritants and current adult-onset asthma and poor asthma control, and with a specific asthma endotype characterized by neutrophilic inflammation and oxidative stress. Recent studies reconfirmed the association of the use of disinfectants and cleaning products (especially sprays) with IIA. A role for genetic susceptibility has been suggested.

Recent literature provided further understanding of both acute/subacute and chronic exposure IIA, in terms of causes, possible mechanisms, and consequences such as poor asthma control. Research is needed to clarify several aspects of IIA, including its frequency (still likely underestimated), modulating factors, and mechanisms. Research aiming at improving irritant exposure assessment, including intensity/duration, and determining relevant exposure windows would be welcome.
Biochemical disturbance in damage control resuscitation: mechanisms, management and prognostic utility
Authors: Milne Andrew , Radhakrishnan Archchana
Published: February 2023

Purpose of review

With advances in resuscitative techniques, trauma patients are surviving increasingly severe injuries and physiological insult. Timely recognition of futility remains important in terms of patient dignity and resource preservation yet is increasingly challenging in the face of these advances. The understanding of biochemical derangement from pathophysiological processes of trauma and iatrogenic effects of resuscitation has expanded recently.

Recent findings

Acidosis and hypocalcaemia have been recognized as important contributors to mortality among trauma patients. Although less well recognized and studied, critical injury and high blood product volume resuscitation render patients vulnerable to life-threatening hyperkalaemia. The methods of correcting disruptions to acid–base and electrolyte homeostasis during damage control resuscitation have changed little recently and often rely on evidence from undifferentiated populations. Biochemical disturbances have value as ancillary predictors of futility in trauma resuscitation.

These findings will contribute to a greater understanding among anaesthesiologists of the causative mechanisms and effects of biochemical derangement after severe injury and aid them in the delivery of well tolerated and effective damage control resuscitation. Gaps in the evidence base are highlighted to encourage future work.
The State of the Science of Nurses' Implicit Bias
Authors: Wei Holly , Price Zula , Evans Kara , Haberstroh Amanda , Hines-Martin Vicki , Harrington Candace C.
Published: February 2023

This article summarizes the current state of nurses' implicit bias and discusses the phenomenon from Levinas' face of the Other and ethics of belonging, Watson's human caring and unitary caring science, and Chinn's peace and power theory. Nurses' implicit bias is a global issue; the primary sources of nurses' implicit bias include race/ethnicity, sexuality, health conditions, age, mental health status, and substance use disorders. The current research stays at the descriptive level and addresses implicit bias at the individual level. This article invites nurses to go beyond “the face of the Other” and revisit the ethics of belonging and power.
Is it time to move on from pelvic radiography as the first-line imaging modality for suspected sacroiliitis?
Authors: Eshed Iris , Diekhoff Torsten , Hermann Kay Geert A.
Published: February 2023

Purpose of review

Pelvic radiography in which structural lesions characteristic of sacroiliitis can be detected, is recommended as the first imaging modality when axial spondyloarthritis (axSpA) is suspected clinically. However, cross-sectional modalities like computed tomography (CT) and magnetic resonance imaging (MRI) are superior to radiographs for diagnosing sacroiliitis. Thus, we currently debate the role of radiography as first imaging modality in the diagnostic workup of axSpA.

Recent findings

Diagnosing sacroiliitis on pelvic radiographs is challenging with large interobserver and intraobserver variation. Low-dose CT (ldCT) of the sacroiliac joints (SIJs) was proved to be more sensitive and reliable than radiographs with comparable ionizing radiation exposure. MRI is the preferred modality for detecting early SIJ inflammation, well before structural lesions evolve. New, promising MRI sequences sensitive to cortical bone improve erosion detection, making MRI a one-stop shop for the diagnosis of sacroiliitis.

Given the debatable additive value of pelvic radiographs for the detection of sacroiliitis, and the presence of excellent alternatives for imaging the bony cortex of the SIJs such as ldCT and MRI with state-of-the-art sequences sensitive to cortical bone, it is high time to discuss the use of these more accurate modalities instead of radiographs.
Early Outcomes of Proximal Humerus Fractures in Adults Treated With Locked Plate Fixation Compared with Nonoperative Treatment: An Age-, Comorbidity-, and Fracture Morphology-Matched Analysis
Authors: Samborski S. Andrew , Haws Brittany E. , Karnyski Steven , Soles Gillian , Gorczyca John T. , Nicandri Gregg , Voloshin Ilya , Ketz John P.
Published: February 2023

Objectives:

To compare patient-reported outcomes (PROs), range of motion (ROM), and complication rates for proximal humerus fractures managed nonoperatively or with open reduction internal fixation (ORIF).

Design:

Retrospective cohort.

Setting:

Academic level 1 trauma center.

Patients/Participants:

Four hundred thirty-one patients older than 55 years were identified retrospectively. 122 patients were excluded. 309 patients with proximal humerus fractures met inclusion criteria (234 nonoperative and 75 ORIF). After matching, 192 patients (121 nonoperative and 71 ORIF) were included in the analysis.

Intervention:

Nonoperative versus ORIF (locked plate) treatment of proximal humerus fracture.

Main Outcome Measurements:

Early Visual Analog Score (VAS), ROM, PROs, complications, and reoperation rates between groups.

Results:

At 2 weeks, ORIF showed lower VAS scores, better passive ROM, and patient-reported outcomes measurement information system (PROMIS) scores (P < 0.05) compared with nonoperative treatment. At 6 weeks, open reduction internal fixation (ORIF) had lower VAS scores, better passive ROM, and PROMIS scores (P < 0.05) compared with nonoperative treatment. At 3 months, ORIF showed similar PROMIS scores (P > 0.05) but lower VAS scores and better passive ROM (P < 0.05) compared with nonoperative treatment. At 6 months, ORIF showed similar VAS scores, ROM, and PROMIS scores (P > 0.05) compared with nonoperative treatment. There was no difference in secondary operation rates between groups (P > 0.05). ORIF patients trended toward a higher secondary reoperation rate (15.5% vs. 5.0%) than nonoperative patients (P = 0.053).

Conclusions:

In an age-, comorbidity-, and fracture morphology-matched analysis of proximal humerus fractures, ORIF led to decreased pain and improved passive ROM early in recovery curve compared with nonoperative treatment that normalized after 6 months between groups.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
An Evaluation of Treatment Patterns for Osteoporosis and Outcomes After a Fragility Fracture in a Real-World Setting
Authors: Singer Andrea J. , Williams Setareh A. , Pearman Leny , Wang Yamei , Pyrih Nick , Jeray Kyle
Published: February 2023

Objectives:

Treatment initiation and persistence after a fragility fracture are critical to reduce the risk of subsequent fractures. The authors evaluated osteoporosis management and outcomes after index fracture.

Methods:

This retrospective cohort study used real-world data for patients (≥50 years), including pharmacy claims linked to commercial and Medicare medical claims from Symphony Health Patient Source. Osteoporosis management was evaluated for at least 12 months after the first case-qualifying fracture during the identification period and continued until a second fracture or March 31, 2020 (depending on data availability). Secondary fracture incidence was evaluated overall and for subgroups at very high risk.

Results:

Of 755,312 eligible patients, the proportion with a claim for bone mineral density testing at 12 months after index fracture was low [64,932 (8.6%)], and 75.3% of those tested were ≥65 years of age. Most patients (88.6%) remained untreated at any time after fracture. Among those treated, most (64.9%) were initially treated with bisphosphonates (oral, 93.7%; IV, 6.3%). Treatment duration and persistence were low for all treatments ranging from 6.5 months with 19.6% persistent for abaloparatide to 11.3 months with 45.0% persistent for denosumab. During follow-up, 13.6% of patients had a secondary fracture at any site, with higher incidence in subgroups considered to be at high risk for fracture than in the overall population.

Conclusions:

Low rates of osteoporosis testing and treatment initiation and high secondary fracture rates (particularly among patients at very high risk) highlight the need for better management of patients after a fracture.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Geriatric Distal Femur Fractures: Equivalent Long-Term Reoperation Rates Between Fixation and Primary Arthroplasty
Authors: Shi Brendan Y. , Upfill-Brown Alexander , Brodke Dane J. , Stavrakis Alexandra I. , Lee Christopher , SooHoo Nelson F.
Published: February 2023

Objective:

Our primary objectives were to (1) determine the rate of requiring conversion to arthroplasty after open reduction internal fixation (ORIF) of geriatric distal femur fractures and (2) compare 10-year reoperation rates after ORIF versus primary arthroplasty for geriatric distal femur fractures.

Design:

Propensity-matched retrospective cohort study.

Setting:

All centers participating in the California Office of Statewide Health Planning and Development (OSHPD) database.

Patients/Participants:

All patients 65 years of age or older who underwent operative management of a distal femur fracture between 2000 and 2017.

Intervention:

ORIF, total knee arthroplasty (TKA), or distal femur replacement (DFR).

Main outcome measurements:

Reoperation.

Results:

A total of 16,784 patients with geriatric distal femur fracture were identified, of which 16,343 (97.4%) underwent ORIF. The cumulative incidence of conversion to arthroplasty within 10 years of ORIF was found to be 3.5%, with young age and female sex identified as risk factors for conversion. There was no significant difference in 10-year reoperation-free survival rate between propensity-matched patients undergoing ORIF versus primary arthroplasty (94.5% vs. 96.2%, P = 0.659). There were no differences in short-term complication or readmission rates between matched treatment cohorts, but arthroplasty was associated with a higher rate of wound infection within 90 days (2.0% vs. 0.2%, P = 0.011).

Conclusions:

The 10-year cumulative incidence of conversion to arthroplasty after ORIF was found to be low. There was no significant difference in long-term reoperation-free survival rates between patients undergoing ORIF versus primary arthroplasty. Primary arthroplasty was associated with significantly higher rates of acute wound or joint infection.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Locked Plating versus Nailing for Proximal Tibia Fractures: A Multicenter RCT
Authors: Dunbar Robert P. , Egol Kenneth A. , Jones Clifford B. , Ostrum Robert F. , Humphrey Catherine A. , Ricci William M. , Phieffer Laura S. , Teague David C. , Sagi H. Claude , Pollak Andrew N. , Schmidt Andrew H. , Sems Andrew , Pape Hans-Christoph , Morshed Saam , Perez Edward A. , Tornetta Paul
Published: February 2023

Objectives:

The main 2 forms of treatment for extraarticular proximal tibial fractures are intramedullary nailing (IMN) and locked lateral plating (LLP). The goal of this multicenter, randomized controlled trial was to determine whether there are significant differences in outcomes between these forms of treatment.

Design:

Multicenter, randomized controlled trial.

Setting:

16 academic trauma centers.

Patients/Participants:

108 patients were enrolled. 99 patients were followed for 12 months. 52 patients were randomized to IMN, and 47 patients were randomized to LLP.

Intervention:

IMN or lateral locked plating.

Main Outcome Measurements:

Functional scoring including Short Musculoskeletal Functional Assessment, Bother Index, EQ-5Dindex and EQ-5DVAS. Secondary measures included alignment, operative time, range of motion, union rate, pain, walking ability, ability to manage stairs, need for ambulatory aid and number, and complications.

Results:

Functional testing demonstrated no difference between the groups, but both groups were still significantly affected 12 months postinjury. Similarly, there was no difference in time of surgery, alignment, nonunion, pain, walking ability, ability to manage stairs, need for ambulatory support, or complications.

Conclusions:

Both IMN and LLP provide for similar outcomes after these fractures. Patients continue to improve over the course of the year after injury but remain impaired even 1 year later.

Level of Evidence:

Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.