Medicine and Biomedical Sciences

Goodbye 2020! Elmahdi A Elkhammas, Salem Arifi Beshyah Ibnosina Journal of Medicine and Biomedical Sciences 2020 12(4):235-236

Characterizing lung cancer in Libya: A stepping stone toward a better lung cancer care in the country Wanis H Ibrahim, Tasleem Raza Ibnosina Journal of Medicine and Biomedical Sciences 2020 12(4):237-239

Ramadan fasting in health and disease (2019): A narrative review Khawla F Ali, Sara A Abdulla, Amal Badi, Khadija Hafidh, Salem Arifi Beshyah Ibnosina Journal of Medicine and Biomedical Sciences 2020 12(4):240-257 Introduction: Literature on the health aspects of Ramadan fasting (RF) is widespread in many journals, making it less readily available to those interested in the subject. Materials and Methods: This is a narrative, nonsystematic review of international literature from two major online databases (viz., Scopus and PubMed) in 1 year (2019). The search term “RF” was used, and relevant literature was narrated in a concise thematic account excluding diabetes. Results: The publications spanned the fundamental, clinical, ethical, professional, cultural, and advocacy facets of the subject. The publications crossed the conventional disciplinary lines and geographical locations and appeared in journals with different access systems. The content is presented under relevant themes depending on the available literature. Basic coverage included changes in physiology, nutrition, and metabolism during Ramadan. Clinical aspects such as the impact of RF on kidney function, pregnancy outcome, fetal life, structure and function of eyes, and athletes' well-being received comparatively prominent coverage by researchers in 2019. Gut, liver, skin, skeleton, and blood were also covered. Other workers focused on documenting the perception, attitudes, and practices of both patients and health-care professionals during Ramadan. Conclusions: The health aspects of RF received sustained academic interest with a wide spectrum in 2019. We provided a scoping overview to help researchers and clinicians catch up quickly with the state-of-the-art today.

Mental health of health-care workers during the COVID-19 pandemic Walaa Mogassabi, Waqar Mogassabi, Maram Saliba, Rana M Emam, Wanis H Ibrahim Ibnosina Journal of Medicine and Biomedical Sciences 2020 12(4):258-263 Besides its effects on physical health, the coronavirus disease 2019 (COVID-19) pandemic has resulted in adverse consequences on mental health of health-care workers. Several factors such as safety concerns and fear of infecting self or family members, social isolation measures, strict infection control procedures, lack of protective measures, exhaustion due to increased duration of working, and seeing patients die or colleagues infected can contribute to the development of mental health problems in health-care workers during the current COVID-19 pandemic. Some health-care staff including nurses, advanced practice providers, frontline health-care workers, and health-care workers who have children are more vulnerable to these mental health problems. Prevention of infection and staff burnout in health-care workers, provision of a timely mental health care, and social support are among the most important measures to provide a mental health care for health-care workers during the current COVID-19 pandemic.

An analysis of gut dysbiosis in obesity, diabetes, and chronic gut conditions Ahmed Haleem, Sama Anvari, Aisha Nazli, Mohamed Sager, Mahmood Akhtar Ibnosina Journal of Medicine and Biomedical Sciences 2020 12(4):264-271 Introduction: Gut dysbiosis is an imbalance in the microbial communities of the intestine and has been associated with numerous chronic diseases. Objectives: We aimed to compare gut dysbiosis within and across various disease states (Crohn's disease [CD], colorectal cancer [CRC], irritable bowel syndrome [IBS], and type 2 diabetes mellitus [T2DM], and obesity). Materials and Methods: Assessing comparative studies which examined levels of bacterial phyla in cases and controls. PubMed and Web of Science were searched to identify relevant studies, in which human fecal samples were used to analyze microbial flora. Results: Twenty-one studies were included, which met inclusion and exclusion criteria. Three studies were included assessing IBS, which found a decrease in Bacteroidetes in the IBS population, but inconsistent findings for other phyla. Six studies were included assessing obesity, and no consistent patterns emerged. Five studies were included examining T2DM, which found a consistent decrease in the Firmicutes/Bacteroidetes ratio in cases as compared to controls. No patterns were found for other phyla. Three studies were included examining CD, and five examining CRC. Conclusions: No consistent patterns were found for either of these diseases. While some patterns were found in bacterial phyla distribution, there were few commonalities, even in same-system disorders. However, uncovering underlying dysbiosis patterns shows great promise in furthering the understanding of disease pathogenesis and the potential for new therapeutic and diagnostic interventions. Further systematic reviews and well-controlled studies are warranted.

Trends, and tumor characteristics of lung cancer and malignant pleural mesothelioma in the East of Libya Wail A Eldukali, Khaled Elmahdi Omran, Raouf Azzuz Ibnosina Journal of Medicine and Biomedical Sciences 2020 12(4):272-279 Background: Lung cancer is the most common cancer worldwide and the leading cancer killer. Lung cancer is classified histologically into two types; small-cell lung cancer and nonsmall-cell lung cancer (NSCLC) (squamous cell carcinoma, adenocarcinoma (AC), large cell carcinoma [LCC]). Malignant pleural mesothelioma is a rare thoracic tumor. We aimed to provide comprehensive epidemiological data about lung cancer in the eastern part of Libya. Patients and Methods: A retrospective medical records review of lung cancer patients attending the oncology department of Benghazi Medical Center from January 1, 2006 to December 31, 2015. Results: There were 684 lung cancer cases out of 7725 total registered cancer cases (8.85%), 627 were male (91.7%, median age 63.5), and 57 females (8.3%, median age 64). NSCLC was the dominant histology 78.5%, SCLC 11%, and malignant mesothelioma 2.5%. NSCLC subtypes were AC (35.1%), squamous carcinoma (25.7%), LCC (4.6%), and not otherwise specified (12.6%). Only 30.6% of cases were diagnosed in Libya, the most commonly used diagnostic modalities were bronchoscopic biopsy 46.6%, and computed tomography guided biopsy 17.4%. Only 18 cases were tested for epidermal growth factor receptor sensitizing mutations and anaplastic lymphoma kinase rearrangement fusion. Stage IV was the most common initial stage for NSCLC 60%, malignant mesothelioma 47.1%, and 74.7% of SCLC presented with extensive disease. Only 42.9% of males and 5.3% of female lung cancer patients were smokers. Conclusions: Lung cancer is a major health burden in Libya, and it is increasing in incidence; this epidemiological study tries to put this problem into public health and clinical perspective.

Impact of COVID-19 on educational and academic activities of health-care professionals: An international survey of doctors, dentists and nurses. Hussain Alsaffar, Haider Al Saffar, Khadija Ali, Fahad Aljaser, Amar Mahdi, Manar Muhammad, Salwa Alaidarous, Najwa Rbiai, Iyad Ahmed, Foued Abdelaziz, Asma Deeb Ibnosina Journal of Medicine and Biomedical Sciences 2020 12(4):280-287 Introduction: The COVID-19 pandemic has affected the whole world in different levels from numerous aspects. This deadly, highly contagious viral infection has led to lockdown in many cities across the world; significantly disrupting previously planned educational activities. Objectives: We aim to evaluate the impact of the COVID-19 pandemic on the educational and academic activities of the health care professionals practicing in different countries. Subjects and Methods: A cross-sectional survey was conducted using a link to an online questionnaire which was sent to doctors, dentists and nurses working in several countries using WhatsApp medical groups. The questionnaire consisted of eight questions related to the impact of COVID-19 on educational and academic activities of the health care professionals (HCPs). Results: 898 responses received from doctors (66.5%), nurses (21%) and dentist (12.5%), working in 36 countries. 66.6% of respondents think their academic activities are less than what it was before the pandemic. However, 63% of participants have attended more webinars and 58% have completed more on-line courses and e-learning sessions during the pandemic. Conclusions: COVID-19 pandemic negatively impacted the academic activities of HCPs. However, COVID-19 health crisis created an opportunity for enriching the educational activities through e-learning, online courses, and webinars. This experience should be in the future, with more online material available.

Predictors of dental general anesthesia receipt among children attending a tertiary hospital in Saudi Arabia Mostafa A Abolfotouh, Ghaida A Alhumaidan, Bashaer Y Almalki, Alanoud H Alhasson, Ibraheem Bushnak, Abdallah Adlan Ibnosina Journal of Medicine and Biomedical Sciences 2020 12(4):288-294 Aim: Children are normally treated in a dental chair, despite that some may have their treatment done under dental general anesthesia (DGA). Factors affecting the decision on DGA include the quality and quantity of treatment needed and child's age and cooperation. This study aimed to estimate the prevalence of DGA among children with dental caries and to identify the associated factors in a tertiary care setting in Saudi Arabia. Methods: A cross-sectional study of 400 children with dental caries was conducted. Data were collected from the patients' records including demographic, behavioral, and clinical information, diagnosis using caries indexes (Decayed, Missing, Filled Teeth/decayed filled teeth [dft]), and number of DGA and its indications. Logistic regression analysis was applied to identify the predictors of DGA, and significance was considered at P ≤ 0.05. Results: The study included 400 children; 55% of them were below the age of 6 years, with a mean age of 6.4 ± 2.3 years. About one-half of children were males (51.7%) and unhealthy (48.2%). The majority were of negative behavior (70.7%) and noncomplaint to dental appointments (70.3%). More than three-fourth of children (78.5%) experienced one or more DGA. GA use was significantly associated with gender (χ2 = 4.30, P < 0.04), age (t = 12.37, P < 0.0001), health status (χ2 = 16.02, P < 0.0001), dft index (z = 11.44, P < 0.0001), child behavior (χ2 = 48.54, P < 0.0001), age at the first dental visit (t = 11.73, P < 0.0001), number of dental treatment visits (z = 11.14, P < 0.0001) and dental preventive visits (z = 7.21, P < 0.0001) before the index dental visit, and compliance with dental appointments (χ2 = 39.50, P < 0.001). However, after adjusting for confounders, using the logistic regression analysis, DGA use was predicted by unhealthy children (odds ratio [OR] = 27.35, P = 0.002), those with a negative behavior (OR = 18.28, P = 0.003), and those with higher dft index (OR = 1.68, P < 0.001). Conclusions: Noncooperation, general health status, and dental caries level (dft) were the main factors for the decision of DGA. High caries-risk children must be the target for behavioral management to minimize their need for treatment under DGA. Post-DGA appointment to guide the child back to normal dental care is recommended.

Family relations of living-related kidney donors in Tripoli, Libya Jamila Salem Elamouri, Nada Bulgasem Fawaris Ibnosina Journal of Medicine and Biomedical Sciences 2020 12(4):295-299 Introduction: Despite efforts to increase community awareness of kidney donation and transplantation, there remains a huge gap between the number of kidneys needed and those available. Objectives: We aimed to document the types of relationship between donors and recipients of kidney transplants in a previously unexamined community. Patients and Methods: This was a descriptive retrospective study of 454 living-related kidney transplant patients registered during 2019 in the posttransplant clinic at the National Centre for Organ Transplantation, Tripoli, Libya. Demographic data and the type of relationship between recipients and donors were studied. Results: There was a male donor predominance (67.4%), with a male-to-female ratio of 2: 1. The mean age of the donors was 34.2 ± 10.27 years. The sibling constituted the majority (62.2%) of donors, with brother predominance. They were followed by off-spring donors (17.6%), with a predominance of sons and parents (12.4%), with mothers acting as donors more than fathers. Donation from spouses was relatively infrequent (3.5%). Conclusions: The study revealed that brothers are the most common donor and all donors more commonly donate to male recipients, except mothers who donate more commonly to female recipients. This may be reflective of the sociocultural factors. More social awareness is needed regarding organ donation, especially among females, to increase their contribution in donation.

Predisposing factors and health-care utilization in liver transplant recipients with takotsubo cardiomyopathy: A national analysis Kishan Patel, Salman K Bhatti, Sylvester M Black, Kyle Porter, James Hanje, Khalid Mumtaz Ibnosina Journal of Medicine and Biomedical Sciences 2020 12(4):300-306 Aims and Objectives: Takotsubo cardiomyopathy (TCMP) is an acquired cardiomyopathy associated with physical, emotional, and surgical stress. Current literature on TCMP in liver transplant recipients (LTRs) is limited to case reports and case series. Methods: The Nationwide Readmission Database was utilized to identify all adults with an index admission for LT between 2010 and 2014 who developed TCMP. The prevalence of TCMP at the LT admission or readmission within the calendar year was examined. Predictors of development and health-care utilization of patients with and without TCMP in LTR were compared. Multivariable regression analysis was performed. Results: The prevalence of TCMP in LTRs was found to be 0.5% (141/28,067). Most of these patients developed early TCMP on the index admission for LT (n = 115; 82%). Older (57.5 ± 1.3 vs. 55.1 ± 0.3 years, P < 0.001) females (adjusted odds ratio [aOR]: 2.27; confidence interval [CI]: 1.20–4.27; P = 0.01) with ≥4 Elixhauser comorbidity (aOR: 2.36; CI: 1.15–4.83; P = 0.02) were predisposed to develop TCMP in LTRs. LT at a medium-sized center (aOR: 0.17; CI: 0.03–0.88) has a protective effect on the development of TCMP. Increased health-care utilization in the form of mechanical ventilation, hemodialysis, vasopressors, and intra-aortic balloon pumps is observed in patients with TCMP. This resulted in increased length of stay and cost in patients with TCMP. Moreover, increased mortality was seen in patients who developed TCMP within the same calendar year. Conclusion: This is the first report showing the prevalence of TCMP in LTRs to be 0.5%. Older females with increased comorbidity are predisposed to TCMP. Patients who developed TCMP necessitate a higher acuity of medical care and cause an increased health-care burden and ultimately experience an increase in mortality.

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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,

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Primary Care Dentistry and Oral Health

Call for dialogue: Primary care, dentistry, oral medicine, and public health Raman Kumar Journal of Primary Care Dentistry and Oral Health 2020 1(1):1-2 The Journal of Primary Care Dentistry and Oral Health has been established with the aim of promoting interdisciplinary research within an academic domain that is of paramount significance but often neglected the most. Poor oro-dental health leads not only to considerable morbidity but also costs to individuals, community, and governments in economic terms. The primary care setting uniquely offers the opportunity to deliver oral health care to the population as part of a comprehensive health-care package. The editorial team of the journal welcomes all primary care, dental and oral health, and public health professionals to support this unique area of human need through their scholastic work.

Are dentists suicide prone? The current scenario Gunjan Kumar, Payal Dash Journal of Primary Care Dentistry and Oral Health 2020 1(1):3-7 There is a widely discussed belief that dentist are at a high risk for suicide. Since 1960, dental journal have been carrying articles with headline like “The suicidal professions.” While this claim is often accepted without question, there are little reliable data that support the alleged risk and on the contrary few data even suggest the opposite. In India, few cases of suicide among dental student have been reported, but not much data are available. This paper aims at presenting a review of literature related to this complex issue and it shows that occupation is not a major predictor of suicide and it does not explain about why person commit suicide.

Role of curcumin as an antioxidant Tarun Vyas Journal of Primary Care Dentistry and Oral Health 2020 1(1):8-11 In recent years, there is an upsurge in the areas related to newer developments in prevention of diseases, especially the role of free radicals and antioxidants; free radicals are unstable chemicals formed in the body during normal metabolism or exposure to environmental toxins such as pollutants in air, food, and water. Curcumin combined with enhancing agents provides multiple health benefits. Most of these benefits can be attributed to its antioxidant and anti-inflammatory effects. Ingesting curcumin by itself does not lead to the associated health benefits due to its poor bioavailability, which appears to be primarily due to poor absorption, rapid metabolism, and rapid elimination. There are several components that can increase bioavailability. The purpose of this review is to provide a brief overview of the plethora of research regarding the health benefits of curcumin.

Internet addiction and its psychosocial impact on urban adolescents of Kanpur, Uttar Pradesh Rahul Srivastava, Devina Pradhan, Lokesh Sharma, Bhuvan Jyoti, Omveer Singh Journal of Primary Care Dentistry and Oral Health 2020 1(1):12-15 Background: Internet addiction is defined as any online-related, compulsive behavior which interferes with normal living and causes severe stress on family, friends, loved ones, and one's work environment. The adolescents are most vulnerable to the numerous addictive temptations offered by the Internet during the transition phase. The present study aims to evaluate the prevalence of Internet addiction in adolescents of urban areas of Kanpur district and assess the association of Internet addiction with stress, anxiety, and depression. Materials and Methods: A cross-sectional study was conducted among students of higher secondary schools/colleges in the urban areas of Kanpur district in Uttar Pradesh. Out of 105 colleges, 10%, i.e., 10 colleges, were selected randomly and a total of 900 students were enrolled in the study. A pretested, predesigned questionnaire, Young's Internet Addiction Scale, and Depression Anxiety Stress Scales 21 were used in the study. Data distribution was assessed for normality using the Shapiro–Wilk test. Categorical data were compared using the Chi-square test. All values were considered statistically significant for a value of P ≤ 0.05. Results: Majority (61.1%) of the respondents were females, and the mean age was 17.20 years. The prevalence of Internet addiction was 89.78%. The main purpose of using Internet was social networking (54.89%), followed by online gaming/gambling (19.67%) and study (12.89%). About 60.44% of the respondents used Internet for 3–6 h/day and 28.67% of the respondents used Internet for <3 h/day. There was a significant association between Internet addiction and stress (odds ratio = 33.55), depression (odds ratio = 0.99), and anxiety (odds ratio = 5.25). Conclusion: Internet addiction is a much quieter problem, and as such, it may be more readily disregarded or not even recognized as a problem. As parents and caregivers, understanding how to differentiate between normal Internet use and compulsive use is critically important.

Endodontic management of mandibular second premolar with three canals Payal Jain, Shubham Jain, Deepali Jain, Prashant Purandhar Shetty Journal of Primary Care Dentistry and Oral Health 2020 1(1):16-18 Knowledge of root canal morphology has been a complex and utmost important issue regarding the planning and implementation of root canal therapy. In addition to having adequate knowledge on periapical radiographs from different angles, careful examination of pulp chamber floor and the use of technological advances are also salient factors that contribute to the diagnosis of additional roots and canals. The occurrence of three canals with three separate (Type V, Vertucci) foramina in mandibular premolars is very rare. This article reports and discusses the treatment for an atypical occurrence of three canals with three separate foramina in the mandibular second premolar.

Reattachment an immediate esthetic protocol Pradeep Bapna, Darshit Jain, Barkha Udhani, Prashant Purandhar Shetty Journal of Primary Care Dentistry and Oral Health 2020 1(1):19-22 The immediate fragment reattachment is a conservative treatment which allows the restoration of the original dental anatomy thus rehabilitating function and esthetics in a shortest time available. Dentists are confronted with managing dental trauma and restoring fractured teeth on a regular basis. Hence, the technique that speed and simplify treatment, restore esthetics and improve long-term success rate are therefore of potential value and should be considered. Fracture reattachment possess challenging conservative and economically viable procedure within a single visit. This article discusses fragment reattachment technique and presents clinical case of coronal fracture involving enamel, dentin, and pulp.

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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,

Telephone consultation 11855 int 1193,

Cardiovascular Nursing

The Efficacy of Psychological Interventions on Health-Related Quality of Life for Patients with Heart Failure and Depression: A Systematic Review Background Depression is prevalent among adults with chronic heart failure (CHF) and is associated with higher rates of morbidity and mortality and higher healthcare costs. Objectives The aim of this study was to explore the efficacy of psychological interventions in reducing depression and improving quality of life and clinical outcomes (mortality, hospitalization) among adults with CHF. Methods This study performed a systematic review involving searches of 6 databases (MEDLINE, CINAHL, EMBASE, PsycINFO, ASSIA, and SSCI), the Cochrane library, and gray literature, completed in January 2020. Experimental and nonexperimental quantitative studies of psychological interventions for adults with CHF were included. Each study was quality appraised, and key data were extracted and tabled. Overall findings are presented as a narrative synthesis. Results Nine studies met eligibility. Study authors sampled 757 participants and evaluated 4 psychological interventions: cognitive behavioral therapy alone or combined with exercise, mindfulness-based psychoeducation, coping skills training, and innovative holistic meditation. Cognitive behavioral therapy was significantly associated with improved depression and quality of life, and reduced hospitalization risk. Mindfulness-based psychoeducation, holistic meditation, and coping skills training positively impacted depression and quality of life. Coping skills training also reduced hospitalization and mortality risks. Conclusion Although this review indicates that psychological interventions can be beneficial to adults with CHF who have depression, the overall weight of evidence contains a number of biases. Larger, higher-powered studies are needed to confirm or refute these findings and to better understand how specific intervention and sample characteristics relate to outcomes. The authors have no funding or conflicts of interest to disclose. Catherine Evans (co-author) is funded by Health Education England/National Institute of Health Research (NIHR) Senior Clinical Lectureship (ICASCL-2015-01-001). Correspondence Sameera I. Helal, MSN, BSN, Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute of Palliative Care, Rehabilitation and Policy, King's College London, Bessemer Rd, London SE5 9PJ, England(sameera.helal@kcl.ac.uk). Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved

Psychometric Properties of the Polish Version of the Self-Care of Hypertension Inventory Background According to evidence-based guidelines, adherence to blood pressure–lowering medication and lifestyle modifications is a crucial part of hypertension management. Self-care is an effective method for secondary prevention. However, patients continue to exhibit major deficits in terms of adherence, self-control, and self-care. Standardized instruments for the effective monitoring of patients' self-care abilities are still lacking. Objective The objectives of this study were to produce a translation and cross-cultural adaptation of the Self-Care of Hypertension Inventory (SC-HI) and to evaluate the psychometric properties of its Polish version. Methods The scale underwent translation and psychometric assessment using the standard methodology (forward-backward translation, review, psychometric analysis, criterion validity). The study included 250 patients, with a mean age of 61.23 ± 14.34 years, treated in a hypertension clinic. Results Mean self-care levels were evaluated in 3 domains: self-care maintenance (56.73 ± 18.57), self-care management (64.17 ± 21.18), and self-care confidence (62.47 ± 24.39). The Cronbach α for each domain showed satisfactory parameters: 0.755 for maintenance, 0.746 for management, and 0.892 for confidence. In the Polish version, the 3-factor structure of the SC-HI was not directly confirmed. Therefore, so-called modification indices were applied to obtain a standardized root mean square residual value less than 0.09 and a root mean square error of approximation value less than 0.06. Conclusions The SC-HI has been successfully translated and adapted for Polish settings, and is suitable for application among patients with hypertension. This work was prepared under the project financed from the funds granted by the Ministry of Science and Higher Education in the "Regional Initiative of Excellence" program for the years 2019–2022, project number 016/RID/2018/19 (http://www.rid.umed.wroc.pl/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the article. All data and materials used in this research are freely available. References have been provided. The study was approved by the local bioethics committee (approval no. KB 42/2019). All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Written informed consent was obtained from all individual participants included in the study. All coauthors have agreed to the submission and publication of this article. All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; gave final approval of the version to be published; and agree to be accountable for all aspects of the work. The authors have no conflicts of interest to disclose. Correspondence Beata Jankowska-Polańska, PhD, Department of Clinical Nursing, Wroclaw Medical University, K. Bartla 5, 51-618 Wroclaw, Poland (beata.jankowska-polanska@umed.wroc.pl). This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved

Resilience and Depressive Symptoms in Adults With Cardiac Disease: A Systematic Review Background Depressive symptoms predict hospitalization and mortality in adults with cardiac disease. Resilience, defined as a dynamic process of positively responding to adversity, could protect against depressive symptoms in cardiac disease. No systematic review has been conducted on the relationship between these variables in this population. Objective The aim of this review was to explore the association between psychological resilience and depressive symptoms in adults with cardiac disease. Methods Seven databases (PubMed, EMBASE, CINAHL, PsycInfo, Web of Science, SCOPUS, and Cochrane) were searched from inception to December 2019 using the search terms "cardiac disease," "depressive symptoms," "depression," and "resilience." Inclusion criteria dictated that studies reported original research on the association between resilience and depressive symptoms in adults with a cardiac disease broadly defined. Quality ratings were performed by 2 independent raters. Results We identified 13 studies for final review. Study sample sizes ranged from 30 to 1022 participants, average age ranged from 52 to 72 years, and all studies had majority male participants (64%–100%). Resilience and depressive symptoms were inversely related in 10 of 13 studies. The 3 studies with poor-quality sampling techniques or significant loss to follow-up found no relationship. Conclusions Resilience seems to protect against depression in adults with cardiac disease. Gaps in the literature include poor understanding of the direction of causality. Methods of promoting resilience need to be identified and studied. The authors have no funding or conflicts of interest to disclose. Correspondence Amy Ketcham, BSN, RN, School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA 19104 (aketcham@nursing.upenn.edu). Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jcnjournal.com). Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved

Development and Validation of a Scale to Measure Self-efficacy and Self-management in People With Coronary Heart Disease Background Self-management is important in reducing coronary risk factors and in preventing recurrent cardiac events. An enabling factor that promotes self-management among patients with coronary heart disease (CHD) is self-efficacy. However, there is no standardized measure that captures self-efficacy and self-management concurrently in this population. Aim The authors of this study report on the development and validation of a brief scale to measure self-efficacy and self-management in patients with CHD. Methods Scale development and testing comprised (1) item generation, (2) content validity, and (3) pilot testing. The Heart Health Self-Efficacy and Self-Management (HH-SESM) scale includes 2 constructs: self-efficacy and self-management, measured concurrently. Components of the HH-SESM scale consisted of items related to behavioral and coronary risk factor modification. Survey data from 143 participants were used in exploratory factor analyses to test the factorial validity and internal consistency of the scale. Results Twelve items with the same response format were included in the exploratory factor analysis. The factor analysis revealed a single-factor solution accounting for 36.7% and 36.5% of the variance in scores of the self-efficacy and self-management scales, respectively. The correlation (r = 0.72, P < .001) between the self-efficacy and self-management constructs indicates moderate convergent validity. Cronbach α of self-efficacy (0.83) and self-management (0.81) constructs showed good internal consistency. Conclusion The HH-SESM is a brief, easy-to-administer, and reliable measure of self-efficacy and self-management in patients with CHD. The authors have no funding or conflicts of interest to disclose. All authors have agreed on the final version and meet the following criteria (recommended by the International Committee of Medical Journal Editors [http://www.icmje.org/ethical_1author.html]): substantial contributions to conception or design of the work; acquisition, analysis, or interpretation of data for the work; drafting the work or revising it critically for important intellectual content; final approval of the version to be published; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jcnjournal.com). Correspondence Maria Mares, BN(Hons), RN, Building 7, Campbelltown campus. Narellan Rd, Cnr David Pilgrim Dr & Goldsmith Ave, Campbelltown, New South Wales, Australia (M.Mares@westernsydney.edu.au). Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved

Naturalistic Decision Making in Everyday Self-care Among Older Adults With Heart Failure Background Every day, older adults living with heart failure make decisions regarding their health that may ultimately affect their disease trajectory. Experts describe these decisions as instances of naturalistic decision making influenced by the surrounding social and physical environment and involving shifting goals, high stakes, and the involvement of others. Objective This study applied a naturalistic decision-making approach to better understand everyday decision making by older adults with heart failure. Methods We present a cross-sectional qualitative field research study using a naturalistic decision-making conceptual model and critical incident technique to study health-related decision making. The study recruited 24 older adults with heart failure and 14 of their accompanying support persons from an ambulatory cardiology center. Critical incident interviews were performed and qualitatively analyzed to understand in depth how individuals made everyday health-related decisions. Results White, male (66.7%), older adults' decision making accorded with a preliminary conceptual model of naturalistic decision making occurring in phases of monitoring, interpreting, and acting, both independently and in sequence, for various decisions. Analyses also uncovered that there are barriers and strategies affecting the performance of these phases, other actors can play important roles, and health decisions are made in the context of personal priorities, values, and emotions. Conclusions Study findings lead to an expanded conceptual model of naturalistic decision making by older adults with heart failure. In turn, the model bears implications for future research and the design of interventions grounded in the realities of everyday decision making. This work was supported by the Agency for Healthcare Research & Quality (R21 HS025232). Dr Holden reports consultant payments from federal research grants awarded to the University of Wisconsin, Clemson University, Oregon Health & Science University, and Kent State University. He receives an annual honorarium for editorial duties from Taylor & Francis publisher. Dr Mirro reports grants from Biotronik Inc, the Agency for Healthcare Research and Quality, Medtronic plc, and Janssen Scientific Affairs; consulting fees/honoraria from iRhythm Technologies Inc and Zoll Medical Corporation; and nonpublic equity/stock interest in Murj, Inc/Viscardia. Dr Mirro's relationships with academia include serving as a trustee of Indiana University. Dr Toscos reports grants from Biotronik Inc, Medtronic plc, Janssen Scientific Affairs, and iRhythm Technologies, Inc. All other authors have no conflicts to disclose. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research & Quality or Parkview Health. Correspondence Richard J. Holden, PhD, Regenstrief Institute, 1101 W 10th St #421, Indianapolis, IN 46202 (rjholden@iu.edu). Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved

A Pilot Study to Evaluate a Computer-Based Intervention to Improve Self-care in Patients With Heart Failure Background Cognitive dysfunction contributes to poor learning and impaired self-care (SC) for patients with heart failure. Objectives The aims of this study were to (1) evaluate the feasibility and acceptability of a nurse-led, virtual home-based cognitive training and SC education intervention to support SC and (2) evaluate the relationship between improvements in SC and cognitive change and examine 30-day readmission rates. Methods In this 2-phase pilot study, we used a prospective, exploratory design. In phase 1, recruitment criteria and retention issues threatened feasibility and acceptance. Significant modifications were made and evaluated in phase 2. Results In phase 2, 12 participants were recruited (7 women and 5 men). Feasibility was supported. All participants and the study nurse positively evaluated acceptability of the intervention. Median SC scores improved over time. Thirty-day hospital readmission rates were 25%. Conclusion Phase 1 indicates the intervention as originally designed was not feasible or acceptable. Phase 2 supports the feasibility and acceptability of the modified intervention. Further testing is warranted. This study was supported by NIH/NINR P20 NR015331-02 (funded as part of the University of Michigan School of Nursing, P20 Center for Complexity and Self-management of Chronic Disease [PIs: Debra Barton, PhD, RN, FAAN; Ivo Dinov, PhD], and Donald and Karin Allen Faculty Fund, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan). The authors have no conflicts of interest to disclose. Correspondence Cynthia Arslanian-Engoren, PhD, RN, ACNS-BC, FAHA, FAAN, University of Michigan School of Nursing, 400 N Ingalls, Room 2176, Ann Arbor, MI 48109 (cmae@umich.edu). Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved

Translation and Psychometric Evaluation of the German Version of the Thirst Distress Scale for Patients With Heart Failure Background In patients with chronic heart failure, thirst can be perceived as an intensive and burdensome symptom, which may have a negative impact on patients' quality of life. To initiate thirst-relieving interventions, assessment of thirst and its related distress is essential. At the time of this study, no instrument was available to evaluate thirst distress in patients with heart failure in Germany. Objective The aims of this study were to translate the "Thirst Distress Scale for patients with Heart Failure" (TDS-HF) from English into German and to test validity and reliability of the scale. Methods The English version of the TDS-HF was translated into German. A linguistically and culturally sensitive forward-and-backward translation was performed. Psychometric evaluation included confirmatory factor analysis, reliability in terms of internal consistency, and concurrent validity. Results Eighty-four hospitalized patients (mean age, 72 ± 10 years; 29% female; mean left ventricular ejection fraction, 36% ± 12%; 62% New York Heart Association functional classes III–IV, 45% on fluid restriction) from an acute care hospital were involved in the study. The item-total correlation ranged from 0.58 to 0.78. Interitem correlations varied between 0.37 and 0.79. Internal consistency was high, with a Cronbach α of 0.89. There was a high correlation between the total score of the TDS-HF and the visual analog scale to assess thirst intensity (r = 0.72, P ≤ .001), and a low correlation with fluid restriction (r = 0.35, P = .002). Conclusions The evaluation of the German TDS-HF showed satisfactory psychometric properties in this sample. The instrument is usable for further research and additional psychometric testing. The authors have no funding or conflicts of interest to disclose. Correspondence Christiane Kugler, PhD, RN, FAAN, Faculty of Medicine, Institute of Nursing Science, Albert-Ludwigs-University Freiburg, Elsässer Str. 2-o, 79106 Freiburg, Germany (christiane.kugler@uniklinik-freiburg.de). Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved

The Influence of Preparedness, Mutuality, and Self-efficacy on Home Care Workers' Contribution to Self-care in Heart Failure: A Structural Equation Modeling Analysis Background Home care workers (HCWs) are increasingly caring for patients with heart failure (HF). Previous studies have shown that they contribute to HF patients' care, but how their preparedness and their relationship with patients (mutuality) influence caregiving is unknown, as well as the role of HCWs' self-efficacy. Objective Guided by the Situation-Specific Theory of Caregiver Contribution to HF Self-Care, we investigated the influence of HCWs' preparedness and mutuality on HCWs' contribution to HF self-care and the mediating effect of HCWs' self-efficacy in the process. Methods We conducted a cross-sectional survey of HCWs who cared for patients with HF. The survey included the Caregiver Preparedness Scale, Mutuality Scale, Caregiver Contribution to Self-Care of HF Index, and Caregiver Self-Efficacy in Contributing to Self-Care Scale. We performed structural equation modeling and a mediation analysis. Results A total of 317 HCWs employed by 22 unique home care agencies across New York, NY, completed the survey. They had a median age of 50 years, 94% were women, and 44% were non-Hispanic Black. Results demonstrated that mutuality had a direct influence on HCW contribution to self-care and preparedness influenced their contribution to self-care, but only through the mediation of self-efficacy. Conclusion Home care workers' preparedness, mutuality, and self-efficacy have important roles in influencing their contribution to HF self-care. As a workforce increasingly involved in the care of patients with HF, knowing the mechanisms underpinning HCWs' contribution to self-care may illuminate future interventions aimed at improving their contributions and HF patient outcomes. This research was made possible, in part, through a generous donation by Douglas Wigdor, Esq. Dr Sterling and this research are supported by the National Heart, Lung, and Blood Institute (K23HL150160). Dr Riegel is supported by the National Institute of Nursing Research of the National Institutes of Health (R01NR018196). REDCap at Weill Cornell Medicine is supported by Clinical and Translational Science Center grant UL1 TR002384. The authors have no conflicts of interest to disclose. Correspondence Madeline R. Sterling, MD, MPH, MS, Weill Cornell Medicine, 420 E 70th St, Box 331, New York, NY 10021 (mrs9012@med.cornell.edu). Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved

Health-Related Quality of Life in Patients With a Left Ventricular Assist Device (QOLVAD) Questionnaire: Initial Psychometrics of a New Instrument Background Patients with a left ventricular assist device are a unique and growing population who deserve their own valid, reliable instrument for health-related quality of life. Objective We developed and tested the Health-Related Quality of Life with a Left Ventricular Assist Device (QOLVAD) questionnaire. Methods In a prospective, descriptive study, patients from 7 sites completed the QOLVAD and comparator questionnaires. Construct validity was tested using confirmatory factor analysis. Convergent validity was tested using correlations of QOLVAD scores to well-established measures of subjective health status, depression, anxiety, and meaning/faith. Reliability and test-retest reliability were quantified. Results Patients (n = 213) were 58.7 ± 13.9 years old; 81.0% were male, 73.7% were White, and 48.0% had bridge to transplant. Questionnaires were completed at a median time of 44 weeks post ventricular assist device. The 5 QOLVAD domains had acceptable construct validity (root mean square error of approximation = 0.064, comparative and Tucker-Lewis fit indices > 0.90, weighted root mean square residual = 0.95). The total score and domain-specific scores were significantly correlated with the instruments to which they were compared. Internal consistency reliability was acceptable for all subscales (α = .79–.83) except the cognitive domain (α = .66). Unidimensional reliability for the total score was acceptable (α = .93), as was factor determinacy for multidimensional reliability (0.95). Total test-retest reliability was 0.875 (P < .001). Conclusion Our analysis provided initial support for validity and reliability of the QOLVAD for total score, physical, emotional, social, and meaning/spiritual domains. The QOLVAD has potential in research and clinical settings to guide decision making and referrals; further studies are needed. This study was supported by grants from the following sources: Abbott-Northwestern Hospital Foundation, Minneapolis Heart Institute Foundation, and Minnesota Nurses Association Foundation. The funding sources had no role in the collection, analysis, or interpretation of the data. Additional support for K.E.S. was received from Bethel University (sabbatical). P.E. received honoraria from or is a consultant for Abbott Laboratories and Medtronic (paid to the institution, not the individual). S.M.J. receives speaking honoraria from Abbot (modest) and consulting fees from Medtronic (minimal). S.H. is a consultant for Abbott Laboratories. E.Y.B. received grants from Impulse Dynamics, personal fees from American Regent, and grants from Medtronic Inc. B.H. received a grant (shared with K.E.S.) from Minnesota Nurses Association Foundation (completed). All were paid to Minneapolis Heart Institute Foundation to be managed (not paid to the individual). J.A.C. Received personal fees from Abbott and Medtronic and is a member of the scientific advisory committee for Medtronic and Procyrion—all outside the submitted work. K.E.S. and B.H. are coauthors of the QOLVAD questionnaire and hold it as intellectual property. BH does contract work with Lippincott/WK as a Nurse Educator Consultant. (JCVN is owned/published by Lippincott/Wolters Kluwer - which is the owner of a Lippincott Clinical Experiences product from which BH receives royalties). [The QOLVAD questionnaire has been granted without charge to others who request permission in advance for nonprofit use.] Correspondence Kristin E. Sandau, PhD, RN, FAHA, FAAN, Bethel University, 3900, Bethel Drive, St Paul, MN 55112 (k-sandau@bethel.edu). Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved

Health-Related Quality of Life Declines Over 3 Years for Congenital Heart Disease Survivors Background Because of medical advancements, many congenital heart disease (CHD) survivors are relatively symptom-free until adulthood, at which time complications may occur. Worsening health status likely drives a change in patient-reported outcomes, such as health-related quality of life (HRQoL), although change in HRQoL has not been investigated among adolescent and young adult CHD survivors. Objective The aims of the current mixed cross-sectional and longitudinal study were to (1) examine changes in HRQoL over 3 years and (2) identify any demographic (age, sex, estimated family income, and distance from medical center) and medical predictors (functional status and number of cardiac-related medications) of that change. Methods Baseline and 3-year follow-up data were obtained via an online survey of 172 CHD survivors (15–39 years old at baseline; 25% simple, 45% moderate, 30% complex) recruited from a pediatric hospital and an adult hospital. Medical predictors were abstracted from electronic medical records. Results After controlling for New York Heart Association functional class, mixed-effects models identified significant declines in all subscales of the Research and Development Corporation 36-Item Health Survey 1.0 across the 3-year timeframe. A lower estimated family income (≤$35 000) predicted more decline in physical functioning (b = 0.5, 95% confidence interval, 0.2–0.8; P = .001) and emotional functioning (b = 0.3, 95% confidence interval, 0.1–0.5; P = .017). No other significant demographic or medical predictors were identified. Conclusions Study findings highlight the importance of tracking patient-reported outcomes over time, suggesting that medical staff should discuss HRQoL with CHD survivors during late adolescence and early adulthood before decline. The authors have no conflicts of interest to disclose. This work was supported by the National Institutes of Health (grant number T32HL-098039) to J.L. Jackson, The Heart Center at Nationwide Children's Hospital, and the Clinical and Translational Science Award (grant number UL1TR001070) to The Ohio State University and Nationwide Children's Hospital. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation. Correspondence Jamie L. Jackson, PhD, 700 Children's Drive, Columbus, OH 43205 (Jamie.jackson2@nationwidechildrens.org). Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved

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Acute diffuse thickening like 'halo' of the coronary tunica adventitia after rotational atherectomy

Ueno, Katsumi^a; Morita, Norihiko^a; Kojima, Yoshinobu^a; Kondo, Hiroki^a; Minatoguchi, Shingo^b; Ando, Yu^c; Higuchi, Sho^a; Kato, Moe^a; Esaki, Masayasu^a

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Coronary Artery Disease: December 29, 2020 - Volume Publish Ahead of Print - Issue -

doi: 10.1097/MCA.0000000000000996

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Allergy and Clinical Immunology

Occupational respiratory and skin diseases among workers exposed to metalworking fluids Purpose of review To examine respiratory and skin diseases that occur among workers exposed to metalworking fluids (MWFs) used during machining processes. Recent findings Five cases of a severe and previously unrecognized lung disease characterized by B-cell bronchiolitis and alveolar ductitis with emphysema (BADE) were identified among workers at a machining facility that used MWFs, although MWF exposure could not be confirmed as the etiology. In the United Kingdom, MWF is now the predominant cause of occupational hypersensitivity pneumonitis (HP). Under continuous conditions associated with respiratory disease outbreaks, over a working lifetime of 45 years, workers exposed to MWF at 0.1 mg/m3 are estimated to have a 45.3% risk of acquiring HP or occupational asthma under outbreak conditions and a 3.0% risk assuming outbreak conditions exist in 5% of MWF environments. In addition to respiratory outcomes, skin diseases such as allergic and irritant contact dermatitis persist as frequent causes of occupational disease following MWF exposure. Summary Healthcare providers need to consider MWF exposure as a potential cause for work-related respiratory and skin diseases. Additional work is necessary to more definitively characterize any potential association between MWF exposures and BADE. Medical surveillance should be implemented for workers regularly exposed to MWF. Correspondence to Randall J. Nett, MD, MPH, National Institute for Occupational Safety and Health (NIOSH). 1000 Frederick Lane, MS-2800, Morgantown, West Virginia 26508, USA. Tel: +001 304 285 6255; e-mail: gge5@cdc.gov Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Epidemiology of non-IgE-mediated food allergies: what can we learn from that? Purpose of review To underline the main characteristics of the non-Immunoglobulin E (IgE)-mediated food allergies (food protein-induced allergic proctocolitis food protein-induced enteropathy and food protein-induced enterocolitis syndrome ), which are common diseases in primary care and in allergy and gastroenterology specialty practices evaluating children. Recent findings Non-IgE-mediated food allergies comprise a spectrum of diseases with peculiar features affecting infants and young children. The most prominent features of these diseases are symptoms that affect mainly the gastrointestinal tract. Summary It is of paramount importance to provide the clinicians with the tools for non-IgE-mediated food allergy recognition in clinical practice to avoid the misdiagnosis with unnecessary laboratory tests and detrimental treatments. Correspondence to Simona Barni, MD, Allergy Unit, Meyer Children's University Hospital, Viale Pieraccini 24, 50139 Florence, Italy. Fax: +39 055 5662900; e-mail: simonabarni@hotmail.com Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Prevention of food allergy: can we stop the rise of IgE mediated food allergies? Purpose of review Food allergy has become more prevalent in recent decades. Without a curative treatment for food allergy, prevention is key. Can we intervene and halt the food allergy epidemic? Recent findings There are three main hypotheses to explain the rise in food allergy: the dual-allergen exposure hypothesis, the hygiene hypothesis and the vitamin D hypothesis. In a recent systematic review of randomized controlled trials, only introduction of allergenic foods, namely egg and peanut, in the diet at the time of weaning and avoidance of temporary supplementation with cow's milk formula in the first few days of life showed low to moderate evidence of a preventive effect. Summary For primary prevention, introduction of allergenic foods at the time of weaning and avoidance of temporary supplementation with cow's milk formula in the first few days of life has been recommended. Introduction of foods once allergy has been excluded may be beneficial for sensitized subjects (secondary prevention). Once food allergy has been established, it is important to minimise complications (tertiary prevention) through allergen avoidance, timely treatment of allergic reactions, control of atopic co-morbidities and dietetic and psychological support, as appropriate. Immunomodulatory treatments can potentially be disease-modifying and require further research. Correspondence to Alexandra F. Santos, MD PhD, Department of Women and Children's Health (Paediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK. Tel: +44 (0) 20 7188 6424; e-mail: alexandra.santos@kcl.ac.uk Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Allergic prevention through breastfeeding Purpose of review To perform a nonsystematic review of the literature on the role of breastfeeding as primary prevention tool for allergic diseases. Recent findings Human milk contains vast amounts of biologically active components that have a significant impact on the development of the gut microbiota. Exclusively breastfed infants show a different microbiota, with a predominance of Bifidobacterium species in their intestines. The mechanisms underlying the antiallergic effects of human milk are most probably complex, as human milk contains not only nutritional substances but also functional molecules including polysaccharides, cytokines, proteins, and other components which can produce an epigenetic modulation of the innate and adaptive immune responses of the infant in very early life. Summary Currently, there is not sufficient strong evidence to guarantee its effectiveness in allergy prevention and therefore the main international scientific societies still do not count it among the recognized primary prevention strategies of allergy. Correspondence to Alessandro Giovanni Fiocchi, MD, Ospedale Pediatrico Bambino Gesù – Piazza di Sant'Onofrio, 4, 00165 Rome, Italy. Tel: +390668592296; e-mail: agiovanni.fiocchi@opbg.net Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Artificial stone silicosis Purpose of review This review details recent findings related to the health effects of occupational exposure to artificial stone dust and the rapid increase in cases of artificial stone associated silicosis around the world. Recent findings High crystalline silica content artificial stone is now commonly used for the production of kitchen benchtops. Reports of artificial stone silicosis from many countries have noted that workers were typically employed at small workplaces and were often diagnosed in their 30s or 40s. Poor exposure control measures were common, including the practice of 'dry processing'. Dust generated from artificial stone has been noted to have properties that influence toxicity, including high silica content, generation of nanosized particles and presence of metals and resins. Artificial stone silicosis differs from silicosis associated with other occupational settings including shorter latency and rapid disease progression. High-resolution computed tomography (CT) chest imaging of artificial stone silicosis has often noted the presence of ground glass opacities, which may not be detected in chest x-ray screening. Increased prevalence of autoimmune disease, such as scleroderma, has also been reported in this industry. Summary Further evaluation of the safety of work with artificial stone is required, including the effectiveness of dust control measures. Current reports of artificial stone silicosis indicate the potential for widespread undiagnosed respiratory disease in this industry. Provision of more sensitive health screening methods for all at-risk workers and the development of new treatment options particularly for this form of silicosis is urgently required. Correspondence to Ryan F. Hoy, School of Public Health & Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, 553 St Kilda Rd, Melbourne, VIC 3004 Australia. E-mail: ryan.hoy@monash.edu Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

New causes of immunologic occupational asthma 2014–2020 Purpose of review The purpose of this review was to list all new confirmed cases of immunological occupational asthma (IOA) described between mid-2014 and April 2020. Findings Several new agents, both of high and low molecular weight, have been identified in the last 6 years as potential respiratory sensitizers being able to induce immunological occupational asthma. This review confirms that new causes of IOA are still identified regularly, particularly in subjects exposed to high molecular agents, in the food industry (farming, pest control, food processing), pharmaceutical industry (antibiotics, various drugs) and cosmetic environment (dyes, powders). Summary It stressed the need for clinicians to stay alert and suspect occupational asthma in any adult with new onset asthma or newly uncontrolled asthma. Correspondence to André Cartier, Chest Physician, Hôpital du Sacré-Cœur de Montréal, Montréal, QC Canada;. e-mail: Andre.cartier@umontreal.ca Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Cleaners and airway diseases Purpose of review Evidence for adverse respiratory effects of occupational exposure to disinfectants and cleaning products (DCPs) has grown in the last two decades. The relationship between DCPs and asthma is well documented but questions remain regarding specific causal agents. Beyond asthma, associations between DCPs and COPD or chronic rhinitis are plausible and have been examined recently. The purpose of this review is to summarize recent advances on the effect of occupational exposure to DCP and chronic airway diseases. Recent findings Recent epidemiological studies have often focused on healthcare workers and are characterized by efforts to improve assessment of exposure to specific DCPs. Despite increasing knowledge on the effect of DCPs on asthma, the burden of work-related asthma caused by DCPs has not decreased in the past decade, emphasizing the need to strengthen prevention efforts. Novel data suggest an association between occupational exposure to DCPs and other chronic airway diseases, such as rhinitis, COPD, and poor lung function. Summary Epidemiological and experimental data showed that many chemicals contained in DCPs are likely to cause airway damage, indicating that prevention strategies should target multiple products. Further research is needed to evaluate the impact of DCP exposure on occupational airway diseases beyond asthma. Correspondence to Orianne Dumas, Inserm, CESP, Équipe d'Épidémiologie respiratoire integrative, 16, avenue Paul Vaillant Couturier, 94807 Villejuif cedex, France. Tel: +33 1 45 59 53 57; e-mail: orianne.dumas@inserm.fr Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

The role of eosinophils in immunotherapy: Retraction No abstract available

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Physical Medicine & Rehabilitation

Comments On "Thalamic Dementia in Acute Inpatient Rehabilitation- Role for Amantadine? A Case Report" No abstract available

How can an intestinal-type adenocarcinoma lead to neurological deficits? No abstract available

Cumulative Efficacy of Longitudinal Repeat Salivary Gland OnabotulinumtoxinA Injection: A Retrospective Study Aim We hypothesized that repeat onabotulinumtoxinA (BTX-A) injections to salivary glands would have a cumulative effect on drooling, leading to prolonged efficacy duration. Methods We retrospectively reviewed medical records and conducted a telephone survey of individuals treated with BTX-A to the salivary glands to investigate ongoing efficacy or side effects. Outcome measures were duration of decrease in drooling, and adverse events. The main independent variable was the number of injections. We identified 52 consecutive individuals (26 females) with cerebral palsy with an average age of 9 years, 3 month ± 5 years, 2 months who had received BTX-A for sialorrhea. Results Linear regression analysis showed that each additional injection resulted in the duration of efficacy being 0.68 months longer (P <0.001, R2=0.47). Age, sex, Gross Motor Function Classification System (GMFCS) level, presence of tube feeding, presence of tracheostomy, gastroesophageal reflex, seizures and concurrent intramuscular injections seizures were not significant contributors to the association between injection number and efficacy duration F (6, 45) = 1.01, p= 0.431. Interpretation There may be a cumulative effect of BTX-A injections to the salivary glands, resulting in longer periods of efficacy with consecutive injection. Corresponding Author: Heakyung Kim, MD, 180 Fort Washington Ave, Harkness Pavilion, St 1-165, New York, NY 10032, Phone 212-305-5337, Fax 212-342-1470. E-mail: hk2641@cumc.columbia.edu This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Hannah Shoval is in training. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

External devices among individuals with spinal cord injury from a developing country Objective To explore the proportion, number, and type of external devices (including mobility devices, ambulatory aides, and orthotics) possessed and used by individuals with spinal cord injury (SCI) from a developing country. Design Cross-sectional study. Participants A total of 163 participants with SCI from several rural communities in a developing country participated in the study from June 2018 to August 2019. Methods The participants were interviewed and assessed for their SCI characteristics and the external devices (i.e., mobility devices, ambulatory aides, and orthotics) possessed and used in their daily living. Results The majority of participants (85%), who lived in rural communities with family income of less than $3,167 per year, possessed external devices (1–5 types), and 80% of all participants actually used the devices (1–3 types) in their daily living. Most participants with motor-complete SCI used a single device, especially a manual wheelchair, whereas those with mild lesion severity used multiple devices for their daily activities, particularly a standard walker. Conclusion Owing to budget and environmental constraints, the external devices used by individuals with SCI from a developing country are different from those reported in a developed country. The findings provide particular insights into the management of external devices for these individuals of a developing country. Corresponding author: Assoc. Prof. Sugalya Amatachaya, PT, PhD., School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, 40002 Thailand, Tel/Fax: + 66 43 202 085. E-mail: samata@kku.ac.th FUNDING SUPPORT AND CONTRIBUTION: The researchers sincerely thank for funding support and contribution from the Research and Researcher for Industry (RRi) (PHD60I0027), Postgraduate School, and the Improvement of Physical Performance and Quality of Life (IPQ) research group, Khon Kaen University, Thailand. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Rehabilitation protocol following hip arthroscopy. A 2015 to 2020 systematic review Objective Although many rehabilitation protocols following hip arthroscopy have been described, there is still significant variability about duration, goals, restrictions and techniques to apply by the physical therapy (PT) after the surgical procedure. Objective of this study is a systematic review about rehabilitation after hip arthroscopy. Design The data Sources were PubMed, Scopus and Cochrane Library. PRISMA guidelines were used for the systematic review. Level I-IV evidence clinical studies and clinical reviews that focused on rehabilitation protocols after hip arthroscopy have been used as study eligibility criteria. Major limitations include the retrospective nature of most of the studies selected (Level IV evidence) and the use of different clinical scores to report the outcomes. Results This review showed that although a standardized guideline on rehabilitation following hip arthroscopy is still missing, the most recent studies and clinical trials are focusing on a four-phased program which includes goals, recommendations and a progression of exercises. Conclusion Rehabilitation after hip arthroscopy is strongly suggested, but different authors recommended different rehabilitation programs. There is not a defined program, but as of today the current standard of care is composed of phase-based programs. Corresponding author: Alessandro Bistolfi, MD Orthopaedic Surgeon, Orthopaedic and Trauma Centre, CTO. Via Zuretti 29, 10126 Turin. Italy. abistolfi@cittadellasalute.to.it; tel +39.011.6933573; fax +39.011.6933760; orcid 0000 0002 4396 6222 CONFLICT OF INTEREST: The authors declare that: 1) no benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article 2) the work has not been published before in any language, is not being considered for publication elsewhere, and has been read and approved by all authors 3) each author contributed significantly to one or more aspects of the study 4) no funding was received Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Association of Academic Physiatrists Women's Task Force Follow-up Report The Association of Academic Physiatrists (AAP) convened a Women's Task Force in 2016, under the leadership of then AAP President Gerard Francisco, MD, to evaluate data and metrics pertaining to the representation and inclusion of women physiatrists in the society. An initial published report focused on a retrospective analysis of data in categories such as leadership, conference presentations, and recognition awards. The findings, which highlighted areas in which the AAP had been successful in supporting gender equity as well as areas in which women physiatrists were underrepresented, provided a base from which to strategically focus on closing gaps in representation. The task force developed an action plan that was approved by the Board of Trustees and included strategies aimed at closing gaps and collecting data to determine corresponding effectiveness. Because most of the categories fell under the supervision of various AAP committees, an appointee from each committee ("diversity steward") liaised with the Women's Task Force. The diversity stewards reviewed the plan with their respective committees and collected data within their committee's purview. This task force follow-up report documents recent progress, consistent with the AAP Board of Trustees commitment to transparency and gender equity. J.K.S. and S.C contributed equally Corresponding Author: Julie K. Silver, MD, Address: 300 1st Avenue, Charlestown, MA 02025, Email: Julie_silver@hms.harvard.edu Phone: 617-680-9504, Fax: 508-718-4035 Julie K. Silver, MD – None related to this work. As an academic physician, Dr. Silver has published books and receives royalties from book publishers, and she gives professional talks such as grand rounds and medical conference plenary lectures and receives honoraria from conference organizers. She has participated in research funded by The Arnold P. Gold Foundation (physician and patient care disparities), Binational Scientific Foundation (culinary telemedicine research, and the Warshaw Institute and Massachusetts General Hospital Department of Medical Oncology (pancreatic cancer). Dr. Silver is an uncompensated founding member of TIMES UP Healthcare. Sara Cuccurullo, MD – None related to this work. As an academic physician, Dr. Cuccurullo has published textbooks and receives royalties from publishers; which are donated to the JFK Johnson Resident Education fund. She has participated in research funded by The Wallerstein Foundation, The North Eastern Cerebrovascular Consortium and an unrestricted grant from NuStep. Dr. Cuccurullo speaks at Medical Conferences, and all honoraria are donated to education. Anne Felicia Ambrose, MD – None related to this work. As a researcher, Dr. Ambrose has received and is currently receiving funding from National Institute of Aging. Glendaliz Bosques, MD – No related or unrelated disclosures to report. Talya K. Fleming, MD – None related to this work. Dr. Fleming has participated in research funded by The Wallerstein Foundation, The North Eastern Cerebrovascular Consortium, an unrestricted grant from NuStep, and the Fred C. Rummel Foundation. Walter R. Frontera, MD, PhD – Editor in Chief of the American Journal of Physical Medicine and Rehabilitation. Unrelated to this work, Dr. Frontera reports speaker honoraria, book royalties, and National Institutes of Health funding. Danielle Perret Karimi, MD – None related to this work. Unrelated to this work, Dr. Karimi has participated in research funded by the Arnold P. Gold Foundation (humanism in medicine). She has a financial investment as a shareholder in Graceland Hospice. Mooyeon Oh-Park, MD – No disclosures related to this work. Unrelated, Dr. Oh-Park discloses that she has grant funding from the David Ju Foundation for transition of care for stroke rehabilitation. Gwendolyn Sowa, MD, PhD – No disclosures related to this work. Unrelated Dr. Sowa reports funding from National Institutes of Health, Patient-Centered Outcomes Research Institute, and The Pittsburgh Foundation. Unrelated non-financial disclosure member of UPMC for You Board of Directors. Christopher Visco, MD – None related to this work. Unrelated Dr. Visco reports speaking at medical conferences with honoraria. Consulting services to Mimedx for ultrasound and injection topics. Lyn Weiss, MD - None related to this work. As an academic physician, Dr. Weiss has published books and receives royalties from book publishers, and she gives professional talks such as grand rounds and medical conference lectures. Tiffany Knowlton, JD, MBA – No related or unrelated disclosures to report. Article Disclosures: Funding Information – No funding was received for this work. Previous Presentation – No previous presentation of this research, manuscript, or article occurred in the public domain. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Evidence of widespread mechanical hyperalgesia but not exercise induced analgesia in athletes with mild patellar tendinopathy compared to pain-free matched controls: a blinded exploratory study Objective To assess centrally induced pain processing with pressure pain thresholds (PPT) bilaterally and remotely in active volleyball and basketball athletes with mild patellar tendinopathy compared to asymptomatic control athletes. Secondary objective was to explore the role of exercised induced analgesia during a training session in athletes with patellar tendinopathy. Design In this exploratory study, PPTs of 21 patellar tendinopathy athletes and 16 age and sex matched asymptomatic team members were measured by a blinded assessor bilaterally on the patellar tendon and unilaterally on the elbow extensor tendon with a pressure algometer before, during and after a regular training session. Results Patellar tendinopathy athletes had a significantly higher average body mass index compared to asymptomatic athletes (mean difference 1.75 (95%CI 0.35, 3.15), p= 0.02). At baseline, athletes with patellar tendinopathy showed lowered PPTs in the affected knee (p=0.001), unaffected knee (p<0.001), and elbow (p=0.01) compared to controls. No clear patterns were identified to explain between group differences in PPTs before, during and after exercise. Conclusion This exploratory study found primary and secondary mechanical hyperalgesia in athletes with patellar tendinopathy compared asymptomatic athletes. Further research is required on the effects of an acute exercise bout on pain thresholds in this population. Corresponding author: Paul van Wilgen, Transcare, Canadalaan 10-b 9728 EE Groningen, 050-2111495, p.vanwilgen@transcare.nl Conflicts of Interest and Source of Funding: No competing interests, funding/grants/equipment provided for the project, or any financial benefits to the authors are declared. This research has not previously been presented in another manuscript or abstract. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

The Rehabilitation Medicine Scientist Training Program: Updates and Perspectives on Addressing an Ongoing Need in Physiatric Research The shortage of physician-scientists in Physical Medicine and Rehabilitation remains a critical problem. The Rehabilitation Medicine Scientist Training Program (RMSTP) was developed in 1995 to provide structured career development training for aspiring rehabilitation medicine researchers. Initially funded by a 5-year K12 grant from the NIH National Center of Medical Rehabilitation Research (NCMRR), the structure was revised in 2001, continued in a stable format through 3 additional funding cycles (2001-2006, 2006-2012, and 2012-2016), and was again revised to a research education program (NIH R25) model in 2019. With this change in format of the RMSTP we now report the productivity of funded trainees and discuss future directions informed by the RMSTP's current R25 structure. Correspondence: John Whyte, MD, PhD, FACRM, Moss Rehabilitation Research Institute, 50 Township Line Rd, Elkins Park, PA, 19027, jwhyte@einstein.edu DISCLOSURES: The authors received support from The National Institutes of Health (5R25HD098048, Boninger PI). There are no other conflicts of interest. Authors' roles: Drafting manuscript: LM, DM, MB, JW. Revising manuscript content: LM, DM, MB, JW. Approving final version of manuscript: LM, DM, MB, JW. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Demonstration with 3D Volumetric MR sequences of Deep Peroneal Nerve Compression on Os Intermetatarseum Syndrome: A case Report The os intermetatarseum is a rare accessory bone of the foot. It is commonly asymptomatic, as are other such accessory bones of the foot. Nevertheless, when it becomes symptomatic, it can cause "os intermetatarseum syndrome". The case is here reported of os intermetatarseum syndrome, which is extremely rarely seen. To the best of our knowledge, there are very few cases in the literature about os intermetatarseum syndrome. Corresponding author: Hayri Ogul M.D., Kazim Karabekir Mah. Terminal Cad. Site Polat Apt. B Blok, Kat 1, No 2, Erzurum, Turkey, +90 442 2361212-1521 (work), +90(442) 2361301, E-mail : drhogul@gmail.com The authors received no financial support for the research and/or authorship of this article. The authors declare that they have no conflict of interest to the publication of this article. Demonstration with 3D Volumetric MR sequences of Deep Peroneal Nerve Compression on Os Intermetatarseum Syndrome: A case Report Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Assessment of Muscle activation of Caregivers Performing Dependent Transfers with a Novel Robotic Assisted Transfer Device Compared to the Hoyer Advance Objective The purpose of this study was to compare muscle activity in caregivers while using a novel robotic assistive transfer device (Strong Arm) to a clinical standard of care (Hoyer Advance). Design A Quasi-Experimental design was used in which twenty caregivers (33±15 years old) performed transfers with three surfaces (toilet, bench and shower chair) with the Strong Arm and Hoyer Advance. Transfer completion time (sec), peak percentage surface electromyography (EMG) and integrated EMG of the bilateral erector spinae, latissimus dorsi, pectoralis major and anterior deltoid were measured. Results Caregivers required less transfer time when transferring from wheelchair to surface using the Hoyer Advance (p=.011, f=.39). Lower back: significantly lower pEMG were found using Strong Arm in 50% and for the iEMG in 25% of the cases, with the remaining cases showing no significant differences. Shoulder: significantly lower pEMG were found using Strong Arm in 19% of transfers and lower iEMG was found in 25% of transfers when using the Hoyer Advance, with the remaining cases showing no significant differences. Conclusion While back muscle activation during Strong Arm transfers is statistically, but not clinically, lower, additional features that couple with significantly lower muscle activation make it an alternative to the clinical standard for further research and possible clinical applicability. Corresponding Author: Rory A. Cooper, PhD, Human Engineering Research Laboratories, 6425 Penn Avenue, Pittsburgh, PA 15206, +1 412-822-3700, rcooper@pitt.edu Author Disclosures: Dr Cooper and Dr Grindle are co-inventors and patent holders of Strong Arm and could therefore potentially benefit from the publication. This work is funded by: VA Merit Review (Grant#: F1454R); VA Centre for Excellence for Wheelchairs and Associates Rehabilitation (Grant #: B9250-C and B9269-L); VA Senior Research Career Scientist (B9269-L); Integrative Graduation Education and Research Traineeship (Grant #: DGE1144584); Paralyzed Veterans of America Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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