bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enlightenment Strikes! Broadening Graduate School Training through Field Campaign Participation
Authors: Rasmussen Kristen L. , Burt Melissa A. , Rowe Angela , Haacker Rebecca , Hence Deanna , Luna Lorena Medina , Nesbitt Stephen W. , Maertens Julie 
Published: June 2021

AbstractThis article provides an overview of the Advanced Study Institute: Field Studies of Convection in Argentina (ASI-FSCA) program, a 3-week dynamic and collaborative hands-on experience that allowed 16 highly motivated and diverse graduate students from the United States to participate in the 2018–19 Remote Sensing of Electrification, Lightning, and Mesoscale/Microscale Processes with Adaptive Ground Observations (RELAMPAGO) field campaign. This program is unique as it represents the first effort to integrate an intensive Advanced Study Institute with a field campaign in atmospheric science. ASI-FSCA activities and successful program outcomes for five key elements are described: 1) intensive field research with field campaign instrumentation platforms; 2) recruitment of diverse graduate students who would not otherwise have opportunities to participate in intensive field research; 3) tailored curriculum focused on scientific understanding of cloud and mesoscale processes and professional/academic development topics; 4) outreach to local K–12 schools and the general public; and 5) building a collaborative international research network to promote weather and climate research. These five elements served to increase motivation and improve confidence and self-efficacy of students to participate in scientific research and field work with goals of increasing retention and a sense of belonging in STEM graduate programs and advancing the careers of students from underrepresented groups as evidenced by a formal program evaluation effort. Given the success of the ASI-FSCA program, our team strongly recommends considering this model for expanding the opportunities for a broader and more diverse student community to participate in dynamic and intensive field work in atmospheric science.
Post-Operative Dysphagia in Anterior Cervical Discectomy and Fusion
Authors: Haller Leonard , Mehul Kharidia Khush , Bertelsen Caitlin , Wang Jeffrey , O’Dell Karla 
Published: June 2021

Objective: We sought to identify risk factors associated with long-term dysphagia, characterize changes in dysphagia over time, and evaluate the incidence of otolaryngology referrals for patients with long-term dysphagia following anterior cervical discectomy with fusion (ACDF). Methods: About 56 patients who underwent ACDF between May 2017 to February 2019 were included in the study. All patients were assessed for dysphagia using the Eating Assessment Tool (EAT-10) survey preoperatively and late postoperatively (≥1 year). Additionally, 28 patients were assessed for dysphagia early postoperatively (2 weeks—3 months). Demographic data, medical comorbidities, intraoperative details, and post-operative otolaryngology referral rates were collected from electronic medical records. Results: Of the 56 patients enrolled, 21 patients (38%) had EAT-10 scores of 3 or more at long-term follow-up. None of the demographics, comorbidities, or surgical factors assessed were associated with long-term dysphagia. Patients who reported no long-term dysphagia had a mean EAT-10 score of 6.9 early postoperatively, while patients with long-term symptoms had a mean score of 18.1 ( P = .006). Of the 21 patients who reported persistent dysphagia symptoms, 3 (14%) received dysphagia testing or otolaryngology referrals post-operatively. Conclusion: Dysphagia is a notable side effect of ACDF surgery, but there are no significant demographics, comorbidities, or surgical risk factors that predict long-term dysphagia. Early postoperative characterization of dysphagia using the EAT-10 questionnaire can help predict long-term symptoms. There is inadequate screening and otolaryngology follow-up for patients with post-ACDF dysphagia.
A prospective observational study on oral administration of Ellagic Acid and Annona Muricata in patients affected by non-muscle invasive bladder cancer not undergoing maintenance after 6-week intravesical prophylaxis
Authors: Serretta Vincenzo , Berardinis Ettore De , Simonato Alchiede , Guarneri Alessio , Dispensa Nino , Pavone Carlo , Busetto Gian Maria , Del Giudice Francesco , Sanfilippo Chiara 
Published: June 2021

Introduction: BCG and MMC shortage and Covid-19 pandemic, more recently, limit accessibility to maintenance regimen in intravesical prophylaxis against recurrence of non-muscle invasive bladder cancer (NMIBC). Ellagic acid (EA) and Annona muricata (AM) exert antitumor activity against different human tumours. An observational prospective study on the prophylactic effect of oral administration of EA+AM in patients avoiding maintenance regimen is presented. Materials and methods: Patients affected by NMIBC and not undergoing maintenance after a 6-week course of intravesical prophylaxis with MMC or BCG were entered. Tis and very high-risk tumours were excluded. After informed consent, the patients were subdivided in relation to the oral assumption or not of EA (100 mg) plus AM (100 mg), daily for 6 months. All patients were submitted to 3-month cytology and cystoscopy. Results: 162 (90%) of 180 entered patients are evaluable, 90 and 72 receiving or not EA+AM. No difference emerged in patients’ characteristics between the two groups. BCG was given in 86 (54%) and chemotherapy in 74 (46%) patients. The recurrence free rate at 3, 6 and 12 months in patients assuming or not EA was 96.5% versus 84.6% ( p = 0.003), 85.4% versus 64.8% ( p = 0.005) and 74.2% versus 60.6% ( p = 0.246), respectively. The recurrence free survival at 12 months in patients assuming or not EA was 63.0% versus 34.5% ( p < 0.0001). Discussion and conclusions: Our study suffers several limits: not randomized trial although prospective, limited number of patients and short follow-up, nevertheless it shows the prophylactic effect of oral EA+AM in absence of maintenance after intravesical chemotherapy or immunotherapy induction.
The Toolkit of Nationalist Populism in Contemporary Hungary: Symbols, Objects, and Modalities of Circulation
Authors: Molnár Virág 
Published: June 2021

This article belongs to the special cluster, “National, European, Transnational: Far-right activism in the 20th and 21st centuries”, guest edited by Agnieszka Pasieka. Research on populism attributes great significance to mapping the distinctive discursive logic of populist reasoning (e.g., the trope of pitting corrupt elites against the people). This article aims to move beyond the primary focus on discursive structures to stress the role of symbols, objects, and different modalities of circulation in the political communication of populist ideas, using the case of Hungary. By tracing the history of one of the key symbols of nationalist populism—the image of “Greater Hungary”—from its emergence in the interwar period to its present-day use, the article shows how the meanings and material forms this symbol assumed in political communication that evolved under different political regimes. The analysis builds on extensive archival, ethnographic, and online data to highlight how the diversity of material forms and the conduits through which this image circulated have contributed to its endurance as a key political symbol. Symbols, like the Greater Hungary image, condense complex historical narratives into a powerful sign that can be easily objectified, reproduced, and diffused. Today’s differentiated consumer markets provide convenient conduits for this kind of material circulation. These symbols carry meaning in and of themselves as signs, and once they are turned into everyday objects, they facilitate the normalization of radical politics by increasing their salience and broad visibility.
Measures of Burnout and Empathy in United States Doctor of Pharmacy Students: Time for a Change?
Authors: Jacoby Jeanne L. , Cole Jaclyn D. , Ruble Melissa J. , Smith Amy B. , Laubach Lexis T. , Greenberg Marna Rayl , Macfarlan Jennifer E. , DeWaay Deborah J. , Barraco Robert D. , Shigo Erin , Crowley Lauren , Quinn Joann Farrell 
Published: June 2021

Purpose: To review interim data regarding longitudinal burnout and empathy levels in a single Doctor of Pharmacy class cohort. Methods: Students were emailed an electronic survey during their first semester and annually at the end of each academic year for a total of 3 years (2017-2020). Validated survey tools included the Jefferson Scale of Empathy (JSE) and the Maslach Burnout Inventory (MBI) student version. The JSE survey consists of 20 questions, with higher scores denoting more empathy. The MBI student version contains 3 subscales: exhaustion (higher scores are worse), cynicism (higher scores are worse) and professional efficacy (higher scores are better). Results: The median JSE score at the end of the third academic year (PY3) was 110, with females scoring significantly higher (114.5 vs. 103.5; p<0.02). A majority of the 62 students reported burn out (82.3%), scoring in the highest category for either exhaustion (76%) or cynicism (55%). A majority (66%) also reported a low or moderate professional efficacy score, a negative finding. Measures of student burnout increased after the start of the program and remained at the higher level each subsequent year (p<0.0001). In the Spring of 2020, during the COVID-19 pandemic, nearly every student had moderate or high levels of emotional exhaustion (97%) and cynicism (78%) as measured by the MBI. Conclusion: This interim data suggests high degrees of pharmacy student burnout. Empathy levels remained stable throughout the duration of the study. Pharmacy schools may need to focus on reform regarding well-being and prevention of burnout.
Prescribing Errors With Direct Oral Anticoagulants and Their Impact on the Risk of Bleeding in Patients With Atrial Fibrillation
Authors: Raccah Bruria Hirsh , Erlichman Yevgeni , Pollak Arthur , Matok Ilan , Muszkat Mordechai 
Published: June 2021

Introduction: Anticoagulants are associated with significant harm when used in error, but there are limited data on potential harm of inappropriate treatment with direct oral anticoagulants (DOACs). We conducted a matched case-control study among atrial fibrillation (AF) patients admitting the hospital with a chronic treatment with DOACs, in order to assess factors associated with the risk of major bleeding. Methods: Patient data were documented using hospital’s computerized provider order entry system. Patients identified with major bleeding were defined as cases and were matched with controls based on the duration of treatment with DOACs and number of chronic medications. Appropriateness of prescribing was assessed based on the relevant clinical guidelines. Conditional logistic regression was used to evaluate the potential impact of safety-relevant prescribing errors with DOACs on major bleeding. Results: A total number of 509 eligible admissions were detected during the study period, including 64 cases of major bleeding and 445 controls. The prevalence of prescribing errors with DOACs was 33%. Most prevalent prescribing errors with DOACs were “drug dose too low” (16%) and “non-recommended combination of drugs” (11%). Safety-relevant prescribing errors with DOACs were associated with major bleeding [adjusted odds ratio (aOR) 2.17, 95% confidence interval (CI) 1.14-4.12]. Conclusion: Prescribers should be aware of the potential negative impact of prescribing errors with DOACs and understand the importance of proper prescribing and regular follow-up.
Food insecurity in the households of children with autism spectrum disorders and intellectual disabilities in the United States: Analysis of the National Survey of Children’s Health Data 2016–2018
Authors: Karpur Arun , Vasudevan Vijay , Lello Angela , Frazier Thomas W , Shih Andy 
Published: June 2021

Individuals with autism spectrum disorder and co-occurring intellectual disabilities experience substantial challenges in accessing needed supports. This research aimed to understand the prevalence and factors associated with food insecurity among families of children with autism spectrum disorder and co-occurring intellectual disabilities. Utilizing the National Survey of Children’s Health (2016–2018) data, this article illustrated that the households of children with autism spectrum disorder and co-occurring intellectual disabilities were about two times more likely to be food insecure than the households of children without disabilities. Furthermore, the households of children with autism spectrum disorder were 1.5 times more likely, and those with other disabilities were 1.3 times more likely to be food insecure than the households of children without disabilities. Implications of these findings in the context of the COVID-19 pandemic are discussed. Lay abstract Families of children with autism spectrum disorder are more likely to experience financial strain and resulting food insecurity due to additional cost of care, disparate access to needed services, and loss of income resulting from parental job loss. Utilizing nationally representative data, this analysis indicates that the families of children with autism spectrum disorder and co-occurring intellectual disabilities are twice as likely to experience food insecurity than families of children without disabilities after adjusting for various factors. Several factors, ranging from state-level policies such as Medicaid expansion to individual-level factors such as higher utilization of emergency room services, were associated with the higher prevalence of food insecurity in families of children with autism spectrum disorder and co-occurring intellectual disabilities. Implications of these findings on programs and policies supporting families in the COVID-19 pandemic are discussed.
Using Biofeedback to Reduce Step Length Asymmetry Impairs Dynamic Balance in People Poststroke
Authors: Park Sungwoo , Liu Chang , Sánchez Natalia , Tilson Julie K. , Mulroy Sara J. , Finley James M 
Published: June 2021

Background People poststroke often walk with a spatiotemporally asymmetric gait, due in part to sensorimotor impairments in the paretic lower extremity. Although reducing asymmetry is a common objective of rehabilitation, the effects of improving symmetry on balance are yet to be determined. Objective We established the concurrent validity of whole-body angular momentum as a measure of balance, and we determined if reducing step length asymmetry would improve balance by decreasing whole-body angular momentum. Methods We performed clinical balance assessments and measured whole-body angular momentum during walking using a full-body marker set in a sample of 36 people with chronic stroke. We then used a biofeedback-based approach to modify step length asymmetry in a subset of 15 of these individuals who had marked asymmetry and we measured the resulting changes in whole-body angular momentum. Results When participants walked without biofeedback, whole-body angular momentum in the sagittal and frontal plane was negatively correlated with scores on the Berg Balance Scale and Functional Gait Assessment supporting the validity of whole-body angular momentum as an objective measure of dynamic balance. We also observed that when participants walked more symmetrically, their whole-body angular momentum in the sagittal plane increased rather than decreased. Conclusions Voluntary reductions of step length asymmetry in people poststroke resulted in reduced measures of dynamic balance. This is consistent with the idea that after stroke, individuals might have an implicit preference not to deviate from their natural asymmetry while walking because it could compromise their balance. Clinical Trials Number: NCT03916562.
Dorsoradial Capsulodesis for Stage I Trapeziometacarpal Joint Arthrosis
Authors: Koehler Logan R. , Rayan Ghazi M. 
Published: June 2021

Background: Thumb trapeziometacarpal (TM) joint arthrosis is a common cause of thumb pain, which adversely affects hand function. Early arthrosis is characterized by capsular laxity, painful pinch and grip, and physical findings of joint tenderness and laxity. Dorsoradial capsulodesis (DRC) is a surgical technique used to stabilize the TM joint and treat early-stage arthrosis. We aim to evaluate the clinical outcomes of DRC for treating trapeziometacarpal instability in early-stage disease. Methods: Between 2003 and 2019, 23 patients underwent DRC. Patients with stage I TM arthritis and more than 6-month postoperative follow-up were included. Pain and disability scores were calculated along with physical examination and radiographic evaluation at the final follow-up. Results: At mean postoperative follow-up of 43.5 months, 13 patients with a mean age of 39.1 years were examined. The mean Disabilities of the Arm, Shoulder, and Hand score was 5.7, and visual analog pain score was 0.5. Patients had no significant difference in strength or range of motion in the ipsilateral versus contralateral hand. Follow-up radiographs did not demonstrate arthritic changes. Conclusions: Dorsoradial capsulodesis is a technically simple and reasonable option for stabilizing the TM joint in patients with early-stage arthrosis. This intervention showed no midterm progression to advanced arthritis in this cohort.
High flow nasal cannula oxygenation in COVID-19 related acute respiratory distress syndrome: a safe way to avoid endotracheal intubation?
Authors: Delbove Agathe , Foubert Ambroise , Mateos François , Guy Tiphaine , Gousseff Marie 
Published: June 2021

Backgrounds: High flow nasal cannula (HFNC) is an alternative therapy for acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19). This study aimed first to describe outcomes of patients suffering from COVID-19-related ARDS treated with HFNC; secondly to evaluate safety of HFNC (patients and healthcare workers) and compare patients according to respiratory outcome. Methods: A retrospective cohort was conducted in French general hospital intensive care unit (ICU). Patients were included if receiving HFNC for hypoxemia (saturation pulse oxygen (SpO2) <92% under oxygen ⩾6 L/min) associated with ARDS and positive SARS-CoV-2 polymerase chain reaction (PCR). Main clinical characteristics and outcomes are described in patients: (a) with do not intubate order (HFNC-DNIO); (b) who did not need intubation (HFNC-only); and (c) eventually intubated (HFNC-intubation). Medians are presented with (1st–3rd) interquartile range. Results: From 26 February to 30 June 2020, 46 patients of median age 75 (70–79) years were included. In the HFNC-DNIO group ( n = 11), partial arterial oxygen pressure (PaO2)/inhaled fraction of oxygen (FiO2) ratio median worst PaO2/FiO2 ratio was 109 (102–172) and hospital mortality was 54.5%. Except the HFNC-DNIO patients ( n = 35), 20 patients (57%) were eventually intubated (HFNC-intubation group) and 15 were only treated by HFNC (HFNC-only). HFNC-intubation patients presented higher worst respiratory rates per minute in ICU [37 (34–41) versus 33 (24–34) min, p < 0.05] and worsened ICU admission PaO2/FiO2 ratios [121 (103–169) versus 191 (162–219), p < 0.001] compared with HFNC-only patients. Hospital mortality was 35% ( n = 7/20) in HFNC-intubation group, 0% in HFNC-only group with a global mortality of these two groups of 20% ( n = 7/35). Among tests performed in healthcare workers, 1/12 PCR in symptomatic healthcare workers and 1.8% serologies in asymptomatic healthcare workers were positive. After review of each case, COVID-19 was likely to be acquired outside hospital. Conclusions: HFNC seems to be useful for COVID-19-related ARDS and safe for healthcare workers. ARDS severity with PaO2/FiO2 <150 associated with respiratory rate >35/min could be regarded as a predictor of intubation. The reviews of this paper are available via the supplemental material section.
The Effectiveness and Safety of Intrathecal Fluorescein in the Management of Cerebrospinal Fluid Leaks
Authors: Jolly Karan , Gupta Keshav Kumar , Banota Abishek , Ahmed Shahzada K. 
Published: June 2021

Background Cerebrospinal fluid (CSF) leaks can be associated with significant morbidity such as meningitis. Surgical management has proven effective, with endoscopic approaches having become the gold standard due to success rates >90%. Inability to localise the leak site prior to surgery is associated with surgical failure. The use of intrathecal fluorescein (IF) to localise CSF fistulae sites was first demonstrated in 1960. Despite this, its use in this context is unlicensed. Objective Evaluate the safety and efficacy of IF use in the management of CSF leak repairs in our centre. Methods All patients who underwent endoscopic repair of CSF fistula by a single surgeon where IF was used between January 2010 – September 2019 at a single-centre (tertiary skull base referral unit in the United Kingdom) were retrospectively analysed. Primary outcome measures were localisation of CSF fistula with IF (efficacy) and peri-operative complications likely to be attributable to IF (safety). Results There were 55 patients included (60 procedures) with a positive localisation rate of 90.0% with IF. The overall peri-operative complication rate was 8.3% (n = 5). It is likely that none were related to IF use. However, three complications may be linked giving a complication rate potentially related to IF of 5.0%. There were no peri-operative mortalities. Conclusion Many studies have demonstrated IF to be safe at low doses (<50mg) with a high sensitivity, specificity and positive predicative value. Our results demonstrate that the use of IF in our centre is safe and effective at identifying CSF fistulae. While we have reported some complications in our cohort, these were unlikely to be directly attributable IF use. We have described no serious complications such as seizures, limb weakness or death. We believe this study adds to the growing body of evidence that IF use in the management CSF fistula repairs is safe and effective.
Reliability and validity of a computer game-based tool of upper extremity assessment for object manipulation tasks in children with cerebral palsy
Authors: Kanitkar Anuprita , Parmar Sanjay T , Szturm Tony J , Restall Gayle , Rempel Gina , Naik Nilashri , Gaonkar Neha , Sepehri Nariman , Ankolekar Bhavana 
Published: June 2021

Introduction A computer game-based upper extremity (CUE) assessment tool is developed to quantify manual dexterity of children with Cerebral Palsy (CP). The purpose of this study was to determine test-retest reliability of the CUE performance measures (success rate, movement onset time, movement error, and movement variation) and convergent validity with the Peabody Developmental Motor Scale version 2 (PDMS-2) and the Quality of Upper Extremity Skills Test (QUEST). Methods Thirty-five children with CP aged four to ten years were tested on two occasions two weeks apart. Results CUE performance measures of five chosen object manipulation tasks exhibited high to moderate intra-class correlation coefficient (ICC) values. There was no significant difference in the CUE performance measures between test periods. With few exceptions, there was no significant correlation between the CUE performance measures and the PDMS-2 or the QUEST test scores. Conclusions The high to moderate ICC values and lack of systematic errors indicate that the CUE assessment tool has the ability to repeatedly record reliable performance measures of different object manipulation tasks. The lack of a correlation between the CUE and the PDMS-2 or QUEST scores indicates that performance measures of these assessment tools represent distinct attributes of manual dexterity.