bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postnatal consultations with an obstetrician after critical perinatal events: a qualitative study of what women and their partners experience
Authors: Høgh Stinne , Navne Laura Emdal , Johansen Marianne , Svendsen Mette Nordahl , Sorensen Jette Led 
Published: September 2020

ObjectiveThe objective of this study was to explore women’s and their partners’ experiences with attending postnatal consultations with an obstetrician after critical perinatal events.DesignQualitative interview study. We did semi-structured individual narrative interviews exploring the lived experiences. Interviews were analysed using a phenomenological approach and the thematic analysis was validated by a transdisciplinary group of anthropologists, obstetricians and a midwife.SettingDepartment of obstetrics at a large hospital in Denmark.ParticipantsWe did a qualitative study with 17 participants (10 women and 7 partners) who had experienced critical perinatal events.ResultsFive major themes were identified: (1) a need to gain understanding and make sense of the critical perinatal events, (2) a need for relational continuity, (3) the importance of discussing emotional effects as well as physical aspects of occurred events, (4) preparing for future pregnancies and (5) closure of the story.Most of the participants emphasised the importance of knowing the obstetrician undertaking the postnatal consultation. The majority of the participants described a need to discuss the emotional effects of the experience as well as the physical aspects of occurred events. The postnatal consultation served as an approach to obtain a positive closure of their birth story and to feel confident about potential future pregnancies.ConclusionsThis interview-based study suggests that postnatal consultation with an obstetrician might be an important tool for women and their partners in understanding the course of events during the critical birth experience and in processing it and preparing for future pregnancies. It appears to be important to assign an obstetrician whom they already know and to encourage them to discuss not only physical aspects of what happened but also the emotional effects of the experience.
Adoptive transfer of zoledronate-expanded autologous Vγ9Vδ2 T-cells in patients with treatment-refractory non-small-cell lung cancer: a multicenter, open-label, single-arm, phase 2 study
Authors: Kakimi Kazuhiro , Matsushita Hirokazu , Masuzawa Keita , Karasaki Takahiro , Kobayashi Yukari , Nagaoka Koji , Hosoi Akihiro , Ikemura Shinnosuke , Kitano Kentaro , Kawada Ichiro , Manabe Tadashi , Takehara Tomohiro , Ebisudani Toshiaki , Nagayama Kazuhiro , Nakamura Yukio , Suzuki Ryuji , Yasuda Hiroyuki , Sato Masaaki , Soejima Kenzo , Nakajima Jun 
Published: September 2020

BackgroundNot all non-small cell lung cancer (NSCLC) patients possess drug-targetable driver mutations, and response rates to immune checkpoint blockade therapies also remain unsatisfactory. Therefore, more effective treatments are still needed. Here, we report the results of a phase 2 clinical trial of adoptive cell therapy using zoledronate-expanded autologous Vγ9Vδ2 T-cells for treatment-refractory NSCLC.MethodsNSCLC patients who had undergone at least two regimens of standard chemotherapy for unresectable disease or had had at least one treatment including chemotherapy or radiation for recurrent disease after surgery were enrolled in this open-label, single-arm, multicenter, phase 2 study. After preliminary testing of Vγ9Vδ2 T-cell proliferation, autologous peripheral blood mononuclear cells were cultured with zoledronate and IL-2 to expand the Vγ9Vδ2 T-cells. Cultured cells (>1×109) were intravenously administered every 2 weeks for six injections. The primary endpoint of this study was progression-free survival (PFS), and secondary endpoints included overall survival (OS), best objective response rate (ORR), disease control rate (DCR), safety and immunomonitoring. Clinical efficacy was defined as median PFS significantly >4 months.ResultsTwenty-five patients (20 adenocarcinoma, 4 squamous cell carcinoma and 1 large cell carcinoma) were enrolled. Autologous Vγ9Vδ2 T-cell therapy was administered to all 25 patients, of which 16 completed the foreseen course of 6 injections of cultured cells. Median PFS was 95.0 days (95% CI 73.0 to 132.0 days); median OS was 418.0 days (179.0–479.0 days), and best overall responses were 1 partial response, 16 stable disease (SD) and 8 progressive disease. ORR and DCR were 4.0% (0.1%–20.4%) and 68.0% (46.5%–85.1%), respectively. Severe adverse events developed in nine patients, mostly associated with disease progression. In one patient, pneumonitis and inflammatory responses resulted from Vγ9Vδ2 T-cell infusions, together with the disappearance of a massive tumor.ConclusionsAlthough autologous Vγ9Vδ2 T-cell therapy was well tolerated and may have an acceptable DCR, this trial did not meet its primary efficacy endpoint.Trial registration numberUMIN000006128
Particle physics violating crypto-nonlocal realism
Authors: Shi Yu , Yang Ji-Chong 
Published: September 2020

AbstractIt has been well established that quantum mechanics (QM) violates Bell inequalities (BI), which are consequences of local realism (LR). Remarkably QM also violates Leggett inequalities (LI), which are consequences of a class of nonlocal realism called crypto-nonlocal realism (CNR). Both LR and CNR assume that measurement outcomes are determined by preexisting objective properties, as well as hidden variables (HV) not considered in QM. We extend CNR and LI to include the case that the measurement settings are not externally fixed, but determined by HV. We derive a new version of LI, which is then shown to be violated by entangled $$B_d$$

B
d

mesons, if charge–conjugation–parity (CP) symmetry is indirectly violated, as indeed established. The experimental result is quantitatively estimated by using the indirect CP violation parameters, and the maximum of a suitably defined relative violation is about $$2.7\%$$

2.7
%

. Our work implies that particle physics violates CNR. Our LI can also be tested in other systems such as photon polarizations.
The Observed Water Vapor Budget in an Atmospheric River over the Northeast Pacific
Authors: Norris Joel R. , Ralph F. Martin , Demirdjian Reuben , Cannon Forest , Blomquist Byron , Fairall Christopher W. , Spackman J. Ryan , Tanelli Simone , Waliser Duane E. 
Published: September 2020

AbstractCombined airborne, shipboard, and satellite measurements provide the first observational assessment of all major terms of the vertically integrated water vapor (IWV) budget for a 150 km × 160 km region within the core of a strong atmospheric river over the northeastern Pacific Ocean centered on 1930 UTC 5 February 2015. Column-integrated moisture flux convergence is estimated from eight dropsonde profiles, and surface rain rate is estimated from tail Doppler radar reflectivity measurements. Dynamical convergence of water vapor (2.20 ± 0.12 mm h−1) nearly balances estimated precipitation (2.47 ± 0.41 mm h−1), but surface evaporation (0.0 ± 0.05 mm h−1) is negligible. Advection of drier air into the budget region (−1.50 ± 0.21 mm h−1) causes IWV tendency from the sum of all terms to be negative (−1.66 ± 0.45 mm h−1). An independent estimate of IWV tendency obtained from the difference between IWV measured by dropsonde and retrieved by satellite 3 h earlier is less negative (−0.52 ± 0.24 mm h−1), suggesting the presence of substantial temporal variability that is smoothed out when averaging over several hours. The calculation of budget terms for various combinations of dropsonde subsets indicates the presence of substantial spatial variability at ~50-km scales for precipitation, moisture flux convergence, and IWV tendency that is smoothed out when averaging over the full budget region. Across subregions, surface rain rate is linearly proportional to dynamical convergence of water vapor. These observational results improve our understanding of the thermodynamic and kinematic processes that control IWV in atmospheric rivers and the scales at which they occur.
A Simplified Measure of Investor Risk Aversion
Authors: Grable John , Kwak Eun Jin , Fulk Martha , Routh Aditi 
Published: September 2020

This article introduces a simplified measure of investor risk aversion. The singleitem question combines elements from revealed preference and propensity measurement techniques in a way that matches traditional constant relative risk-aversion estimation procedures. Based on survey data from 500 investors living in the United States, scores from the proposed measure were found to correlate with other measures of risk aversion, as well as with indicators of risk-taking. A validity test showed that answers to the proposed measure were statistically associated with equity and cash ownership holdings in respondent portfolios. The simplicity and intuitive nature of the proposed measure and the alignment of question response categories to estimates of constant relative risk aversion make this a potentially valuable addition to the toolkit of researchers, financial educators, investors and those who provide advice to investors. JEL: C83, D10, D11, D14, D19, D81
Pharmacist Transition-of-Care Services Improve Patient Satisfaction and Decrease Hospital Readmissions
Authors: March Katherine L. , Peters Michael J. , Finch Christopher K. , Roberts Lauchland A. , McLean Katie M. , Covert Ashley M. , Twilla Jennifer D. 
Published: September 2020

Background: Pharmacists ability to directly impact patient satisfaction through increases in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys utilizing transitions-of-care (TOC) services is unclear. Methods: Retrospective analysis of TOC patients from 07/01/2018 to 03/31/2019 was conducted. Intervention (INV) patients received pharmacist medication reconciliation and education prior to discharge and post-discharge telephone follow-up. All other patients served as control group (CON). Primary outcome: Evaluate impact of TOC services on HCAHPS scores for “Communication about Medicines” and “Care Transitions.” Secondary outcomes: 30-day readmissions, quantification of prevented potential safety events, assessment of discharge prescriptions sent to the academic medical center outpatient pharmacy (MOP) for TOC patients. Results: Of 1,728 patients screened, 414 patients met inclusion criteria (INV = 414, CON = 1314). A significant improvement (14.7%; p = <0.0001) in overall medication-related HCAHPS results was seen when comparing pre- vs post-implementation of the TOC service. Statistically significant increases for individual questions “staff told you what the medicine was for” (14.2%; p = 0.018), “staff describe possible effects” (21.2%; p = 0.004), and “understood the purpose of taking medications” (11.4%; p = 0.035) were observed. A non-significant decrease in 30-day readmission rates for the groups was observed (CON 16.4%, INV 13.3%; p = 0.133); however, an unplanned subgroup analysis evaluating impact of discharge phone calls on 30-day readmission rates revealed a significant reduction of 17.3% to 12.4% (p = 0.007). One hundred forty-three medication safety event(s) were potentially prevented by the TOC pharmacist. Lastly, 562 prescriptions were captured at the MOP as a result of the TOC initiative. Conclusions: Pharmacy-based TOC models can improve patient satisfaction, prevent hospital readmissions, and generate revenue.
A survey about postoperative delirium in older patients among nurses and anaesthetists: implications for future practice and policy
Authors: Igwe Ezinne O , Traynor Victoria , Rodgers Sheila , Waite Alasdair , MacLullich Alasdair , Foo Irwin 
Published: September 2020

Background Postoperative delirium is a major complication associated with anaesthesia and surgery, more commonly seen in older people. Aims The aims of this study were to explore the knowledge and understanding of anaesthetists and nurses involved in anaesthesia through their responses to two case scenarios of postoperative delirium experienced by older people. Methods A 30-item online survey was sent to 500 potential respondents. Results Two hundred and twenty-six practitioners from Australia, New Zealand and Scotland responded. Most had no workplace protocols for anaesthesia planning in older people. There was substantial variability in practice in relation to postoperative delirium screening, detection, prevention and management. Conclusions Improvements in education and awareness, together with a more coherent approach, for example, as recommended in the European Society of Anaesthesiology Guidelines, could help to reduce the impact of postoperative delirium in older people. This should be combined with ongoing research into perioperative optimisation of detection, prevention and management of postoperative delirium.
Assessment of the additional clinical potential of X-ray dark-field imaging for breast cancer in a preclinical setup
Authors: Emons Julius , Fasching Peter A. , Wunderle Marius , Heindl Felix , Rieger Jens , Horn Florian , Pelzer Georg , Ritter Andre , Weber Thomas , Radicke Marcus , Polifka Iris , Wachter David L. , Wenkel Evelyn , Michel Thilo , Uder Michael , Hartmann Arndt , Anton Gisela , Beckmann Matthias W. , Schulz-Wendtland Rüdiger , Jud Sebastian M. 
Published: September 2020

Background: Mammography can identify calcifications up to 50–100 μm in size as a surrogate parameter for breast cancer or ductal carcinoma in situ (DCIS). Microcalcifications measuring <50 µm are also associated with breast cancer or DCIS and are frequently not detected on mammography, although they can be detected with dark-field imaging. This study examined whether additional breast examination using X-ray dark-field imaging can increase the detection rate of calcifications. Advances in knowledge:  (1) evaluation of additional modality of breast imaging;  (2) specific evaluation of breast calcifications. Implications for patient care: the addition of X-ray dark-field imaging to conventional mammography could detect additional calcifications. Methods: Talbot–Lau X-ray phase–contrast imaging and X-ray dark-field imaging were used to acquire images of breast specimens. The radiation dosage with the technique is comparable with conventional mammography. Three X-ray gratings with periods of 5–10 µm between the X-ray tube and the flat-panel detector provide three different images in a single sequence: the conventional attenuation image, differential phase image, and dark-field image. The images were read by radiologists. Radiological findings were marked and examined pathologically. The results were described in a descriptive manner. Results: A total of 81 breast specimens were investigated with the two methods; 199 significant structures were processed pathologically, consisting of 123 benign and 76 malignant lesions (DCIS or invasive breast cancer). X-ray dark-field imaging identified 15 additional histologically confirmed carcinoma lesions that were visible but not declared suspicious on digital mammography alone. Another four malignant lesions that were not visible on mammography were exclusively detected with X-ray dark-field imaging. Conclusions: Adding X-ray dark-field imaging to digital mammography increases the detection rate for breast cancer and DCIS associated lesions with micrometer-sized calcifications. The use of X-ray dark-field imaging may be able to provide more accurate and detailed radiological classification of suspicious breast lesions. Adding X-ray dark-field imaging to mammography may be able to increase the detection rate and improve preoperative planning in deciding between mastectomy or breast-conserving therapy, particularly in patients with invasive lobular breast cancer.
Can Scoliotic Discs Be Controls for Molecular Studies in Intervertebral Disc Research? Insights From Proteomics
Authors: Rajasekaran S. , Tangavel Chitraa , Anand K. S. Sri Vijay , Soundararajan Dilip Chand Raja , Nayagam Sharon Miracle , Sunmathi R. , Raveendran M. , Shetty Ajoy Prasad , Kanna Rishi Mugesh , Pushpa B. T. 
Published: September 2020

Study Design: Proteomic analysis of human intervertebral discs. Objectives: To compare the characters of scoliotic discs and discs from magnetic resonance imaging (MRI)–normal voluntary organ donors controls used in disc research employing proteomics and establish “true controls” that can be utilized for future intervertebral disc (IVD) research. Methods: Eight MRI-normal discs from 8 brain-dead voluntary organ donors (ND) and 8 scoliotic discs (SD) from 3 patients who underwent anterior surgery for adolescent idiopathic scoliosis were subjected to tandem mass spectrometry, and further analysis was performed. Results: Mass spectrometry identified a total of 235 proteins in ND and 438 proteins in the SD group. Proteins involved in extracellular matrix integrity (Versican, keratins KRT6A, KRT14, KRT5, and KRT 13A1, A-kinase anchor protein 13, coagulation factor XIII A chain, proteoglycan 4) and proteins involved in transcription and DNA repair (Von Willebrand factor A domain-containing 3B, eukaryotic initiation factor 2B, histone H4, leukocyte cell–derived chemotaxin 2) were found to be downregulated in SD. Inflammatory proteins (C3, C1S), and oxidative stress response proteins (peroxiredoxin-2,6, catalase, myeloperoxidase, apolipoprotein E) were found to be upregulated in SD. These changes were reflected at the pathway level also. Conclusion: Findings of our study confirm that scoliotic discs have an abundance of inflammatory, oxidative stress response proteins, which are either absent or downregulated in the ND group indicating that scoliotic discs are not pathologically inert. Furthermore, this study has established MRI-normal discs from voluntary organ donors as the “true” control for molecular studies in IVD research.
Vogesella perlucida-induced bacteremia in an advanced-age patient: first case report
Authors: Yu Zengxian , Zhu Fang , Tao Xinghe , Zhang Lu , Wu Suliu , Dong Chunfu , Dong Yeqing , chen Ge , Zhou Xinyang , Fang Yinfei , Xu Kechen 
Published: September 2020

Abstract
Background
Vogesella species are common aquatic, Gram-negative rod-shaped bacteria, originally described in 1997. Vogesella perlucida was first isolated from spring water in 2008. Furthermore, bacterial pathogenicity of Vogesella perlucida has never been reported. Here, we report the first case of rare Vogesella perlucida-induced bacteremia in an advanced-age patient with many basic diseases and history of dexamethasone abuse.

Case presentation
A 71-year-old female was admitted with inflamed upper and lower limbs, rubefaction, pain and fever (about 40 °C). She had been injured in a fall at a vegetable market and then touched river snails with her injury hands. A few days later, soft tissue infection of the patient developed and worsened. Non-pigmented colonies were isolated from blood cultures of the patient. Initially, Vogesella perlucida was wrongly identified as Sphingomonas paucimobilis by Vitek-2 system with GN card. Besides, we failed to obtain an acceptable identification by the MALDI-TOF analysis. Finally, the isolated strain was identified as Vogesella perlucida by 16S rRNA gene sequences. In addition, the patient recovered well after a continuous treatment of levofloxacin for 12 days.

Conclusion
Traditional microbiological testing system may be inadequate in the diagnosis of rare pathogenic bacteria. Applications of molecular diagnostics techniques have great advantages in clinical microbiology laboratory. By using 16S rRNA gene sequence analysis, we report the the first case of rare Vogesella perlucida-induced bacteremia.
Membranous nephropathy in patients with HIV: a report of 11 cases
Authors: Charu Vivek , Andeen Nicole , Walavalkar Vighnesh , Lapasia Jessica , Kim Jin-Yon , Lin Andrew , Sibley Richard , Higgins John , Troxell Megan , Kambham Neeraja 
Published: September 2020

Abstract
Background
Membranous nephropathy (MN) has been recognized to occur in patients with human immunodeficiency virus (HIV) infection since the beginning of the HIV epidemic. The prevalence of phospholipase A2 receptor (PLA2R)-associated MN in this group has not been well studied.

Methods
We conducted a retrospective review of electronic pathology databases at three institutions to identify patients with MN and known HIV at the time of renal biopsy. Patients with comorbidities and coinfections known to be independently associated with MN were excluded.

Results
We identified 11 HIV-positive patients with biopsy-confirmed MN meeting inclusion and exclusion criteria. Patient ages ranged from 39 to 66 years old, and 10 of 11 patients (91%) were male. The majority of patients presented with nephrotic-range proteinuria, were on anti-retroviral therapy at the time of biopsy and had low or undetectable HIV viral loads. Biopsies from 5 of 10 (50%) patients demonstrated capillary wall staining for PLA2R. Measurement of serum anti-PLA2R antibodies was performed in three patients, one of whom had positive anti-PLA2R antibody titers. Follow-up data was available on 10 of 11 patients (median length of follow-up: 44 months; range: 4–145 months). All patients were maintained on anti-retroviral therapy (ARV) and 5 patients (52%) received concomitant immunosuppressive regimens. Three patients developed end-stage renal disease (ESRD) during the follow-up period.

Conclusions
MN in the setting of HIV is often identified in the setting of an undetectable viral loads, and similar to other chronic viral infection-associated MNs, ~ 50% of cases demonstrate tissue reactivity with PLA2R antigen, which may be seen without corresponding anti-PLA2R serum antibodies.
Pain management in patients with end-stage renal disease and calciphylaxis- a survey of clinical practices among physicians
Authors: Chinnadurai Rajkumar , Sinha Smeeta , Lowney Aoife C , Miller Mary 
Published: September 2020

Abstract
Background
Calciphylaxis is a rare condition usually seen in patients with end-stage renal disease. Pain is a hallmark of this condition and can be extremely difficult to control. Anecdotal data suggests that pain management in calciphylaxis is challenging with variable approaches across the United Kingdom (UK) and internationally. A knowledge and practice survey was conducted to establish current practice in the management of pain in patients with calciphylaxis, in the UK. Based on the results and clinical experience the authors suggest a clinical practice guideline.

Methods
An online questionnaire was circulated among physicians (renal and palliative care) involved in the management of pain in calciphylaxis. The questionnaire included a mix of open-ended questions and questions with drop down options.

Results
One hundred and six clinicians responded to the survey of which 60 (57%) respondents were from palliative medicine; the remaining 46 (43%) were from renal medicine. 31 (30%) respondents across both specialties had not encountered any patients with a diagnosis of calciphylaxis (renal-2, palliative care-29). A referral to the palliative care team was undertaken by 18% of renal physicians, 32% referred to the pain team and 50% referred to both. Only 3% of the palliative medicine respondents indicated that they had received a referral from the renal team at the time of diagnosis. Opioids were the preferred initial drug of choice for the management of all types of pain. Paracetamol was universally selected as the preferred first-choice adjuvant agent for management of all types of pain. The importance of advance care planning was highlighted with 72% undertaking advanced care planning discussions often or most of the time.

Conclusion
There was wide variation in the current practice of pain management in patients with calciphylaxis, with variation between renal specialists and palliative care specialists. Referral to specialists in pain management is not universal despite the severe nature of the pain experienced by patients with calciphylaxis. The data generated has facilitated the development of a clinical practice guideline to support complex pain management in a group of patients with multiple comorbidities.