bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Core Outcome Set for Nonpharmacological Community-Based Interventions for People Living With Dementia at Home: A Systematic Review of Outcome Measurement Instruments
Authors: Harding Andrew J E , Morbey Hazel , Ahmed Faraz , Opdebeeck Carol , Elvish Ruth , Leroi Iracema , Williamson Paula R , Keady John , Reilly Siobhan T 
Published: June 2020

Abstract

Background and Objectives
It is questionable whether existing outcome measurement instruments (OMIs) in dementia research reflect what key stakeholders’ value. We attained consensus from more than 300 key stakeholders, including people living with dementia, and identified 13 core outcome items for use in nonpharmacological and community-based interventions for people with dementia living at home. In this systematic review, we review OMIs that have previously been used in dementia care research to determine how, or even if, the 13 core outcome items can be measured.

Research Design and Methods
We extracted self-reported OMIs from trials, reviews, and reports of instrument development. Searches were undertaken in the ALOIS database, MEDLINE, PsycINFO, CINAHL, SocINDEX, and COSMIN databases. We aimed to assess the psychometric properties of OMI items for face validity with the core outcome items, content validity, internal consistency, and responsiveness. We held a coresearch workshop involving people living with dementia and care partners in order to ratify the findings.

Results
In total 347 OMIs were located from 354 sources. Of these, 76 OMIs met the inclusion criteria. No OMIs were deemed to have sufficient face validity for the core outcome set (COS) items, and no OMIs proceeded to further assessment. The “best” available OMI is the Engagement and Independence in Dementia Questionnaire.

Discussion and Implications
This study provides a practical resource for those designing dementia research trials. Being able to measure the COS items would herald a paradigm shift for dementia research, be responsive to what key stakeholders value and enhance the ability to make comparisons.
Can Morphology Predict the Conservation Status of Iguanian Lizards?
Authors: Miles Donald B 
Published: June 2020

SynopsisThe integrity of regional and local biological diversity is under siege as a result of multiple anthropogenic threats. The conversion of habitats, such as rain forests, into agricultural ecosystems, reduces the area available to support species populations. Rising temperatures and altered rainfall patterns lead to additional challenges for species. The ability of conservation biologists to ascertain the threats to a species requires data on changes in distribution, abundance, life history, and ecology. The International Union for the Conservation of Nature (IUCN) uses these data to appraise the extinction risk for a species. However, many species remain data deficient (DD) or unassessed. Here, I use 14 morphological traits related to locomotor function, habitat, and feeding to predict the threat status of over 400 species of lizards in the infraorder Iguania. Morphological traits are an ideal proxy for making inferences about a species’ risk of extinction. Patterns of morphological covariation have a known association with habitat use, foraging behavior, and physiological performance across multiple taxa. Results from phylogenetic general linear models revealed that limb lengths as well as head characters predicted extinction risk. In addition, I used an artificial neural network (ANN) technique to generate a classification function based on the morphological traits of species with an assigned IUCN threat status. The network approach identified eight morphological traits as predictors of extinction risk, which included head and limb characters. The best supported model had a classification accuracy of 87.4%. Moreover, the ANN model predicted &gt;18% of DD/not assessed species were at risk of extinction. The predicted assessments were supported by other sources of threat status, for example, Convention on International Trade in Endangered Species appendices. Because of the functional link between morphology, performance, and ecology, an ecomorphological approach may be a useful tool for rapid assessment of DD or poorly known species.
Emotional Labor and the Power of International Bureaucrats
Authors: Nair Deepak 
Published: June 2020

AbstractThis article advances a theory on the power of international bureaucrats and bureaucracies in world politics. It argues that bureaucrats become powerful when they stage emotionally calibrated performances as “servants” before state principals and carve out space for action through “whispering,” “propagating,” cultivating patrons, and building coalitions in the backstage of official interaction. These “servant” performances involve what sociologist Arlie Hochschild calls “emotional labor”—the management of feelings in work performances. I develop a theory of emotional labor that suggests why international bureaucrats manage emotions as they perform as servants and why some bureaucrats with prized sociological profiles are empowered on the back of “confident” servant performances. In contrast to principal–agent, constructivist, and psychological accounts, this is a micro-sociological explanation for bureaucratic power. I evaluate this theory with an ethnography of the Secretariat of the Association of Southeast Asian Nations (ASEAN)—a “least likely” case for bureaucratic power under prevailing theorizations. I also demonstrate how the ASEAN case is a sharper instance of a more general phenomenon. This article advances the study of emotions and emotional labor, the role of social class in shaping competent practice, and the debate on the power of bureaucrats and international organizations in international relations.
Universal Screening of Gastrointestinal Malignancies for Mismatch Repair Deficiency at Stanford
Authors: Abrha Aser , Shukla Navika D , Hodan Rachel , Longacre Teri , Raghavan Shyam , Pritchard Colin C , Fisher George , Ford James , Haraldsdottir Sigurdis 
Published: June 2020

Abstract

Background
In light of recent Food and Drug Administration (FDA) approval of immune checkpoint inhibitors for mismatch repair deficient (dMMR) malignancies, identifying patients with dMMR malignancies has become increasingly important. Although screening for dMMR in colorectal cancer (CRC) is recommended, it is less common for extracolonic gastrointestinal (GI) malignancies. At Stanford Comprehensive Cancer Institute (SCCI), all GI malignancies have been screened for dMMR via immunohistochemistry since January 2016.

Methods
In this study, we conducted a retrospective review of all patients with GI malignancies screened for dMMR between January 2016 and December 2017. Tumor sequencing was performed on cases negative for germline pathogenic variants where tumor material was available.

Results
A total of 1425 consecutive GI malignancies were screened for dMMR at SCCI during the study period, and 1374 were included for analysis. dMMR was detected in 7.2% of all GI malignancies. We detected the highest prevalence of dMMR in gastric (15 of 150, 10.0%) followed by colorectal (63 of 694, 9.1%), pancreatic (13 of 244, 5.3%), and gastroesophageal malignancy (6 of 132, 4.5%) patients. Lynch syndrome was the most common etiology for dMMR in colorectal cancer (41.5%), double somatic (confirmed or possible) pathogenic variants the most common etiology in pancreatic cancer (44.4%), and somatic MLH1 hypermethylation the most common etiology in gastric (73.3%) and gastroesophageal cancer (83.3%).

Conclusions
Given the relatively high incidence of dMMR in GI malignancies, we recommend screening all GI malignancies. Our results suggest that although a rare occurrence, double somatic pathogenic variants may be a biologically significant pathway causing dMMR in pancreatic cancer.
An Early Test-and-Treat Strategy for Severe Acute Respiratory Syndrome Coronavirus 2
Authors: Schiffer Joshua T , Johnston Christine , Wald Anna , Corey Lawrence 
Published: June 2020

Abstract
As coronavirus disease 2019 cases and deaths continue to expand globally, there is an urgent need to develop, test, and approve effective antiviral therapies. Currently, a majority of clinical trials are evaluating therapies in patients who are already hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) infection. Given that the median time between development of symptoms and need for hospitalization is 1 week, a golden opportunity to intervene early is being missed. Indeed, for many other viral infections, early treatment soon after development of symptoms is associated with decreased mortality, lower hospitalization rates, and lower likelihood of transmission to others. In this study, we advocate for randomized, double-blind, placebo controlled, clinical trials to evaluate promising agents early during SARS CoV-2 infection.
Education Policy Trump Style: The Administrative Presidency and Deference to States in ESSA Implementation
Authors: Wong Kenneth K 
Published: June 2020

Abstract
Since the 1960s, U.S. presidents have used their executive, administrative, and political power to pursue policy goals in elementary and secondary education. This article analyzes the K-12 education policy strategies pursued during the first three years of the Donald Trump presidency, focusing on two main aspects of Trump’s approach to education policy. First, I analyze Trump’s heavy reliance on executive and administrative tools and his use of these tools to promote state flexibility, diminish federal direction on civil rights issues, and expand private and public school choice. Second, I examine the Trump administration’s approach to implementing the Every Student Succeeds Act of 2015 (ESSA), especially in reviewing state plans pursuant to the ESSA. The administration took a highly deferential approach as states sought approval for their ESSA plans and in a way that suggests the Trump presidency is shifting federal involvement in K-12 education policy away from prioritizing equity and oversight.
Outcomes in patients with severe COVID-19 disease treated with tocilizumab: a case–controlled study
Authors: Rojas-Marte G , Khalid M , Mukhtar O , Hashmi A T , Waheed M A , Ehrlich S , Aslam A , Siddiqui S , Agarwal C , Malyshev Y , Henriquez-Felipe C , Sharma D , Sharma S , Chukwuka N , Rodriguez D C , Alliu S , Le J , Shani J 
Published: June 2020

Summary

Background
COVID-19 is an ongoing threat to society. Patients who develop the most severe forms of the disease have high mortality. The interleukin-6 inhibitor tocilizumab has the potential to improve outcomes in these patients by preventing the development of cytokine release storm.

Aims
To evaluate the outcomes of patients with severe COVID-19 disease treated with the interleukin-6 inhibitor tocilizumab.

Methods
We conducted a retrospective, case–control, single-center study in patients with severe to critical COVID-19 disease treated with tocilizumab. Disease severity was defined based on the amount of oxygen supplementation required. The primary endpoint was the overall mortality. Secondary endpoints were mortality in non-intubated patients and mortality in intubated patients.

Results
A total of 193 patients were included in the study. Ninety-six patients received tocilizumab, while 97 served as the control group. The mean age was 60 years. Patients over 65 years represented 43% of the population. More patients in the tocilizumab group reported fever, cough and shortness of breath (83%, 80% and 96% vs. 73%, 69% and 71%, respectively). There was a non-statistically significant lower mortality in the treatment group (52% vs. 62.1%, P = 0.09). When excluding intubated patients, there was statistically significant lower mortality in patients treated with tocilizumab (6% vs. 27%, P = 0.024). Bacteremia was more common in the control group (24% vs. 13%, P = 0.43), while fungemia was similar for both (3% vs. 4%, P = 0.72).

Conclusion
Our study showed a non-statistically significant lower mortality in patients with severe to critical COVID-19 disease who received tocilizumab. When intubated patients were excluded, the use of tocilizumab was associated with lower mortality.
High proton pump inhibitor exposure increases risk of calcinosis in systemic sclerosis
Authors: Host Lauren V , Campochiaro Corrado , Afonso Ana , Nihtyanova Svetlana I , Denton Christopher P , Ong Voon H 
Published: June 2020

Abstract

Objective
To investigate the association between proton pump inhibitor (PPI) use and the presence and severity of calcinosis in SSc.

Methods
We analysed data from two SSc cohorts from a single centre. Cohort 1 included 199 patients reviewed over 10 years, for whom retrospective data on PPI use and calcinosis were available. Cohort 2 was recruited prospectively and included 215 consecutive patients, who underwent clinical assessment. Outcomes of interest were presence of current calcinosis (CC) or calcinosis at any time (CAT).

Results
The cohort 1 data analysis showed that among patients on standard dose PPI 20% had calcinosis, while in those on high doses of PPI calcinosis was present in 39% (P = 0.003). Analysis of the data from cohort 2 confirmed these findings, demonstrating that the odds of CAT increased significantly with longer PPI exposure [odds ratio (OR) 1.04, 95% CI: 1.02, 1.06; P &lt; 0.001], longer disease duration (OR 1.08, 95% CI: 1.05, 1.12; P &lt; 0.001) and greater age (OR 1.03, CI: 1.01, 1.05; P = 0.010). Multivariable logistic regression showed that higher exposure to PPI remained a significant predictor of calcinosis, with PPI exposure &gt;10 years increasing the risk of CAT &gt;6-fold, compared with no PPI (OR 6.37, 95% CI: 1.92, 21.17; P = 0.003) after adjusting for disease duration and antibodies.

Conclusion
We confirm a significant association between high PPI exposure with severity of calcinosis in SSc. Given the clinical impact of calcinosis and reflux in SSc, PPI exposure as a potentially modifiable risk factor for calcinosis requires further evaluation.
Time to remission in swollen joints is far faster than patient reported outcomes in rheumatoid arthritis: results from the Ontario Best Practices Research Initiative (OBRI)
Authors: Pope Janet E , Rampakakis Emmanouil , Movahedi Mohammad , Cesta Angela , Sampalis John S , Bombardier Claire ,   for OBRI investigators
Published: June 2020

AbstractObjectivesRA patients are often not in remission due to patient global assessment of disease activity (PtGA) included in disease activity indices. The aim was to assess the lag of patient-reported outcomes (PROs) after remission measured by clinical disease activity index (CDAI) or swollen joint count (SJC28).MethodsRA patients enrolled in the Ontario Best Practices Research Initiative registry not in low disease state at baseline with at ≥6 months of follow-up, were included. Low disease state was defined as CDAI ≤ 10, SJC28 ≤ 2, PtGA ≤ 2cm, pain score ≤ 2cm, or fatigue ≤ 2cm. Remission included CDAI ≤ 2.8, SJC28 ≤ 1, PtGA ≤ 1cm, pain score ≤ 1cm, or fatigue ≤ 1cm. Time to first low disease state/remission based on each definition was calculated overall and stratified by early vs established RA.ResultsA total of 986 patients were included (age 57.4 (12.9), disease duration 8.3 (9.9) years, 80% women). The median (95% CI) time in months to CDAI ≤ 10 was 12.4 (11.4, 13.6), SJC28 ≤ 2 was 9 (8.2, 10), PtGA ≤ 2cm was 18.9 (16.1, 22), pain ≤ 2cm was 24.5 (19.4, 30.5), and fatigue ≤ 2cm was 30.4 (24.8, 31.7). For remission, the median (95% CI) time in months to CDAI ≤ 2.8 was 46.5 (42, 54.1), SJC28 ≤ 1 was 12.5 (11.4, 13.4), PtGA ≤ 1cm was 39.6 (34.6, 44.8), pain ≤ 1cm was 54.7 (43.6, 57.5) and fatigue ≤ 1cm was 42.6 (36.8, 48). Time to achieving low disease state and remission was generally significantly shorter in early RA compared with established RA with the exception of fatigue.ConclusionTime to achieving low disease state or remission based on PROs was considerably longer compared with swollen joint count. Treating to a composite target in RA could lead to inappropriate changes in DMARDs.
Varieties of Gender Regimes
Authors: Walby Sylvia 
Published: June 2020

AbstractWhat are the varieties of gender regimes? The focus is the theory of varieties of gender regimes—domestic and public regimes; and, within the public, both neoliberal and social democratic varieties—and pathways to alternative forms. Is this model sufficient to encompass the turn to less progressive forms and multiple global regions or are further varieties needed? At stake here is the distinction between modern and premodern, public and domestic, the meaning of conservative, the concept of the family, and the theorization of violence. The article offers engagement with critics and further development of the theory.
Induction of Oxidative DNA Damage and Epithelial Mesenchymal Transitions in Small Airway Epithelial Cells Exposed to Cosmetic Aerosols
Authors: Pearce Kaitlin M , Okon Imoh , Watson-Wright Christa 
Published: June 2020

Abstract
Engineered metal nanoparticles (ENPs) are frequently incorporated into aerosolized consumer products, known as nano-enabled products (NEPs). Concern for consumer pulmonary exposures grows as NEPs produce high concentrations of chemically modified ENPs. A significant knowledge gap still exists surrounding NEP aerosol respiratory effects as previous research focuses on pristine/unmodified ENPs. Our research evaluated metal-containing aerosols emitted from nano-enabled cosmetics and their induction of oxidative stress and DNA damage, which may contribute to epithelial mesenchymal transitions (EMT) within primary human small airway epithelial cells. We utilized an automated NEP generation system to monitor and gravimetrically collect aerosols from two aerosolized cosmetic lines. Aerosol monitoring data were inputted into modeling software to determine potential inhaled dose and in vitro concentrations. Toxicological profiles of aerosols and comparable pristine ENPs (TiO2 and Fe2O3) were used to assess reactive oxygen species and oxidative stress by fluorescent-based assays. Single-stranded DNA (ssDNA) damage and 8-oxoguanine were detected using the CometChip assay after 24-h exposure. Western blots were conducted after 21-day exposure to evaluate modulation of EMT markers. Results indicated aerosols possessed primarily ultrafine particles largely depositing in tracheobronchial lung regions. Significant increases in oxidative stress, ssDNA damage, and 8-oxoguanine were detected post-exposure to aerosols versus pristine ENPs. Western blots revealed statistically significant decreases in E-cadherin and increases in vimentin, fascin, and CD44 for two aerosols, indicating EMT. This work suggests certain prolonged NEP inhalation exposures cause oxidative DNA damage, which may play a role in cellular changes associated with reduced respiratory function and should be of concern.
Adjuvant chemotherapy in colon cancer: state of the art and future perspectives
Authors: Iveson Tim 
Published: June 2020

Purpose of review
This article will review the results of recent studies, which have investigated the duration of adjuvant chemotherapy and also suggest, which aspects of adjuvant treatment need investigation in future studies.

Recent findings
The IDEA collaboration investigated whether the duration of adjuvant chemotherapy with an oxaliplatin doublet could be reduced from 6 to 3 months. Although this study did not demonstrate noninferiority for 3 months treatment, it did show noninferiority for patients receiving 3 months CAPOX chemotherapy and for those patients with low-risk stage III disease receiving 3 months’ treatment. There was also significantly less toxicity seen with 3 months’ treatment. Recent studies have shown that detectable ctDNA postoperatively can predict those patients most likely to relapse and so benefit from adjuvant treatment.

Summary
It has been shown that for patients receiving adjuvant CAPOX chemotherapy, or those receiving adjuvant chemotherapy for low-risk stage III colon 3 months’ chemotherapy gives similar outcomes to 6 months’ treatment with significantly less toxicity.
PENTOSAN POLYSULFATE SODIUM-INDUCED PIGMENTARY MACULOPATHY WITH NONLEAKING CYSTOID MACULAR EDEMA SUCCESSFULLY TREATED WITH ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY
Authors: De Larochellière Elianne , Bourgault Serge 
Published: June 2020

Purpose:
To report a case of nonleaking cystoid macular edema (CME) associated with pentosan polysulfate sodium (PPS)-induced pigmentary maculopathy.

Methods:
Multimodal imaging, including optical coherence tomography, fundus photography, autofluorescence, and fluorescein angiography, was used to substantiate our diagnosis, further characterize the cystoid macular edema showed by our patient and to monitor the response to treatment.

Results:
A 59-year-old woman was referred for decreased visual acuity and bilateral macular edema. She had been treated for interstitial cystitis with PPS for 10 years. Multimodal imaging showed the characteristic features of PPS-induced pigmentary maculopathy. Moreover, fluorescein angiogram showed nonleaking cystoid macular edema in both eyes. She was treated successfully with intravitreal injections of bevacizumab.

Conclusion:
To our knowledge, this report is the first to demonstrate that PPS-associated cystoid macular edema can be nonleaking on fluorescein angiography and responds well to intravitreal anti-vascular endothelial growth factor injections.
Learning in Pediatric Emergency Situations: A Qualitative Study of Residents’ Perspectives*
Authors: Petrescu Matei S. , Stalmeijer Renee E. , Rethans Jan-Joost , Thammasitboon Satid 
Published: June 2020

Objectives:
To explore resident learning in the context of emergency situations. The guiding research questions were: How do residents learn in emergency situations? What factors facilitate or hinder their learning?

Design:
A qualitative approach was used in order to understand the different perspectives of participants and explore the context of emergency situations. Aware of the complex sociocultural interactions in emergency situations, we used the methodology of constructivist grounded theory.

Setting:
A medium-sized pediatric academic hospital in San Antonio, TX.

Subjects:
Twenty pediatric residents participated in semi-structured interviews.

Interventions:
None.

Measurements and Main Results:
We used an iterative process of data collection and analysis. The process continued until thematic saturation was reached. The data were coded and analyzed using constant comparison. Codes were clustered into themes informed by the theory of situated learning. Several methods were used to ensure trustworthiness of results. Three main themes were identified. First, resident participation in emergency situations takes different forms. Residents participate mostly in helping roles. Watching is an under-recognized form of participation yet offered unique experiences. Managing roles are rarely afforded to residents. Second, resident participation is informed by the context of the emergency situation. Based on contextual clues (e.g., safety, needs), residents infer potential risks and values from their participation, which guides their participatory role. Residents may shift their form of participation, based on changes in the context. Supervisors play a significant role in guiding resident participation. Third, engagement, a state of cognitive and emotional focus, is critical in learning. The context of the emergency situation plays a role in the level of resident engagement. Supervisors may also foster resident engagement.

Conclusions:
Resident participation in emergency situations is complex and informed by the context. Learning in emergency situations is influenced by residents’ level of mental engagement. Supervisors may positively guide resident participation, foster engagement, and enable them to reach their learning goals in emergency situations.