bluuebunny/crossref_metadata_2025 huggingface dataset:
Oral Trypanosoma cruzi Transmission Resulting in Advanced Chagasic Cardiomyopathy in an 11-Month-Old Male
Authors: Nolan Melissa S. , Tonussi Mendes Joseane Elza , Perez Riera Andres Ricardo , Laporta Gabriel Zorello
Published: October 2020

Our case report describes the youngest clinical acute Chagas disease case and their unusual disease presentation of cardiac failure. In parts of the Brazilian Amazon, cultural practices include weaning infants from breastmilk to solid foods with açaí consumption serving as an intermediary. This practice could place infants at an increased risk of oral Trypanosoma cruzi infection and severe Chagasic cardiac disease.
The Therapeutic Prospects of Naturally Occurring and Synthetic Indole Alkaloids for Depression and Anxiety Disorders
Authors: Munir Samman , Shahid Aqsa , Aslam Bilal , Ashfaq Usman Ali , Akash Muhammad Sajid Hamid , Ali Muhammad Akhtar , Almatroudi Ahmad , Allemailem Khaled S. , Rajoka Muhammad Shahid Riaz , Khurshid Mohsin
Published: October 2020

Depression and anxiety are the most common disorders among all age groups. Several antidepressant drugs including benzodiazepine, antidepressant tricyclics, azapirone, noradrenaline reuptake inhibitors, serotonin selective reuptake inhibitors, serotonin, noradrenaline reuptake inhibitors, and monoamine oxidase inhibitors have been used to treat these psychiatric disorders. However, these antidepressants are generally synthetic agents and can cause a wide range of side effects. The potential efficacy of plant‐derived alkaloids has been reviewed against various neurodegenerative diseases including Alzheimer’s disease, Huntington disease, Parkinson’s disease, schizophrenia, and epilepsy. However, data correlating the indole alkaloids and antidepressant activity are limited. Natural products, especially plants and the marine environment, are rich sources of potential new drugs. Plants possess a variety of indole alkaloids, and compounds that have an indole moiety are related to serotonin, which is a neurotransmitter that regulates brain function and cognition, which in turn alleviates anxiety, and ensures a good mood and happiness. The present review is a summary of the bioactive compounds from plants and marine sources that contain the indole moiety, which can serve as potent antidepressants. The prospects of naturally occurring as well as synthetic indole alkaloids for the amelioration of anxiety and depression‐related disorders, structure‐activity relationship, and their therapeutic prospects have been discussed.
URDNet: A Unified Regression Network for GGO Detection in Lung CT Images
Authors: Liu Weihua , Ren Yuchen , Li Huiyu
Published: October 2020

We present a 3D deep neural network known as URDNet for detecting ground-glass opacity (GGO) nodules in 3D CT images. Prior work on GGO detection repurposes classifiers on a large number of windows to perform detection or fine-tuning by box regression based on a previous window classification step. Instead, we consider GGO detection as a multitarget regression problem to focus on the location of GGO. Furthermore, to capture multiscale information, we introduce a backbone network which is a contracting-expanding structure similar to 2D U-net, but we inject the source CT inputs into each layer in the contracting pathway to prevent source information loss at different scales. At last, we propose a two-stage training method for URDNet. In the first stage, the backbone of the network for feature extraction is trained, and in the second, the overall URDNet is fine-tuned based on the previous pretrained weights. By using this training method in conjunction with data augmentation and hard negative mining techniques, our URDNet can be effectively trained even on a small amount of annotated CT images. We evaluate the proposed method on the LIDC-IDRI dataset. It achieves the sensitivity of 90.8% with only 1 false positive per scan. Experimental results show that our detection method achieves the superior detection performance over the state-of-the-art methods. Due to its simplicity and effective, URDNet can be easier to apply to medical IoT systems for improving the efficiency of overall health systems.
Intravenous γ Globulin for Intractable Abdominal Pain due to IgA Vasculitis
Authors: Naifa George , Totikidis George , Alexiadou Sonia , Kolona Christina , Mantadakis Elpis
Published: October 2020

IgA vasculitis (formerly known as Henoch–Schönlein purpura or anaphylactoid purpura) is a usually benign vasculitis that affects children of school age. The disease is characterized by the tetrad of palpable purpura, arthralgia/arthritis, abdominal pain, and hematuria. Treatment of IgA vasculitis is mainly supportive, with administration of simple analgesics. Corticosteroids have been shown to reduce and/or ameliorate the occurrence of abdominal pain which may be severe. We present two children with IgA vasculitis and severe abdominal pain despite corticosteroid administration, who responded promptly to intravenous γ globulin (IVIg) with complete resolution of their symptoms and review of the relevant medical literature. Given the toxicity and/or need for long-term administration of other second-line immunosuppressive therapies in corticosteroid-resistant IgA vasculitis, such as rituximab, cyclosporine, cyclophosphamide, azathioprine, or colchicine, we propose that IVIg may be a useful and safe treatment option, although randomized controlled clinical trials are needed in order to clarify its role in the treatment of abdominal pain in IgA vasculitis.
Deformation Characteristics of Soft Marine Soil Tested under Cyclic Loading with Low Frequency
Authors: Lu Yu , Fu Wenbin , Xue Danxuan
Published: October 2020

Soft marine soil which could be found widely at the coastal and offshore areas is usually associated with high settlement and instability, especially under cyclic loading. Many research studies have been conducted on its deformation characteristics under the cyclic loading with high frequency, whereas few works have been reported on that under the low‐frequency cyclic loading which largely existed in engineering. In this work, a comprehensive series of undrained triaxial tests under cyclic loading with low frequency was conducted to investigate the deformation characteristics of soft marine soil. The results demonstrate that soil specimens accumulate plastic deformation and pore pressure under cyclic loading. Specimens tested under conditions such as high confining stress, high‐stress ratio, and long cyclic period generally reveal higher deformation and pore pressure. Meanwhile, the rectangular wave presents the largest contribution to plastic strain and pore pressure, followed by the trapezoidal and triangular waves, respectively, whereas the difference between the various waves decreased gradually with the increasing load level and cyclic period. The undisturbed specimens displayed lower deformations and pore pressures than the reconstructed specimens, whereas the differences are not significant when the confining stress is much higher than the structural yield stress. Furthermore, an empirical model for predicting the evolution of pore pressure is proposed and then validated against the experimental data in both this work and the literature.
A Deep Fusion Gaussian Mixture Model for Multiview Land Data Clustering
Authors: Li Peng , Chen Zhikui , Gao Jing , Zhang Jianing , Jin Shan , Zhao Wenhan , Xia Feng , Wang Lu
Published: October 2020

With the rapid industrialization and urbanization, pattern mining of soil contamination of heavy metals is attracting increasing attention to control soil contamination. However, the correlation over various heavy metals and the high-dimension representation of heavy metal data pose vast challenges on the accurate mining of patterns over heavy metals of soil contamination. To solve those challenges, a multiview Gaussian mixture model is proposed in this paper, to naturally capture complicated relationships over multiviews on the basis of deep fusion features of data. Specifically, a deep fusion feature architecture containing modality-specific and modality-common stacked autoencoders is designed to distill fusion representations from the information of all views. Then, the Gaussian mixture model is extended on the fusion representations to naturally recognize the accurate patterns of the intra- and inter-views. Finally, extensive experiments are conducted on the representative datasets to evaluate the performance of the multiview Gaussian mixture model. Results show the outperformance of the proposed methods.
A Privacy-Preserving Personalized Service Framework through Bayesian Game in Social IoT
Authors: Bi Renwan , Chen Qianxin , Chen Lei , Xiong Jinbo , Wu Dapeng
Published: October 2020

It is enormously challenging to achieve a satisfactory balance between quality of service (QoS) and users’ privacy protection along with measuring privacy disclosure in social Internet of Things (IoT). We propose a privacy-preserving personalized service framework (Persian) based on static Bayesian game to provide privacy protection according to users’ individual security requirements in social IoT. Our approach quantifies users’ individual privacy preferences and uses fuzzy uncertainty reasoning to classify users. These classification results facilitate trustworthy cloud service providers (CSPs) in providing users with corresponding levels of services. Furthermore, the CSP makes a strategic choice with the goal of maximizing reputation through playing a decision-making game with potential adversaries. Our approach uses Shannon information entropy to measure the degree of privacy disclosure according to the probability of game mixed strategy equilibrium. Experimental results show that Persian guarantees QoS and effectively protects user privacy despite the existence of adversaries.
Multiple-Devices-Process Integrated Scheduling Algorithm with Time-Selective Strategy for Process Sequence
Authors: Zhang Xiaohuan , Zhang Dan , Wang Zhen , Xin Yu
Published: October 2020

This paper is in view of the current algorithm to solve Multiple-Devices-Process integrated scheduling problems without considering parallel process between the parallel processing. Meanwhile, the influence of the first processing procedure on the second processing procedure is ignored, resulting in poor tightness between serial processes and poor parallelism between parallel processes, ultimately affecting the product scheduling results. We proposed Multiple-Devices-Process integrated scheduling algorithm with time-selective for process sequence. The proposed Multiple-Devices-Process sequencing strategy determines the process of scheduling order and improves the tightness between serial process. This paper presents a method to determine the quasischeduling time point of the multiequipment process, the time-selective strategy of Multiple-Devices-Process, and the time-selective adjustment strategy of Multiple-Devices-Process so that the first and the second processing processes cooperate with each other, and the purpose of improving the tightness of the serial process and the parallelism of the parallel processes is achieved, so as to shorten the product processing time.
Efficacy and Safety of Acupuncture Therapy for Patients with Acute Ankle Sprain: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials
Authors: Liu Ai-Feng , Gong Shu-Wei , Chen Ji-Xin , Zhai Jing-Bo
Published: October 2020

Background. The efficacy of acupuncture for acute ankle sprain (AAS) is controversial. This study aimed to critically assess the efficacy and safety of acupuncture for AAS. Methods. Parallel‐group randomized controlled trials (RCTs) were included regardless of language or publication date. Participants with AAS were included regardless of age, sex, race, nationality, or diagnostic criteria for AAS. Experimental interventions included acupuncture alone or in combination with traditional therapies. Control interventions included no treatment, placebo, or traditional therapies. The primary outcome was the Kofoed ankle score. The secondary outcomes included visual analogue scale, duration of pain, use of painkiller, ankle circumference, effective rate, cure rate, and adverse events. PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Digital Periodicals, and Chinese Science and Technology Periodicals database were searched to identify potentially eligible studies from inception to September 10, 2020. World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), ClinicalTrials.gov, Chinese Clinical Trial Registry (ChiCTR), and the reference list of eligible RCTs were checked to identify ongoing or unpublished studies. Risk of bias was assessed by the Cochrane Collaboration’s tool. Statistical analyses were performed by RevMan 5.3 software. P < 0.05 indicated statistical significance. Results. Seventeen eligible studies were included for the statistical analysis. There was no statistically significant difference of Kofoed ankle score between acupuncture and Rest, Ice, Compression, and Elevation (RICE) group (P = 0.75). However, acupuncture could significantly relieve pain (P = 0.02) and increase cure rate (P = 0.004) compared with RICE. Moreover, acupuncture plus RICE could also significantly relieve pain (P < 0.00001) and increase cure rate (P = 0.01) compared with RICE alone. Acupuncture combined with massage could significantly relieve pain (P = 0.04) compared with massage alone. Acupuncture plus Chinese medicine might be more effective for relieving pain (P < 0.00001), reducing the duration of pain (P < 0.00001), and increasing cure rate (P = 0.0002) compared with Chinese medicine alone. Two studies reported no adverse reactions. One study reported that a participant suffered from mild drug‐related allergic reaction and was healed without treatment. Conclusions. The findings of the present study suggest that acupuncture may be beneficial for AAS. However, more large‐scale and well‐designed RCTs are warranted.
Value of CT Features in the Diagnosis of Papillary Thyroid Tumors in Incidental Thyroid Nodules
Authors: Zhang Fengyan , Qiao Ying , Zhang Hui
Published: October 2020

The present work has investigated the value of computed tomography (CT) features in the diagnosis of papillary thyroid tumors in the incidental thyroid nodules (ITNs). In the 82 enrolled patients, 101 thyroid nodules were incidentally found by the neck CT scanning, among which 49 were histologically confirmed to be papillary thyroid carcinoma (PTC) while the other 52 were nodular goiter (NG). The tumor location, size, shape, tiny calcification, cystic change, and signs of an irregular ring, marginal defects, and enhanced blurring were all depicted by CT features. Both univariate and multivariate analyses were employed to identify independent predictors of PTC. The univariate analysis of PTC and NG showed that four CT features were statistically significant, including tiny calcification and signs of an irregular ring, marginal defects, and enhanced blurring. Furthermore, the multivariate logistic regression model indicated that signs of an irregular ring, marginal defects, and enhanced blurring were strongly correlated with PTC, of which the odds ratio (OR) was 27.374 (95% CI: 5.871∼127.636), 28.587 (95% CI: 4.139∼197.460), and 4.315 (95% CI: 0.858∼21.694), respectively. In the predictive model of PTC, the value of sensitivity, specificity, accuracy, and Youden index was 87.8%, 94.2%, 91.1%, and 0.82 with a likelihood ratio of 15.1. Therefore, the signs of an irregular ring, marginal defects, and enhanced blurring may be helpful in the diagnosis of PTC in incidentally found thyroid nodules.
Generation of Chicken IgY against SARS-COV-2 Spike Protein and Epitope Mapping
Authors: Lu Yan , Wang Yajun , Zhang Zhen , Huang Jingliang , Yao Meicun , Huang Guobin , Ge Yuanyuan , Zhang Peichun , Huang Huaxin , Wang Yong , Li Huiliang , Wang Wen
Published: October 2020

This new decade has started with a global pandemic of COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), precipitating a worldwide health crisis and economic downturn. Scientists and clinicians have been racing against time to find therapies for COVID-19. Repurposing approved drugs, developing vaccines and employing passive immunization are three major therapeutic approaches to fighting COVID-19. Chicken immunoglobulin Y (IgY) has the potential to be used as neutralizing antibody against respiratory infections, and its advantages include high avidity, low risk of adverse immune responses, and easy local delivery by intranasal administration. In this study, we raised antibody against the spike (S) protein of SARS-CoV-2 in chickens and extracted IgY (called IgY-S) from egg yolk. IgY-S exhibited high immunoreactivity against SARS-CoV-2 S, and by epitope mapping, we found five linear epitopes of IgY-S in SARS-CoV-2 S, two of which are cross-reactive with SARS-CoV S. Notably, epitope SIIAYTMSL, one of the identified epitopes, partially overlaps the S1/S2 cleavage region in SARS-CoV-2 S and is located on the surface of S trimer in 3D structure, close to the S1/S2 cleavage site. Thus, antibody binding at this location could physically block the access of proteolytic enzymes to S1/S2 cleavage site and thereby impede S1/S2 proteolytic cleavage, which is crucial to subsequent virus-cell membrane fusion and viral cell entry. Therefore, the feasibility of using IgY-S or epitope SIIAYTMS-specific IgY as neutralizing antibody for preventing or treating SARS-CoV-2 infection is worth exploring.
RxLegal: The Evolving Legal Landscape of Telehealth
Authors: Gabay Michael
Published: October 2020

The provision of telehealth services has increased dramatically during the COVID-19 pandemic with the introduction of various temporary waivers and rules designed to increase flexibility in the pandemic response. This expansion of telehealth has not only increased patient access, but protected essential healthcare workers from potential virus exposure. The advantages of increased telehealth services has prompted the introduction of a bipartisan bill in Congress, which seeks to make some of the temporary measures undertaken during the pandemic permanent. Pharmacists have been able to expand telehealth services further with the implementation of these regulatory changes.
Effects of unmodelled dynamic factors on an under-actuated quadrotor: A review of hybrid observer design methods
Authors: Abro Ghulam E Mustafa , Asirvadam Vijanth Sagayan , Bin Mohd Zulkifli Saiful Azrin , Sattar Abdul , Kumar Dileep , Anwer Ali
Published: October 2020

Unmodelled dynamic factors are either the left-over or the estimated factors such as lower or upper bound values while modelling any mechatronic system. Hence, with the inclusion of under-actuation in a system such as fewer number of actuators as compared to degrees of freedom, this will lead the system to high instability. These factors are changing instantly during multiple flights of quadrotor that is, the values of these factors in path following may vary from the values in hovering mode. Hence, it is one of the strenuous tasks to tackle these unmodelled dynamic factors for the multiple flight modes of an underactuated quadrotor craft. One of the better ways for tracking control of a quadrotor aerial vehicle with unmodelled dynamics is to observe and estimate the instant change in parameters. Thus, this paper exhibits an extensive review of several hybrid observer design methods being fused with some novel control strategies. In addition to this, the survey paper also summarises the limitations of the current state of the art approaches. This paper demonstrates an unexplored field of study where researchers must need to evaluate the performance of hybrid observer design methods.
Extracellular Vesicles of GMSCs Alleviate Aging-Related Cell Senescence
Authors: Shi H.Z. , Zeng J.C. , Shi S.H. , Giannakopoulos H. , Zhang Q.Z. , Le A.D.
Published: October 2020

Healthy aging is a complex biological process with progressive accumulation of senescent cells characterized by stable cell cycle arrest, resulting in impaired homeostasis, regenerative potential, and gradual functional decline in multiple tissues and organs, whereby the aberrant activation of mammalian target of rapamycin (mTOR) signaling networks plays a central role. Herein, we explored the effects of extracellular vesicles (EVs) released by gingiva-derived mesenchymal stem cells (GMSC-EVs) on oxidative stress–induced cellular senescence in human endothelial cells and skin fibroblasts and their antiaging potentials. Our results showed that GMSC-EVs robustly abrogated oxidative stress–induced upregulation in the expression of cellular senescence-related genes, such as β-galactosidase, p21, p53, and γH2AX, and mTOR/pS6 signaling pathway, in human umbilical vein endothelial cells (HUVECs) and skin fibroblasts. Meanwhile, GMSC-EVs restored oxidative stress–induced impairment in proliferation and tube formation by HUVECs. Systemic administration of GMSC-EVs attenuated aging-associated elevation in the expression levels of p21, mTOR/pS6, interleukin 6, and tumor necrosis factor α in skin and heart tissues of aged mice. These findings suggest that GMSC-EVs could be a potential alternative source of cell-free product for attenuation of aging-related skin and vascular dysfunctions due to their potent inhibitory effects on oxidative stress–induced cellular senescence in endothelial cells and skin fibroblasts.
mTOR Inhibition Ablates Cisplatin-Resistant Salivary Gland Cancer Stem Cells
Authors: Nakano T. , Warner K.A. , Oklejas A.E. , Zhang Z. , Rodriguez-Ramirez C. , Shuman A.G. , Nör J.E.
Published: October 2020

Patients with advanced salivary gland mucoepidermoid carcinoma (MEC) are treated with surgery and radiotherapy, as current systemic therapies are largely ineffective. As such, current treatment frequently leads to poor long-term survival due to locoregional recurrence or metastases. We have shown that salivary gland cancer stem cells (CSCs) are resistant to platinum-based chemotherapy and drive tumor progression. The purpose of this study was to investigate the effect of therapeutic inhibition of mTOR (mechanistic target of rapamycin) on resistance of CSCs to cisplatin, a prototypic platinum-based chemotherapeutic agent. Viability assays determined the effect of several inhibitors of PI3k/mTOR signaling (e.g., temsirolimus, BKM120, AZD8055, PF4708671) and/or cisplatin on survival of human MEC cells. The impact of mTOR inhibitors and/or cisplatin on MEC stemness was examined with salisphere assays, flow cytometry for ALDH/CD44 (CSC markers for MEC), and Western blots for Bmi-1 expression (marker of stem cell self-renewal). Salivary gland MEC patient-derived xenografts were used to examine the effect of cisplatin and/or temsirolimus on CSCs in vivo. We observed that cisplatin induced mTOR and S6K1 phosphorylation, increased the number and size of MEC salispheres, and induced Bmi-1 expression and the fraction of CSCs in MEC models in vitro. Cisplatin also increased the fraction of CSCs in vivo. In contrast, mTOR inhibition (e.g., temsirolimus) blocked cisplatin-induced Bmi-1 expression and salisphere formation in vitro. Remarkably, temsirolimus slowed down tumor growth and decreased the fraction of CSCs ( P < 0.05) even in presence of cisplatin in a short-term in vivo experiment. Collectively, these results demonstrate that therapeutic inhibition of mTOR ablates cytotoxic-resistant CSCs, and they suggest that a combination of an mTOR inhibitor and platinum-based chemotherapy might be beneficial to patients with salivary gland mucoepidermoid carcinoma.
Express Your Self: Exploring the Nature of the Expressive Self and the Health and Well-Being Consequences of Its Restriction in a Market Society
Authors: Kimiecik Jay , Teas Elizabeth
Published: October 2020

The purpose of this article is to explore the expressive aspects of the self. Three main assumptions underlying our notion of the expressive self are it is innate, experiential, and holistic. The expressive self is by nature a dynamic inner imperative that both creates and uses energy. Our primary focus is to propose and explain four innate central tendencies of the expressive self: eudaimonia, self-determination, flow, and biophilia. We first describe the essence of each of these innate potentialities with an overview of how they interrelate to form a coherent expressive self. Then, we delve into how our present cultural system (market society) is thwarting the development of this naturally expressive self that is longing for release. This thwarting process of the expressive self has led to the emergence of a restrictive self with myriad negative physical, psychological, social, and behavioral health and well-being consequences. We conclude with research possibilities and ideas for future exploration of the expressive self.
The Balanced Scorecard: Measures That Drive Performance Evaluation in Auditing Firms
Authors: Hegazy Mohamed , Hegazy Karim , Eldeeb Mohamed
Published: October 2020

The purpose of this article is to establish a framework with its related measures for the development of a balanced scorecard (BSC) for auditing firms. A BSC was developed providing the detailed measures for performance evaluation comprising five key elements: learning and growth, clients, internal business processes, financials, and audit-related perspectives of corporate ethics. A survey was undertaken along with descriptive statistics and confirmatory factor analysis in four auditing firms, to assess the external auditors’ opinions for the proposed BSC measures. The results suggest that the development and use of the proposed BSC measures will enhance audit firms’ performance. Audit firms would have a better understanding of the various drivers of performance and strategies thereby creating a competitive advantage. The results are valuable to not only audit firms but also auditing oversight boards who could direct the design of their monitoring process by understanding performance systems in different size audit firms.
“Pretty Disgusted Honestly”: Exploring Fans’ Affective Responses on Facebook to the Modified Rules of Australian Football League Women’s
Authors: Pavlidis Adele , Toffoletti Kim , Sanders Kellie
Published: October 2020

In this article, we argue that the “turn to affect” can provide a generative framework for working through key sticking points for women in sport. Through an analysis of the rule changes and subsequent social media comments in the lead-up to the inaugural Australian Football League Women’s (AFLW) competition, we demonstrate the power of emotions for intensifying and resisting discussion about women’s participation in male-dominated sport, as they accumulate through fan encounters on social media. Through a focus on the expression of emotions such as disappointment and contempt, we interrogate the collective workings of digital affects for constituting gendered knowledge production and subjectivity in sport contexts. We conclude with a discussion of the implications of feminist thinking for sport research and practice.
The effect of levosimendan on postoperative bleeding and blood transfusion in cardiac surgical patients: a PRISMA-compliant systematic review and meta-analysis
Authors: Yao Yun-tai , He Li-xian , Zhao Yuan-yuan
Published: October 2020

Background:

Levosimendan (LEVO), is an inotropic agent which has been shown to be associated with better myocardial performance, and higher survival rate in cardiac surgical patients. However, preliminary clinical evidence suggested that LEVO increased the risk of post-operative bleeding in patients undergoing valve surgery. Currently, there has been no randomized controlled trials (RCTs) designed specifically on this issue. Therefore, we performed present systemic review and meta-analysis.

Methods:

Electronic databases were searched to identify all RCTs comparing LEVO with Control (placebo, blank, dobutamine, milrinone, etc). Primary outcomes include post-operative blood loss and re-operation for bleeding. Secondary outcomes included post-operative transfusion of red blood cells (RBC), fresh frozen plasma (FFP) and platelet concentrates (PC). For continuous variables, treatment effects were calculated as weighted mean difference (WMD) and 95% confidential interval (CI). For dichotomous data, treatment effects were calculated as odds ratio (OR) and 95% CI.

Results:

Search yielded 15 studies including 1,528 patients. Meta-analysis suggested that, LEVO administration was not associated with increased risk of reoperation for bleeding post-operatively (OR = 1.01; 95%CI: 0.57 to 1.79; p = 0.97) and more blood loss volume (WMD = 28.25; 95%CI: –19.21 to 75.72; p = 0.24). Meta-analysis also demonstrated that, LEVO administration did not increase post-operative transfusion requirement for RBC (rate: OR = 0.97; 95%CI: 0.72 to 1.30; p = 0.83 and volume: WMD = 0.34; 95%CI: –0.55 to 1.22; p = 0.46), FFP (volume: WMD = 0.00; 95%CI: –0.10 to 0.10; p = 1.00) and PC (rate: OR = 1.01; 95%CI: 0.41 to 2.50; p = 0.98 and volume: WMD = 0.00; 95%CI: –0.05 to 0.04; p = 0.95).

Conclusion:

This meta-analysis suggested that, peri-operative administration of LEVO was not associated with increased risks of post-operative bleeding and blood transfusion requirement in cardiac surgical patients.
Platelet factor-4 concentration in adult veno-arterial ECMO patients
Authors: Mazzeffi Michael , Clark Madeline , Grazioli Alison , Dugan Colleen , Rector Raymond , Dalton Heidi , Madathil Ronson , Menaker Jay , Herr Daniel , Tanaka Kenichi
Published: October 2020

Background:

Heparin induced thrombocytopenia (HIT) is reported at a variable rate in extracorporeal membrane oxygenation (ECMO) patients. A critical factor impacting platelet factor-4 (PF4)-heparin antibody formation is plasma PF4 concentration. We hypothesized that PF4 concentration would be increased during veno-arterial (VA) ECMO.

Methods:

Plasma PF4 concentration was measured during the first 5 ECMO days in 20 VA ECMO patients and 10 control plasma samples. PF4-heparin ratios were estimated using an assumed heparin concentration of 0.4 IU/mL. This correlates with an activated partial thromboplastin time of 60 to 80 seconds, which is the anticoagulation target in our center.

Results:

Twenty VA ECMO patients were enrolled, 10 of which had pulmonary embolism. Median PF4 concentration was 0.03 µg/mL [0.01, 0.13] in control plasma. Median PF4 concentration was 0.21 µg/mL [0.12, 0.34] on ECMO day 1 or 2, 0.16 µg/mL [0.09, 0.25] on ECMO day 3, and 0.12 µg/mL [0.09, 0.22] on ECMO day 5. Estimated median PF4-heparin ratios were 0.04, 0.03, and 0.02 respectively. Two patients (10%) developed HIT that was confirmed by serotonin release assay. PF4 concentration did not differ significantly in these patients compared to non-HIT patients (p = 0.37). No patient had an estimated PF4-heparin ratio between 0.7 and 1.4, which is the reported optimal range for PF4-heparin antibody formation.

Conclusion:

Our data suggest that PF4 concentration is mildly elevated during VA ECMO compared to control plasma. Estimated PF4-heparin ratios were not optimal for HIT antibody formation. These data support epidemiologic studies where HIT incidence is low during VA ECMO.
The imagined scientist of science governance
Authors: Åm Heidrun , Solbu Gisle , Sørensen Knut H
Published: October 2020

In this article, we introduce the concept of ‘the imagined scientist’. It inverts previous discussions of the public as an imagined community with a knowledge deficit, to examine imagined scientists representing an actor (or group of actors) with deficits in knowledge or concern about social issues. We study how Norwegian science policymakers, on the one hand, and biotechnologists and nanotechnologists, on the other, articulate and engage with social responsibility. The article identifies what we call ‘deficit trouble’, when there is poor alignment of the deficits of different imagined scientists, which may lead to a stalemate in the communication between science policymakers and scientists. We argue that ‘the imagined scientist’ can function as sensitizing concept for further studies of science governance across a range of topics, bringing into view how different deficit logics operate in science policy.
The financial market of ideas: A theory of academic social media
Authors: Delfanti Alessandro
Published: October 2020

Millions of scholars use academic social media to share their work and construct themselves as legitimate and productive workers. An analysis of Academia.edu updates ideas about science as a ‘marketplace of ideas’. Scholarly communication via social media is best conceptualized as a ‘financial market of ideas’ through which academic value is assigned to publications and researchers. Academic social media allow for the inclusion of scholarly objects such as preprint articles, which exceed traditional accounting systems in scholarly communication. Their functioning is based on a valorization of derived qualities, as their algorithms analyze social interactions on the platform rather than the content of scholarship. They are also oriented toward the future in their use of data analytics to predict research outcomes.
Group Stability and Reading Profiles of Students With Dyslexia: A Double-Deficit Perspective
Authors: Younger Rachel , Meisinger Elizabeth B.
Published: October 2020

This study examined the Double-Deficit Hypothesis (DDH) by classifying students with dyslexia into four distinct groups, comparing group differences on text-level reading tasks, and examining group stability across one school year (fall to spring). Elementary students ( N = 109) were administered measures of reading fluency, reading comprehension, and phonological processing across the school year. DDH group membership was determined by the presence of phonological awareness deficits (PD), naming speed deficits (NSD), double-deficits (DD) in both skills, or no deficits for typically developing (TD) readers. The McNemar test was used to determine the stability of DDH group membership. Analysis of covariance was used to compare DDH groups on text-level reading tasks at each time point after controlling for gender. Overall, reading profiles across the fall DDH groups were congruent with DDH theory, but instability was found in the reading patterns and group membership across time. Nearly half (47.71%) of participants changed DDH groups across the school year, and reading skill differences between the single-deficit groups dissipated in the spring. Results provide partial support for the DDH subgroups. More research is needed to understand the utility of the DDH subtypes for future assessment and intervention practices.
How is distress understood in existential philosophies and can phenomenological therapeutic practices be “evidence-based”?
Authors: Wharne Simon
Published: October 2020

The “evidence-based practice” movement frames counselling and psychotherapy as causal processes, something the therapist does to the client. The value of what it is that is done is measured by interpreting mental and emotional distress as an abnormal behaviour, by giving this “symptom” a numerical score, before and after interventions in a quantitative research approach. In existential therapies emotions are viewed instead as healthy responses to our being in the world; as transient communications in relational contexts, altered only through the client’s autonomous choice. Human distress will be encountered and explored by all practitioners regardless of their modality. This article is an attempt to reclaim that exploration, as a phenomenological enquiry founded in the radically different epistemological framework of existential theory. Less value might then be placed on systemized measurement and control, and more placed on human responses to emotionality. Those who are distressed might feel understood and validated.
“Are You Able-Bodied?” Embodying Accountability in the Modern Criminal Justice System
Authors: Cadigan Michele , Smith Tyler
Published: October 2020

Monetary sanctions are a common tool for enforcing accountability within the criminal justice system. However, it is unclear how individuals with disabilities who have a limited capacity to work interact with the system of monetary sanctions. Drawing on courtroom observations and interviews in Washington State, we find that although the court does take disability into account when imposing economic sanctions and monitoring payment compliance, individuals with disabilities end up in a perpetual cycle of administrative hearings that can result in serious financial and health consequences for those involved. Implications for findings are discussed.
Modeling of piezoelectric power nano-generators using Brownian particles
Authors: Sun Fang , Singh Mahi R
Published: October 2020

We have designed a piezoelectric power nano-generator unitcell (device) where gas molecules are moving in Brownian motion and these molecules collide with a piezoelectric material. Due to the collision by gas molecules on the piezoelectric material, a voltage difference is induced across the piezoelectric material. We developed a simple model to calculate the voltage and power generation by using the method of statistical mechanics. Here we considered that gas molecules are not interacting with each other. We have created a design to connect nano-generator unitcells to form a chip in series configurations to enhance the production of the power nano-generation. Our design for the new power generator shows that as the thickness of the piezoelectric material increases so does the voltage generation. Our design can continuously generate electricity and this feature is better than solar panels that only work during daytime and windmills that cannot work without wind. It can work in a natural atmosphere environment. In the future when a new way of printing chips at low costs is discovered, then generating electricity will be very cheap using our design.
Use of Cannabis and Cannabinoids in Patients With Cancer
Authors: Sawtelle Lindsey , Holle Lisa M.
Published: October 2020

Objective:

To review pharmacology, available dosage forms, efficacy, and safety of cannabis and cannabinoids in cancer patients.

Data Sources:

In PubMed (1965 to June 2020) the search was conducted using the search terms cannabidiol, cannabis, CBD, dronabinol, endocannabinoids, medical marijuana, nabiximols, nabilone, THC, and cancer. Abstracts from article bibliographies were reviewed.

Study Selection and Data Extraction:

Relevant English-language studies conducted in humans evaluating cannabis and cannabinoids for cancer treatment or related symptoms were considered. Reference lists in relevant articles, package inserts, guidance documents, and addditional articles evaluating cannabis and cannabinoids were identified.

Data Synthesis:

Cannabis and cannabinoid effectiveness can be attributed to active components delta-9-tetrahydrocannabinol and cannabidiol. Multiple dosage forms exist, each with different properties contributing to efficacy and safety differences. No data supports use as anticancer agents, and mixed efficacy results have been reported when used in cancer patients with nausea, pain, and anorexia. Inclusion of medicinal and synthetic products, small sample sizes, varying patient populations, and different dosage forms, doses, and drug combinations. These products are well tolerated, and adverse effects depend on the main active component.

Relevance to Patient Care and Clinical Practice:

Healthcare professionals need to identify appropriateness, monitor, and document use of cannabis and cannabinoids similar to other drug therapies as well as educate the patients/ caregivers about potential benefits and risks.

Conclusions:

Current evidence for use of medical cannabis and cannabinoids in cancer patients is weak. However, healthcare professionals are in an ideal role to monitor and educate patients using medical cannabis and cannabinoids.
Impact of Extended-Interval Versus Standard Dosing of Zoledronic Acid on Skeletal Events in Non–Small-Cell Lung Cancer and Small-Cell Lung Cancer Patients With Bone Metastases
Authors: Tam Andrew H. , Schepers Allison J. , Qin Angel , Nachar Victoria R.
Published: October 2020

Background:

Zoledronic acid every 4 weeks (Q4wk) reduces the incidence of skeletal-related events (SREs) in patients with metastatic lung cancer. Lung cancer patients were excluded from extended-interval dosing trials (every 12 weeks [Q12wk]) that demonstrated noninferiority of the 2 dosing schemes. To date, the optimal dosing of zoledronic acid in metastatic lung cancer remains unknown.

Objective:

To determine whether zoledronic acid dosed Q12wk is similar to Q4wk dosing for prevention of SRE in patients with metastatic lung cancer.

Methods:

A retrospective analysis was performed in patients with non–small-cell lung cancer and small-cell lung cancer with bone metastases who received Q12wk and Q4wk zoledronic acid. The primary outcome was incidence of SRE at 1 year. Secondary analyses included time to first SRE, overall survival (OS), incidence of osteonecrosis of the jaw (ONJ), kidney dysfunction, and hypocalcemia.

Results:

A total of 34 patients received Q12wk and 46 patients received Q4wk zoledronic acid. Incidence of SRE at 1 year (Q12wk, 23.5%, vs Q4wk, 23.9%; 95% CI = −0.184 to 0.192; P = 0.968) and median time to SRE (not reached for either cohort; P = 0.530) did not differ. The Q12wk cohort had longer median OS (24.00 vs 8.97 months; P = 0.022). There were no differences in incidence of ONJ, kidney dysfunction, and hypocalcemia.

Conclusion and Relevance:

This is the first report examining extended-interval dosing of zoledronic acid in metastatic lung cancer. Incidence and time to SRE at 1 year were similar. This extended-interval dosing may be safe and reasonable for patients with lung cancer with bone metastases.
3D Assessment in Posttraumatic Ankle Osteoarthritis
Authors: Kvarda Peter , Heisler Lukas , Krähenbühl Nicola , Steiner Caspar Samuel , Ruiz Roxa , Susdorf Roman , Sripanich Yantarat , Barg Alexej , Hintermann Beat
Published: October 2020

Background:

Auto-generated 3-dimensional (3D) measurements based on weightbearing cone-beam computed tomography (CT) scan technology may allow for a more accurate hind- and midfoot assessment. The current study evaluated the reliability and clinical relevance of such measurements in patients with posttraumatic end-stage ankle osteoarthritis.

Methods:

Seventy-two patients treated at our institution for posttraumatic end-stage ankle osteoarthritis, with available weightbearing conventional radiographs and a cone-beam CT scan, were analyzed. Twenty healthy individuals aged between 40 and 70 years served as controls. Seven variables were measured on weightbearing conventional radiographs (2D) and compared to 3D measurements that were based on reconstructions from weightbearing cone-beam CT scans. The reliability of each measurement was calculated and subgroups formed according to commonly observed deformities.

Results:

Inter- and intraobserver reliability was superior for 3D compared to 2D measurements. The accuracy of 3D measurements performed on osteoarthritic ankles was similar to 3D measurements performed on healthy individuals. Thirty-three of the 72 included patients (46%) evidenced an inframalleolar compensation of a supramalleolar/intra-articular ankle deformity (78% = varus compensation; 22% = valgus compensation), whereas 24 of those 72 patients (33%) showed no compensation or a further increase of a supramalleolar/intra-articular ankle deformity (67% = varus deformity; 33% = valgus deformity).

Conclusion:

Auto-generated 3D measurements of the hind- and midfoot were found to be reliable in both healthy individuals and patients with posttraumatic end-stage ankle osteoarthritis. Such measurements may be crucial for a detailed understanding of the location and extent of hindfoot deformities, possibly impacting decision making in the treatment of end-stage ankle osteoarthritis.

Level of Evidence:

Level III, comparative study.
In Their Own Voices: Identity and Racial Socialization Experiences of Young Adult Chinese Adoptees
Authors: Reynolds (Taewon Choi) Jason D. , Elimelech Nicole T. , Miller Simonleigh P. , Ingraham Megan E. , Anton Bridget M. , Bhattacharjee Chiroshri
Published: October 2020

This qualitative study explored the experiences of transracial Chinese adoptees who were born in China, separated from their biological families, raised in the United States by White families, and given an Anglicized name at the time of their adoption. This study focused on participant experiences as they navigated being raised in the United States as transracial Chinese adoptees, their feelings related to their Chinese names, thoughts about China and birth family search, and experiences of ethnic and racial socialization within their adoptive families. Data were collected from in-depth, semi-structured interviews via Skype that integrated a constructivist–interpretivist and critical epistemological paradigm and coded using grounded-theory methods. Participants ( N = 8) were transracial Chinese adoptees with ages ranging from 18 to 25 years ( M = 21.5 years) who were between 6 and 17 months ( M = 10.6 months) at the time of adoption. Results from the interviews revealed eight axial categories and three overarching selective categories related to their experience as transracial Chinese adoptees: (a) experiences of race and adoption, (b) factors influencing racial–ethnic socialization, and (c) recommendations for adoptive parents. Limitations of the study, future areas of research, and clinical and practice implications are discussed.
Changing clinical patterns of Rhegmatogeneous Retinal Detachments during the COVID19 pandemic lockdown in the North West of the UK
Authors: Jasani Kirti M , Ivanova Tsveta , Sabatino Francesco , Patton Niall , Dhawahir-Scala Felipe , Chew Grace , Charles Stephen , David Philip , Davies Andrew , Jalil Assad
Published: October 2020

Introduction:

The UK Government imposed a COVID19 lockdown (LD) restricting all but essential activities from 24th March 2020. Subsequently, there has been a significant reduction in casualty attendances nationwide including for ophthalmic emergencies. We aim to study the presentation of rhegmatogenous retinal detachments (RRD) and significant vitreous haemorrhage caused by posterior vitreous detachment (PVD-VH) in three tertiary centres covering most of the North West of England in the 6 weeks before and during the lockdown.

Methods:

A retrospective multicenter non-randomised consecutive case series study was designed to collect information on all cases of RRD and PVD-VH requiring surgery presenting to the vitreoretinal departments of Manchester Royal Eye Hospital, East Lancashire NHS Foundation Trust and the Lancashire NHS Foundation Trust from 11th February to 4th May 2020.

Results:

A total of 137 eyes of 137 patients were identified between the three centres of which 132 eyes were operated for RRD. Of these, 86 (64.7%) were operated pre-LD compared with 46 eyes (34.8%) during LD. Forty-five out of 86 eyes (52.3%) were macula-off pre-LD compared with 31 out of 46 eyes (67.3%) during LD ( p = 0.06). There was lower proportion of non-PVD related RRD during LD (11 pre-LD to 1 during LD, p = 0.05). PVR was present in four cases during LD compared to 2 before ( p = 0.19).

Conclusion:

There was a clinically significant reduction in the overall incidence of RRD in our centres with an increase in the proportion of macula-off and proliferative vitreoretinopathy during the LD period compared to a similar period before.