bluuebunny/crossref_metadata_2025 huggingface dataset:
Therapeutically Increasing MHC-I Expression Potentiates Immune Checkpoint Blockade
Authors: Gu Shengqing Stan , Zhang Wubing , Wang Xiaoqing , Jiang Peng , Traugh Nicole , Li Ziyi , Meyer Clifford , Stewig Blair , Xie Yingtian , Bu Xia , Manos Michael P. , Font-Tello Alba , Gjini Evisa , Lako Ana , Lim Klothilda , Conway Jake , Tewari Alok K. , Zeng Zexian , Sahu Avinash Das , Tokheim Collin , Weirather Jason L. , Fu Jingxin , Zhang Yi , Kroger Benjamin , Liang Jin Hua , Cejas Paloma , Freeman Gordon J. , Rodig Scott , Long Henry W. , Gewurz Benjamin E. , Hodi F. Stephen , Brown Myles , Liu X. Shirley
Published: February 2021

Immune checkpoint blockade (ICB) therapy revolutionized cancer treatment, but many patients with impaired MHC-I expression remain refractory. Here, we combined FACS-based genome-wide CRISPR screens with a data-mining approach to identify drugs that can upregulate MHC-I without inducing PD-L1. CRISPR screening identified TRAF3, a suppressor of the NFκB pathway, as a negative regulator of MHC-I but not PD-L1. The Traf3-knockout gene expression signature is associated with better survival in ICB-naïve patients with cancer and better ICB response. We then screened for drugs with similar transcriptional effects as this signature and identified Second Mitochondria-derived Activator of Caspase (SMAC) mimetics. We experimentally validated that the SMAC mimetic birinapant upregulates MHC-I, sensitizes cancer cells to T cell–dependent killing, and adds to ICB efficacy. Our findings provide preclinical rationale for treating tumors expressing low MHC-I expression with SMAC mimetics to enhance sensitivity to immunotherapy. The approach used in this study can be generalized to identify other drugs that enhance immunotherapy efficacy.

Significance:

MHC-I loss or downregulation in cancer cells is a major mechanism of resistance to T cell–based immunotherapies. Our study reveals that birinapant may be used for patients with low baseline MHC-I to enhance ICB response. This represents promising immunotherapy opportunities given the biosafety profile of birinapant from multiple clinical trials.

This article is highlighted in the In This Issue feature, p. 1307
A Patient with Noonan Syndrome with a KRAS Mutation Who Presented Severe Nerve Root Hypertrophy
Authors: Ando Yoshihito , Sawada Mikio , Kawakami Tadataka , Morita Mitsuya , Aoki Yoko
Published: February 2021

We report a 45-year-old female with clinical features resembling Noonan syndrome (NS) who presented with significant nerve root hypertrophy. She was initially diagnosed with Charcot-Marie-Tooth disease because her gait disturbance gradually deteriorated and nerve conduction velocity was reduced. However, she did not carry a PMP22 gene mutation. RASopathies are a group of phenotypically overlapping developmental syndromes caused by germline mutations that encode components of the Ras/MAPK signaling pathway. These disorders include NS, cardiofaciocutaneous (CFC) syndrome, and Costello syndrome and are associated with molecular abnormalities in the Ras/MAPK pathway. The patient was suspected to have NS and related disorders because of pulmonary artery stenosis, lymphedema, distinctive facial appearance, and intellectual disability. Genetic analysis identified a heterozygous de novo mutation in KRAS (c.211T>G, p.Tyr71Asp), which is usually observed in patients with NS or CFC syndrome. Although our patient was diagnosed with NS, she revealed clinical manifestations that were typical to CFC syndrome, including intellectual disability. It has been reported that some patients diagnosed with RASopathies with mutations in PTPN11, SOS1, or KRAS developed nerve root hypertrophy. These results suggest that nerve root hypertrophy may be associated with RASopathy, although the onset mechanisms of nerve root hypertrophy are unknown.
Perforated Acute Appendicitis in a Six-Day-Old Neonate: A Rare Differential Diagnosis of Neonatal Peritonitis
Authors: Nguyen Thanh Xuan , Dang Nhu Thanh , Phan Hai Thanh , Pham Nhu Hien , Vu Hoai Anh
Published: February 2021

Acute appendicitis is a rare diagnosis of acute abdomen in neonates which is associated with high mortality due to late diagnosis. Here, we presented a case of acute neonatal appendicitis in a 6-year-old full-term infant with Down syndrome and pulmonary atresia with ventricular septal defect. The patient underwent surgery and postoperative critical care. However, he died on postoperative day 5 due to worsening sepsis and decompensated hemodynamic instability.
Comedone-Like Lesions as a Manifestation of Lichen Planopilaris beyond the Scalp: A Case Report with Dermoscopic Features and Literature Review
Authors: Iamsumang Wimolsiri , Rutnin Suthinee , Suchonwanit Poonkiat
Published: February 2021

Lichen planopilaris is a rare inflammatory condition that is also known as follicular lichen planus. Although the condition commonly affects the scalp, it sometimes involves the other regions of the body with a variety of clinical presentations. The involvement beyond the scalp is considered to be a generalized nature of disease process. In this report, we present a case of generalized follicular lichen planus in a 34-year-old Thai female presenting with comedone-like lesions on the trunk and extremities as well as scarring alopecia on the scalp. Dermoscopic features were also discussed.
COVID-19 Has Made the Elderly Lonelier
Authors: Naeim Mahdi , Rezaeisharif Ali , Kamran Aziz
Published: February 2021

Loneliness is a major risk factor for the elderly and can double their problems. When COVID-19 started, things became more difficult for the elderly. The news that the elderly are at a higher risk for severe COVID-19 than others made the elderly lonelier. This is a library type study that was conducted over 2 months using valid scientific sources and books. Based on the findings of this study, we believe that focusing on education and reminding people of the necessary dos and don’ts of illness, modifying their diet, emphasizing masking, and even familiarizing the elderly with social media and virtual activities will prevent them from suffering loneliness.
Routine Use of Tenecteplase for Thrombolysis in Acute Ischemic Stroke
Authors: Zhong Cathy S. , Beharry James , Salazar Daniel , Smith Kelly , Withington Stephen , Campbell Bruce C.V. , Wilson Duncan , Le Heron Campbell , Mason Deborah , Duncan Roderick , Reimers Jon , Mein-Smith Frances , Diprose William K. , Barber P. Alan , Ranta Annemarei , Fink John N. , Wu Teddy Y.
Published: February 2021

Background and Purpose:

In ischemic stroke, intravenous tenecteplase is noninferior to alteplase in selected patients and has some practical advantages. Several stroke centers in New Zealand changed to routine off-label intravenous tenecteplase due to improved early recanalization in large vessel occlusion, inconsistent access to thrombectomy within stroke networks, and for consistency in treatment protocols between patients with and without large vessel occlusion. We report the feasibility and safety outcomes in tenecteplase-treated patients.

Methods:

We performed a retrospective analysis of consecutive patients thrombolyzed with intravenous tenecteplase at 1 comprehensive and 2 regional stroke centers from July 14, 2018, to February 29, 2020. We report the baseline clinical characteristics, rates of symptomatic intracranial hemorrhage, and angioedema. These were then compared with patient outcomes with those treated with intravenous alteplase at 2 other comprehensive stroke centers. Multivariable mixed-effects logistic regression models were performed assessing the association of tenecteplase with symptomatic intracranial hemorrhage and independent outcome (modified Rankin Scale score, 0–2) at day 90.

Results:

There were 165 patients treated with tenecteplase and 254 with alteplase. Age (75 versus 74 years), sex (56% versus 60% male), National Institutes of Health Stroke Scale scores (8 versus 10), median door-to-needle times (47 versus 48 minutes), or onset-to-needle time (129 versus 130 minutes) were similar between the groups. Symptomatic intracranial hemorrhage occurred in 3 (1.8% [95% CI, 0.4–5.3]) tenecteplase patients compared with 7 (2.7% [95% CI, 1.1–5.7]) alteplase patients (
P
=0.75). There were no differences between tenecteplase and alteplase in the rates of angioedema (4 [2.4%; 95% CI, 0.7–6.2] versus 1 [0.4%; 95% CI, 0.01–2.2],
P
=0.08) or 90-day functional independence (100 [61%] versus 140 [57%],
P
=0.47), respectively. In mixed-effects logistic regression models, there was no significant association between thrombolytic choice and symptomatic intracranial hemorrhage (odds ratio tenecteplase, 0.62 [95% CI, 0.14–2.80],
P
=0.53) or functional independence (odds ratio tenecteplase, 1.20 [95% CI, 0.74–1.95],
P
=0.46).

Conclusions:

Routine use of tenecteplase for stroke thrombolysis was feasible and had comparable safety profile and outcome to alteplase.
Dabigatran or Aspirin in East Asian Patients With Embolic Stroke of Undetermined Source
Authors: Uchiyama Shinichiro , Toyoda Kazunori , Lee Byung-Chul , Liou Chia-Wei , Wong Lawrence Ka Sing , Grauer Claudia , Brueckmann Martina , Taniguchi Atsushi , Urano Yasuhisa , Easton J. Donald ,   on behalf of the RE-SPECT ESUS Investigators
Published: February 2021

Background and Purpose:

We assessed the outcomes of dabigatran versus aspirin in a prespecified subgroup analysis of East Asian patients with embolic stroke of undetermined source in the RE-SPECT ESUS trial (Randomized, Double-Blind, Evaluation in Secondary Stroke Prevention Comparing the Efficacy and Safety of the Oral Thrombin Inhibitor Dabigatran Etexilate Versus Acetylsalicylic Acid in Patients With Embolic Stroke of Undetermined Source).

Methods:

Patients with a recent embolic stroke of undetermined source were randomized to dabigatran (150 or 110 mg BID) or aspirin (100 mg QD). The primary efficacy outcome was recurrent stroke; the primary safety outcome was major bleeding. The East Asia cohort was compared with patients from all other countries (non-East Asia cohort).

Results:

Overall, 988 of 5390 patients (18%) were randomized in East Asia. During a median follow-up of 18.8 months, there was no statistically significant difference in recurrent stroke (hazard ratio, 0.65 [95% CI, 0.41–1.03]) or major bleeding (hazard ratio, 1.04 [95% CI, 0.57–1.91]) in East Asian patients receiving dabigatran versus aspirin. Death from any cause occurred more often in the dabigatran versus the aspirin group (hazard ratio, 3.98 [95% CI, 1.32–12.01]).

Conclusions:

The treatment effect of dabigatran versus aspirin was consistent between cohorts, with no apparent superiority for dabigatran over aspirin in preventing recurrent stroke in patients with embolic stroke of undetermined source.

Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02239120.
Qualitative Study of Chinese Stroke Caregivers’ Caregiving Experience During the COVID-19 Pandemic
Authors: Lee Jung Jae , Tsang Wing Nga , Yang Sook Ching , Kwok Jojo Yan Yan , Lou Vivian W.Q. , Lau Kui Kai
Published: February 2021

Background and Purpose:

The coronavirus disease 2019 (COVID-19) outbreak has led to disruptions in health care service delivery worldwide, inevitably affecting stroke survivors requiring ongoing rehabilitation and chronic illness management. To date, no published research has been found on stroke caregiving during the COVID-19 pandemic. This study aimed to explore Hong Kong stroke caregivers’ caregiving experiences in the midst of this difficult time.

Methods:

Individual semistructured interviews were conducted with 25 Chinese adult primary stroke caregivers from May to June 2020 via telephone. Interviews were transcribed verbatim and analyzed using an interpretive description approach and constant comparison strategy.

Results:

Five themes of the stroke caregiving experience during the COVID-19 pandemic emerged: care service adversities, additional caregiving workload and strain, threatened relationship between caregiver and stroke survivors, threats to caregivers’ physical and psychological well-being, and needs for continuing caregiving roles. Our findings suggested that caregivers have worsened physical and psychological well-being because of increases in care burden with simultaneously reduced formal and informal support. The relationship between caregiver and stroke survivor was subsequently affected, placing some survivors at heightened risk of abuse.

Conclusions:

Our study provides valuable findings about stroke caregiving experiences and needs during the pandemic. Delivery of psychological support, telemedicine, and household hygiene resources would be useful to mitigate caregivers’ psychological distress during the COVID-19 pandemic.
Territoriale Culten in West-Congo: Verdwijning of Transformatie?
Authors: Vanhee Hein
Published: February 2021

Territorial Cults in West-Congo: Vanished or Transformed?

This paper discusses some of the key issues in my current research on the history of the relationship between society, tradition and Christianity in the west of Congo-Kinshasa over the last century. My focus here is on the process of progressive transformation of the nineteenth-century territorial cults and the structural continuity which is apparent in the development of the Congolese Christian church in the area. In presenting some of my working hypotheses I am suggesting that after an initial period of open hostility towards the first missionaries, BaKongo became aware – ‘empirically’ as it were – of the fact that new ways were to be explored in order to compete with the challenges of Western colonialism and the forces of modernity and globalisation. In this regard, the history of religious life in West Congo can be described as a progressive attempt to regain control over the relations between human society and the supernatural world.
Le President Mobutu et le Premier Ministre Sous L’acte Constitutionnel de la Transition: Duel ou Duo?
Authors: Esambo Kangashe Jean-Louis
Published: February 2021

President Mobutu and the Prime Minister Under the Transitional Constitutional Act: Duel or Duo?

Since the beginning of the democratic process in Mobutu’s Zaire, in April 1990, a judicial and political debate has continued to divide the opinion on the power sharing within the executive.

The Transitional Constitutional Act, a result of the political negotiations of the Palais du Peuple, was aimed at resolving the competence conflicts between the President of the Republic and the Prime Minister. This constitutional framework, however, was unable to avoid neither the possibility of a “duel” nor the avatars of an alleged “duo” between the two main representatives of the executive function.

In the meantime, the frequent violations of the constitution by the head of state have shown that power sharing within a parliamentary system could not come to a compromise with the power practice under Mobutu.
Worlding Cinema
Authors: Gledhill Christine
Published: February 2021

Against the narrowly commercial and homogenising term ‘world cinema’ that lumps together a diversity of ‘foreign’ films as a category, the notion of ‘the local’ relativizes the idea of the ‘national’ as a singular entity. It suggests the pivoting around each other of ‘there’ and ‘here,’ thereby avoiding precisely fixed locations and calling on the dynamism of their relationship. The local, captures not only particular geo-political locations but historical relationships, which, interacting with changing conditions, produce the shifting frameworks of thinking, feeling, experience, and aesthetic perception that shape local practices, traditions, and cultural forms. However, this specificity is often called on to endorse an authenticity uncontaminated by metropolitan sophistication or global uniformity, enabling local products to travel to an elsewhere beyond national boundaries. The value of ‘world’ over ‘global’ lies in its call on the space shared by many different nationals, whereas ‘global’ suggests the homogenisation enforced by multi-national corporate and neo-colonial Western powers. As an alternative concept, ‘trans-national’ applied to cinema has the virtue of acknowledging the existence of nationally defined geo-historical and cultural differences as well as the reality of cross-border migration of personnel, technologies, and films, along with the complexity of international co-production. However, if the term keeps the idea of the ‘national’ in place, the boundaries it marks are neither natural nor fixed. If local film genres and narrative forms function as public sites in which aesthetic histories, cultural frames of reference and social experiences feed and negotiate with each other, the question arises how far the trans-national intensification of this activity now produces a new space for an emergent ‘world imaginary’: the idea of a shared ‘world’.
Revision of the deep-sea Eulimidae (Gastropoda, Caenogastropoda) from off Northeast Brazil
Authors: DE SOUZA LEONARDO SANTOS , PIMENTA ALEXANDRE DIAS , DE BARROS JOSÉ CARLOS NASCIMENTO
Published: February 2021

The present study reviews the taxonomy of the marine gastropods belonging to the family Eulimidae Philippi, 1853 from the continental slope off Northeast Brazil. The genera Abyssoaclis Barros, Mello, Barros, Lima, Santos, Cabral & Padovan, 2003 and Aclis Lovén, 1846 were not treated here. A total of 20 taxa were identified in this region, excluding Eulima hebes Watson, 1883, a species with a doubtful classification in Eulimidae. The species were assigned to the following genera: Costaclis Bartsch, 1947, Eulima Risso, 1826, Fusceulima Laseron, 1955, Melanella Bowdich, 1822, Ophieulima Warén & Sibuet, 1981, Sticteulima Laseron, 1955, Thaleia Warén, 1979, and Umbilibalcis Bouchet & Warén, 1986. The genera Sticteulima, Ophieulima and Umbilibalcis are reported for the first time in the southwestern Atlantic. Four species represent new records for the southwestern Atlantic. A redescription of the shell morphology is provided for: Costaclis egregia (Dall, 1889b), Melanella doederleini (Brusina, 1886), and Umbilibalcis lata (Dall, 1889b). Additional information to the original description are reported for other species. Melanella sarissa is considered as a synonym of Melanella cinca Dall, 1927. Six new species are described: Eulima cracentis sp. nov., Melanella paraabida sp. nov., M. adiastalta sp. nov., M. anapetes sp. nov., Sticteulima cabrali sp. nov. and S. canopusensis sp. nov. Lectotypes are designated for: Costaclis hyalina, C. egregia, Eulima ephamilla (Watson, 1883), E. psila and E. (?) hebes. Eulima sp. 1, Melanella sp. 1 and Melanella sp. 2 are potential new species, but the scarcity of material precludes a formal description at this moment.
Studies on the genus Lefroyothrips, with new records from Malaysia, New Caledonia and a new species from Australia (Thysanoptera, Thripidae)
Authors: MOUND L.A. , NG Y.F.
Published: February 2021

Six species are recognised in the genus Lefroyothrips, including one new species from Australia. The metascutal chaetotaxy of two of these species is unique amongst Thripidae. New distribution records given here indicate that four of the species are widely distributed: L. pictus across tropical Africa, L. lefroyi from northern India to Taiwan, L. fasciatus from Malaysia to northern Australia and New Guinea, and L. varatharajani from southern India to New Caledonia and northern Australia. An illustrated key is provided to the six known species in this genus.
Numerical Simulation of Mountain Waves over the Southern Andes. Part II: Momentum Fluxes and Wave–Mean-Flow Interactions
Authors: Fritts David C. , Lund Thomas S. , Wan Kam , Liu Han-Li
Published: February 2021

A companion paper by Lund et al. employed a compressible model to describe the evolution of mountain waves arising due to increasing flow with time over the southern Andes, their breaking, secondary gravity waves and acoustic waves arising from these dynamics, and their local responses. This paper describes the mountain wave, secondary gravity wave, and acoustic wave vertical fluxes of horizontal momentum, and the local and large-scale three-dimensional responses to gravity breaking and wave–mean-flow interactions accompanying this event. Mountain wave and secondary gravity wave momentum fluxes and deposition vary strongly in space and time due to variable large-scale winds and spatially localized mountain wave and secondary gravity wave responses. Mountain wave instabilities accompanying breaking induce strong, local, largely zonal forcing. Secondary gravity waves arising from mountain wave breaking also interact strongly with large-scale winds at altitudes above ~80 km. Together, these mountain wave and secondary gravity wave interactions reveal systematic gravity wave–mean-flow interactions having implications for both mean and tidal forcing and feedbacks. Acoustic waves likewise achieve large momentum fluxes, but typically imply significant responses only at much higher altitudes.
Synoptic–Dynamic and Airmass Characteristics Distinguishing Long- and Short-Duration Freezing Rain Events in the South-Central United States
Authors: McCray Christopher D. , Gyakum John R. , Atallah Eyad H.
Published: February 2021

Though prolonged freezing rain events are rare, they can result in substantial damage when they occur. While freezing rain occurs less frequently in the south-central United States than in some regions of North America, a large number of extremely long-duration events lasting at least 18 h have been observed there. We explore the key synoptic–dynamic conditions that lead to these extreme events through a comparison with less severe short-duration events. We produce synoptic–dynamic composites and 7-day backward trajectories for parcels ending in the warm and cold layers for each event category. The extremely long-duration events are preferentially associated with a deeper and more stationary 500-hPa longwave trough centered over the southwestern United States at event onset. This trough supports sustained flow of warm, moist air from within the planetary boundary layer over the Gulf of Mexico northward into the warm layer. The short-duration cases are instead characterized by a more transient upper-level trough axis centered over the south-central U.S. region at onset. Following event onset, rapid passage of the trough leads to quasigeostrophic forcing for descent and the advection of cold, dry air that erodes the warm layer and ends precipitation. While trajectories ending in the cold layer are very similar between the two categories, those ending in the warm layer have a longer history over the Gulf of Mexico in the extreme cases compared with the short-duration ones, resulting in warmer and moister onset warm layers.
KR20 and KR21 for Some Nondichotomous Data (It’s Not Just Cronbach’s Alpha)
Authors: Foster Robert C.
Published: February 2021

This article presents some equivalent forms of the common Kuder–Richardson Formula 21 and 20 estimators for nondichotomous data belonging to certain other exponential families, such as Poisson count data, exponential data, or geometric counts of trials until failure. Using the generalized framework of Foster (2020), an equation for the reliability for a subset of the natural exponential family have quadratic variance function is derived for known population parameters, and both formulas are shown to be different plug-in estimators of this quantity. The equivalent Kuder–Richardson Formulas 20 and 21 are given for six different natural exponential families, and these match earlier derivations in the case of binomial and Poisson data. Simulations show performance exceeding that of Cronbach’s alpha in terms of root mean square error when the formula matching the correct exponential family is used, and a discussion of Jensen’s inequality suggests explanations for peculiarities of the bias and standard error of the simulations across the different exponential families.
Determining the Number of Factors When Population Models Can Be Closely Approximated by Parsimonious Models
Authors: Xia Yan
Published: February 2021

Despite the existence of many methods for determining the number of factors, none outperforms the others under every condition. This study compares traditional parallel analysis (TPA), revised parallel analysis (RPA), Kaiser’s rule, minimum average partial, sequential χ2, and sequential root mean square error of approximation, comparative fit index, and Tucker–Lewis index under a realistic scenario in behavioral studies, where researchers employ a closing–fitting parsimonious model with K factors to approximate a population model, leading to a trivial model-data misfit. Results show that while traditional and RPA both stand out when zero population-level misfits exist, the accuracy of RPA substantially deteriorates when a K-factor model can closely approximate the population. TPA is the least sensitive to trivial misfits and results in the highest accuracy across most simulation conditions. This study suggests the use of TPA for the investigated models. Results also imply that RPA requires further revision to accommodate a degree of model–data misfit that can be tolerated.
Hong Kong under COVID-19: Roles of community development service
Authors: Lau Siu Mei , Chan Yu Cheung , Fung Kwok Kin , Hung Suet Lin , Feng Juxiong
Published: February 2021

This short article presents the plight of grassroots under the Covid-19 pandemic, which has been in the third wave from mid-July 2020. Like in many other places, the outbreak has caused economic downturn, and intensified stress about health and rising unemployment. The disadvantaged groups are suffering the most, which shows the problem of social inequality in the community. The roles of community social work in Hong Kong are highlighted to show how social workers can contribute to crisis management and empowerment of the deprived.
Salivary Gland Choristoma of the Middle Ear in a Child: A Case Report
Authors: Jančíková Jana , Šikolová Soňa , Machač Josef , Ježová Marta , Pavlovská Denisa , Urík Milan
Published: February 2021

Salivary gland choristoma is an extremely rare middle ear pathology. We present the case of a 10-year-old girl with unilateral conductive hearing loss. Tympanotomy showed a nonspecific middle ear mass, absence of stapes, anomaly of incus, and displaced facial nerve. It was not possible to remove the mass completely. Histology confirmed salivary gland choristoma. The hearing in this case can be improved with a bone-anchored hearing aid.
Acute diet soda consumption alters brain responses to food cues in humans: A randomized, controlled, cross-over pilot study
Authors: Farr Olivia M.
Published: February 2021

Background:

Diet soda consumption has frequently been linked to obesity and its comorbidities in epidemiological studies. Whether this link is causal and a potential mechanism remains to be determined.

Aim/Methods:

This randomized, cross-over, controlled pilot study sought to determine whether there may be changes in reward-related brain activations to visual food cues after acute consumption of diet soda versus regular soda or carbonated water using functional magnetic resonance imaging.

Results:

Diet soda as compared to carbonated water consumption increased activation of reward-related caudate to highly versus less desirable food cues. Diet soda as compared to regular soda increased reward-related insula and decreased activation of cognitive control-related dorsolateral prefrontal cortex to food cues versus non-food cues. No changes in ratings of hunger an hour after beverage consumption were observed.

Conclusions:

These results may suggest a potential mechanism for diet soda to increase food palatability through activation of the reward system and suppression of inhibitory control that remains to be confirmed by future studies.
Fabrication of Aligner Removal Tool
Authors: Ram RSVM Raghu , Ranganayakulu I , Viswanadh K Anand
Published: February 2021

Firm adaptation and locking of the thermoplastic aligners, retainers, and bleaching trays make it difficult during removal, making the patients often frustrated, leading to poor compliance. Generally, to remove these, patients tend to use their fingernails or some sharp hooks, which would cause distortion or a tear. Hence, a simple, user-friendly aligner removal tool was designed to overcome these issues.
Work life balance among female school teachers [k-12] delivering online curriculum in Noida [India] during COVID: Empirical study
Authors: Rawal Debyani Mukherjee
Published: February 2021

Job satisfaction is a vital factor regarding turnover rates, especially among women. Work life balance today, especially in times of COVID where home and work place have transgressed boundaries is an imperative precursor for the well-being of an individual. A satisfying job well-integrated into life, balances the overall mental and emotional quotient of working women particularly in the current pandemic in which the workplace is posing a new and unlike set of challenges and problems for women. Research suggests that work place problems faced by the Indian women are mostly long working hours, less recognition of work, lack of motivation and stress related issues, but the new normal of working remotely from home now is altogether an unexpected work scenario. With respect to emerging nations, problems of work life balance among women in the education sector are not well researched. Increased women employment has led to a swelling attention from academia and industry on WLB. With greater access to better educational opportunities, increasing number of women are entering the workforce, and shifting from being home-makers to the organized work force, thereby necessitating an urgent need to examine this phenomenon. Carrying on with online classes remotely has become the order of the day, and it is becoming stressful when both school and personal life operate from the same space. The main idea here is to understand challenges during COVID which are being faced by school teachers in Noida delivering content to students from home and their surviving strategies.
Diagnostic capability of ultrasound in peritoneal catheter malfunction compared to videolaparoscopy
Authors: Zeiler Matthias , Federico Antonio , Lentini Paolo , Dell’Aquila Roberto , Santarelli Stefano , Granata Antonio ,   for the Project Group ‘Integrated Imaging and Interventional Nephrology’ of the Italian Society of Nephrology
Published: February 2021

Background:

The approach to peritoneal catheter malfunction consists usually in a diagnostic and therapeutic sequence of laxative prescription, abdominal radiography, brushing of the catheter, guide-wire manipulation or fluoroscopy and in the end of a videolaparoscopy (VLS) rescue intervention. Ultrasound (US) is able to find out major causes of peritoneal catheter malfunction, however without a clearly defined diagnostic value. The aim of the study was to validate the diagnostic capability of US in catheter malfunction compared to the diagnostic reference of VLS.

Methods:

US scans of the subcutaneous and intraperitoneal segment of the catheter were performed prior to a VLS intervention in 40 adult patients presenting persistent catheter malfunction within a prospective multicentre study. Laxative prescription and brushing of the catheter lumen were undertaken prior to US scan. US diagnosis was compared to the corresponding at VLS, kappa coefficient calculated and the causes of mismatch analysed.

Results:

In US, causes of persistent malfunction were catheter dislocation combined with omental wrapping in 21 cases, omental wrapping without dislocation in 11 cases, dislocation only in 4 cases, adherences to non-omental structures in 3 cases and entrapment in the lateral inguinal fossa in 1 case. The US diagnosis corresponded to the respective at VLS in 36 of 40 cases, resulting in a kappa coefficient of 0.89 (95% CI: 0.78–1.00). The discrepancies were due to improper visualization of the catheter between omentum and intestinal loops, resulting in an erroneous US diagnosis of omental wrapping.

Conclusions:

This study suggests that US might have a pivotal role in the diagnostic approach to peritoneal catheter dysfunction.
Improvement of lupus-associated fatigue with modafinil: Report of two cases
Authors: Korsten Peter , Piantoni Silvia
Published: February 2021

Fatigue is a frequently reported and disabling symptom in patients with systemic lupus erythematosus (SLE). The management of Lupus-associated fatigue (LAF) is complex and requires the exclusion of disease activity and comorbidities as potentially treatable causes. Standard of care recommendations includes psychological counselling and regular physical activity. However, many SLE patients still report the persistence of LAF despite these measures. Therefore, pharmacological management may be required, which has been insufficiently investigated in clinical trials. Here, we report two patients who improved with pharmacological treatment with modafinil (MODA), a central nervous system stimulant. Both patients had an overall low disease activity (SLEDAI-2K score of 0). Their FACIT fatigue scores were 15 and 20, respectively (with a maximum score of 52, where 52 indicates the best quality of life). With MODA treatment, the first patient’s FACIT fatigue score improved from 15 to 42, the second patient’s score from 20 to 37. In the latter patient, it returned to 21 after stopping the drug and increased back again to 37 after re-treatment.

In conclusion, our report demonstrates, for the first time, that MODA treatment is a potential pharmacological treatment option in selected patients with LAF. Clinical trials in SLE are required to confirm our observations.
Determinants of Exports Behaviour of India’s Agro-processing Firms: Role of Technology, Imported Raw Materials and Logistics Infrastructure
Authors: Ramaiah Suresh , Roy Gopal Krishna
Published: February 2021

Despite accounting for a sizeable share in the overall output and employment of the manufacturing sector, the export potential of India’s Agro-processing firms has received less attention. This article investigates the determinants of export propensity and intensity of relatively labour-intensive agro-processing firms in India with a focus on the role of technology adopted, the proportion of imported raw materials used and status of the logistics infrastructure at the location of the firm. The article makes use of the CMIE-PROWESS dataset to obtain a cross-section of agro-processing firms for the year 2016–2017 and the Logistic Ease Across Different States (LEADS) database. The empirical strategy involves the Heckman two-step process to address the sample selection bias originating in modelling export behaviour. The article finds that the likelihood of an agro-processing firm to enter the exporting market increases with an increase in technology enhancing investment in terms of expenditure on research and development and import of capital goods. Moreover, a better level of logistics infrastructure enhances the likelihood of exporting. The likelihood of a firm to export also increases with the increase in the use of imported raw materials, firm size, age and superior managerial quality. However, the paper finds only the expenditure on imported capital goods and imported raw materials to be positively and significantly associated with the export intensity of the exporting firms.
Help-seeking pathways prior to referral to outpatient child and adolescent mental health services
Authors: Hansen Anna Sofie , Kjaersdam Telléus Gry , Færk Emil , Mohr-Jensen Christina , Lauritsen Marlene Briciet
Published: February 2021

Aim:

To investigate parental help-seeking patterns prior to referral to outpatient child and adolescent mental health services (CAMHS), and whether type of symptoms or duration of mental health problems prior to referral influence help-seeking.

Setting:

Child mental health services in Denmark involve several sectors collaborating based on stepped-care principles. Access to CAMHS is free of charge but requires a formal referral.

Methods:

In this cross-sectional observational study, parents of 250 children were interviewed about pathways to outpatient CAMHS using the Children’s Services Interview.

Results:

The median parent-reported duration of mental health problems prior to referral to CAMHS was 6.0 (IQR 3.4–8.5) years for children referred for neurodevelopmental disorders compared to 2.8 (IQR 1.0–6.5) years for children referred for emotional disorders. Educational services were the first help-seeking contact for the majority (57.5%) but referrals to CAMHS were most frequently from healthcare services (56.4%), predominantly general practitioners. Educational services played a greater part in help-seeking pathways for children referred for neurodevelopmental disorders.

Conclusion:

The majority of children referred to CAMHS have mental health problems for years before referral. The delay in time-to-referral was most pronounced for children referred for neurodevelopmental disorders. Help-seeking pathways differ by symptom duration and type of symptoms.
A mixed methods study of clinician reported challenges in the assessment of ADHD and treatment decisions for children with ADHD in Brazil
Authors: Honorio Neto Fabiola , Camargo Ana Paula , Polanczyk Gilherme , Adamis Dimitrios , McNicholas Fiona
Published: February 2021

Objective: This ADHD national survey has obtained original data on the assessment and treatment of attention deficit hyperactivity disorder (ADHD) reported by Brazilian paediatricians and child psychiatrists; and has compared their practice. Method: The study questionnaire was delivered to 165 neuro/community paediatricians and 272 child and adolescent psychiatrists. Quantitative and qualitative data were collected and analysed. Results: Paediatricians assess children with a suspected ADHD, but do not feel confident to prescribe methylphenidate alone. Both paediatricians and child psychiatrists consider combined treatment of medication and psychotherapy more effective. Clinicians want to involve other professionals in the medical decisions but experience difficulties accessing specialist services, especially in public practice. Conclusion: This study showed the impact of the public–private mix in the delivery of and access to appropriate assessment and treatment services for children with ADHD in Brazil.
Hazy clouds: Making black carbon visible in climate science
Authors: Bhojvaid Vasundhara
Published: February 2021

In 1995, a multimillion-dollar experiment – the Indian Ocean Experiment – discovered a dark mass of polluting air hovering above the Indian subcontinent. This mass of air was termed a cloud and found to be composed of a high amount of black carbon that was judged to be the second biggest threat to climate change after carbon-dioxide. In this article, an attempt is made to trace the life of black carbon by documenting its changing forms since the experiment. It emerges that the changing forms allow for the movement of air – smoke from traditional cookstoves and vehicular diesel emissions in India lead to the formation of the cloud – and reveal how an ethnography of air can be undertaken.
Nordic population-based study on internet use and perceived meaningfulness in later life: How they are linked and why it matters
Authors: Viklund Emilia W.E. , Nilsson Ingeborg , Forsman Anna K.
Published: February 2021

Aim:

The aim was to explore the association between internet use, the use of specific internet-based activities and perceiving life as meaningful, among older adults in two regions in Finland and Sweden.

Methods:

The data was collected through a population-based survey ( N = 9386) as part of the GERDA project conducted in 2016. In order to analyse the associations between perceiving life as meaningful and internet use and related activities, odds ratios with a 95% confidence interval were calculated using binary logistic regression analysis, where socio-demographic factors and health status were controlled for.

Results:

Statistically significant associations were found between perceiving life as meaningful and internet use in later life. When looking further at the specific internet-based activities under study, activities related to leisure and entertainment showed a statistically significant connection to perceived meaningfulness in later life, after controlling for socio-demographic factors and health status.

Conclusions:

The results indicated that there was a statistically significant positive association between internet use and perceiving life as meaningful in later life. Online activities related to leisure and entertainment seem to be especially associated with perceived meaningfulness. Although causal direction could not be determined, the results suggest that internet use may support the experience of wellbeing in everyday life among older persons, through the unlimited access to interest-driven activities that it provides.
Stress–strain evaluation of structural parts using artificial neural networks
Authors: Ribeiro João PA , Tavares Sérgio MO , Parente Marco
Published: February 2021

The last decades have been driven by significant progress in the computational capacity, which have been supporting the development of increasingly realistic and detailed simulations. However, despite these improvements, several problems still do not have an effective solution, due to their numerical complexity. As a result, the answer to these problems can be improved by using techniques that enable the description of phenomena with less resolution, but with lower computational costs, which is the case of the reduced order models. The main objective of this article is the presentation of a new approach for reduced order model development and application in the design and optimization of structural parts. The selected method is the artificial neural networks. Artificial neural networks allow the prediction of certain variables based on a given dataset. Two typical case studies are addressed: the first is a fixed plate subjected to uniformly distributed pressure and the second is a reinforced panel also subjected to internal pressure, with regular reinforcements to improve the specific strength. With this method, a substantial reduction in the simulation time is observed, being, approximately, 40 times faster than the solution obtained with Ansys. The developed neural network has a relative average difference of about 20 %, which is considered satisfactory given the complexity of the problem and considering it is a first application of these networks in this domain. In conclusion, this research made it possible to highlight the potential of reduced order model: including the shorter response time, the less computational resources, and the simplification of problems in detriment of less resolution in the description of structural behaviour. Given these advantages, it is expected that these models will play a key role in future applications, as in digital twins.
Violent crime, hate speech or terrorism? How Canada views and prosecutes far-right extremism (2001–2019)
Authors: Nesbitt Michael
Published: February 2021

Fifty-six individuals were charged with terrorism between December 2001 when Canada first enacted its antiterrorism criminal offences and December 2019. Not a single such individual was associated with a far-right group or espoused a far-right ideology. Over the same period of time, Canada saw a rise in far-right violence and crime, including several deadly attacks that raised the spectre of terrorism. This article seeks to identify why terrorism has not been associated with the activities of those on the far right, how Canada has prosecuted far-right violence if not for terrorism and what the implications are for Canada’s criminal prosecutions going forward. It finds that since December 2001 all publicly reported hate speech cases and cases where an individual’s sentence was aggravated for hate have involved individuals espousing far-right rhetoric; likewise, all but one case where the media raised the spectre of terrorism but no such charge ensued can be described as being motivated by far-right ideation. In the result, Canadian law punishes more seriously Al-Qaida (AQ)-inspired extremism than far-right extremism, while stigmatizing the former more than the latter. The time has thus come to tackle head-on the concept of ideology in Canadian criminal law, and how the law treats various ideologies.
Expectations of Patients and Their Informal Caregivers from an Integrative Oncology Consultation
Authors: Samuels Noah , Oberbaum Menachem , Ben-Arye Eran
Published: February 2021

Integrative physicians (IPs) working in supportive and palliative care are often consulted about the use of herbal medicine for disease-related outcomes. We examined 150 electronic files of oncology patients referred to an IP consultation for demographic and cancer-related data; use of herbal medicine for disease-related outcomes; and narratives of patients and informal caregivers describing their expectations from the IP consultation. Over half (51.3%) of patients reported using herbal medicine for disease-related outcomes, more so among those adopting dietary changes for this goal ( P < .005). Most (53.3%) were accompanied by an informal caregiver, especially those using herbal medicine (66.2%, P = .002) or adopting dietary changes (69.8%, P < .001). The majority of patients (84.4%) expected the IP to provide guidance on the use of herbal medicine for disease-related outcomes (e.g., “curing,” “shrinking,” “eradicating” and “cleansing”). Most caregivers (88.8%) expressed a similar expectation, with some having additional questions not mentioned by the patient. IPs need to identify and understand expectations of oncology patients and their informal caregivers, helping them make informed decisions on the effective and safe use of herbal medicine. The IP may need to “reframe” expectations regarding the ability of herbal medicine to treat cancer and immunity, to more realistic quality of life-focused goals.
Full Analysis of Lung Cancer Mortality/Radon Relationship with Simple Nonlinear Concepts
Authors: Lai Ralph W.
Published: February 2021

We analyze the relationship between the lung cancer mortality and the indoor radon intensity from the viewpoint of nonlinear mathematics. We conclude that their relationship is governed by the proportionality law where the cumulative lung cancer mortality Y is negatively proportional to the cumulative radon intensity X; or specifically, the nonlinear change of nonlinear face value (qYu – qY) is negatively proportional to the nonlinear change of nonlinear face value (X – Xb).

The author obtained a set of data from late Professor Cohen on the lung-cancer mortality rate versus indoor radon level collected from 1,597 counties and territory of the USA. We initially presented the data as various primitive elementary graphs; then extended them to the primary graphs, leading graphs, and the proportionality graphs. The article emphasizes the building of a straight-line proportionality relationship for the dose-response data in a log-linear and/or log-log graphs. It demonstrates a straightforward methodology for solving the key upper asymptotes (Yu) for the proportionality equation using the Microsoft Excel via determining the “coefficient of determination”. (Note: q = log, Yu = upper asymptote of Y, Xb = bottom asymptote of X)