bluuebunny/crossref_metadata_2025 huggingface dataset:
Western Dualism and the Regulation of Cultural Production
Authors: Macmillan Fiona
Published: August 2021

This work sets out to consider the fate of creativity and forms of cultural production as they fall into and between the regimes of cultural heritage law and intellectual property law. It examines and challenges the dualisms that ground both regimes, exposing their (unsurprising) reflection of occidental ways of seeing the world. The work reflects on the problem of regulating creativity and cultural production according to Western thought systems in a world that is not only Western. At the same time, it accepts that the challenge in taking on the dualisms that hold together the existing legal regimes regulating creativity and cultural production lies in a critically nuanced approach to the geo-political distinction between the West and the rest. Like many of the distinctions considered in this book, this is one that holds and does not hold.
Etruscan Orientalization
Authors: Nowlin Jessica
Published: August 2021

The terms ‘orientalizing’ and ‘orientalization’ have been employed to describe an art historical style, historical period, and process of cultural interaction between East and West within the early first-millennium BCE Mediterranean. With particular focus on Etruria and Italy, this historiography explores the Orientalist framework at the heart of ‘orientalizing’ terms while outlining how modern political movements and ideologies of nationalism and colonialism have influenced interpretations of ‘orientalizing.’ By showing the political viewpoints underlying the origins of the term and the ways in which these positions have continued to shape modern interpretations of the effects of eastern imported objects, ideas, and practices in Etruria, this work argues that the term ‘orientalizing’ should no longer be used. Instead, the period should be fit into existing chronological periodizations, and the process of cultural change should be interrogated outside of an Orientalist discourse.
Taxonomic updates and a new variety of Cosmarium redimitum from South America
Authors: RAMOS GERALDO JOSÉ PEIXOTO , OLIVEIRA IVANIA BATISTA DE , MOURA CARLOS WALLACE DO NASCIMENTO
Published: August 2021

Here we provide an updated distribution and taxonomic notes on Cosmarium redimitum, an endemic species from South America. In addition, a new variety is proposed and the zygospore of that species is described for the first time, based on material from Bahia, northeastern Brazil.
Celep, F., Karaer, F., Duman, H. (2021) Resurrection of Lamium ponticum (Lamiaceae) with a new subspecies, Lamium ponticum subsp. anatolicum, from Turkey. Phytotaxa 511 (1): 071‒076.
Authors: CELEP FERHAT , KARAER FERGAN , DUMAN HAYRI
Published: August 2021

N/A
The genus Creaserinus Hobbs, 1973 (Decapoda: Cambaridae) in Texas
Authors: JOHNSON DANIEL P. , STERN DAVID B. , CRANDALL KEITH A.
Published: August 2021

Presented is an account of the crayfish genus Creaserinus Hobbs, 1973 for Texas, based on materials gathered during a 13-year survey of the state. Home to Texas are six members of the genus, including C. hedgpethi (Hobbs, 1948) stat. rev., n. comb., which is resurrected from the synonymy of C. fodiens; and five species new to science described herein, including C. brevistylus n. sp., C. clausus n. sp., C. crenastylus n. sp., C. limulus n. sp., and C. trinensis n. sp. Collections of these species except for C. trinensis n. sp. were previously known and studied but ascribed to C. fodiens (Cottle, 1863), which is removed from the fauna of the state. Support for the taxonomic acts comes from genetics, morphology, distribution, life history, habitat, and syntopy. Accounts are provided for each species and include illustrations and information on distribution, color pattern, relationships, life history, ecology, size, variations, and crayfish associates. A key to the species in the state based on form I males is provided. Creaserinus limulus n. sp. is extraordinary in that a majority of its populations sampled have been composed mostly or entirely of females. Additions to the faunas of Texas’s neighboring states include C. clausus n. sp. (Louisiana), C. crenastylus n. sp. (Louisiana), and C. limulus n. sp. (Arkansas and Oklahoma).
Rediscovery of Kurian’s types of Hymenoptera at Forest Research Institute, Dehradun, India with notes on Indian bethylid fauna
Authors: SINGH SUDHIR , COLOMBO WESLEY D. , SHREEVIHAR SANTHOSH , FAISAL MOHD. , PANDEY VIJAY P. , TRIBULL CARLY M.
Published: August 2021

The types specimens of many taxa described by Chandy Kurian were considered lost for many years, which prevented the recognition of the species delimited by him. Fifty holotypes have been rediscovered in the National Forest Insect Collection of Forest Research Institute, Dehradun, Uttarakhand, India. Forty-five types belong to Bethylidae (Cephalonomia tritici, Chlorepyris biharina, C. mackenziei, C. pusana, C. sanctipauli, Epyris agraensis, E. agrensis, E. bombayensis, E. delhiensis, E. duni, E. duttai, E. indicae, E. manii, E. patnae, E. pusae, E. shishami, Goniozus ahmeadi, G. chatterjii, G. chowdhari, G. hybleae, G. lygropiae, G. madrassippattanami, G. marasmi, G. mori, G. morindae, G. nephoterycis, G. nilamburensis, G. pulveriae, G. salvadorae, G. sanctijohannis, G. thalasodi, Laelius agraensis, Odontepyris argyriae, O. batrae, O. cirphi, O. hypsipylae, O. indicus, Pristepyris agraensis, Pristocera govindrami, Sclerodermus delhiensis, Sc. hardwickiae, Sc. mori, Sc. raonis, Sulcomesitius bahaduri and Su. duni), one to Chrysididae (Lustrina assamensis), three to Dryinidae (Lestodryinus guptai, Neodryinus karnalensis and N. pusae) and one to Formicidae (Neoclystopsenella luffae). Six new combinations are proposed: Epyris mackenziei comb. nov. from Chlorepyris; Formosiepyris agraensis comb. nov. from Epyris; Holepyris raonis comb. nov. from Sclerodermus; Holepyris patnae comb. nov. from Epyris; Pristocera agraensis comb. nov. from Pristepyris; and Trachepyris sanctipauli comb. nov. from Chlorepyris. We also provide updated diagnoses, as well as detailed remarks and photographs for all types rediscovered. In addition, we provide researchers worldwide with valuable taxonomic information for the Bethylidae, Chrysididae, Dryinidae and Formicidae described by Kurian. A review of Bethylidae from India and a tribute to Chandy Kurian has also been provided.
Households’ Risk Management and Coping Strategies: How do the Poor Respond to Various Idiosyncratic and Covariate Shocks in Pakistan?
Authors: Nigar Neelum , Qayyum Unbreen
Published: August 2021

This study examines poor households’ vulnerability to idiosyncratic and covariate shocks in Pakistan. First, it observes households’ socioeconomic, demographic, and geographic factors that influence the incidence of shocks. Second, it examines households coping strategies adopted to mitigate the negative effects of these shocks. For this purpose, we have studied the shock patterns in poor households and examined the role of the Benazir Income Support Program (BISP) in protecting these households against various shocks. Results indicate simultaneous exposure of idiosyncratic and covariate shocks to the targeted households. Moreover, with a low level of physical and financial assets owned by these households, they resort to coping strategies which are further damaging in nature. We also analyzed shock coping strategies of the sampled households and found that informal coping mechanisms are more prevalent among the poor households when hit by shocks. We have concluded that BISP is ineffective in protecting households in times of shocks and it is thus suggested that the transfers under this program should be generous in size and responsive to shocks in order to be an effective coping strategy for the poor.
Usability testing of radiotherapy systems as a medical device evaluation tool to inform hospital procurement decision-making
Authors: Jiang Mingyin , Tu Xuancheng , Xiao Wanchao , Tang Jinhui , Li Qiang , Sun Dongjie , Wang Daoxiong
Published: August 2021

Purpose:

Poor usability designs of radiotherapy systems can contribute to use errors and adverse events. Therefore, we evaluated the usability of two radiotherapy systems through radiation therapists’ performance, workload, and experience that can inform hospital procurement decision-making about the selection of appropriate radiotherapy system for radiation therapist use.

Methods:

We performed a comparative usability study for two radiotherapy systems through user testing. Thirty radiation therapists participated in our study, in which four typical operational tasks were performed in two tested radiotherapy systems. User performance was measured by task completion time and completion difficulty level. User workloads were measured by perceived and physiological workload using NASA-TLX questionnaires and eye motion data. User experience was measured by the USE questionnaire.

Results:

Significantly less task completion time and an easier task completion difficulty level were shown with the Varian Trilogy than with the XHA600E. The study results suggest that higher perceived and physiological workloads were experienced with the XHA600E than with the Varian Trilogy. Radiation therapists reported better user experience with the Varian Trilogy than with the XHA600E. Five paired t-tests regarding user performance, user workload, and user experience between the Varian Trilogy and the XHA600E were performed, showing that the Varian Trilogy radiotherapy system has a better usability design than the XHA600E radiotherapy system.

Conclusions:

Based on study results, we confirmed that the Varian Trilogy radiotherapy system has a better usability design than the XHA600E radiotherapy system. Furthermore, the study results provide valuable evidence for hospital procurement decision-making regarding the selection of a suitable radiotherapy system for radiation therapists to use.
Development and Cross-National Validation of a French Version of the Jefferson Scale of Empathy for Students
Authors: Gerbase Margaret W. , Gustin Marie-Paule , Bajwa Nadia , Abbiati Milena , Baroffio Anne
Published: August 2021

Empathy is a multifaceted personal ability combining emotional and cognitive features modulated by cultural specificities. It is widely recognized as a key clinical competence that should be valued during professional training. The Jefferson Scale of Empathy for medical students (JSE-S) has been developed for this purpose and validated in several languages, but not in French. The aims of this study were to gather validity evidence for a newly developed version of the JSE-S and compare it between two French-speaking contexts. In total, 1,433 undergraduate medical students from the universities of Lyon (UL), France and Geneva (UG), Switzerland participated in the study completing the JSE-S in French. Total and partial scores of the three subscales (“perspective taking,” “compassionate care” and “walking in patient’s shoes”) were calculated for each site. Construct validity of the JSE-S was analyzed considering three sources of evidence: content, internal structure and relations to other variables. A first-order Confirmatory Factor Analysis using structural equation modeling examined the three latent variables of the JSE-S subscales. Cronbach’s α coefficients were 0.75 (UG) and 0.81 (UL). The items’ discrimination power ranged between 0.29 and 1.60 (median effect size of 1.24). The overall correlations between items and total or partial scores derived from the latent JSE-S subscales were consistently similar in both study sites. Findings of this study confirm the latent structure of the JSE-S in French and its cross-national reproducibility. The comparable underlying structure of the questionnaire tested in two distinct French-speaking contexts endorses the generalizability of its measure.
Predictive Pediatric Characteristics for Revision Tonsillectomy After Intracapsular Tonsillectomy
Authors: Sagheer S. Hamad , Kolb Caroline M. , Crippen Meghan M. , Tawfik Andrew , Vandjelovic Nathan D. , Nardone Heather C. , Schmidt Richard J.
Published: August 2021

Objectives

There is little research on the rate and risk factors for revision tonsillectomy after primary intracapsular tonsillectomy. Our study aimed to determine the revision rate following intracapsular tonsillectomy, identify patient characteristics that may increase the probability of revision surgery, and report the tonsillar hemorrhage rate after revision.

Study Design

Level III, retrospective case‐control study.

Setting

A tertiary care pediatric center (Alfred I. duPont Hospital for Children, Wilmington, Delaware).

Methods

A case‐control study of pediatric patients who underwent intracapsular tonsillectomy between January 1, 2004, and December 31, 2018, was performed. Patients aged 2 to 20 years were analyzed and compared with matched controls who underwent intracapsular tonsillectomy within 7 days of the same surgeon’s case. In total, 169 revision procedures were included with 169 matched controls.

Results

A 1.39% revision rate was observed among a total of 12,145 intracapsular tonsillectomies. Among the 169 patients who underwent a revision procedure, the mean time between cases was 3.5 years. Tonsillitis was the most common diagnosis prompting revision tonsillectomy. Four (2.4%) patients underwent operative control of a postoperative tonsillar hemorrhage after revision surgery. Younger patients (P <. 001) and patients with a history of gastroesophageal reflux disease (P =. 006) were more likely to undergo revision tonsillectomy.

Conclusion

Patients below age 4 years and patients with gastroesophageal reflux disease may be at increased risk of undergoing revision tonsillectomy after primary intracapsular tonsillectomy. These factors should be considered when selecting an intracapsular technique for primary tonsillectomy in pediatric patients.
Hypoglossal Nerve Stimulation Usage by Therapy Nonresponders
Authors: Coca Kimberly K. , Heiser Clemens , Huntley Colin , Boon Maurits , de Vries Nico , Mamidala Madhu , Gillespie M. Boyd
Published: August 2021

Objective

The purpose of this study is to examine differences in therapy usage and outcomes of therapy between responder (R) and nonresponder (NR) groups in an international, multicenter prospective registry of patients undergoing hypoglossal nerve stimulation for obstructive sleep apnea (OSA).

Study Design

Database analysis (level III).

Setting

International, multicenter registry.

Methods

The studied registry prospectively collects data pre‐ and postimplantation, including sleep parameters, Epworth score, patient experience, and safety questions, over the course of 12 months. Patients are defined as a “responder” based on Sher criteria, which require a final apnea‐hypopnea index (AHI) of ≤20 and a final AHI reduction of >50% at their 12‐month follow‐up.

Results

Overall, there were 497 (69%) R and 220 (31%) NR. Most patients in both groups experienced improvement in quality of life following implantation (96% of R; 77% of NR) with reductions in oxygen desaturation index and Epworth score. At final follow‐up, the R group demonstrated significantly better adherence to recommended therapy (>4 hours/night) (P =. 001), average hours of nightly use (P =. 001), final Epworth scores (P =. 001), and degree of subjective improvement (P <. 001).

Conclusion

Patients classified as NR to upper airway stimulation continue to use therapy with improvement in percent time of sleep with O2 <90%, reduction in daytime sleepiness, and improvement in quality of life. Therefore, ongoing usage of the device should be encouraged in NR patients who note improvement while integrating additional strategies to lower the long‐term effects of OSA.
Solidifying Grounds: The Intricate Art of Foundation Building
Authors: Meulemans Germain
Published: August 2021

Modern thinking about the ground tends to take it as a purely material base for the unfolding of history and ideas emerging on its surface. In this article, I question above-ground visions of city building by drawing on both the history of ground engineering and ethnographic fieldwork carried out in Paris with geotechnicians. I address the difficulties that theorists have faced over past centuries in modelling soils, and the contemporary practice of building piles underneath buildings to anchor them. From this unfolds an understanding of the ground as produced through an equilibrium between forces and materials in which buildings become participants, rather than a solid base upon which they stand. Looking at the activities of foundation builders, we find that the inertia of the urban soil no longer betokens an absence of activity or movement, but is rather a continuous achievement, a slow and dangerous process of balancing tensions.
Blurred lines: Technologies of heterosexual coercion in “sugar dating”
Authors: Recio Rocío Palomeque
Published: August 2021

“Sugar dating” is the practice of establishing a “mutually beneficial relationship” between an older, affluent male – Sugar Daddy – and a younger, financially disempowered female – Sugar Baby. Although the figure of the “Sugar Daddy” has become commonplace in popular culture, this area of study remains largely unexplored, especially in the UK. Among the numerous websites that have mushroomed in the last decades in this country, Seeking.com stands out not only for providing an online meet-up place for Sugar Daddies and Babies, but also for serving as the matrix where the “sugar” discourse is constructed. The site functions as a discursive producer of the subject, inasmuch as Sugar Babies and Daddies are subjected and subjugated through a process of assujettissement by this kind of discursive power. Interviews conducted with four women who had recently acted as Sugar Babies showed how this discourse permeates the subjects and acts as a “technology of coercion” that works to perpetuate hegemonic notions of heterosexuality and undermines the participants” agency to refuse to engage in sexual intercourse, effectively “blurring the lines” of sexual consent.
Sexuality and Intimacy Needs Within a Hospitalized Palliative Care Population: Results From a Qualitative Study
Authors: Kelemen Anne , Van Gerven Clara , Mullins Katherine , Groninger Hunter
Published: August 2021

Background:

Palliative care (PC) clinicians are well trained to address physical, psychosocial and spiritual needs of patients who have a serious illness. However, one area that is often overlooked is intimacy and sexuality.

Objective:

To explore patient concerns regarding intimacy as it relates to illness, family reactions, physician conversations, and coping strategies and challenges.

Methods:

Eligible subjects (at least 18 years old, capacitated, receiving PC consultation at the lead author’s institution) participated in semi-structured interviews between November and December 2017. Transcripts were open-coded and analyzed using Dedoose 3.5.35 software. A constant comparative method was used to identify patterns in the data.

Results:

21 interviews were analyzed and several themes emerged. Participants described the effect of physical and mental/emotional changes on their relationships. Family relationships, romantic relationships, and sexuality were prominent in patients’ experiences of intimacy and how it changed as the illness progressed. Relationships were often noted to strengthen during the course of illness, while sexual activity was frequently reported to be negatively impacted. Patients consistently reported little provider communication on the impact of illness on intimacy beyond instructions about what sexual activities they could or could not engage in.

Conclusion:

This study underlines the significant impact of serious, progressive illness on relationships, sexuality, and physical and emotional intimacy. It highlights that these topics continue to be priorities for patients with serious illness, and that medical teams frequently fail to address them at all. Future research should further explore these issues across diverse patient populations.
Significance of Al2O3 addition in the aluminum 6063 metal foam formation through friction stir processing route – A comprehensive study
Authors: Nisa Sharaf U , Pandey Sunil , Pandey PM
Published: August 2021

Closed-cell porous aluminum is expected to be a prominent material in near future because of its light weight, high specific modulus of elasticity, high energy absorption efficiency and high sound-insulating capacity in the automotive and aerospace industries. Recently, a new method of foaming has been developed in which a precursor is formed using friction stir processing. In the friction stir processing route, a precursor is fabricated by embedding a mixture of blowing agent powder and stabilization agent powder into aluminum alloy plates by the significant stirring action of friction stir processing. By applying the friction stir processing route precursor method, the cost-effective Al-foam formation along with high productivity can be accomplished. In this study, titanium hydride powder has been used as the blowing agent as it is reported to be most compatible with aluminum matrix. The effect of percentage of stabilization agent, i.e. alumina powder on porosity of aluminum foams formed using friction stir processing route is analyzed. The porous aluminum formed with three different percentages of alumina is observed and their porosity is calculated. Also, the compressive performance of the obtained samples is observed in order to examine the alumina powder addition on mechanical properties of the obtained metal foam. This study aims at analyzing the significance of addition of the alumina into the blowing agent while developing the metal foam through friction stir processing route.
Responding to the Multifaceted COVID-19 Crisis: The Case of Mumbai, India
Authors: Duvendack Maren , Sonne Lina
Published: August 2021

COVID-19 has severely impacted the society not only in terms of health but also in terms of economic survival of individuals. Unless adequate support is provided, the pandemic will have long-lasting effects, especially on the lives of the most vulnerable, often working in the informal sector. In this article, we present a case study drawing on systems thinking and complexity theory, outlining how the city of Mumbai has responded to COVID-19. We find a multifaceted scenario where non-profit organizations, businesses and citizen volunteers operate alongside government bodies to support Mumbai’s population to overcome this pandemic. We provide broader policy lessons, as well as more specific lessons in relation to particular actors, from the first wave of the pandemic stressing the importance of becoming ‘systems thinkers’ and highlighting the importance of forming new partnerships and exploring new modes of knowledge sharing to effectively respond to crises.
Producing In Situ Data From a Distance With Mobile Instant Messaging Interviews (MIMIs): Examples From the COVID-19 Pandemic
Authors: Kaufmann Katja , Peil Corinna , Bork-Hüffer Tabea
Published: August 2021

Researching people in their chaotic and complex everyday lives is challenging for researchers at any time but especially during the application of social distancing measures. In this article, we make the case for the methodical potential of mobile messengers such as WhatsApp for qualitative mobile in situ research. We exemplify the productive use of the Mobile Instant Messaging Interview (MIMI), a research method developed by Kaufmann and Peil in 2020, to study participants’ everyday life in real-time. Based on two case studies from geography and communication studies conducted during the COVID-19 pandemic, we expound our experiences in the practical application of the MIMI approach and give recommendations. We conclude that MIMIs are a low-cost, easily feasible and short-term implemented approach for research interests across disciplines and possessing great potential for exceptional circumstances like the COVID-19 pandemic. They allow direct access to the practices and experiences of people in situ and in real-time that would otherwise stay hidden and inaccessible to social sciences. The method is suitable for research projects of any size, and can be applied as part of multi- and mixed methods designs and as well for longitudinal designs. Nonetheless, the MIMIs have to be well prepared, demand smart ways of nudging participants into elaborating their responses and require careful coordination between larger teams of researchers.
An American Perspective of the Dental and Public Health Initiatives in Cuba
Authors: Watson Colleen , Rhein Laura , Fanelli Stephanie M.
Published: August 2021

Aim:

To compare following the Cuban Revolution, Cuba’s economy and civil society was transformed by the initiation of a program of nationalization and political consolidation. The Cuban government operates a national health system and assumes fiscal and administrative responsibility for the healthcare of its citizens. Other industrialized nations continue to surpass the US in health-related outcomes indicating areas of improvement in its healthcare system. Assessing the successes and failures as well as the advantages and disadvantages of other countries’ healthcare systems may be instrumental in the development of modifications to the organization and delivery system of healthcare in the US. This paper aims to report the information attained from previous literature as well as from first-hand observations from a public health trip to Cuba in order to compare the healthcare systems in Cuba and the United States.

Materials and Methods:

A group of New York University College of Dentistry faculty and students traveled to Cuba in April 2019 for professional research and professional meetings (CFR 515.564). While in Cuba, the researchers took written notes of the lecture-based material and conversations. Upon return to the United States, published literature was searched for the collection of any additional data and all qualitative data and quantitative data was compiled and organized. Since 1959, Cuba has made continuous adjustments and improvements to its universal, free and accessible healthcare system.

Results:

There have been notable improvements to the country’s public health status, such as the implementation of an immunization program and subsequent eradication of communicable diseases, such as polio and rubella. Additionally, the implementation of the National Program on Dentistry guarantees dental care to all Cuban children under the age of 19. Today, the Cuban National Health System (NHS) initiatives have evolved to combat the novel coronavirus (COVID-19) pandemic.

Conclusion:

Recognizing the advantages as well as the disadvantages of the Cuba’s National Health System (NHS) would be useful for future policymakers in the United States. Cuban approaches to health could be tailored to the United States environment to improve healthcare effectiveness and population health status in the future.
A Method to Select Best Among Multi-Nash Equilibria
Authors: Punniyamoorthy M. , Abraham Sarin , Thoppan Jose Joy
Published: August 2021

A non-zero sum bimatrix game may yield numerous Nash equilibrium solutions while solving the game. The selection of a good Nash equilibrium from among the many options poses a dilemma. In this article, three methods have been proposed to select a good Nash equilibrium. The first approach identifies the most payoff-dominant Nash equilibrium, while the second method selects the most risk-dominant Nash equilibrium. The third method combines risk dominance and payoff dominance by giving due weights to the two criteria. A sensitivity analysis is performed by changing the relative weights of criteria to check its effect on the ranks of the multiple Nash equilibria, infusing more confidence in deciding the best Nash equilibrium.

JEL Codes: C7, C72, D81
Ratlas-LH: An MRI template of the Lister hooded rat brain with stereotaxic coordinates for neurosurgical implantations
Authors: Prior Malcolm J. W. , Bast Tobias , McGarrity Stephanie , Goldschmidt Jürgen , Vincenz Daniel , Seaton Adam , Hall Gerard , Pitiot Alain
Published: August 2021

There is currently no brain atlas available to specifically determine stereotaxic coordinates for neurosurgery in Lister hooded rats despite the popularity of this strain for behavioural neuroscience studies in the United Kingdom and elsewhere. We have created a dataset, which we refer to as ‘Ratlas-LH’ (for Lister hooded). Ratlas-LH combines in vivo magnetic resonance images of the brain of young adult male Lister hooded rats with ex vivo micro-computed tomography images of the ex vivo skull, as well as a set of delineations of brain regions, adapted from the Waxholm Space Atlas of the Sprague Dawley Rat Brain. Ratlas-LH was produced with an isotropic resolution of 0.15 mm. It has been labelled in such a way as to provide a stereotaxic coordinate system for the determination of distances relative to the skull landmark of bregma. We have demonstrated that the atlas can be used to determine stereotaxic coordinates to accurately target brain regions in the Lister hooded rat brain. Ratlas-LH is freely available to facilitate neurosurgical procedures in the Lister hooded rat.
Laryngeal Subsite Analysis of Granulomatosis With Polyangiitis (Wegener’s)
Authors: Minaya Natasha J. , Rao Vishwanatha , Naunheim Matthew R. , Song Phillip C.
Published: August 2021

Objective

To analyze specific intralaryngeal findings associated with granulomatosis with polyangiitis (GPA).

Study Design

Retrospective chart review.

Setting

Tertiary referral center.

Methods

A retrospective chart review was performed on all patients diagnosed with GPA who were evaluated at the laryngology division of Massachusetts Eye and Ear Infirmary between January 2006 and September 2019.

Results

Forty‐four patients (14 male, 30 female) were evaluated for laryngeal pathology. The mean age at onset was 48 years. Nine patients (21%) were identified with only vocal fold disease, 11 (25%) with subglottic disease, and 8 (18%) with disease at the glottis and subglottis (transglottic). The remaining 16 patients (36%) had a normal airway upon examination although they presented with laryngeal symptoms. Patients with glottic disease had statistically significantly lower voice‐related quality of life scores than patients with isolated subglottic stenosis.

Conclusions

Although laryngeal manifestations of GPA is often described as a subglottic disease presenting with respiratory symptoms, subsite analysis show that only 25% of patients had subglottic disease alone, with similar rates of glottic disease alone. Laryngeal subsites have different epithelial mucosa, function, and physiology, and understanding the specific sites of involvement will determine symptoms and enable better analysis of the underlying mechanisms of disease. Glottic disease is associated with a reduction in vocal fold motion and voice changes. Subglottic involvement presents more frequently with airway symptoms. Further research is necessary to better define the specific regions of laryngeal involvement in patients diagnosed with GPA.
Host lipidome and tuberculosis treatment failure
Authors: Shivakoti Rupak , Newman John W. , Hanna Luke Elizabeth , Queiroz Artur T.L. , Borkowski Kamil , Gupte Akshay N. , Paradkar Mandar , Satyamurthi Pattabiraman , Kulkarni Vandana , Selva Murugesh , Pradhan Neeta , Shivakumar Shri Vijay Bala Yogendra , Natarajan Saravanan , Karunaianantham Ramesh , Gupte Nikhil , Thiruvengadam Kannan , Fiehn Oliver , Bharadwaj Renu , Kagal Anju , Gaikwad Sanjay , Sangle Shashikala , Golub Jonathan E. , Andrade Bruno B. , Mave Vidya , Gupta Amita , Padmapriyadarsini Chandrasekaran
Published: August 2021

Introduction

Host lipids play important roles in tuberculosis (TB) pathogenesis. Whether host lipids at TB treatment initiation (baseline) affect subsequent treatment outcomes has not been well characterised. We used unbiased lipidomics to study the prospective association of host lipids with TB treatment failure.

Methods

A case–control study (n=192), nested within a prospective cohort study, was used to investigate the association of baseline plasma lipids with TB treatment failure among adults with pulmonary TB. Cases (n=46) were defined as TB treatment failure, while controls (n=146) were those without failure. Complex lipids and inflammatory lipid mediators were measured using liquid chromatography mass spectrometry techniques. Adjusted least-square regression was used to assess differences in groups. In addition, machine learning identified lipids with highest area under the curve (AUC) to classify cases and controls.

Results

Baseline levels of 32 lipids differed between controls and those with treatment failure after false discovery rate adjustment. Treatment failure was associated with lower baseline levels of cholesteryl esters and oxylipin, and higher baseline levels of ceramides and triglycerides compared to controls. Two cholesteryl ester lipids combined in a unique classifier model provided an AUC of 0.79 (95% CI 0.65–0.93) in the test dataset for prediction of TB treatment failure.

Conclusions

We identified lipids, some with known roles in TB pathogenesis, associated with TB treatment failure. In addition, a lipid signature with prognostic accuracy for TB treatment failure was identified. These lipids could be potential targets for risk-stratification, adjunct therapy and treatment monitoring.
Adequacy of maternal anesthesia depth with two sodium thiopental doses in elective caesarean section: a randomized clinical trial
Authors: Sabetian Golnar , Zand Farid , Mirhadi Fatemeh , Hadavi Mohammad Reza , Asadpour Elham , Dehghanpisheh Laleh , Fattahi Saravi Zeinabsadat , Razavi Seyed Mostajab
Published: August 2021

Background

Administration of an optimal dose of anesthetic agent to ensure adequate depth of hypnosis with the lowest risk of adverse effects to the fetus is highly important in cesarean section. Sodium thiopental (STP) is still the first choice for induction of anesthesia in some countries for this obstetric surgery. We aimed to compare two doses of STP with regarding the depth of anesthesia and the condition of newborn infants.

Methods

In this clinical trial, parturient undergoing elective Caesarian section were randomized into two groups receiving either low-dose (5 mg/kg) or high-dose (7 mg/kg) STP. Muscle relaxation was provided with succinylcholine 2 mg/kg and anesthesia was maintained with O2/N2O and sevoflurane. The depth of anesthesia was evaluated using isolated forearm technique (IFT) and bispectral index (BIS) in various phases. Additionally, infants were assessed using Apgar score and neurobehavioral test.

Results

Forty parturient were evaluated in each group. BIS was significantly lower in high-dose group at skin incision to delivery and subcutaneous and skin closure. Also, significant differences were noticed in IFT over induction to incision and incision to delivery. Apgar score was significantly lower in high-dose group at 1 min after delivery. Newborn infants in low-dose group had significantly better outcomes in all three domains of the neurobehavioral test.

Conclusion

7 mg/kg STP is superior to 5 mg/kg in creating deeper hypnosis for mothers. However, it negatively impacts Apgar score and neurobehavioral test of neonates. STP seems to has dropped behind as an acceptable anesthetic in Cesarean section.

Trial registration

IRCT No: 2016082819470 N45, 13/03/2019.
Renal denervation in a patient with a highly tortuous renal artery using a guide extension catheter: a case report
Authors: Wang Peijiang , Wan Jindong , Hou Jixin , Liu Sen , Ran Fei
Published: August 2021

Background

Catheter-based renal denervation (RDN) has been introduced to treat resistant hypertension. Although the technology of RDN has been largely improved, denervation of tortuous renal arteries remains challenging.

Case presentation

This is a case report of a 49-year-old man with drug resistant hypertension. The patient was selected for RDN after ruling out possible causes of secondary hypertension. Computed tomography angiography showed a highly tortuous left renal artery. An Iberis multielectrode ablation catheter failed to reach the target vessel with a regular guiding catheter. A 5-French extension catheter was introduced into the proximal segment of the main left renal artery to provide extra support force, which enabled successful ablation of the highly tortuous left renal artery. His ambulatory blood pressure was significantly decreased at 1 month follow-up.

Conclusions

It is feasible and effective to use a guide extension catheter for denervation of highly tortuous renal arteries. The present study provides a useful method to ablate tortuous and angled renal arteries and branches.
Establishment of a novel scoring model for mortality risk prediction in HIV-infected patients with cryptococcal meningitis
Authors: Zhao Ting , Xu Xiao-Lei , Nie Jing-Min , Chen Xiao-Hong , Jiang Zhong-Sheng , Liu Shui-Qing , Yang Tong-Tong , Yang Xuan , Sun Feng , Lu Yan-Qiu , Harypursat Vijay , Chen Yao-Kai
Published: August 2021

Background

Cryptococcal meningitis (CM) remains a leading cause of death in HIV-infected patients, despite advances in CM diagnostic and therapeutic strategies. This study was performed with the aim to develop and validate a novel scoring model to predict mortality risk in HIV-infected patients with CM (HIV/CM).

Methods

Data on HIV/CM inpatients were obtained from a Multicenter Cohort study in China. Independent risk factors associated with mortality were identified based on data from 2013 to 2017, and a novel scoring model for mortality risk prediction was established. The bootstrapping statistical method was used for internal validation. External validation was performed using data from 2018 to 2020.

Results

We found that six predictors, including age, stiff neck, impaired consciousness, intracranial pressure, CD4+ T-cell count, and urea levels, were associated with poor prognosis in HIV/CM patients. The novel scoring model could effectively identify HIV/CM patients at high risk of death on admission (area under curve 0.876; p<0.001). When the cut-off value of 5.5 points or more was applied, the sensitivity and specificity was 74.1 and 83.8%, respectively. Our scoring model showed a good discriminatory ability, with an area under the curve of 0.879 for internal validation via bootstrapping, and an area under the curve of 0.886 for external validation.

Conclusions

Our developed scoring model of six variables is simple, convenient, and accurate for screening high-risk patients with HIV/CM, which may be a useful tool for physicians to assess prognosis in HIV/CM inpatients.
Investigation of fatal human Borna disease virus 1 encephalitis outside the previously known area for human cases, Brandenburg, Germany – a case report
Authors: Tappe Dennis , Pörtner Kirsten , Frank Christina , Wilking Hendrik , Ebinger Arnt , Herden Christiane , Schulze Christoph , Muntau Birgit , Eggert Petra , Allartz Petra , Schuldt Gerlind , Schmidt-Chanasit Jonas , Beer Martin , Rubbenstroth Dennis
Published: August 2021

Background

The true burden and geographical distribution of human Borna disease virus 1 (BoDV-1) encephalitis is unknown. All detected cases so far have been recorded in Bavaria, southern Germany.

Case presentation

A retrospective laboratory and epidemiological investigation of a 2017 case of fatal encephalitis in a farmer in Brandenburg, northeast Germany, demonstrated BoDV-1 as causative agent by polymerase chain reaction, immunohistochemistry and in situ hybridization. Next-generation sequencing showed that the virus belonged to a cluster not known to be endemic in Brandenburg. The investigation was triggered by a recent outbreak of animal Borna disease in the region. Multiple possible exposures were identified. The next-of-kin were seronegative.

Conclusions

The investigation highlights clinical awareness for human BoDV-1 encephalitis which should be extended to all areas endemic for animal Borna disease. All previously diagnosed human cases had occurred > 350 km further south. Further testing of shrews and livestock with Borna disease may show whether this BoDV-1 cluster is additionally endemic in the northwest of Brandenburg.
Prevalence of impaired renal function and determinants in the southwest of Iran
Authors: Alvand Saba , Abolnezhadian Farhad , Alatab Sudabeh , Mohammadi Zahra , Hayati Fatemeh , Noori Mohammad , Danehchin Leila , Paridar Yousef , Cheraghian Bahman , Rahimi Zahra , Hariri Sanam , Masoudi Sahar , Mard Seyed Ali , Shayesteh Ali Akbar , Poustchi Hossein
Published: August 2021

Background

Chronic kidney disease (CKD) is a growing global health problem with faster progression in developing countries such as Iran. Here we aimed to evaluate the prevalence and determinants of CKD stage III+.

Methods

This research is part of the Khuzestan Comprehensive Health Study (KCHS), a large observational population-based cross-sectional study in which 30,041 participants aged 20 to 65 were enrolled. CKD was determined with estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73m2, based on two equations of Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). The multivariate logistic regression was used to evaluate the CKD stage III+ determinants.

Results

Prevalence of CKD stage III+ is estimated to be 7.1, 5.5, and 5.4% based on MDRD, CKD-EPI, and combination of both equations, respectively. More than 89% of CKD subjects aged higher than 40 years. In regression analysis, age more than 40 years had the strongest association with CKD stage III+ probability (OR: 8.23, 95% CI: 6.91–9.18). Higher wealth score, hypertension, High-Density Lipoprotein levels less than 40 mg/dl, and higher waist to hip ratio were all associated with CKD stage III+ while Arab ethnicity showed a protective effect (OR: 0.69, 95% CI: 0.57–0.78).

Conclusion

Our findings provide detailed information on the CKD stage III+ and its determinants in the southwest region of Iran. Due to strong association between age and CKD stage III+, within a few decades we might expect a huge rise in the CKD prevalence.
Beyond choice architecture: advancing the science of changing behaviour at scale
Authors: Marteau Theresa M. , Fletcher Paul C. , Munafò Marcus R. , Hollands Gareth J.
Published: August 2021

Addressing the global threats to population and planetary health requires changing many behaviours at scale. This demands consideration not only of the effect size of an intervention but also its reach – the proportion of the population exposed to the intervention.

We propose that a relatively under-researched and generally poorly specified set of interventions involving changes to physical micro-environments – often referred to as Choice Architecture - has the potential to make a significant contribution to meeting this urgent challenge.

Realising the potential of Choice Architecture interventions requires integration of basic – i.e. laboratory-based – and applied – i.e. field-based – research, generating interventions that can be delivered at scale alongside advancing theory. We illustrate this with examples to highlight the complementarity of laboratory and field studies informed by and in turn updating the results of evidence synthesis. The examples comprise two sets of interventions – changing the relative availability of products and changing their size - to reduce consumption of meat, energy from food and alcohol across populations.
Study protocol: behaviour change intervention to promote healthy diet and physical activity in overweight/obese adults with diabetes attending health care facilities in Muscat: a cluster rendomised control trial
Authors: Al Ghafri Thamra , Anwar Huda , Al Hinai Eiman , Al Harthi Thuraya , Al Jufaili Fathiya , Al Siyabi Reyadh , Al Harthi Shamsa , Al Hasani Said , Al Harthi Mohammed , Al Harthi Saud
Published: August 2021

Background

Healthy behavior is an essential component in type 2 diabetes (T2D) management. Promoting healthy lifestyle is one of the priorities of primary health care in Oman. This study aims to evaluate the effectiveness of a multi-component intervention in promoting physical activity (PA) and healthy diet and its implications on body mass index and glycemic control in adults with diabetes attending primary care.

Methods

A one year 1:1 cluster randomized controlled trial will be utilized to compare the use of phone consultations, a multi component interactive phone application and pedometers with the usual diabetes care on promoting PA and healthy diet. Participants will be screened for inactivity and should be T2D, aged18–65 years, and overweight or obese. Eight primary centers will be randomly selected in each arm (n = 375). The primary outcome is the between arms differences in PA and diet scores, BMI and HbA1c over 12 months from baseline. Additionally, secondary outcomes will include cardiovascular outcomes (BP, and lipids).

The trial has received ethical approval from the Omani Research and Ethical Review and Approval Committee. All eligible participants will be invited to their respected health centers to provide informed consent.

Discussion

This study will contribute to the integration of healthy lifestyle approach using artificial intelligence to primary diabetes care. Results from this study will be disseminated through workshops, policy briefs, and peer-reviewed publications, local and international conferences.

Trial registration

Trial registration number ISRCTN71889430. Date applied: 28/11/2020. Date assigned: 01/12/2020.
Use of iliac screw associated with more correction of lumbar lordosis than S2-alar-iliac screw for adult spinal deformity
Authors: Luo Qiang , Kim Yong-Chan , Kim Ki-Tack , Ha Kee-Yong , Ahn Joonghyun , Kim Sung-Min , Kim Min-Gyu
Published: August 2021

Background

To date, there is a paucity of reports clarifying the change of spinopelvic parameters in patients with adult spinal deformity (ASD) who underwent long segment spinal fusion using iliac screw (IS) and S2-alar-iliac screw (S2AI) fixation.

Methods

A retrospective review of consecutive patients who underwent deformity correction surgery for ASD between 2013 and 2017 was performed. Patients were divided into two groups based on whether IS or S2AI fixation was performed. All radiographic parameters were measured preoperatively, immediately postoperatively, and the last follow-up. Demographics, intraoperative and clinical data were analyzed between the two groups. Additionally, the cohort was subdivided according to the postoperative change in pelvic incidence (PI): subgroup (C) was defined as change in PI ≥5° and subgroup (NC) with change < 5°. In subgroup analyses, the 2 different types of postoperative change of PI were directly compared.

Results

A total of 142 patients met inclusion criteria: 111 who received IS and 31 received S2AI fixation. The IS group (65.6 ± 26°, 39.8 ± 13.8°) showed a significantly higher change in lumbar lordosis (LL) and upper lumbar lordosis (ULL) than the S2AI group (54.4 ± 17.9°, 30.3 ± 9.9°) (p < 0.05). In subgroup (C), PI significantly increased from 53° preoperatively to 59° postoperatively at least 50% of IS cohort, with a mean change of 5.8° (p < 0.05). The clinical outcomes at the last follow-up were significantly better in IS group than in S2AI group in terms of VAS scores for back and leg. The occurrence of sacroiliac joint pain and pelvic screw fracture were significantly greater in S2AI group than in IS group (25.8% vs 9%, p < 0.05) and (16.1% vs 3.6%, p < 0.05).

Conclusions

Compared with the S2AI technique, the IS technique usable larger cantilever force demonstrated more correction of lumbar lordosis, and possible increase in pelvic incidence. Further study is warranted to clarify the clinical impaction of these results.