bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of Personal Protective Equipment with De Novo Headaches in Frontline Healthcare Workers during COVID-19 Pandemic: A Cross-Sectional Study
Authors: Zaheer Rumeesha , Khan Maheen , Tanveer Ahmed , Farooq Amal , Khurshid Zohaib
Published: December 2020

Objectives This study aimed to determine the association of personal protective equipment (PPE) usage with new-onset headaches and exacerbation of pre-existing headache disorders among healthcare workers at the frontlines during coronavirus disease 2019 (COVID-19) pandemic.

Materials and Methods A descriptive cross-sectional survey was conducted across Pakistan in June–July 2020. The study was approved by Ethical Committee, Armed Forces Institute of Dentistry, Rawalpindi (IRB form no.905/Trg-ABP 1K2). A qualitative questionnaire was developed and was shared via different social networks. The questionnaire was closed when 241 responses were received.

Statistical Analysis Descriptive analysis was performed on demographic data. Chi-squared analysis was performed between demographic data and PPE-usage patterns among participants with or without de novo headaches. Univariable and multivariable logistic regression models were used to compare variables with the development of new-onset headaches. Chi-squared test was also performed between demographic data and other factors that may be causing new-onset headaches. A p-value < 0.05 was considered significant.

Results A total of 241 healthcare workers participated, of which 68 participants (28.2%) reported de novo headaches since the start of the pandemic. Incidence of pre-existing headaches (odds ratio [OR] = 1.91; 95% confidence interval [CI]: 0.99–0.37; p = 0.049) was associated with new-onset headaches. Post hoc multivariable logistic regression analysis stated that incidence of pre-existing headaches (OR = 1.88; 95% CI: 0.94–3.78; p = 0.75) and age (OR = 2.21; 95% CI: 0.47–10.33; p = 0.36) was independently associated with new-onset PPE-induced headaches but was not statistically significant. Chi-squared analysis showed a statistically significant relationship between other factors (sleep deprivation, emotional stress, etc.) and department of activity, gender, and occupation (p < 0.05).

Conclusion Healthcare workers with previous history of pre-existing headaches were found to be more susceptible to PPE-induced headaches during COVID-19 pandemic. However, age and the department where the healthcare workers performed may also be risk factors.
L’enseignement de la traduction économique et financière
Authors: Poder Marie-Évelyne Le
Published: December 2020

Cet article présente une proposition didactique visant à améliorer les compétences thématiques et instrumentales
des étudiants de traduction économique et financière de quatrième année du diplôme en Traduction et Interprétation de la Faculté
de traduction et d’interprétation de l’Université de Grenade qui pourrait d’ailleurs être étendue à
d’autres centres universitaires. Cette proposition est développée à partir d’une série d’activités liées
aux phases d’analyse-compréhension du texte source et de transfert de la langue source vers la langue cible dans la
combinaison linguistique espagnol/français. Elle est directement reliée aux objectifs consistant, d’une part, à acquérir
des techniques pour surmonter les obstacles de nature cognitive présents dans les textes et, d’autre part, à appliquer
certaines notions acquises dans le cours de « Terminologie ». Quant à sa structure, l’article s’articule autour
des parties suivantes : l’introduction, la recherche didactique en traduction économique et financière, les fondements
théoriques de la proposition didactique, la méthodologie appliquée, la proposition en elle-même et la conclusion.
Changing translation practices and moving boundaries in translation studies
Authors: Gambier Yves , Kasperẹ Ramunė
Published: December 2020

This article aims at describing the changes in translation by referring to practices such as localization, amateur translation, translating in the media. The changes are enhanced by the computing, information, and communication technologies. In three decades, a new work environment has shaken up the translator’s world. New types of translators are emerging, with a new hierarchy between them, in parallel with a multiplication of labels created for “translation.” The concept of translation has, therefore, become ambiguous and, relating to it, other concepts, such as text, need to be revisited.
Lexical and cultural choices in Slovene translations of German and English car slogans
Authors: Kučiš Vlasta , Vid Natalia Kaloh
Published: December 2020

The current paper presents the analysis of translation strategies and linguistic characteristics in Slovene translations of commercial car slogans from English and German. There is no uniform definition of the advertising slogan in the scientific literature; therefore, we attempt to provide the definition of a slogan in the context of marketing communication. One of the main functions of both social and commercial advertising is to provide information to the target audience and make it act in the way desired by the advertisers. In contemporary Translation Studies, translation is defined as a transnational and intercultural communication activity. Therefore, one of the primary tasks of translators is to mediate not only between languages but also between cultures. The objective of the paper has been to identify and describe the language features of car slogans at phonological, lexical, syntactic, and semantic levels, with due attention to the functionality of these messages in comparison with the messages relayed by slogans in other trades. The study has revealed that, due to the specific market niche, most car slogans tend to use specific language devices and discourse. The theoretical framework is based on German functionalist approaches in Translation Studies – Holz-Mänttäri’s theory of action (Handlungstheorie) and Reiß/Vermeer’s theory of translation’s purpose (Skopostheorie).
Critical theory of technology and actor-network theory in the examination of techno-empowered online collaborative
translation practice
Authors: Kung Szu-Wen
Published: December 2020

While “turns” in translation studies have long been embracing the theoretical complexity integrated into the
discussion of various translation phenomena, the theorisation of the use of technology and its impact on translation remain
under-represented in scholarly literature of the field (O’Hagan 2016). This article
considers the influence of technology on translation and reflects on the question as to how the interactive relationship between
technology and translation may be theoretically conceptualised. Taking an approach informed by sociological theory, this article
combines critical theory of technology (CTT) and actor-network theory (ANT) to examine the relationship between technology and
translation, as well as the translation players involved. With the advent of Web 2.0, techno-empowered collaborative translation
in the online TED Talks environment using Amara subtitling platform becomes a useful locale for discussion. Through a
participant-observation approach, that is, with the author’s experience in the online translation environment, this article aims
to explore how the technological elements in translation often described as “emergent property from new forms of translation
practice” (Cronin 2010, 1) may offer critical insights from an epistemological
perspective, especially the reciprocity between technology and its users.
A multifactorial account of analogical developments in Old English nominal paradigms
Authors: Adamczyk Elżbieta
Published: December 2020

The present paper focuses on the interaction of factors that conditioned analogical developments in Old English nominal paradigms. They include especially the absolute and relative frequency of occurrence, the salience of inflectional exponents, the formal inflectional overlap across paradigms, functional factors, semantics and syllable structure (stem weight). They could work in two opposite directions, namely towards retaining the etymological inflections or they could facilitate the adoption of analogical endings. The significance of individual factors for the reorganisation of nominal paradigms is investigated by employing a statistical analysis (multivariate logistic regression) which allows us to rank them. The analysis demonstrates that the attested inflectional patterns can largely be explained by an interaction of three factors, namely salience and frequency, which can be linked to the cognitive aspects of storage and retrieval of linguistic information, and the overlap of inflectional forms across paradigms, which is a manifestation of analogical pressure in the paradigms.
Palatalization and assibilation of /k/ in English and Scottish place-names
Authors: Laker Stephen
Published: December 2020

There are very few place-names with initialCh-[tʃ-] in Scotland, Northern England and much of the East Midlands. Names that do exist are almost exclusively late formations and usually consist of French rather than Old English place-name elements. This article investigates the reasons why assibilation is either present or absent from specific areas and why. The results lead to a reassessment of several points, including: (1) the phonetic and phonological development of the voiceless velar in Early English in particular environments; (2) the extent to which external influence counteracted palatalization and assibilation in some areas; (3) the disparities between the place-name and dialectal evidence.
Analysis of the Molecular Signature of Breast Implant-Associated Anaplastic Large Cell Lymphoma in an Asian Patient
Authors: Kim Il-Kug , Hong Ki Yong , Lee Choong-kun , Choi Bong Gyu , Shin Hyunjong , Lee Jun Ho , Kim Min Kyoung , Gu Mi Jin , Choi Jung Eun , Kim Tae Gon
Published: December 2020

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)—a new category of anaplastic large cell lymphoma associated with textured breast implants—has a distinct variation in incidence and is especially rare in Asia. We report the first case of BIA-ALCL in Korea and present its histological and genetic characteristics. A 44-year-old female patient presented with a typical clinical course and symptoms, including breast augmentation with textured breast implants, late-onset peri-implant effusion, and CD30+ALK− histology, followed by bilateral implant removal and total capsulectomy. For histological analysis, we performed immunohistochemistry of the bilateral breast capsules. For transcriptome analysis, we identified highly upregulated gene sets employing RNA-sequencing and characterized the lymphoma immune cell components. In the lymphoma-associated capsule, CD30+ cells infiltrated not only the lymphoma lesion but also the peritumoral lesion. The morphologies of the myofibroblasts and vessels in the peritumoral lesion were similar to those in the tumoral lesion. We observed strong activation of the JAK/STAT3 pathway and expression of programmed death ligand-1 in the lymphoma. Unlike the molecular profiles of BIA-ALCL samples from Caucasian patients—all of which contained activated CD4+ T cells—the Asian patient’s profile was characterized by more abundant CD8+ T cells. This study contributes to a better understanding of the pathogenesis and molecular mechanisms of BIA-ALCL in Asian patients that will ultimately facilitate the development of clinical therapies.

Level of Evidence: 5
BamSnap: a lightweight viewer for sequencing reads in BAM files
Authors: Kwon Minseok , Lee Soohyun , Berselli Michele , Chu Chong , Park Peter J
Published: December 2020

Despite the improvement in variant detection algorithms, visual inspection of the read-level data remains an essential step for accurate identification of variants in genome analysis. We developed BamSnap, an efficient BAM file viewer utilizing a graphics library and BAM indexing. In contrast to existing viewers, BamSnap can generate high-quality snapshots rapidly, with customized tracks and layout. As an example, we produced read-level images at 1000 genomic loci for >2500 whole-genomes.

Availability and implementation

BamSnap is freely available at https://github.com/parklab/bamsnap.

Supplementary information

Supplementary data are available at Bioinformatics online.
Designing delivery models of traditional and complementary medicine services: a review of international experiences
Authors: Chung Vincent C H , Ho Leonard T F , Leung Ting Hung , Wong Charlene H L
Published: December 2020

Background

The World Health Organization advocates integration of traditional and complementary medicine (T&CM) into the conventional health services delivery system. Integrating quality services in a patient-centred manner faces substantial challenges when T&CM is delivered within a health system dominated by conventional medicine. This review has synthesized international experiences of integration strategies across different contexts.

Sources of data

Publications describing international experiences of delivering T&CM service in conventional healthcare settings were searched. Backward and forward citation chasing was also conducted.

Areas of agreement

Capable leaders are crucial in seeking endorsement from stakeholders within the conventional medicine hierarchy and regulatory bodies. However, patient demands for integrative care can be successful as demonstrated by cases included in this review, as can the promotion of the use of T&CM for filling effectiveness gaps in conventional medicine. Safeguarding quality and safety of the services is a priority.

Areas of controversy

Different referral mechanisms between conventional and T&CM practitioners suit different contexts, but at a minimum, general guideline on responsibilities across the two professionals is required. Evidence-based condition-specific referral protocols with detailed integrative treatment planning are gaining in popularity.

Growing points

Interprofessional education is critical to establishing mutual trust and understanding between conventional clinicians and T&CM practitioners. Interprofessional communication is key to a successful collaboration, which can be strengthened by patient chart sharing, instant information exchange, and dedicated time for face-to-face interactions.

Areas timely for developing research

Research is needed on the optimal methods for financing integrated care to ensure equitable access, as well as in remuneration of T&CM practitioners working in integrative healthcare.
Fujifilm SILVAMP TB LAM Assay on Cerebrospinal Fluid for the Detection of Tuberculous Meningitis in Adults With Human Immunodeficiency Virus
Authors: Quinn Carson M , Kagimu Enock , Okirworth Michael , Bangdiwala Ananta S , Mugumya Gerald , Ramachandran Prashanth S , Wilson Michael R , Meya David B , Cresswell Fiona V , Bahr Nathan C , Boulware David R
Published: December 2020

Background

Tuberculous meningitis (TBM) has a high fatality rate, with inadequate diagnostic tests being a major contributor. The rollout of Xpert MTB/Rif and Xpert MTB/RIF Ultra (Xpert Ultra) have improved time-to-diagnosis with sensitivities similar to culture, yet test availability and sensitivity are inadequate. The TB lipoarabinomannan lateral flow assay (AlereLAM) offers ease of use, but its low sensitivity in cerebrospinal fluid (CSF) limits clinical utility for TBM. The Fujifilm SILVAMP TB LAM (FujiLAM) assay has excellent sensitivity in urine, but performance on cerebrospinal fluid is uncertain.

Methods

We conducted a prospective cohort study at Kiruddu National Referral Hospital in Kampala, Uganda, enrolling patients suspected to have TBM. CSF was tested using AlereLAM, Xpert Ultra, culture, and FujiLAM. Results were compared with 2 reference standards: probable and definite TBM or definite TBM alone by the uniform TBM case definition.

Results

Of 101 patients enrolled (95/101 HIV-positive), 34 had definite TBM and 24 had probable TBM. FujiLAM sensitivity on CSF was 52% (30/58) for definite or probable TBM compared with 55% (32/58) for Xpert Ultra. AlereLAM had lower sensitivity than FujiLAM in the subgroup of patients tested with both assays (14% [4/28] vs 50% [14/28]; P < .01). FujiLAM specificity was 98% (42/43) for patients without probable or definite TBM.

Conclusions

FujiLAM showed higher sensitivity than AlereLAM, with sensitivity potentially approaching that of Xpert Ultra. FujiLAM could improve time-to-treatment-initiation, especially in settings where the more technical Xpert Ultra system might not be feasible. Large confirmatory studies are needed.
Object Detection and Localization Using Sparse-FCM and Optimization-driven Deep Convolutional Neural Network
Authors: Raghu A Francis Alexander , Ananth J P
Published: December 2020

Object detection and localization attract the researchers to address the challenges associated with the computer vision. The literature presents numerous unsupervised methods to detect and localize the objects, but with inaccuracies and inconsistencies. The problem is tackled through proposing a novel model based on the optimization algorithm. The object in the image is detected using the Sparse Fuzzy C-Means (Sparse FCM) that is the enhanced Fuzzy C-Means algorithm used to manage the high-dimensional data. The detected objects are subjected to the object localization, which is performed using the proposed Cat Crow Optimization (CCO)-based Deep Convolutional Neural Network. The proposed CCO is the integration of Cat Swarm Optimization Algorithm and Crow Search Algorithm and inherits the advantages of both the optimization algorithms. The experimentation of the proposed method is performed using images obtained from the Visual Object Classes Challenge 2012 dataset. The analysis revealed that the proposed method acquired an average accuracy, precision, and recall of 0.8278, 0.8549, and 0.7911, respectively.
Ratchet mechanism selectively causing idiopathic macrodislodgement of an active-fixation coronary sinus lead: a case report
Authors: Golzio Pier Giorgio , Bissolino Arianna , Ceci Raffaele , Frea Simone
Published: December 2020

Background 

‘Idiopathic’ lead macrodislodgement may be due to Twiddler’s syndrome depending on active twisting of pulse generator within subcutaneous pocket. All leads are involved, at any time from implantation, and frequently damaged. In the past few years, a reel syndrome was also observed: retraction of pacemaker leads into pocket without patient manipulation, owing to lead circling the generator. In other cases, a ‘ratchet’ mechanism has been postulated. Reel and ratchet mechanisms require loose anchoring, occur generally briefly after implantation, with non-damaged leads. We report the first case of an active-fixation coronary sinus lead selective macrodislodgement involving such ratchet mechanism.

Case summary 

A 65-year-old man underwent biventricular defibrillator device implantation, with active-fixation coronary sinus lead. Eight months later, he complained of muscle contractions over device pocket. At fluoroscopy, coronary sinus lead was found near to pocket, outside of thoracic inlet. Atrial and ventricular leads were in normal position. After opening pocket, a short tract of coronary sinus lead appeared anteriorly dislocated to generator, while greater length of lead body twisted a reel behind. The distal part of lead was found outside venous entry at careful dissection. Atrial and ventricular leads were firmly anchored.

Discussion 

Our case is a selective ‘Idiopathic’ lead macrodislodgement, possibly due to a ratchet mechanism between the lead and the suture sleeve, induced by normal arm motion; such mechanism incredibly, and for first time in literature involves a coronary sinus active-fixation lead.

Conclusion 

Careful attention should always be paid to secure anchoring even of active-fixation coronary sinus leads.
Superficial temporal artery access for percutaneous coronary artery stenting during the COVID-19 pandemic: a case report
Authors: Csavajda Ádám , Bertrand Olivier F , Merkely Béla , Ruzsa Zoltán
Published: December 2020

Background

The COVID-19 pandemic creates new challenges for healthcare, including invasive cardiology.

Case summary

We discuss the case of a 65-year-old man who presented with non-ST segment elevation myocardial infarction combined with bilateral pneumonia. The patient had known severe iliac artery lesions with prior interventions and bilateral subclavian artery occlusions. After unsuccessful femoral artery access, the diagnostic angiography and the right coronary artery percutaneous coronary intervention were successfully performed from ultrasound-guided lower superficial temporal artery access.

Discussion

We showed that superficial temporal access can be used as an alternate access site for diagnostic coronary angiography and intervention when standard wrist and femoral access sites are not readily accessible.
Ilio-femoral venous thrombosis with hereditary antithrombin deficiency: a case report of rare thrombotic disease and successful treatment with catheter directed thrombolysis
Authors: Miyashita Hirokazu , Tobita Kazuki , Morishita Eriko , Saito Shigeru
Published: December 2020

Background

Hereditary antithrombin (AT) deficiency is an uncommon autosomal dominant thrombogenic disorder, which can cause venous thromboembolism (VTE). Although conservative treatment options for hereditary AT deficiency-associated VTE such as anticoagulation (warfarin, direct oral anticoagulant, or heparin), intravenous thrombolysis, and recombinant AT are well known, interventional treatment options have not been reported so far.

Case summary

A 19-year-old man with a family history of thrombogenic diseases, referred to our hospital with left leg pain, was diagnosed with AT deficiency-associated VTE. In the absence of symptomatic relief with intravenous thrombolysis and anticoagulation, he received venous intervention and catheter directed thrombolysis (CDT) for 4 days for left iliac venous thrombosis. Following a second venous intervention, venous thrombus disappeared almost entirely on cross-sectional imaging, and his symptoms improved. He was discharged on apixaban and has been recurrence-free for one and a half years.

Discussion

This case presents CDT and maintenance therapy with apixaban as possible treatment options for VTE in patients with hereditary AT deficiency, especially following failure of conservative therapy. Individual risks and benefits should be considered when CDT is performed for acute VTE in patients with AT deficiency.
Effect of Aspirin on Activities of Daily Living Disability in Community-Dwelling Older Adults
Authors: Woods Robyn L , Espinoza Sara , Thao Le T P , Ernst Michael E , Ryan Joanne , Wolfe Rory , Shah Raj C , Ward Stephanie A , Storey Elsdon , Nelson Mark R , Reid Christopher M , Lockery Jessica E , Orchard Suzanne G , Trevaks Ruth E , Fitzgerald Sharyn M , Stocks Nigel P , Williamson Jeff D , McNeil John J , Murray Anne M , Newman Anne B
Published: December 2020

Background

Cerebrovascular events, dementia, and cancer can contribute to physical disability with activities of daily living (ADL). It is unclear whether low-dose aspirin reduces this burden in aging populations. In a secondary analysis, we now examine aspirin’s effects on incident and persistent ADL disability within a primary prevention aspirin trial in community-dwelling older adults.

Methods

The ASPREE (ASPirin in Reducing Events in the Elderly) trial of daily 100 mg aspirin versus placebo recruited 19 114 healthy adults aged 70+ years (65+ years if U.S. minority) in Australia and the United States. Six basic ADLs were assessed every 6 months. Incident ADL disability was defined as inability or severe difficulty with ≥1 ADL; persistence was confirmed if the same ADL disability remained after 6 months. Proportional hazards modeling compared time to incident or persistent ADL disability for aspirin versus placebo; death without prior disability was a competing risk.

Results

Over a median of 4.7 years, incident ADL disability was similar in those receiving aspirin (776/9525) and placebo (787/9589) with walking, bathing, dressing, and transferring the most commonly reported. Only 24% of incident ADL disability progressed to persistent. Persistent ADL disability was lower in the aspirin group (4.3 vs 5.3 events/1000 py; hazard ratio [HR] = 0.81, 95% confidence interval [CI]: 0.66–1.00), with bathing and dressing the most common ADL disabilities in both groups. Following persistent ADL disability, there were more deaths in the aspirin group (24 vs 12).

Discussion

Low-dose aspirin in initially healthy older people did not reduce the risk of incident ADL disability, although there was evidence of reduced persistent ADL disability.
SoupX removes ambient RNA contamination from droplet-based single-cell RNA sequencing data
Authors: Young Matthew D , Behjati Sam
Published: December 2020

Background

Droplet-based single-cell RNA sequence analyses assume that all acquired RNAs are endogenous to cells. However, any cell-free RNAs contained within the input solution are also captured by these assays. This sequencing of cell-free RNA constitutes a background contamination that confounds the biological interpretation of single-cell transcriptomic data.

Results

We demonstrate that contamination from this "soup" of cell-free RNAs is ubiquitous, with experiment-specific variations in composition and magnitude. We present a method, SoupX, for quantifying the extent of the contamination and estimating "background-corrected" cell expression profiles that seamlessly integrate with existing downstream analysis tools. Applying this method to several datasets using multiple droplet sequencing technologies, we demonstrate that its application improves biological interpretation of otherwise misleading data, as well as improving quality control metrics.

Conclusions

We present SoupX, a tool for removing ambient RNA contamination from droplet-based single-cell RNA sequencing experiments. This tool has broad applicability, and its application can improve the biological utility of existing and future datasets.
Apparent earthquake rupture predictability
Authors: Meier Men-Andrin , Ampuero Jean-Paul , Cochran Elizabeth , Page Morgan
Published: December 2020

To what extent can the future evolution of an ongoing earthquake rupture be predicted? This question of fundamental scientific and practical importance has recently been addressed by studies of teleseismic source time functions (STFs) but reaching contrasting conclusions. One study concludes that the initial portion of STFs is the same regardless of magnitude. Another study concludes that the rate at which earthquakes grow increases systematically and strongly with final event magnitudes. Here, we show that the latter reported trend is caused by a selection bias towards events with unusually long durations and by estimates of STF growth made when the STF is already decaying. If these invalid estimates are left out, the trend is no longer present, except during the first few seconds of the smallest events in the data set, Mw 5–6.5, for which the reliability of the STF amplitudes is questionable. Simple synthetic tests show that the observations are consistent with statistically indistinguishable growth of smaller and larger earthquakes. A much weaker trend is apparent among events of comparable duration, but we argue that its significance is not resolvable by the current data. Finally, we propose a nomenclature to facilitate further discussions of earthquake rupture predictability and determinism.
Developing a charter of spiritual care for patients
Authors: Heidari Akram , Kazemi Abdolhasan , Abbasi Mohammad , Adeli Seyed hasan , Ahmari tehran Hoda , Eskandari Narges , Heidari Morteza , Khalajinia Zohre , Yoosefee Sadegh
Published: December 2020

Background

Spirituality is recognized as an important issue in health care, and every individual has spiritual needs. Despite increased knowledge about spiritual care and its necessity, there is no unique agreed-upon framework for spiritual care among the practitioners. This study aimed to explore the concept from the viewpoint of both health-care providers and patients within the Iranian social, cultural and overall contexts and present a charter for providing spiritual care.

Methods

The first phase of the study was a systematic literature review. The next phase consisted of two qualitative studies on the components of spiritual care from the perspective of healthcare providers and its dimensions as perceived by patients. The findings were then integrated to make up a charter draft that was accredited through expert opinion.

Results

The review of literatures led to the identification of two main themes and 10 themes. Perspectives of health-care providers were categorized into four main themes and 10 themes, and patients’ opinions were classified into three main themes and 11 themes. The themes and their subthemes were integrated to build the concepts and form the proposed charter with 30 statements.

Conclusion

The charter of spiritual care for patients is intended to present an agreed-upon framework for spiritual care delivery and resolve some of the problems in this path. This can improve health-care delivery system.
Formulative Strategy: Why the African Union-led International Mediation in South Sudan Failed to Prevent Atrocity Crimes
Authors: Ifediora Obinna F
Published: December 2020

The puzzle of the African Union mediation is that it enjoys regional effectiveness in leading peace processes and yet often fails to prevent atrocity crimes. While existing studies focus on the lack of capacity to explain failures, I draw on atrocity mediation literature that emphasizes coercive strategies for ripening to explore widely significant factors associated with the AU mediation. I adopt the “framework of mediator behavior” in international mediation studies to analyze AU policies on conflict responses and the mediation in South Sudan. My approach is consistent with the content analysis of qualitative data. I find that the significant factor in the AU mediation is the “patient” policy, like “strategic patience.” The policy reflects formulative strategy of conflict mediation that describes the mediator who controls the process but shifts control of substantive decision-making to the parties. Formulative strategy is technically non-coercive, so the AU embraces it to respect sovereignty. The paradox is that formulative strategy is the AU legitimacy source—which anchors effectiveness—and failure. The AU mediation failed because of strategic choice, not the lack of capabilities. This study contributes to a broader understanding of the AU mediation and challenges mediator behavior assumptions.
A multicriteria function for polymer gear design optimization
Authors: Tavčar Jože , Černe Borut , Duhovnik Jože , Zorko Damijan
Published: December 2020

A reliable method of optimization of polymer gears remains, to date, an open challenge, due to the lack of specific material characterization of polymers and to the complex nonlinear relations between different geometric and operating parameters. For spur and helical gears, the authors herein have developed the optimization algorithm, which primarily enables variation of geometry according to various criteria: the number of teeth (z1, z2), face width (b), helix angle (β), and normal module (mn). The method enables a better insight into how design parameters influence the target criteria. The main paper contribution is a newly developed multicriteria function that enables a simultaneous consideration of different criteria such as root/flank stress, gear bulk/flank temperature, wear, deformation, quality, cost, and volume.
Sex- and age-related differences in the distribution of bladder cancer metastases
Authors: Rosiello Giuseppe , Palumbo Carlotta , Deuker Marina , Stolzenbach Lara Franziska , Martin Thomas , Tian Zhe , Gallina Andrea , Montorsi Francesco , Black Peter , Kassouf Wassim , Shariat Shahrokh F , Saad Fred , Briganti Alberto , Karakiewicz Pierre I
Published: December 2020

Objective

Our objective was to investigate age- and sex-related differences in the distribution of metastases in patients with metastatic bladder cancer.

Methods

Within the National Inpatient Sample database (2008–2015), we identified 7040 patients with metastatic bladder cancer. Trend test and Chi-square test analyses were used to evaluate the relationship between age and site of metastases, according to sex.

Results

Of 7040 patients with metastatic bladder cancer, 5226 (74.2%) were men and 1814 (25.8%) were women. Thoracic, abdominal, bone and brain metastases were present in 19.5 vs. 23.0%, 43.6 vs. 46.9%, 23.9 vs. 18.7% and 2.4 vs. 2.9% of men vs. women, respectively. Bone was the most common metastatic site in men (23.9%) vs. lung in women (22.4%). Increasing age was associated with decreasing rates of abdominal (from 44.9 to 40.2%) and brain (from 3.2 to 1.4%) metastases in men vs. decreasing rates of bone (from 21.0 to 13.3%) and brain (from 5.1 to 2.0%) metastases in women (all P < 0.05). Finally, rates of metastases in multiple organs also decreased with age, in both men and women.

Conclusions

The distribution of metastases in bladder cancer varies according to sex. Moreover, differences exist according to patient age and these differences are also sex-specific. In consequence, patient age and sex should be considered in the interpretation of imaging, especially when findings are indeterminate.
Preferences for Northern Hardwood Silviculture among Family Forest Owners in Michigan’s Upper Peninsula
Authors: Helman Alexander C , Kelly Matthew C , Rouleau Mark D , Dickinson Yvette L
Published: December 2020

Managing northern hardwood forests using high-frequency, low-intensity regimes, such as single-tree selection, favors shade-tolerant species and can reduce tree species diversity. Management decisions among family forest owners (FFO) can collectively affect species and structural diversity within northern hardwood forests at regional scales. We surveyed FFOs in the Western Upper Peninsula of Michigan to understand likely future use of three silvicultural treatments—single-tree selection, shelterwood, and clearcut. Our results indicate that FFOs were most likely to implement single-tree selection and least likely to implement clearcut within the next 10 years. According to logistic regression, prior use of a treatment and perceived financial benefits significantly increased the odds for likely use for all three treatments. Having received professional forestry assistance increased likely use of single-tree selection but decreased likely use of shelterwood. We discuss these results within the context of species diversity among northern hardwood forests throughout the region.
Characterizing Canopy Openness in Open Forests: Spherical Densiometer and Canopy Photography Are Equivalent but Less Sensitive than Direct Measurements of Solar Radiation
Authors: Russavage Emily , Thiele Jake , Lumbsden-Pinto Joanna , Schwager Kathy , Green Tim , Dovciak Martin
Published: December 2020

In forest ecosystems, canopy openness affects understory light availability, plant growth, and tree species recruitment, thus shaping future forest composition, structure, and functional diversity. Foresters must correctly and quickly measure canopy openness to meet their management objectives. To help guide the selection of an appropriate method for measuring canopy openness, we compared three common techniques that vary in cost, complexity, and time required for measurements and data processing: smartphone-based hemispherical photography, spherical densiometer measurements, and direct measurements of solar radiation (using AccuPAR ceptometer). We measured canopy openness using these three methods on 28 permanent forest health monitoring plots in pine-oak forests of the Central Pine Barrens of Long Island in New York State. By analysis of variance and regression analyses, we found the three methods (particularly densiometer and hemispherical photographs) yielded broadly equivalent and strongly positively correlated descriptions of canopy openness. The direct measurements of solar radiation seemed to have a greater potential to detect subtle variation in forest understory light. Forest managers may sufficiently characterize canopy openness using quick and cheap methods (e.g., spherical densiometers) and avoid larger costs of devices for direct light measurements (e.g., ceptometers) and the larger data-processing times of hemispherical photography.
Prolonged Post-Discontinuation Antibiotic Exposure in Very Low Birth Weight Neonates at Risk for Early-Onset Sepsis
Authors: Le Jennifer , Greenberg Rachel G , Benjamin Daniel K , Yoo YoungJun , Zimmerman Kanecia O , Cohen-Wolkowiez Michael , Wade Kelly C ,   Administrative Core Committee of the Best Pharmaceuticals for Children Act–Pediatric Trials Network, Benjamin Daniel K , Hornik Christoph , Zimmerman Kanecia , Kennel Phyllis , Beci Rose , Hornik Chi Dang , Kearns Gregory L , Laughon Matthew , Paul Ian M , Sullivan Janice , Wade Kelly , Delmore Paula , Taylor-Zapata Perdita , Lee June , Anand Ravinder , Sharma Gaurav , Simone Gina , Kaneshige Kim , Taylor Lawrence , Green Thomas
Published: December 2020

Background

Premature, very low birth weight (VLBW) neonates are at risk for early-onset sepsis and receive ampicillin and gentamicin post-birth. Antimicrobial stewardship supports short-course antibiotics, but how long antibiotic concentrations remain therapeutic post-last dose is unknown.

Methods

Using Monte Carlo simulations (NONMEM 7.3), we analyzed antibiotic exposures in a retrospective cohort of 34 689 neonates (<1500 g, 22-27 weeks of gestation). Therapeutic exposure for ampicillin and gentamicin was evaluated relative to the minimum inhibitory concentration (MIC) for common pathogens (MIC 0.25-8 mcg/mL for group B streptococcus [GBS] and Escherichia coli). Post-discontinuation antibiotic exposure (PDAE) was defined as the time from the last dose to time when concentration decreased below MIC.

Results

Neonates had a median (range) gestational age of 26 (22-27) weeks and BW, 790 g (400-1497) . All ampicillin dosing regimens (50-100 mg/kg every 8-12 hours for 2-6 doses) achieved therapeutic exposures > MIC range. After the last dose, the PDAE mean (95% confidence interval [CI]) ranged from 34 to 50 hours (17–79) for E. coli (MIC 8) and 82 to 104 hours (95% CI: 39-122) for GBS (MIC 0.25); longer PDAE occurred with higher dose, shorter interval, and longer course. Short-course ampicillin (2 doses, 50 mg/kg every 12 hours) provided PDAE 34 hours for E. coli and 82 hours for GBS. Single-dose 5 mg/kg gentamicin provided PDAE > MIC 2 for 26 hours.

Conclusions

In VLBW neonates, ampicillin exposure remains therapeutic long after the last dose. Short-course ampicillin provided therapeutic exposures throughout the typical blood culture incubation period.
Baryons shaping dark matter haloes
Authors: Cataldi P , Pedrosa S E , Tissera P B , Artale M C
Published: December 2020

In this work, we aim at investigating the effects of baryons on the dark matter (DM) haloes structure, focusing on the correlation between the presence and importance of stellar discs and the halo shapes. We study the properties of a subsample of DM haloes from Fenix and eagle cosmological simulations. We inspect the central regions of haloes in the mass range $[10.9-992.3] \times 10^{10} \ \rm M_{\odot }$ at z = 0, comparing the hydrodynamic runs and their dark matter only (DMo) counterparts. Our results indicate that baryons have a significant impact on the shape of the inner halo, mainly within ∼20 per cent of the virial radius. We find haloes to be more spherical when hosting baryons. While the impact of baryons depends on the mass of the haloes, we also find a trend with morphology which suggests that the way baryons are assembled is also relevant in agreement with previous works. Our findings also indicate that disc galaxies preferentially form in haloes whose DMo counterparts were originally more spherical and with stronger velocity anisotropy. The presence of baryons alter the orbital structure of the DM particles of the haloes, which show a decrease in their velocity anisotropy, towards more tangentially biased orbits. This relative decrease is weaker in the case of disc-dominated galaxies. Our results point out to a cosmological connection between the final morphology of galaxies and the intrinsic properties of their DM haloes, which gets reinforce by the growth of the discs.
Pharmacokinetic properties of the temozolomide perillyl alcohol conjugate (NEO212) in mice
Authors: Cho Hee-Yeon , Swenson Steve , Thein Thu Zan , Wang Weijun , Wijeratne Neloni R , Marín-Ramos Nagore I , Katz Jonathan E , Hofman Florence M , Schönthal Axel H , Chen Thomas C
Published: December 2020

Background

NEO212 is a novel small-molecule anticancer agent that was generated by covalent conjugation of the natural monoterpene perillyl alcohol (POH) to the alkylating agent temozolomide (TMZ). It is undergoing preclinical development as a therapeutic for brain-localized malignancies. The aim of this study was to characterize metabolism and pharmacokinetic (PK) properties of NEO212 in preclinical models.

Methods

We used mass spectrometry (MS) and modified high-performance liquid chromatography to identify and quantitate NEO212 and its metabolites in cultured glioblastoma cells, in mouse plasma, brain, and excreta after oral gavage.

Results

Our methods allowed identification and quantitation of NEO212, POH, TMZ, as well as primary metabolites 5-aminoimidazole-4-carboxamide (AIC) and perillic acid (PA). Intracellular concentrations of TMZ were greater after treatment of U251TR cells with NEO212 than after treatment with TMZ. The half-life of NEO212 in mouse plasma was 94 min. In mice harboring syngeneic GL261 brain tumors, the amount of NEO212 was greater in the tumor-bearing hemisphere than in the contralateral normal hemisphere. The brain:plasma ratio of NEO212 was greater than that of TMZ. Excretion of unaltered NEO212 was through feces, whereas its AIC metabolite was excreted via urine.

Conclusions

NEO212 preferentially concentrates in brain tumor tissue over normal brain tissue, and compared to TMZ has a higher brain:plasma ratio, altogether revealing favorable features to encourage its further development as a brain-targeted therapeutic. Its breakdown into well-characterized, long-lived metabolites, in particular AIC and PA, will provide useful equivalents for PK studies during further drug development and clinical trials with NEO212.
Tocilizumab for the Treatment of COVID-19 Among Hospitalized Patients: A Matched Retrospective Cohort Analysis
Authors: Ignatius Elisa H , Wang Kunbo , Karaba Andrew , Robinson Matthew , Avery Robin K , Blair Paul , Chida Natasha , Jain Tania , Petty Brent G , Siddiqui Zishan , Melia Michael T , Auwaerter Paul G , Xu Yanxun , Garibaldi Brian T
Published: December 2020

Background

There is currently no single treatment that mitigates all harms caused by severe acute respiratory syndrome coronavirus 2 infection. Tocilizumab, an interleukin-6 antagonist, may have a role as an adjunctive immune-modulating therapy.

Methods

This was an observational retrospective study of hospitalized adult patients with confirmed coronavirus disease 2019 (COVID-19). The intervention group comprised patients who received tocilizumab; the comparator arm was drawn from patients who did not receive tocilizumab. The primary outcome was all-cause mortality censored at 28 days; secondary outcomes were all-cause mortality at discharge, time to clinical improvement, and rates of secondary infections. Marginal structural Cox models via inverse probability treatment weights were applied to estimate the effect of tocilizumab. A time-dependent propensity score–matching method was used to generate a 1:1 match for tocilizumab recipients; infectious diseases experts then manually reviewed these matched charts to identify secondary infections.

Results

This analysis included 90 tocilizumab recipients and 1669 controls. Under the marginal structural Cox model, tocilizumab was associated with a 62% reduced hazard of death (adjusted hazard ratio [aHR], 0.38; 95% CI, 0.21 to 0.70) and no change in time to clinical improvement (aHR, 1.13; 95% CI, 0.68 to 1.87). The 1:1 matched data set also showed a lower mortality rate (27.8% vs 34.4%) and reduced hazards of death (aHR, 0.47; 95% CI, 0.25 to 0.88). Elevated inflammatory markers were associated with reduced hazards of death among tocilizumab recipients compared with controls. Secondary infection rates were similar between the 2 groups.

Conclusions

Tocilizumab may provide benefit in a subgroup of patients hospitalized with COVID-19 who have elevated biomarkers of hyperinflammation, without increasing the risk of secondary infection.
Clinical and Economic Burden of Valley Fever in Arizona: An Incidence-Based Cost-of-Illness Analysis
Authors: Grizzle Amy J , Wilson Leslie , Nix David E , Galgiani John N
Published: December 2020

Background

Coccidioidomycosis, ie, Valley fever, is an important fungal infection in the Southwest, with half to two thirds of all cases occurring in Arizona. This endemic respiratory disease can range from primary uncomplicated pneumonia to disseminated infection such as meningitis with chronic pulmonary complications. Valley fever diagnoses have risen over recent years and cause substantial morbidity and economic burden in Arizona.

Methods

We estimated the lifetime cost-of-illness associated with all cases of Valley fever diagnosed in 2019 in Arizona. Natural history of the disease was determined from literature and expert opinion and assigned costs from national data sources to determine lifetime direct and indirect costs (work loss).

Results

Total lifetime costs of $736 million were estimated for the 10 359 cases of Valley fever diagnosed in Arizona in 2019. Direct costs of $671 million accounted for over 90% of expenditures, with $65 million in indirect costs. Disseminated infection produces the highest economic burden at $1.26 million direct and $137 400 indirect costs per person. The lowest Valley fever lifetime costs were for cases of primary uncomplicated pneumonia with $23 200 in direct costs and $1300 in lost wages. The average lifetime direct costs across all Valley fever manifestations are $64 800 per person diagnosed in Arizona in 2019 and $6300 for indirect costs.

Conclusions

Valley fever is responsible for substantial economic burden in Arizona. Our estimates underscore the value of supporting research into developing more rapid diagnostic tests, better therapies, and ultimately a preventative vaccine to address this important public health problem in Arizona.