bluuebunny/crossref_metadata_2025 huggingface dataset:
Modeling the Distribution of the Invasive Alien Cycad Aulacaspis Scale in Africa Under Current and Future Climate Scenarios
Authors: Kanle Satishchandra Nitin , Geerts Sjirk
Published: June 2020

The cycad aulacaspis scale, Aulacaspis yasumatsui Takagi (Hemiptera: Coccoidea: Diaspididae), is native to Southeast Asia but an invasive pest of the gymnosperm order Cycadales in many parts of the world. Aulacaspis yasumatsui was recently reported on the cycad genus Encephalartos in South Africa and is currently categorized as a ‘prohibited terrestrial invertebrate’ in the invasive species legislation, National Environmental Management: Biodiversity Act, 2004 (NEM:BA). Encephalartos is endemic to Africa, and 11 species are listed as critically endangered and four species as endangered. Seeing the limited distribution of A. yasumatsui in South Africa and only one unconfirmed record from the Ivory Coast, understanding the potential distribution range is essential for control and management. Here we model the potential distribution of A. yasumatsui under current and future climate scenarios in Africa, with a focus on South Africa. Future climatic scenarios were simulated using a bio-climatic software, CLIMEX. The model indicates that, under the current climatic scenario, all 17 African countries possessing Encephalartos are susceptible to A. yasumatsui establishment. However, under climatic change, the suitability decreases for large parts of Africa. In South Africa, 93% of the winter rainfall areas, and 90% of the temperate, summer rainfall areas are suitable for A. yasumatsui establishment. In this study, we highlight the urgent need for regulation, management, and research on A. yasumatsui in African countries with native cycads.
Cronyism in State Violence: Evidence from Labor Repression During Argentina's Last Dictatorship
Authors: Klor Esteban F , Saiegh Sebastian , Satyanath Shanker
Published: June 2020

We study whether crony governance can extend beyond economic policy to the targeting of state violence against citizens. Specifically, we examine the logic driving the choice of firm-level union representatives who were subjected to state repression by the 1976–1983 Argentine military junta. Using an original dataset, we find a positive, nonspurious, and robust correlation between labor repression and cronyism, measured by political, business, and social connections to the regime. Our results indicate that the number of firm-level union representatives victimized by the regime is three times higher for connected firms relative to nonconnected ones. The effect is pronounced in privately owned (as opposed to state-owned) firms, suggesting that the correlation is driven by cronyism for financial gain rather than ideology or information transmission. We show that connected firms benefited from violence against union representatives by subsequently having less strikes and a higher market valuation. Our findings highlight the pervasiveness of governmental cronyism, even in cases where one of the regime's main stated goals was to curb such behavior.
Behavior Training is Not Enough: Empowering Middle Managers by Shifting Mindset
Authors: Otocki Austin C , Turner Brian F
Published: June 2020

In most organizations, middle managers are expected to meet goals and expectations passed down from above while also connecting with and inspiring the frontline employees doing the work of the organization. Caught in the middle, they often receive training on competencies intended to help them manage issues that arise from this situation. Yet this training tends to be temporarily helpful at best—and harmful at worst. Competency training, because it focuses on changing behavior, fails to address a foundational element necessary to consistently and effectively resolve their challenges. That foundational element is mindset. Providing training and tools to shift their mindset regarding their management objectives better prepares mid-level leaders to be more effective in their challenging positions.
Pharmacological serum concentrations of epinephrine and norepinephrine do not affect growth rate, morphogenesis, stress tolerance, and virulence ofCandida albicans
Authors: Wurster Sebastian , Lyos Sebastian , Albert Nathaniel D , Kontoyiannis Dimitrios P
Published: June 2020

Vasopressors are frequently given in hemodynamically unstable patients with severe Candida sepsis. While catecholamines can aggravate sepsis-induced immune dysfunction and modulate bacterial virulence traits, their impact on fungal pathogenicity is poorly understood. Using IncuCyte time-lapse microscopy and a fruit fly candidiasis model, we studied growth rates, morphogenesis, stress tolerance, and virulence of C. albicans cocultured with epinephrine and norepinephrine. We found that pharmacologically attainable catecholamine serum concentrations caused minimal changes to in vitro growth kinetics, filamentation, and fungal resistance to thermal or oxidative stress. Similarly, exposure of C. albicans to catecholamines did not alter the survival of infected flies.
The Ophiuchus DIsc Survey Employing ALMA (ODISEA) – II. The effect of stellar multiplicity on disc properties
Authors: Zurlo Alice , Cieza Lucas A , Pérez Sebastián , Christiaens Valentin , Williams Jonathan P , Guidi Greta , Cánovas Hector , Casassus Simon , Hales Antonio , Principe David A , Ruíz-Rodríguez Dary , Fernandez-Figueroa Antonia
Published: June 2020

We present adaptive optics (AO) near-infrared (NIR) observations using VLT/NACO and Keck/NIRC2 of Ophiuchus DIsc Survey Employing ALMA (ODISEA) targets. ODISEA is an ALMA survey of the entire population of circumstellar discs in the Ophiuchus molecular cloud. From the whole sample of ODISEA, we select all the discs that are not already observed in the NIR with AO and that are observable with NACO or NIRC2. The NIR-ODISEA survey consists of 147 stars observed in NIR AO imaging for the first time, as well as revisiting almost all the binary systems of Ophiuchus present in the literature (20 out of 21). In total, we detect 20 new binary systems and one triple system. For each of them, we calculate the projected separation and position angle of the companion, as well as their NIR and millimetre flux ratios. From the NIR contrast, we derived the masses of the secondaries, finding that nine of them are in the substellar regime (30–50 MJup ). Discs in multiple systems reach a maximum total dust mass of ∼50 M⊕, while discs in single stars can reach a dust mass of 200 M⊕. Discs with masses above 10 M⊕ are found only around binaries with projected separations larger than ∼110 au. The maximum disc size is also larger around single star than binaries. However, since most discs in Ophiuchus are very small and low-mass, the effect of visual binaries is relatively weak in the general disc population.
Distinguishing Felsenstein Zone from Farris Zone Using Neural Networks
Authors: Leuchtenberger Alina F , Crotty Stephen M , Drucks Tamara , Schmidt Heiko A , Burgstaller-Muehlbacher Sebastian , von Haeseler Arndt
Published: June 2020

Maximum likelihood and maximum parsimony are two key methods for phylogenetic tree reconstruction. Under certain conditions, each of these two methods can perform more or less efficiently, resulting in unresolved or disputed phylogenies. We show that a neural network can distinguish between four-taxon alignments that were evolved under conditions susceptible to either long-branch attraction or long-branch repulsion. When likelihood and parsimony methods are discordant, the neural network can provide insight as to which tree reconstruction method is best suited to the alignment. When applied to the contentious case of Strepsiptera evolution, our method shows robust support for the current scientific view, that is, it places Strepsiptera with beetles, distant from flies.
Treatment outcomes in adult tuberculous meningitis: a systematic review and meta-analysis
Authors: Stadelman Anna M , Ellis Jayne , Samuels Thomas H A , Mutengesa Ernest , Dobbin Joanna , Ssebambulidde Kenneth , Rutakingirwa Morris , Tugume Lillian , Boulware David R , Grint Daniel , Cresswell Fiona V
Published: June 2020

Background

There is substantial variation in the reported treatment outcomes for adult tuberculous meningitis (TBM). Data on survival and neurological disability by continent and HIV serostatus are scarce.

Methods

We performed a systematic review and meta-analysis to characterize treatment outcomes for adult TBM. Following a systematic literature search (MEDLINE and EMBASE), studies underwent duplicate screening by independent reviewers in two stages to assess eligibility for inclusion. Two independent reviewers extracted data from included studies. We employed a random effects model for all meta-analyses. We evaluated heterogeneity by the I2 statistic.

Results

We assessed 2,197 records for eligibility; 39 primary research articles met our inclusion criteria reporting on treatment outcomes for 5,752 adults with TBM. The commonest reported outcome measure was six-month mortality. Pooled six-month mortality was 24% and showed significant heterogeneity (I2 >95%; p<0·01). Mortality ranged from 2% to 67% in Asian studies and from 23% to 80% in sub-Saharan African studies. Mortality was significantly worse in HIV-positive adults at 57% (95%CI; 48-67%), compared with 16% (95%CI; 10-24%) in HIV-negative adults (p<0·01). Physical disability was reported in 32% (95%CI; 22-43%) of adult TBM survivors. There was considerable heterogeneity between studies in all meta-analyses with I2 statistics consistently >50%.

Conclusions

Mortality in adult TBM is high and varies considerably by continent and HIV-status. The highest mortality is amongst HIV-positive adults in sub-Saharan Africa. Standardized reporting of treatment outcomes will be essential to improve future data quality and increase potential for data sharing, meta-analyses, and facilitating multi-center tuberculosis research to improve outcomes.
An “Infodemic”: Leveraging High-Volume Twitter Data to Understand Early Public Sentiment for the Coronavirus Disease 2019 Outbreak
Authors: Medford Richard J , Saleh Sameh N , Sumarsono Andrew , Perl Trish M , Lehmann Christoph U
Published: June 2020

Background

Twitter has been used to track trends and disseminate health information during viral epidemics. On January 21, 2020, the Centers for Disease Control and Prevention activated its Emergency Operations Center and the World Health Organization released its first situation report about coronavirus disease 2019 (COVID-19), sparking significant media attention. How Twitter content and sentiment evolved in the early stages of the COVID-19 pandemic has not been described.

Methods

We extracted tweets matching hashtags related to COVID-19 from January 14 to 28, 2020 using Twitter’s application programming interface. We measured themes and frequency of keywords related to infection prevention practices. We performed a sentiment analysis to identify the sentiment polarity and predominant emotions in tweets and conducted topic modeling to identify and explore discussion topics over time. We compared sentiment, emotion, and topics among the most popular tweets, defined by the number of retweets.

Results

We evaluated 126 049 tweets from 53 196 unique users. The hourly number of COVID-19-related tweets starkly increased from January 21, 2020 onward. Approximately half (49.5%) of all tweets expressed fear and approximately 30% expressed surprise. In the full cohort, the economic and political impact of COVID-19 was the most commonly discussed topic. When focusing on the most retweeted tweets, the incidence of fear decreased and topics focused on quarantine efforts, the outbreak and its transmission, as well as prevention.

Conclusions

Twitter is a rich medium that can be leveraged to understand public sentiment in real-time and potentially target individualized public health messages based on user interest and emotion.
Vaccine Effectiveness Against Influenza-Associated Lower Respiratory Tract Infections in Hospitalized Adults, Louisville, Kentucky, 2010–2013
Authors: Chow Eric J , Rolfes Melissa A , Carrico Ruth L , Furmanek Stephen , Ramirez Julio A , Ferdinands Jill M , Fry Alicia M , Patel Manish M
Published: June 2020

Background

Preventing severe complications of influenza such as hospitalization is a public health priority; however, estimates of influenza vaccine effectiveness (VE) against influenza-associated acute lower respiratory tract infection (LRTI) hospitalizations are limited. We examined influenza VE against influenza-associated LRTIs in hospitalized adult patients.

Methods

We retrospectively analyzed data from a randomized trial of oseltamivir treatment in adults hospitalized with LRTI in Louisville, Kentucky, from 2010 to 2013. Patients were systematically tested for influenza at the time of enrollment. We estimated VE as 1 – the adjusted odds ratio (aOR) of antecedent vaccination in influenza-positives vs negatives × 100%. Vaccination status was obtained by patient self-report. Using logistic regression adjusting for age, sex, season, timing of illness, history of chronic lung disease, and activities of daily living, we estimated VE against hospitalized influenza-associated LRTIs and community-acquired pneumonia (CAP) with radiographic findings of infiltrate.

Results

Of 810 patients with LRTI (median age, 62 years), 184 (23%) were influenza-positive and 57% had radiographically confirmed CAP. Among influenza-positives and -negatives, respectively, 61% and 69% were vaccinated. Overall, 29% were hospitalized in the prior 90 days and >80% had comorbidities. Influenza-negatives were more likely to have a history of chronic obstructive pulmonary disease than influenza-positives (59% vs 48%; P = .01), but baseline medical conditions were otherwise similar. Overall, VE was 35% (95% CI, 4% to 56%) against influenza-associated LRTI and 51% (95% CI, 13% to 72%) against influenza-associated radiographically confirmed CAP.

Conclusions

Vaccination reduced the risk of hospitalization for influenza-associated LRTI and radiographically confirmed CAP. Clinicians should maintain high rates of influenza vaccination to prevent severe influenza-associated complications.
Outcomes of Hepatitis C Virus Treatment in the New York City Jail Population: Successes and Challenges Facing Scale up of Care
Authors: Chan Justin , Schwartz Jessie , Kaba Fatos , Bocour Angelica , Akiyama Matthew J , Hobstetter Laura , Rosner Zachary , Winters Ann , Yang Patricia , MacDonald Ross
Published: June 2020

Background

The population detained in the New York City (NYC) jail system bears a high burden of hepatitis C virus (HCV) infection. Challenges to scaling up treatment include short and unpredictable lengths of stay. We report on the clinical outcomes of direct-acting antiviral (DAA) treatment delivered by NYC Health + Hospitals/Correctional Health Services in NYC jails from 2014 to 2017.

Methods

We performed a retrospective observational cohort study of HCV patients with detectable HCV ribonucleic acid treated with DAA therapy while in NYC jails. Some patients initiated treatment in jail, whereas others initiated treatment in the community and were later incarcerated. Our primary outcome was sustained virologic response at 12 weeks (SVR12).

Results

There were 269 patients included in our cohort, with 181 (67%) initiating treatment in jail and 88 (33%) continuing treatment started in the community. The SVR12 virologic outcome data were available for 195 (72%) individuals. Of these, 172 (88%) achieved SVR12. Patients who completed treatment in jail were more likely to achieve SVR12 relative to those who were released on treatment (adjusted risk ratio, 2.93; 95% confidence interval, 1.35–6.34). Of those who achieved SVR12, 114 (66%) had a subsequent viral load checked. We detected recurrent viremia in 18 (16%) of these individuals, which corresponded to 10.6 cases per 100 person-years of follow-up.

Conclusions

Hepatitis C virus treatment with DAA therapy is effective in a jail environment. Future work should address challenges related to discharging patients while they are on treatment, loss to follow-up, and a high incidence of probable reinfection.
Willingness to Seek Diagnostic Testing for SARS-CoV-2 With Home, Drive-through, and Clinic-Based Specimen Collection Locations
Authors: Siegler Aaron J , Hall Eric , Luisi Nicole , Zlotorzynska Maria , Wilde Gretchen , Sanchez Travis , Bradley Heather , Sullivan Patrick S
Published: June 2020

Background

SARS-CoV-2 virus testing for persons with COVID-19 symptoms, and contact tracing for those testing positive, will be critical to successful epidemic control. Willingness of persons experiencing symptoms to seek testing may determine the success of this strategy.

Methods

A cross-sectional online survey in the United States measured willingness to seek testing if feeling ill under different specimen collection scenarios: home-based saliva, home-based swab, drive-through facility swab, and clinic-based swab. Instructions clarified that home-collected specimens would be mailed to a laboratory for testing. We presented similar willingness questions regarding testing during follow-up care.

Results

Of 1435 participants, comprising a broad range of sociodemographic groups, 92% were willing to test with a home saliva specimen, 88% with home swab, 71% with drive-through swab, and 60% with clinic-collected swab. Moreover, 68% indicated they would be more likely to get tested if there was a home testing option. There were no significant differences in willingness items across sociodemographic variables or for those currently experiencing COVID-19 symptoms. Results were nearly identical for willingness to receive testing for follow-up COVID-19 care.

Conclusions

We observed a hierarchy of willingness to test for SARS-CoV-2, ordered by the degree of contact required. Home specimen collection options could result in up to one-third more symptomatic persons seeking testing, facilitating contact tracing and optimal clinical care. Remote specimen collection options may ease supply chain challenges and decrease the likelihood of nosocomial transmission. As home specimen collection options receive regulatory approval, they should be scaled rapidly by health systems.
The Reinvention of Immigration Detention in Italy in the Aftermath of the “Refugee Crisis”: A Study of Parliamentary Records (2013–2018)
Authors: Campesi Giuseppe
Published: June 2020

The aim of this article is to explore the peculiarity of Italian policies on immigration detention and their evolution over time. This will be done by highlighting the main factors that might explain the apparent political disinvestment in immigration detention in Italy, in particular in the years between 2013 and 2015, and account for the turnaround in approach announced and then implemented by the two Interior Ministers in charge between 2017 and 2019. The article uses the Italian case as an opportunity to explore the functions that are assigned to immigration detention in destination countries. In particular, it considers whether or not it can be argued that immigration detention in Italy has been “reinvented” (meaning that its functions have somewhat changed) as a consequence of the so-called “refugee crisis” and in light of Italy’s specific position in the contemporary geopolitics of the EU’s border control regime.
A Review of Multimodal Hallucinations: Categorization, Assessment, Theoretical Perspectives, and Clinical Recommendations
Authors: Montagnese Marcella , Leptourgos Pantelis , Fernyhough Charles , Waters Flavie , Larøi Frank , Jardri Renaud , McCarthy-Jones Simon , Thomas Neil , Dudley Rob , Taylor John-Paul , Collerton Daniel , Urwyler Prabitha
Published: June 2020

Hallucinations can occur in different sensory modalities, both simultaneously and serially in time. They have typically been studied in clinical populations as phenomena occurring in a single sensory modality. Hallucinatory experiences occurring in multiple sensory systems—multimodal hallucinations (MMHs)—are more prevalent than previously thought and may have greater adverse impact than unimodal ones, but they remain relatively underresearched. Here, we review and discuss: (1) the definition and categorization of both serial and simultaneous MMHs, (2) available assessment tools and how they can be improved, and (3) the explanatory power that current hallucination theories have for MMHs. Overall, we suggest that current models need to be updated or developed to account for MMHs and to inform research into the underlying processes of such hallucinatory phenomena. We make recommendations for future research and for clinical practice, including the need for service user involvement and for better assessment tools that can reliably measure MMHs and distinguish them from other related phenomena.
Conceiving of Contraception: World Society, Cultural Resistance, and Contraceptive Use, 1970–2012
Authors: Cole Wade M , Geist Claudia
Published: June 2020

Taking world society theory as our point of departure, we examine the effect of world culture on contraceptive use rates around the world. World-cultural rhetoric frames contraception as a necessity for economic development, a human rights issue, and a women’s health matter. Using data on contraceptive use among married women for a sample of 159 countries over the period from 1970 to 2012, we find that linkages to all three sets of discourses are associated with increased use of modern contraceptive methods, over and above countries’ sociocultural and economic characteristics. Nevertheless, we also find that world society influences vary across major cultural zones, defined in terms of predominant religions and geographic regions. World cultural effects are strongest in Orthodox Christian, Hindu, non-Western Protestant, and sub-Saharan African countries. There is no effect in Western and East Asian countries, where contraceptive use is comparatively high, or in zones such as non-Western Catholic nations, where the unmet need for contraception is often greatest. Compared to development and women’s rights rhetoric, health-based frames appear to have the broadest and most effective reach across cultural divides. Overall, however, we find that world society processes tend to produce cross-cultural convergence in contraceptive use rates.
Virulence Spectrum of Single-Spore and Field Isolates of Plasmodiophora brassicae Able to Overcome Resistance in Canola (Brassica napus)
Authors: Askarian Homa , Akhavan Alireza , Manolii Victor P. , Cao Tiesen , Hwang Sheau-Fang , Strelkov Stephen E.
Published: June 2020

Clubroot, caused by Plasmodiophora brassicae Woronin, is an important disease of canola (Brassica napus L.) that is managed mainly by planting clubroot-resistant (CR) cultivars. Field isolates of P. brassicae can be heterogeneous mixtures of various pathotypes, making assessments of the genetics of host–pathogen interactions challenging. Thirty-four single-spore isolates were obtained from nine field isolates of the pathogen collected from CR canola cultivars. The virulence patterns of the single-spore and field isolates were assessed on the 13 host genotypes of the Canadian Clubroot Differential (CCD) set, which includes the differentials of Williams and Somé et al. Indices of disease (IDs) severity of 25, 33, and 50% (±95% confidence interval) were compared as potential thresholds to distinguish between resistant and susceptible reactions, with an ID of 50% giving the most consistent responses for pathotype classification purposes. With this threshold, 13 pathotypes could be distinguished based on the CCD system, 7 on the differentials of Williams, and 3 on the hosts of Somé et al. The highest correlations were observed among virulence matrices generated using the three threshold IDs on the CCD set. Genetically homogeneous single-spore isolates gave a clearer profile of the P. brassicae pathotype structure. Novel pathotypes, not reported in Canada previously, were identified among the isolates. This large collection of single-spore isolates can serve as a reference in screening and breeding for clubroot resistance.
Evaluation of a Small-Molecule Compound, N-Acetylcysteine, for the Management of Bacterial Spot of Tomato Caused by Copper-Resistant Xanthomonas perforans
Authors: Qiao Kang , Liu Qingchun , Xia Ye , Zhang Shouan
Published: June 2020

Bacterial spot caused by Xanthomonas spp. is one of the major diseases in tomato. Xanthomonas perforans is the main pathogen of bacterial spot on tomato in Florida. Currently, application of copper fungicides is the primary measure used to manage this disease. However, the development of copper resistance in X. perforans and accumulation of copper in the environment are major concerns for excessive use of copper-based products in agriculture. Due to its antibacterial properties and low environmental impact, N-acetylcysteine (NAC), a small molecule commonly used in medicine for human bacterial diseases, has been studied in agriculture for the control of plant bacterial pathogens, including X. citri and Xylella fastidiosa. This study evaluated the effect of NAC alone and in combination with copper on a copper-resistant X. perforans strain in vitro and its ability to control bacterial spot of tomato under greenhouse and field conditions. In vitro, the minimum inhibitory concentration of NAC against the X. perforans strain was 2,048 mg liter−1. NAC increased sensitivity of the copper-resistant X. perforans to copper in vitro when application of NAC was followed by copper application after 6 h. In greenhouse assays, NAC applied alone or in combination with copper significantly (P < 0.05) reduced the disease severity of bacterial spot on tomato compared with the untreated control. NAC at 100 mg liter−1 + copper at 300 mg liter−1 consistently exhibited synergistic effects against bacterial spot. In the field trials, NAC at 1,000 mg liter−1 + copper at 150 mg liter−1 significantly reduced disease severity compared with the untreated control. Results from this study demonstrated that NAC significantly reduced the disease severity of bacterial spot of tomato and enhanced the efficacy of copper against copper-resistant X. perforans, indicating that NAC could be applied for the effective management of bacterial spot of tomato.
Epidemiology: Past, Present, and Future Impacts on Understanding Disease Dynamics and Improving Plant Disease Management—A Summary of Focus Issue Articles
Authors: Ojiambo P. S. , Yuen J. , van den Bosch F. , Madden L. V.
Published: June 2020

Epidemiology has made significant contributions to plant pathology by elucidating the general principles underlying the development of disease epidemics. This has resulted in a greatly improved theoretical and empirical understanding of the dynamics of disease epidemics in time and space, predictions of disease outbreaks or the need for disease control in real-time basis, and tactical and strategic solutions to disease problems. Availability of high-resolution experimental data at multiple temporal and spatial scales has now provided a platform to test and validate theories on the spread of diseases at a wide range of spatial scales ranging from the local to the landscape level. Relatively new approaches in plant disease epidemiology, ranging from network to information theory, coupled with the availability of large-scale datasets and the rapid development of computer technology, are leading to revolutionary thinking about epidemics that can result in considerable improvement of strategic and tactical decision making in the control and management of plant diseases. Methods that were previously restricted to topics such as population biology or evolution are now being employed in epidemiology to enable a better understanding of the forces that drive the development of plant disease epidemics in space and time. This Focus Issue of Phytopathology features research articles that address broad themes in epidemiology including social and political consequences of disease epidemics, decision theory and support, pathogen dispersal and disease spread, disease assessment and pathogen biology and disease resistance. It is important to emphasize that these articles are just a sample of the types of research projects that are relevant to epidemiology. Below, we provide a succinct summary of the articles that are published in this Focus Issue .
Doctor of Nursing Practice Team Project Synthesis Form
Authors: McMullan Susan P. , Johnson Karmie M.
Published: June 2020

The importance of teamwork in health care, the need for doctorally prepared advanced practice nurses, and the nationwide faculty shortage provided the impetus for an educational tool to synthesize the doctor of nursing practice (DNP) project. Clearly outlining the stages of the DNP project in a concise manner, the DNP project synthesis form aids learners and faculty in organization and documentation of planning, implementation, and evaluation of the project and serves as a one-stop resource when students are completing semesters. This article delineates why one school of nursing developed a project synthesis form for use across all DNP programs.
Reported Barriers Impeding Adherence to a Physical Exercise Program in Patients With Breast Cancer: A Systematic Review
Authors: Michael Meghan , Goble Jordan , Hawk Megan , Kujawa David J.
Published: June 2020

Background:

More than 80% of those newly diagnosed with breast cancer are now surviving 5 years or more, which creates a target group that is in need of activity programs to prevent treatment side effects and complications.

Purpose:

The purpose of our systematic review was to identify patient perceptions, preferences, and barriers as well as the strategies to improve adherence to a physical exercise program.

Data Sources:

PubMed, Academic Search Complete, MEDLINE, SPORTDiscus, EMBASE, Web of Science, PsycINFO, and CINAHL were searched, yielding 2511 studies.

Study Selection:

In total, 16 qualitative studies were retained and published from 2013 to 2018 in English.

Data Extraction:

Three reviewers independently extracted data from the studies, evaluated the evidence, and organized the data into tables for ease of reference and analysis.

Data Synthesis:

Of the 16 retained studies, 7 used interviews, 6 used surveys/questionnaires, and 3 used a mix of interviews and questionnaires. The CASP (Critical Appraisal Skills Programme) instrument was used to appraise quality.

Discussion and Limitations:

Patient education, group-based programming, electronic tracking devices, enhancing confidence and self-efficacy, and providing alternatives for exercising at home were identified as strategies that could be used to improve adherence. Publication bias and 100% female participation within the retained studies could have affected the results of this review.

Conclusions:

The barriers, perceptions, preferences, motivators, and recommendations that have been identified will enable physical therapists to optimize, design, and implement a well-rounded program for the initiation and maintenance of physical activity for women with breast cancer.
Professional Identity Formation: A Role for Patients as Mentors
Authors: Kline Cathy C. , Park So Eyun , Godolphin William J. , Towle Angela
Published: June 2020

Purpose

Medical education should foster professional identity formation, but there is much to be learned about how to support learners in developing their professional identity. This study examined the role that patients can play in supporting professional identity development during the University of British Columbia Interprofessional Health Mentors Program (HMP), a longitudinal preclinical elective in which patients, or their caregivers, act as mentors and educate students about their lived experience of a chronic condition or disability.

Method

The authors interviewed 18 medical residents in 2016, 3 to 4 years after they completed the HMP. Professional identity was explored by asking participants how the HMP had influenced their ideas about the ideal physician and the kind of doctor they aspire to become. The authors analyzed the data using the identify status paradigm as a conceptual framework.

Results

The authors identified 7 themes: patient as more than disease, patient as autonomous, patient as expert, doctor as partner, doctor as collaborator, self-aware doctor, and empathic doctor. They found firm commitments to patient partnership, interprofessional collaboration, and holistic care for patients rooted in the exploration of professional values that was prompted by patient mentors during HMP.

Conclusions

Patient mentors can help medical students begin to construct their professional identity during the preclinical period by supporting exploration of and commitment to the professional values that society expects of physicians.
The future of neuromuscular blocking agents
Authors: Stäuble Christiane G. , Blobner Manfred
Published: June 2020

Purpose of review

The present review provides a summary of the literature on recent development of new neuromuscular blocking agents and presents clinically well established and new reversal agents.

Recent findings

Anesthesiologists are still waiting for the ideal neuromuscular blocking agent with a succinylcholine-like rapid onset and offset without side effects. Recent drug development led to a new series of neuromuscular compounds, called the chlorofumarates such as gantacurium, CW002, and CW011. These drugs have a promising pharmacodynamic profile; importantly, they can rapidly be reversed by L-cysteine adduction without relevant side effects. In addition, a new spectrum of reversal agents are currently examined in preclinical studies: adamgammadex sodium, a modified γ-cyclodextrin derivate that forms an inactive tight inclusion complex with rocuronium or vecuronium and calabadions, capable of reversing both benzylisoquinolines and steroidal neuromuscular blocking agents.

Although the recent advancements in neuromuscular research are very promising, to date, the presented drugs are currently not available for clinical use. Clinical studies will determine the role of these developments in anesthesia practice. Therefore, well established combinations such as rocuronium-sugammadex are popular in clinical practice to offer quick paralysis for intubation and to optimize surgical conditions, while providing a fast neuromuscular recovery at the end of surgery.
Nonoperating room anaesthesia: safety, monitoring, cognitive aids and severe acute respiratory syndrome coronavirus 2
Authors: Borshoff David C. , Sadleir Paul
Published: June 2020

Purpose of review

With an ageing population, mounting pressure on the healthcare dollar, significant advances in medical technology, and now in the context of coronavirus disease 2019, the traditional paradigm in which operative procedures are undertaken is changing. Increasingly, procedures are performed in more distant, isolated and less familiar locations, challenging anaesthesiologists and requiring well developed situational awareness. This review looks at implications for the practitioner and patient safety, outlining considerations and steps involved in translation of systems and processes well established in the operating room to more unfamiliar environments.

Recent findings

Despite limited nonoperating room anaesthesia outcome data, analysis of malpractice claims, anaesthesia-related medical disputes and clinical outcome registries have suggested higher morbidity and mortality. Complications were often associated with suboptimal monitoring, nonadherence to recommended guidelines and sedationist or nonanaesthesiologist caregivers. More recently, clear monitoring guidelines, global patient safety initiatives and widespread implementation of cognitive aids may have contributed to nonoperating room anaesthesia (NORA) outcomes approaching that of traditional operating rooms.

As NORA caseloads increase, understanding structural and anaesthetic requirements is essential to patient safety. The severe acute respiratory syndrome coronavirus 2 pandemic has provided an opportunity for anaesthesiologists to implement lessons learned from previous analyses, share expertise as patient safety leaders and provide valuable input into protecting patients and caregivers.
Simulation to Support Standardization of Delivery Room Management of the Very Low Birth-Weight Infant
Authors: Wiesbrock Jeanne , Andresen Pamela , Brough Megan
Published: June 2020

Background:

The birth of a very low birth-weight (VLBW) infant occurs infrequently, especially in the community hospital setting. It is critical that the team managing care of the infant in its first minutes of life follow evidence-based resuscitation guidelines and practices to optimize outcomes for this population.

Purpose:

To implement a simulation program in a community hospital setting that supports standardized evidence-based delivery room practices of the premature infant born less than 30 weeks' gestation.

Methods:

Two VLBW emergent delivery scenarios were developed utilizing the neonatal resuscitation program scenario template. Special care nursery interprofessional team members from a community hospital were invited to participate in the simulation program (n = 28). Participants were asked to complete a neonatal version of the Emergency Response Confidence Tool, then view a short presentation related to delivery room management of VLBW infants. Participants attended a simulation program and completed the confidence tool after simulation. The simulation facilitator and unit educator documented team actions during each simulation session.

Findings/Results:

Fifteen opportunities for improvement within 4 simulation sessions were identified and categorized. Fourteen paired pre- and postsurveys were analyzed. Reported confidence increased in 22 of 23 resuscitation-related items.

Implications for Practice:

Education and simulation programs providing opportunities to experience high-risk, low-frequency VLBW delivery situations can assist in identifying areas for improvement and may improve team member confidence.

Implications for Research:

Additional research is needed to assess whether results would be similar if this program were provided at all levels of neonatal care throughout the healthcare system.
Tocilizumab and Remdesivir in a Pregnant Patient With Coronavirus Disease 2019 (COVID-19)
Authors: Naqvi Mariam , Zakowski Phillip , Glucksman Lindsey , Smithson Sarah , Burwick Richard M.
Published: June 2020

BACKGROUND:

There are limited data regarding treatment options for pregnant women with severe coronavirus disease 2019 (COVID-19).

CASE:

A 35-year-old primigravid patient at 22 weeks of gestation presented with 7 days of fever, cough, anosmia, and dyspnea. Nasopharyngeal swab was positive for the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and a chest X-ray demonstrated bilateral patchy infiltrates. Laboratory evaluation was notable for marked elevation of interleukin-6 and C-reactive protein concentrations. On hospital day 3, owing to increased dyspnea and oxygen requirement, the patient was treated with tocilizumab followed by 5 days of remdesivir. She responded well, recovered to room air, and was discharged home after a 9-day hospitalization.

CONCLUSION:

Tocilizumab and remdesivir may be effective for treatment of severe COVID-19 in pregnancy, but additional data are needed to guide risk–benefit considerations.
Implementation of an Electronic Nursing Record for Nursing Documentation and Communication of Patient Care Information in a Tertiary Teaching Hospital
Authors: Lee Myeong-Seon , Lee Seonah
Published: June 2020

Despite the fact that implementing an electronic nursing record has become an everyday event for nurses, little is known about which type of documentation used in an electronic nursing record is better for nursing practice. The aim of this exploratory study was to identify the most suitable type of electronic nursing documentation that nurses used to record care and communicate with clinicians. Participants consisted of 118 nurses and 12 physicians. Researchers developed a self-report questionnaire of 17 items about electronic nursing record use for documentation and communication of patient care information. Data were analyzed using descriptive statistics to calculate frequencies and percentages. The χ
2 test was used to identify differences in responses by demographic and clinical characteristics of participants. Bar charts were used to identify response patterns. Results showed that semistructured nursing documentation was the most preferred for care documentation and communication of patient information. Nurses did not always use the electronic nursing record to communicate patient care-related information. This study adds empirical knowledge about which type of documentation used in the electronic nursing record works well, what improvement is needed for better nursing practice, and whether the electronic nursing record has been used for communication.
FINGERPRINT SIGN OF THE HENLE FIBER LAYER
Authors: Griffin Shane M. , McDonald H. Richard , Johnson Robert N. , Jumper J. Michael , Fu Arthur D. , Cunningham Emmett T. , Kiang Lee , Ng Caleb C. , Lujan Brandon J.
Published: June 2020

Purpose:

To describe the appearance of concentric, fingerprint-like waves within the Henle fiber layer (HFL) using en face optical coherence tomography in patients with tractional pathologies of the retina.

Methods:

Retrospective analysis of six eyes of six patients imaged by optical coherence tomography with volumetric slabs positioned at the level of the HFL.

Results:

Optical coherence tomography data from six patients with tractional vitreoretinal pathology were reviewed. Concentric, fingerprint-like microwaves were visualized through en face optical coherence tomography in all six study eyes at the level of the HFL. This finding resembled the finding of HFL waves previously noted histopathologically from force exerted on this layer.

Conclusion:

In retinal pathologies in which specific physical forces act on the retina, volumetric optical coherence tomography may permit visualization of en face concentric, fingerprint-like hyperreflective rings within the HFL. This “fingerprint sign” may represent a biomechanical consequence of traction on the retina and allow clinical decision making based on improved recognition of the existence of such traction.
Uptake and Release of a Multipurpose Solution Biocide (MAP-D) From Hydrogel and Silicone Hydrogel Contact Lenses Using a Radiolabel Methodology
Authors: Yee Alan , Phan Chau-Minh , Chan Vivian W. Y. , Heynen Miriam , Jones Lyndon
Published: June 2020

Purpose:

The purpose of this study was to evaluate the uptake and release of radiolabelled myristamidopropyl dimethylamine (MAP-D) on reusable daily wear contact lenses (CLs) over 7 days.

Methods:

Three silicone hydrogel (SH) CL materials (lotrafilcon B, balafilcon A, senofilcon A) and two conventional hydrogel (CH) materials (etafilcon A, omafilcon A) were tested. A short-term (experiment 1, N=4) and a longer-term (experiment 2, N=3) study was conducted. In experiment 1, the CLs were incubated in 2 mL of phosphate buffered solution (PBS) containing 14C MAP-D (5 μg/mL) for 8 hrs. The release of 14C MAP-D was measured at t=0.25, 0.5, 1, 2, 4, 8, and 24 hr in PBS. In experiment 2, the CLs were incubated in the 14C MAP-D solution for 8 hrs followed by a 16-hr release in PBS. This cycle was repeated daily for 7 days. At the end of both experiments, lenses were extracted to determine the total uptake of MAP-D. The radioactivity was measured using a beta scintillation counter.

Results:

In experiment 1, all three SH lenses sorbed similar amounts of MAP-D (P=0.99), all of which were higher than the two CH materials (P<0.01). However, the CH materials released a greater amount of MAP-D than the SH materials (P<0.01). In experiment 2, the uptake of MAP-D in SH materials increased over 7 days, whereas the amount of MAP-D remained constant in the CH materials (P=0.99). Similar to experiment 1, the CH lenses released more MAP-D than SH lenses after 7 days (P<0.01).

Conclusion:

The SH materials absorbed greater amounts of MAP-D compared to CH materials. However, the CH materials released the greatest amount of MAP-D. Radioactive labelling of MAP-D offers a highly sensitive method of assessing the uptake and release profiles of biocides to CL materials.
Absence of Severe Acute Respiratory Syndrome-Coronavirus-2 RNA in Human Corneal Tissues
Authors: Bayyoud Tarek , Iftner Angelika , Iftner Thomas , Bartz-Schmidt Karl Ulrich , Rohrbach Jens Martin , Ueffing Marius , Schindler Michael , Thaler Sebastian
Published: June 2020

Purpose:

To examine corneal tissue for severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) positivity regarding implications for tissue procurement, processing, corneal transplantation, and ocular surgery on healthy patients. We performed quantitative reverse transcription-polymerase chain reaction qRT-PCR-testing for SARS-CoV-2 RNA on corneal stroma and endothelium, bulbar conjunctiva, conjunctival fluid swabs, anterior chamber fluid, and corneal epithelium of coronavirus disease 2019 (COVID-19) postmortem donors.

Methods:

Included in this study were 10 bulbi of 5 COVID-19 patients who died because of respiratory insufficiency. Informed consent and institutional review board approval was obtained before this study (241/2020BO2). SARS-CoV-2 was detected by using a pharyngeal swab and bronchoalveolar lavage. Tissue procurement and tissue preparation were performed with personal protective equipment (PPE) and the necessary protective measures. qRT-PCR-testing was performed for each of the abovementioned tissues and intraocular fluids.

Results:

The qRT-PCRs yielded no viral RNA in the following ocular tissues and intraocular fluid: corneal stroma and endothelium, bulbar-limbal conjunctiva, conjunctival fluid swabs, anterior chamber fluid, and corneal epithelium.

Conclusions:

In this study, no SARS-CoV-2-RNA was detected in conjunctiva, anterior chamber fluid, and corneal tissues (endothelium, stroma, and epithelium) of COVID-19 donors. This implicates that the risk for SARS-CoV-2 infection using corneal or conjunctival tissue is very low. However, further studies on a higher number of COVID-19 patients are necessary to confirm these results. This might be of high importance for donor tissue procurement, processing, and corneal transplantation.
Adverse events associated with immune checkpoint inhibitors: a new era in autoimmune diabetes
Authors: Akturk Halis Kaan , Michels Aaron W.
Published: June 2020

Purpose of review

To summarize a new form of autoimmune diabetes as an adverse event of specific cancer immunotherapies. Immune checkpoint inhibitors are revolutionary treatments in advanced cancers; however, they can cause type 1 diabetes following treatment with these state-of-the-art therapies.

Recent findings

A review of the literature showed that this new form of autoimmune diabetes has significant similarities with childhood-onset type 1 diabetes but also some distinctions. It frequently presents with severe diabetic ketoacidosis and almost half of the patients have type 1 diabetes-associated antibodies at presentation. Rapid loss of residual beta-cell function with a lack of honeymoon phase is typical. Certain human leukocyte antigen risk genes for prototypical type 1 diabetes that develops in children and young adults are also commonly found in patients with immune checkpoint inhibitor-induced type 1 diabetes.

Immune checkpoint inhibitor-induced type 1 diabetes presenting with diabetic ketoacidosis is a life-threatening adverse event of cancer immunotherapy. Healthcare providers should be aware of this adverse event to prevent morbidity and mortality related to diabetic ketoacidosis. Developing guidelines to identify and monitor risk groups are of utmost importance.