bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lived Experience of Medicine Nurses Caring for COVID-19 Patients
Authors: Mohammed Natasha , Lelièvre Hannah 
Published: August 2021

Background:
The COVID-19 pandemic has overwhelmed health care systems globally. To understand how health care systems can best support frontline health care providers caring for patients in similar situations, it is necessary to gain insights into their experience.

Purpose:
This quality improvement study explored the lived experience of Canadian frontline medicine nurses caring for COVID-19 patients during the first wave of the pandemic.

Method:
A qualitative interpretive phenomenological approach was conducted. Forty-three eligible nurses participated in semistructured interviews and online surveys. Full transcription and thematic content analysis were performed.

Results:
Three overarching themes were deduced: (1) a traumatic experience, (2) living through the experience, and (3) achieving transcendence.

Conclusion:
Several recommendations were identified. These recommendations aim to aid health care systems in emergency preparation planning and future pandemic responses while supporting frontline health care providers' resilience and well-being.
Seated postural control measure: Italian translation and validation in children with cerebral palsy
Authors: Tofani Marco , Blasetti G Giulia , Lucibello Luca , Sabbadini Maurizio , Berardi Anna , Galeoto Giovanni , Field Debra , Castelli Enrico 
Published: August 2021

Background:Seating interventions are part of the postural management program recommended for children with Cerebral Palsy (CP) who are nonambulatory or have difficulty in walking. The lack of validated outcome measures for assessing seating interventions limits access to obtain valid and comparable data internationally.Objective:To translate the Seated Postural Control Measure (SPCM) into Italian and assess reliability and validity of the translated measure in a population of children with CP.Study design:Cross-sectional and repeated measures study.Methods:The original version of the SPCM was translated and culturally adapted by a multidisciplinary team according to international guidelines. Internal consistency was examined with Cronbach's alpha. Both inter- and intrarater reliabilities were estimated using intraclass correlation coefficients with 95% confidence intervals. Intrarater reliability was estimated over a 1-week period. Convergent construct validity was investigated by comparing SPCM values with the Level of Sitting Scale, the Gross Motor Function Classification System, and the Manual Ability Classification System using Pearson's correlation coefficients.Results:The Italian version of the SPCM (IT-SPCM) was evaluated on 72 children with CP aged 4–18 years. Cronbach's alpha was 0.83, 0.95, and 0.93 for IT-SPCM alignment subscale, IT-SPCM functioning subscale, and total score, respectively. Reliability for IT-SPCM total score was high for both inter- and intrarater reliabilities (0.95 and 0.93). The IT-SPCM total score was moderately correlated with the Level of Sitting Scale (0.37), Gross Motor Function Classification System (−0.41), and Manual Ability Classification System (−0.56).Conclusion:Preliminary evidence supports the reliability and validity of using IT-SPCM with a population of children with CP.
The Effects of Local Alendronate With or Without Recombinant Human Bone Morphogenetic Protein 2 on Dental Implant Stability and Marginal Bone Level: A Randomized Controlled Study
Authors: Al-Assaf Dhuha A. , Bede Salwan Y. 
Published: August 2021

AbstractThe aim of this study was to evaluate the effects of local application of bisphosphonate gel and recombinant human bone morphogenic protein 2 gel, on titanium dental implant stability and marginal bone level. Twenty-seven patients with upper and lower missing posterior tooth/teeth were included in the study with a total of 71 implants that were used for rehabilitation. The implants were randomly divided into 4 groups: 3 study groups and 1 control. Group1; local application of bisphosphonate gel, group 2; local application of recombinant human bone morphogenic protein 2 gel, group 3; local application of a mixed formula of both gels. The gel application was immediately preimplant insertion, group 4; implant insertion without application of any medication. Using resonance frequency analyzer, implant stability was measured 4 times; primary, 8 weeks (second stage surgery), 12 weeks, and at least 14 weeks post functional loading. The level of the marginal bone around each implant were assessed using cone beam computed tomography. Four implants failed. Generally, there was a similar pattern of changes in implant stability over the study period in all groups and the stability was dependent on the healing time with no significant difference between groups. There was no significant treatment effect regarding marginal bone level differences of study groups against control, although there were significant differences on palatal and mesiodistal surfaces among the study (test) groups.
The Opportunity Cost of Resident Involvement in Adult Craniofacial Surgery: An Analysis of Relative Value Units
Authors: Khetpal Sumun , Phillips Sarah , Parsaei Yassmin , Peck Connor , Lopez Joseph , Prsic Adnan 
Published: August 2021

Purpose:
Within the academic surgical setting resident involvement may confer longer operative times. The increasing pressures to maximize clinical productivity and decreasing reimbursement rates, however, may conflict with these principles. This study calculates the opportunity cost of resident involvement in craniofacial surgery.

Methods:
Retrospective analysis was conducted with patients who underwent craniofacial procedures from the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2012. Patients were selected based on relevant Current Procedural Terminology codes for craniofacial pathologies (ie, trauma, head and neck reconstruction, orthognathic surgery, and facial reanimation). Variables included patient demographics, operative time, and presence or absence of resident trainee. Average relative value units were calculated to determine the opportunity cost of resident involvement for each craniofacial procedure.

Results:
In total, 2096 patients were identified through the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2012. Resident involvement was associated with a statistically significant higher operative time (P < 0.001) for facial reanimation, facial trauma, orthognathic surgery, and head and neck reconstruction. The opportunity costs per case associated with resident involvement were the highest for head and neck reconstruction ($1468.04), followed by orthognathic surgery ($1247.03), facial trauma ($533.03), and facial reanimation ($358.32). Resident involvement was associated with higher rate of complications for head and neck reconstruction (P < 0.043).

Conclusions:
Resident involvement is associated with longer operative times, higher complications, and higher re-operations, compared to attending exclusive surgical care. Future studies may consider how reimbursements should align incentives to promote resident education and training.
Short-Term Stability After Segmental Le Fort I Maxillary Impaction Surgery With Mandibular Autorotation in Seven High-Angle Class II Patients: A Case Series
Authors: Takahara Namiaki , Tomomatsu Nobuyoshi , Hsieh Diana , Kurasawa Yasuhiro , Morita Kei-ichi , Yoda Tetsuya 
Published: August 2021

Purpose:
To retrospectively evaluate skeletal stability after Le Fort I maxillary impaction surgery and mandibular autorotation without bilateral sagittal split osteotomy (BSSO) in high-angle class II patients.

Materials and Methods:
Seven female high-angle class II patients who underwent maxillary impaction surgery and mandibular autorotation without bilateral sagittal split osteotomy were included in this study. Surgical changes and relapse were measured on lateral cephalograms taken preoperatively and at 1 month, 6 months and 1 year postoperatively.

Results:
The horizontal movement of the maxilla at point A was 5.8 ± 3.3 mm backward, and the upward movement at the posterior nasal spine was 3.3 ± 1.4 mm. The mean horizontal change at point A during the 1-year follow-up period was 0.1 ± 0.2 mm, and the vertical change at posterior nasal spine was 0.2 ± 1.3 mm, which were not statistically significant. The horizontal surgical change at point B was 4.0 ± 1.8 mm forward and the vertical surgical change at point B was 4.7 ± 1.8 mm upward. Postoperative relapse was 10.9% and 13.7% in the horizontal and vertical directions, respectively.

Conclusions:
Le Fort I maxillary impaction surgery with mandibular autorotation may be 1 of the suitable procedures for high-angle class II patients.
Randomized trials on non-pharmaceutical interventions for COVID-19 as of August 2021: a meta-epidemiological analysis
Authors: Hirt Julian , Janiaud Perrine , Hemkens Lars G. 
Published: August 2021

AbstractBackgroundNumerous non-pharmaceutical interventions (NPIs) were taken worldwide to contain the spread of the COVID-19 pandemic. We aimed at providing an overview of randomized trials assessing NPIs to prevent COVID-19.MethodsWe included all randomized trials assessing NPIs to prevent COVID-19 in any country and setting registered in ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform using the COVID-evidence platform (until 17 August 2021). We searched for corresponding publications in MEDLINE/PubMed, Google Scholar, the Living Overview of Evidence platform (L-OVE), and the Cochrane COVID-19 registry as well as for results posted in registries.ResultsWe identified 41 randomized trials. Of them, 11 were completed (26.8%) including 7 with published results. The 41 trials planned to recruit a median of 1,700 participants (IQR, 588 to 9,500, range 30 to 35,256,399) with a median planned duration of 8 months (IQR, 3 to 14, range 1 to 24). Most came from the United States (n=11, 26.8%). The trials mostly assessed protective equipment (n=11, 26.8%), COVID-19-related information and education programs (n=9, 22.0%), access to mass events under specific safety measures (n=5, 12.2%), testing and screening strategies (n=5, 12.2%), and hygiene management (n=5, 12.2%).ConclusionsWorldwide, 41 randomized trials assessing NPIs have been initiated with published results available to inform policy decisions for only 7 of them. A long-term research agenda including behavioral, environmental, social, and systems level interventions is urgently needed to guide policies and practices in the current and future public health emergencies.
Localized and Whole-Room Effects of Portable Air Filtration Units on Aerosol Particle Deposition and Concentration in a Classroom Environment
Authors: Kong Meng , Li Linhao , Eilts Stephanie M. , Li Li , Hogan Christopher J. , Pope Zachary C. 
Published: August 2021

AbstractIn indoor environments with limited ventilation, recirculating portable air filtration (PAF) units may reduce COVID-19 infection risk via not only the direct aerosol route (i.e., inhalation) but also via an indirect aerosol route (i.e., contact with the surface where particles deposited). We systematically investigated the impact of PAF units in a mock classroom, as a supplement to background ventilation, on localized and whole-room surface deposition and particle concentration. Fluorescently tagged particles with a volumetric mean diameter near two micrometers were continuously introduced into the classroom environment via a breathing simulator with a prescibed inhalation-exhalation waveform. Deposition velocities were inferred on >50 horizontal and vertical surfaces throughout the classroom, while aerosol concentrations were spatially monitored via optical particle spectrometry. Results revealed a particle decay rate consistent with expectations based upon the reported clean air delivery rates of the PAF units. Additionally, the PAF units reduced peak concentrations by a factor of around 2.5 compared to the highest concentrations observed and led to a statistically significant reduction in deposition velocities for horizontal surfaces >2.5 m from the aerosol source. Our results not only confirm PAF units can reduce particle concentrations but also demonstrate that they may lead to reduced particle deposition throughout an indoor environment when properly positioned.Practical ImplicationsPortable air filtration units should be prioritized in classrooms as part of a multi-layed strategy to mitigate potentially infectious particle transmission by direct aerosol transmission via inhalation and indirect aerosol transmission via particle deposition to surfaces and later contact with said surfaces.When placing portable air filtration unit(s) within a classrom space, one should consider the airflow field within the classroom, the characteristic operational mode (heating vs. cooling) of the heating, ventilation, and air conditioning system, the predominantly occupied areas of the classroom, and interference with the regular teaching and learning activities.
Predictive factors of response to 3rd dose of COVID-19 mRNA vaccine in kidney transplant recipients
Authors: Charmetant Xavier , Espi Maxime , Barba Thomas , Ovize Anne , Morelon Emmanuel , Thaunat Olivier 
Published: August 2021

AbstractOnly a minority of kidney transplant recipients (KTRs) develop protective neutralizing titers of anti-receptor binding domain of spike protein (RBD) IgG after two doses of mRNA COVID-19 vaccine. Administration of a third dose of mRNA vaccine to KTRs with sub-optimal response increase anti-RBD IgG titers but with high inter-individual variability. Patients with the higher response rate to the third dose of vaccine can be identified by the presence of low anti-RBD IgG titers and spike-specific CD4+ T cells in their circulation 14 days after the second dose.
CLINICAL OPPORTUNITIES FOR GERMLINE PHARMACOGENETICS AND MANAGEMENT OF DRUG-DRUG INTERACTIONS IN PATIENTS WITH ADVANCED SOLID CANCERS
Authors: Shugg Tyler , Ly Reynold C. , Rowe Elizabeth J. , Philips Santosh , Hyder Mustafa A. , Radovich Milan , Rosenman Marc B. , Pratt Victoria M. , Callaghan John T. , Desta Zeruesenay , Schneider Bryan P. , Skaar Todd C. 
Published: August 2021

ABSTRACTPURPOSEPrecision medicine approaches, including germline pharmacogenetics (PGx) and management of drug-drug interactions (DDIs), are likely to benefit advanced cancer patients who are frequently prescribed multiple concomitant medications to treat cancer and associated conditions. Our objective was to assess the potential opportunities for PGx and DDI management within a cohort of adults with advanced cancer.PATIENTS AND METHODSMedication data were collected from the electronic health records (EHRs) for 481 subjects since their first cancer diagnosis. All subjects were genotyped for variants with clinically actionable recommendations in Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for 13 pharmacogenes. DDIs were defined as concomitant prescription of strong inhibitors or inducers with sensitive substrates of the same drug-metabolizing enzyme and were assessed for six major cytochrome P450 (CYP) enzymes.RESULTSApproximately 60% of subjects were prescribed at least one medication with CPIC recommendations, and ∼14% of subjects had an instance for actionable PGx, defined as prescription of a drug in a subject with an actionable genotype. The overall subject-level prevalence of DDIs and serious DDIs were 50.3% and 34.8%, respectively. Serious DDIs were most common for CYP3A, CYP2D6, and CYP2C19, occurring in 24.9%, 16.8%, and 11.7% of subjects, respectively. When assessing PGx and DDIs together, ∼40% of subjects had at least one opportunity for a precision medicine-based intervention and ∼98% of subjects had an actionable phenotype for at least one CYP enzyme.CONCLUSIONOur findings demonstrate numerous clinical opportunities for germline PGx and DDI management in adults with advanced cancer.
Waning immunity of the BNT162b2 vaccine: A nationwide study from Israel
Authors: Goldberg Yair , Mandel Micha , Bar-On Yinon M. , Bodenheimer Omri , Freedman Laurence , Haas Eric J. , Milo Ron , Alroy-Preis Sharon , Ash Nachman , Huppert Amit 
Published: August 2021

ABSTRACTBackgroundStarting December 2020, Israel began a mass vaccination campaign against coronavirus administering the Pfizer BNT162b2 vaccine, which led to a sharp curtailing of the outbreak. After a period with almost no SARS-CoV-2 infections, a resurgent COVID-19 outbreak initiated mid June 2021. Possible reasons for the breakthrough were reduced vaccine effectiveness against the Delta variant, and waning immunity. The aim of this study was to quantify the extent of waning immunity using Israel’s national-database.MethodsData on all PCR positive test results between July 11-31, 2021 of Israeli residents who became fully vaccinated before June 2021 were used in this analysis. Infection rates and severe COVID-19 outcomes were compared between individuals who were vaccinated in different time periods using a Poisson regression, stratifying by age group and adjusting for possible confounding factors.ResultsThe rates of both documented SARS-CoV-2 infections and severe COVID-19 exhibit a statistically significant increase as time from second vaccine dose elapsed. Elderly individuals (60+) who received their second dose in March 2021 were 1.6 (CI: [1.3, 2]) times more protected against infection and 1.7 (CI: [1.0, 2.7]) times more protected against severe COVID-19 compared to those who received their second dose in January 2021. Similar results were found for different age groups.ConclusionsThese results indicate a strong effect of waning immunity in all age groups after six months. Quantifying the effect of waning immunity on vaccine effectiveness is critical for policy makers worldwide facing the dilemma of administering booster vaccinations.
Analysis of Mutational Profile of Hypopharyngeal and Laryngeal Head and Neck Cancers Identifies KMT2C as a Potential Tumor Suppressor
Authors: Machnicki Marcin M. , Rzepakowska Anna , Janowska Joanna I. , Pepek Monika , Krop Alicja , Pruszczyk Katarzyna , Stawinski Piotr , Rydzanicz Malgorzata , Grzybowski Jakub , Gornicka Barbara , Wnuk Maciej , Ploski Rafal , Osuch-Wojcikiewicz Ewa , Stoklosa Tomasz 
Published: August 2021

AbstractHypopharyngeal cancer represents one of worst types of head and neck tumors with only few studies focusing on the genomic profile of this type of cancer. Using targeted next-generation sequencing we analyzed 48 HPV-negative tumor samples including 23 originating from hypopharynx, and 25 from larynx. Among genes previously described as significantly mutated, TP53, FAT1, NOTCH1, KMT2C and CDKN2A were found to be most frequently mutated. We also found that more than three-fourths of our patients harbored candidate actionable or prognostic alterations in genes belonging to RTK/ERK/PI3K, cell-cycle and DNA-damage repair pathways. Using previously published data we compared 67 hypopharyngeal cancers to 595 head and neck cancers from other sites and found no prominent differences in mutational frequency except for CASP8 and HRAS genes. Since we observed relatively frequent mutations of KTM2C (MLL3) in our dataset, we analyzed their role in vitro by generating KMT2C-mutant hypopharyngeal cancer cell line FaDu with CRISPR-Cas9. We demonstrate that KMT2C loss-of-function results in increased colony formation and proliferation, in concordance with its previously published results. In summary, our results show that mutational profile of hypopharyngeal cancers might be similar to the one observed for other head and neck cancers with respect to minor differences and includes multiple candidate actionable and prognostic genetic alterations. We also demonstrate for the first time that KMT2C gene may play a role of tumor suppressor in head and neck cancer, which opens new possibilities in the search for new targeted treatment approaches.
Policy-relevant indicators for invasive alien species assessment and reporting
Authors: McGeoch Melodie A. , Arlé Eduardo , Belmaker Jonathan , Buba Yehezkel , Clarke David A. , Essl Franz , García-Berthou Emili , Groom Quentin , Henriksen Marie V. , Jetz Walter , Kühn Ingolf , Lenzner Bernd , Meyer Carsten , Pagad Shyama , Pili Arman , Roigé Mariona , Seebens Hanno , Tingley Reid , Vicente Joana R. , Wilson John R.U. , Winter Marten 
Published: August 2021

AbstractInvasive alien species are repeatedly shown to be amongst the top threats to biodiversity globally. Robust indicators for measuring the status and trends of biological invasions are lacking, but essential for monitoring biological invasions and the effectiveness of interventions. Here, we formulate and demonstrate three such indicators that capture the key dimensions of species invasions, each a significant and necessary advance to inform invasive alien species policy targets: 1) Rate of Invasive Alien Species Spread, which provides modelled rates of ongoing introductions of species based on invasion discovery and reporting. 2) Impact Risk, that estimates invasive alien species impacts on the environment in space and time and provides a basis for nationally targeted prioritization of where best to invest in management efforts. 3) Status Information on invasive alien species, that tracks improvement in the essential dimensions of information needed to guide relevant policy and data collection and in support of assessing invasive alien species spread and impact. We show how proximal, model-informed status and trend indicators on invasive alien species can provide more effective global (and national) reporting on biological invasions, and how countries can contribute to supporting these indicators.
Evaluation of Residual Disinfectant Levels in Public Drinking Water Distribution Systems in Relation to anAcanthamoebaKeratitis Outbreak—Illinois 2002–2009
Authors: Holsinger Hannah , Blackstock Anna , Shaw Susan , Roy Sharon L. 
Published: August 2021

AbstractAcanthamoebakeratitis (AK) is a painful, potentially blinding eye disease associated with contact lens use and corneal injury. AK, caused by the free-living amoebaAcanthamoeba, is ubiquitous in the environment and has been isolated from municipal water supplies. It can be tolerant of normal chlorine levels in drinking water. An AK outbreak investigated in 2003–2005 in five Illinois counties showed a lower AK age-standardized rate ratio in Cook County than in surrounding counties and was hypothesized to be due in part to reductions in residual disinfectant levels (RDLs) in drinking water. We evaluated RDLs in public water systems in the same five Illinois counties over eight years (2002–2009) using a multivariable model of water system RDL measurements. Fitted RDLs for each county were in the acceptable range by United States Environmental Protection Agency standards for the entire study period. After correcting for multiple testing, two of the surrounding counties had fitted RDLs that differed from Cook County for one year—this pattern differed from the epidemiologic pattern of cases observed in the AK outbreak. Our findings do not support the hypothesis that the development of AK was associated with changes in RDLs in the five Illinois counties.