bluuebunny/crossref_metadata_2025_split huggingface dataset:
Meta-Ethics
Authors: Irwin Terence 
Published: July 2020

Abstract
Moore’s arguments begin a debate that revives sentimentalist and rationalist arguments. According to Moore, ‘good’ is indefinable, because there is no definition of it that mentions only ‘natural’ properties. Non-naturalist objectivists argue that we know about objective moral properties, but not in the way we know about other properties. Non-cognitivists argue that goodness is not an objective property at all; when we say that something is good, we are not stating a fact about it, but expressing an emotion, or issuing some prescription. Even if objectivism is correct about the meaning of moral judgments, we may still deny that any moral judgments are true, on the ground that we have no reason to believe that there are any moral facts of the sort that objectivists claim to describe. Further discussion of these arguments against objectivism requires closer attention to the difference between moral concepts and moral properties.
Fish oil supplementation reduces osteoarthritis-specific pain in older adults with overweight/obesity
Authors: Kuszewski Julia C , Wong Rachel H X , Howe Peter R C 
Published: July 2020

Abstract

Objectives
OA is a leading cause of chronic pain and disability. Next to inflammation, vascular pathology has been hypothesized to play a role in its aetiology and progression. Owing to side effects and the low efficacy of pharmacological treatments, dietary supplements are popular as alternative treatments, but evidence of efficacy is limited. We tested whether fish oil and curcumin supplementation can reduce chronic pain and OA burden in older adults.

Methods
A 16-week randomized, double-blind, placebo-controlled, 2 × 2 factorial design supplementation trial with fish oil (2000 mg/day docosahexaenoic acid + 400 mg/day eicosapentaenoic acid), curcumin (160 mg/day) or a combination of both was undertaken in sedentary overweight/obese older adults. Secondary outcomes included treatment-induced changes in self-reported chronic pain and OA burden and whether changes were related to changes in small artery elasticity (surrogate marker for microvascular function), CRP (inflammatory marker) and well-being.

Results
The majority of participants (131 of 152) reported chronic pain, which was predominantly OA specific. Fish oil significantly reduced OA-specific pain (P = 0.002, Cohen’s d = 0.56) and burden (P = 0.015, Cohen’s d = 0.45) compared with no fish oil treatment; reductions were correlated with improvements in microvascular function and well-being. Curcumin, alone or in combination with fish oil, did not reduce pain measures.

Conclusion
Our findings indicate potential for fish oil to alleviate OA pain and burden in overweight/obese older adults. Further investigations should be undertaken in patients with clinically diagnosed OA to evaluate fish oil alone and as an adjunct to conventional pharmacotherapy and to investigate underlying mechanisms.

Trial registration
Australian and New Zealand Clinical Trials Register, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370788, ACTRN12616000732482p.
Ranitidine Withdrawn From the Market
Authors: Aschenbrenner Diane S. 
Published: July 2020

The H2 blocker ranitidine (Zantac) has been withdrawn from the U.S. market because of concerns over levels of the contaminant N-nitrosodimethylamine, which can increase with time and temperature, posing a risk of cancer.Patients should be told to discard all products containing ranitidine.
Building a Foundation of Evidence to Support Nurses Returning to School: The Role of Empowerment
Authors: Sarver Wendy L. , Seabold Kelly , Kline Melissa 
Published: July 2020

Abstract

AIM
The aim of the study was to investigate the role of Kanter’s theory of workplace empowerment in nurses’ attitude toward returning to school.

BACKGROUND
Increasing the percentage of BSNs has a positive effect on outcomes, but few hospitals offer formal support systems beyond tuition reimbursement. Workplace empowerment theory may explain attitudes toward returning to school.

METHOD
A mixed-methods design was used with a cross-sectional survey and focus group.

RESULTS
Significant predictors of attitude toward returning to school (n = 162) were formal power (p = .003), access to support (p = .007), and access to resources (p = .050). Focus group themes (n = 3) were resources important to returning to school/manager support, timing, becoming aware of opportunities after enrolling, and intrinsic desire to return to school.

CONCLUSION
Exploring relationships between workplace empowerment and attitudes toward returning to school will guide hospital executives in building support systems for nurses returning to school.
Pinna-Imitating Microphone Directionality Improves Sound Localization and Discrimination in Bilateral Cochlear Implant Users
Authors: Fischer Tim , Schmid Christoph , Kompis Martin , Mantokoudis Georgios , Caversaccio Marco , Wimmer Wilhelm 
Published: July 2020

Objectives:
To compare the sound-source localization, discrimination, and tracking performance of bilateral cochlear implant users with omnidirectional (OMNI) and pinna-imitating (PI) microphone directionality modes.

Design:
Twelve experienced bilateral cochlear implant users participated in the study. Their audio processors were fitted with two different programs featuring either the OMNI or PI mode. Each subject performed static and dynamic sound field spatial hearing tests in the horizontal plane. The static tests consisted of an absolute sound localization test and a minimum audible angle test, which was measured at eight azimuth directions. Dynamic sound tracking ability was evaluated by the subject correctly indicating the direction of a moving stimulus along two circular paths around the subject.

Results:
PI mode led to statistically significant sound localization and discrimination improvements. For static sound localization, the greatest benefit was a reduction in the number of front-back confusions. The front-back confusion rate was reduced from 47% with OMNI mode to 35% with PI mode (p = 0.03). The ability to discriminate sound sources straight to the sides (90° and 270° angle) was only possible with PI mode. The averaged minimum audible angle value for the 90° and 270° angle positions decreased from a 75.5° to a 37.7° angle when PI mode was used (p < 0.001). Furthermore, a non-significant trend towards an improvement in the ability to track moving sound sources was observed for both trajectories tested (p = 0.34 and p = 0.27).

Conclusions:
Our results demonstrate that PI mode can lead to improved spatial hearing performance in bilateral cochlear implant users, mainly as a consequence of improved front-back discrimination with PI mode.
The Effect of Increasing Interphase Gap on N1 Latency of the Electrically Evoked Compound Action Potential and the Stimulation Level Offset in Human Cochlear Implant Users
Authors: Skidmore Jeffrey , He Shuman 
Published: July 2020

Objective:
This study reports two potential biomarkers of the physiological status of the cochlear nerve (CN) in cochlear implant users.

Design:
This project represents a complementary analysis on a subset of electrophysiological data from our recently published study. This study compared changes in N1 latency and stimulation level (i.e., N1 latency offset and stimulation level offset) with increasing interphase gap of a biphasic pulse between children with cochlear nerve deficiency and children with normal-sized CNs.

Results:
Children with cochlear nerve deficiency showed smaller N1 latency offsets and larger stimulation level offsets than children with normal-sized CNs at all electrode locations tested.

Conclusions:
The N1 latency and stimulation level offsets differ in two patient populations with different physiological statuses of the CN. These parameters may be useful for evaluating CN function in individual cochlear implant patients.
Comparison the effect of kinetic parameters of innovative storing-restoring hybrid passive (comfort gait) ankle-foot orthosis (AFO) with posterior leaf spring AFO in drop-foot patients: a prospective cohort study
Authors: Saeedi Hassan , Pourhoseingholi Ensieh 
Published: July 2020

Background:
Drop-foot syndrome is a disorder in which the dorsiflexor muscles are weakened or completely paralyzed, leading to foot slapping after the initial contact and foot-dragging during the swing phase. Passive and hybrid passive ankle-foot orthoses (AFOs) are often prescribed as an intervention for this disorder; however, the effects of these AFOs on kinetic parameters during the gait of drop-foot patients seem unclear. This study aimed to compare the affected lower limb joints of ankle, knee, and hip kinetics parameters (moments and powers) during walking in drop-foot patients using an innovative AFO storing-restoring hybrid passive AFO, named “Comfort Gait” and posterior leaf spring (PLS) AFO.

Methods:
Ten drop-foot patients were recruited in the current study to walk at a comfortable self-selected speed while wearing two different AFO selections. Kinetic parameters with a motion capture system were obtained for these patients.

Results:
The results of this study revealed a significant increase in the peak values of kinetic parameters of the lower limb of the affected side (ankle, knee, and hip moments and powers) with the innovative designed AFO when compared to PLS AFO (P<0.05).

Conclusions:
The significant increase of kinetic parameters in drop foot with use of the Comfort Gait as compared to the PLS AFO might suggest the effectiveness of this innovative AFO in improving the gait of foot drop patients more than the use of PLS AFO.

Level of Evidence:
Level II
Comparison of Novel Immunoassay With Liquid Chromatography/Tandem Mass Spectrometry (LC-MS/MS) for Therapeutic Drug Monitoring of Clozapine
Authors: Buckley Tiffany , Kitchen Christopher , Vyas Gopal , Siegfried Nathan A. , Tefera Eshetu , Chen Shuo , DiPaula Bethany A. , Kelly Deanna L. 
Published: July 2020

Background:
Clozapine is the most effective antipsychotic for treatment-resistant schizophrenia. Although serum clozapine levels can help guide treatment, they are underutilized owing to requirements for frequent venous blood draws and lack of immediate results.

Methods:
Clozapine levels measured with a novel immunoassay technology (which enables point-of-care development) were compared with those measured by standard liquid chromatography/tandem mass spectrometry (LC-MS/MS). Frozen serum aliquots of 117 samples (N = 48 patients with schizophrenia on clozapine; N = 24 patients with schizophrenia not on clozapine; N = 45 healthy controls) were sent to a national reference laboratory (NRL) for clozapine level determination by LC-MS/MS, and matching samples were subjected to novel immunoassay (3 runs). At a later date, another frozen aliquot from the same date was sent to the NRL for repeat testing.

Results:
The NRL obtained 18 false-positive clozapine results (mean 42.39 ± 32.06, range 21–159 ng/mL) in participants not on clozapine (N = 3) and healthy controls (N = 15). The immunoassay showed no false-positive clozapine results. The clozapine levels were correlated between both assays (r = 0.84, P < 0.0001), despite 16% higher clozapine levels with immunoassay (482.08 ± 270.88 ng/mL immunoassay, 414.98 ± 186.29 ng/mL LC-MS/MS [P = 0.03]). Agreement analysis using concordance correlation coefficient (CCC) for LC-MS/MS of the 2 aliquots yielded CCC = 0.869; 95% confidence interval = 0.690–0.970, whereas higher agreement results were observed for the 3 runs of immunoassay (CCC = 0.99; 95% confidence interval = 0.979–0.997).

Conclusions:
The lack of false positives observed with immunoassay, higher repeat performance agreement, and good correlation with LC-MS/MS may indicate the more robust performance of immunoassay than that of LC-MS/MS clozapine-level determination.
Measuring Intracellular Concentrations of Calcineurin Inhibitors: Expert Consensus from the International Association of Therapeutic Drug Monitoring and Clinical Toxicology Expert Panel
Authors: Lemaitre Florian , Vethe Nils T. , D'Avolio Antonio , Tron Camille , Robertsen Ida , De Winter Brenda , Denicolo Amedeo , Koch Birgit C. P. , Venkataramanan Raman , Van Gelder Teun , Brunet Mercè , Bergan Stein , Hesselink Dennis A. , Wallemacq Pierre 
Published: July 2020

Background:
Therapeutic drug monitoring (TDM) of the 2 calcineurin inhibitors (CNIs), tacrolimus (TAC) and cyclosporin A, has resulted in improvements in the management of patients who have undergone solid organ transplantation. As a result of TDM, acute rejection (AR) rates and treatment-related toxicities have been reduced. Irrespective, AR and toxicity still occur in patients who have undergone transplantation, showing blood CNI concentrations within the therapeutic range. Moreover, the AR rate is no longer decreasing. Hence, smarter TDM approaches are necessary. Because CNIs exert their action inside T lymphocytes, intracellular CNIs may be a promising candidate for improving therapeutic outcomes. The intracellular CNI concentration may be more directly related to the drug effect and has been favorably compared with the standard, whole-blood TDM for TAC in liver transplant recipients. However, measuring intracellular CNIs concentrations is not without pitfalls at both the preanalytical and analytical stages, and standardization seems essential in this area. To date, there are no guidelines for the TDM of intracellular CNI concentrations.

Methods:
Under the auspices of the International Association of TDM and Clinical Toxicology and its Immunosuppressive Drug committees, a group of leading investigators in this field have shared experiences and have presented preanalytical and analytical recommendations for measuring intracellular CNI concentrations.
Quantification of Serum Sulfamethoxazole and Trimethoprim by Ultra-fast Solid-Phase Extraction–Tandem Mass Spectrometry
Authors: Fatica Erica , Faber Jennifer , Gaffron Christopher , Bjergum Matthew , Langman Loralie , Jannetto Paul 
Published: July 2020

Background:The combination of trimethoprim (TMP) and sulfamethoxazole (SMX) is used to treat a number of bacterial infections. TMP/SMX concentrations in serum are conventionally monitored using high-performance liquid chromatography (HPLC) or liquid chromatography tandem mass spectrometry. These methods require laborious manual extraction techniques and relatively long sample analysis times, necessitating the development of a simple, high-throughput method. A simple, high-throughput method to measure TMP/SMX using ultra-fast solid-phase extraction (SPE)–tandem mass spectrometry has been developed.Methods:Calibration standards, quality control materials, and patient samples were precipitated with acetonitrile containing isotopically labeled internal standards. Samples were vortexed, centrifuged for 5 minutes at 2053g, and the resulting supernatant was diluted in aqueous mobile phase and injected onto the C18 SPE cartridge. MS/MS analysis was performed by electrospray ionization in positive ion mode at a rate of <20 seconds per sample. A 5-point linear 1/x calibration curve was used to calculate sample concentrations.Results:The intra-assay precision coefficients of variation were <6% and <7% for SMX and TMP, respectively, and <10% for both interassay precision coefficients of variation. Comparison studies using 50 patient and spiked serum samples showed r2values of 0.9890 and 0.9853 andy-intercept values of −1.918 and −1.357, respectively compared with the HPLC reference method. All data points were <±15% of the mean. Linearity [r2= 0.9952 (SMX) and 0.9954 (TMP)] was established from 12 to 400 mcg/mL with a detection limit of 0.47 mcg/mL, and 1.2–40 mcg/mL with a detection limit of 0.06 mcg/mL, for SMX and TMP, respectively. For either drug, no significant carryover was observed after samples at the upper limit of quantification. No interference was observed from any of the 77 drugs and respective metabolites tested.Conclusions:A high-throughput SPE–tandem mass spectrometry method for TMP/SMX quantification was developed. The <20 seconds analysis time is a significant improvement compared with traditional HPLC and liquid chromatography tandem mass spectrometry methods, without sacrificing analytical performance.
Is Europe Facing an Emerging Opioid Crisis Comparable to the U.S.?
Authors: van Amsterdam Jan , Pierce Mimi , van den Brink Wim 
Published: July 2020

Abstract:
In the U.S., an opioid overdose crisis has emerged, attributable to over-prescription of opioid analgesics, driven by aggressive marketing by pharmaceutical companies, followed by surging heroin overdose deaths, and more recently, by the high mortality rates predominately because of illicitly manufactured fentanyl and analogs of fentanyl. In Europe, the use of prescription opioids for pain management has also increased in the last 2 decades, although it is debatable as to whether this could lead to a similar opioid overdose crisis. To address this issue, recent trends in opioid prescription rates, prevalence rates of fatal and nonfatal incidents, and addiction care treatment were used as proxies of opioid-related harm. The current overview, comparing opioid use and its negative consequences in Germany, France, the U.K., and the Netherlands, using the same indicators as in the U.S., demonstrates that there is no evidence of a current or emerging opioid crisis in these European countries. Scotland, however, is an alarming exception, with high rates of opioid-related harms. Considering that the use of prescription opioids has been declining rather than increasing in Europe, an opioid crisis is not anticipated there yet. Authorities should, however, remain vigilant.
FOVEAL AVASCULAR ZONE VOLUME
Authors: Xu Qiuzhuo , Zhang Weiwei , Zhu Hongjing , Chen Qiang 
Published: July 2020

Purpose:
To propose a new clinical evaluation index, foveal avascular zone (FAZ) volume, and analyze its statistical significance.

Methods:
A semiautomatic method is proposed to measure the FAZ volume in optical coherence tomography angiography images as follows: The region of interest was flattened and annotated axially. The labeled pixels in the restored region of interest were counted as the FAZ volume. Linear regression and the independent samples t-test were performed for the statistical analysis.

Results:
Sixty-one normal, 64 high myopia, and 42 diabetic retinopathy eyes were imaged using optical coherence tomography angiography. For normal eyes, the FAZ volume correlates inversely with central macular thickness (superficial: P = 0.004; deep: P < 0.001) and positively with area (P < 0.001). For high myopia eyes, the deep plexus FAZ (P = 0.34) and total FAZ (P = 0.38) volumes show no significant difference, whereas the superficial plexus FAZ volume is significantly larger than control (P < 0.001). For diabetic retinopathy eyes, the superficial plexus FAZ (P = 0.001), deep plexus FAZ (P = 0.014), and total volumes (P = 0.002) are significantly larger than control.

Conclusion:
The FAZ volume is proposed for depicting the 3D structure of the FAZ. It shows greater sensitivity for vascular alteration that makes it meaningful for clinical analysis.
ASSESSMENT OF EARLY CHANGES IN SPECTRAL DOMAIN-OPTICAL COHERENCE TOMOGRAPHY AFTER INITIATION OF TREATMENT WITH INTRAVITREAL AFLIBERCEPT (EYLEA) OVER A 12-WEEK PERIOD FOR PATIENTS WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Authors: Korobelnik Jean-François , Souied Eric H. , Oubraham Hassiba , Razavi Sam , Mauget-Faÿsse Martine , Savel Helene , Chene Genevieve , Wolf Sebastian 
Published: July 2020

Purpose:
To assess early changes in spectral-domain optical coherence tomography during the loading phase with intravitreal aflibercept therapy in patients with neovascular age-related macular degeneration.

Methods:
In this prospective, open-label, single-arm, multicenter study, patients with neovascular age-related macular degeneration, who were antivascular endothelial growth factor treatment-naïve, received three monthly initial doses of intravitreal aflibercept 2 mg. The primary outcome was the proportion of patients with dry spectral-domain optical coherence tomography at 12 weeks, defined as an absence of intraretinal edema, intraretinal cysts, subretinal fluid, and subretinal pigment epithelium fluid.

Results:
Fifty eyes of 50 patients were investigated. At 12 weeks, 34.0% (17/50) had dry spectral-domain optical coherence tomography. Marked reductions were observed for all other spectral-domain optical coherence tomography parameters. The mean macular central thickness fell significantly from 463.2 ± 184.3 µm at baseline to 288.9 ± 76.8 µm at Week 12 (P < 0.0001). The mean best-corrected visual acuity also improved significantly from 61.0 ± 16.0 letters at baseline to 66.6 ± 19.0 letters at Week 12 (P = 0.0006).

Conclusion:
The anatomic and functional outcomes improved over the 12-week study period. All outcome variables peaked after the third aflibercept injection, confirming the benefit of three initial doses.
PATIENTS WEARING FACE MASKS DURING INTRAVITREAL INJECTIONS MAY BE AT A HIGHER RISK OF ENDOPHTHALMITIS
Authors: Hadayer Amir , Zahavi Alon , Livny Eitan , Gal-Or Orly , Gershoni Assaf , Mimouni Karin , Ehrlich Rita 
Published: July 2020

Purpose:
To investigate the safety of face masks worn by patients during intravitreal injections.

Methods:
A prospective, qualitative, interventional study performed in a tertiary university hospital. Healthy volunteers were asked to wear three different professional surgical face masks while air leaks around the eyes were monitored. Three types of masks were investigated as follows: 1) surgical face mask with four tying strips, 2) surgical face mask with elastic ear loops and 3) 2200 N95 tuberculosis particulate face mask. For each session the periocular area was inspected for air leak during normal respiration, speech, and deep respiration. Detection of air leak was performed using the following two professional thermal cameras: FLIR A310—thermal camera and EyeCGas 2.0—super sensitive infrared camera used for detection of minute fugitive emissions of industrial gases.

Results:
Ten healthy volunteers were enrolled in this study. The experiment was repeated 45 times for each camera; 3 times for each of 3 mask types, on 5 volunteers, for a total of 90 trials. Air jets were detected originating from the superior edges of the masks radiating toward the eyes in 81% (73/90) of cases in total; 71% (32/45) with the FLIR camera and 91% (41/45) with the OPGAL camera. Air leaks were detected with all investigated mask types.

Conclusion:
Patients wearing face masks during intravitreal injections may be at a higher risk of endophthalmitis. Until further data are available, we recommend verifying proper face mask fitting and either taping the upper edges of the face masks with a medical adhesive tape or using an adhesive surgical drape around the injected eye.