bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparative Study of Financial Crises: Fractal Dissection of Investor Rationality
Authors: Agarwal Sonali , Vats Anshul
Published: June 2021

Any non-linear dynamic system can be checked for structural properties only at the time of extremes/crises. Hence, in this research article we tried to investigate stock markets for visible patterns or structures in the vicinity of crashes. We used fractal dimension analysis for studying the volatility of prices and presence of noise and patterns in the time series data of NIFTY, SENSEX and gold. We found change in market predictability of the various time series in the surrounding of crash points. There was measurable change in persistence levels around rupture points. It can be concluded that excessive order in stock markets can choke the markets which then witness crashes to relieve this symmetry and resume randomness for normal functioning. We supported the results with behavioural biases and patterns of investors. The repetitive trading psychology, different intensity of emotions of investors towards their gains and losses, and onset of irrationality and fear leads to worsening of any financial crisis. The crashes can have devastating effects on the economy and the investors. We there have tried to find visible patterns that can serve as warning signals of an approaching crisis. This can be of special assistance to the investors, traders and speculators who enjoy playing in the stock market.
Exports and Inequality: Evidence from the Highly Concentrated Textile and Garment Sector of Bangladesh
Authors: Bhuyan Md. Iqbal , Oh Keun-Yeob
Published: June 2021

In this study, we investigate the effects of textile and garment (T&G) exports on income inequality in Bangladesh. Focusing on T&G exports alone, which contribute more than 90% of the country’s total exports, we hypothesize that the export sector of a country being concentrated on a single industry widens income inequality. Based on time series data over the period 1991–2015, the autoregressive distributed lag (ARDL) bounds testing approach to cointegration indicates that there is a long-run relationship between the variables. It seems that exports from the T&G sector have a statistically significant effect on income inequality in the long run, such that the high concentration of T&G exports contributes to widening income inequality in Bangladesh. This result implies that policies oriented toward export diversification are necessary so that people working in other sectors can also engage in income generating activities from exports. Our results also demonstrate that income inequality rises in the initial stages of economic growth. Then, after reaching a threshold level of growth, income inequality falls. This result confirms the validity of the Kuznets hypothesis in the case of Bangladesh.
Spontaneous Pneumomediastinum: Uncommon Cause of Air Leak in Late Preterm Neonate
Authors: Bhushan Jyotsna , Iqbal Shagufta , Chopra Abhishek
Published: June 2021

A clinical case report of spontaneous pneumomediastinum in a late-preterm neonate, chest x-ray showing classical “spinnaker sail sign,” which was managed conservatively and had excellent prognosis on conservative management. Respiratory distress in a preterm neonate is a common clinical finding. Common causes include respiratory distress syndrome, transient tachypnea of the newborn, pneumonia, and pneumothorax. Pneumomediastinum is not very common cause of respiratory distress and more so spontaneous pneumomediastinum. We report here a preterm neonate with spontaneous pneumomediastinum who had excellent clinical recovery with conservative management. A male baby was delivered to G3P1A1 mother at 34 + 6 weeks through caesarean section done due to abruptio placenta. Apgar scores were 8 and 9. Maternal antenatal history was uneventful and there were no risk factors for early onset sepsis. Baby had respiratory distress soon after birth with Silverman score being 2/10. Baby was started on oxygen (O2) by nasal prongs through blender 0.5 l/min, FiO2 25%, and intravenous fluids. Blood gas done was normal. Possibility of transient tachypnea of newborn or mild hyaline membrane disease was kept. Respiratory distress increased at 20 h of life (Silverman score: 5), urgent chest x-ray done revealed “spinnaker sign” suggestive of pneumomediastinum, so baby was shifted to O2 by hood with FiO2 being 70%. Blood gas repeated was normal. Baby was managed conservatively on intravenous fluids and O2 by hood. Baby was gradually weaned off from O2 over next 5 days. As respiratory distress decreased, baby was started on orogastric feed, which baby tolerated well and then was switched to oral feeds. Serial x-rays showed resolution of pneumomediastinum. Baby was discharged on day 7 of life in stable condition on breast feeds and room air.
The Education of Students With Disabilities in Remote or Rural Areas of China
Authors: Han Chen , Cumming Therese M. , Strnadová Iva
Published: June 2021

In recent decades, China has experienced rapid economic development, and the education system has significantly improved, especially in special education. However, there are still some issues directly influencing access to and quality of special education in remote and rural areas of China, although the Chinese government has enacted some policies to promote equity and quality of education for students with disabilities. This highlights the need for additional efforts by all levels of government authorities. This column presents a summary of current issues related to the educational provision for students with disabilities in remote or rural areas of China and brief descriptions of main policies in rural education and special education. Suggestions for how to improve the development of special education in rural areas are also provided.
Nursing Diagnosis for Potential Organ Donors: Accuracy Study
Authors: Menna Barreto Luciana Nabinger , Cabral Éder Marques , Buffon Marina Raffin , Mauro Juliana Elenice Pereira , Pruinelli Lisiane , de Abreu Almeida Miriam
Published: June 2021

The objective was to analyze the diagnostic accuracy of Impaired physiological balance syndrome in potential brain-dead organ donors. It is a study of diagnostic accuracy. Data was retrospectively collected from 145 medical records through the filling out of an instrument containing 25 indicators of the nursing diagnosis (ND). Descriptive and inferential statistics were used. The prevalence of the ND was 77 (53.1%). The indicator with the best measures of accuracy was altered heart rate. Therefore, it has the best predictive capacity for determining the ND. It was identified that the absence of the indicators altered heart rate, hyperglycemia, and altered blood pressure is associated with the absence of the ND, while the presence of the indicators hyperthermia, hypothermia, and altered heart rhythm is associated with the presence of the ND. Accurate indicators will assist in diagnostic inference and the interventions and results will have greater chances of targeting and effectiveness.
The Significance of Squamous Histology on Clinical Outcomes and PD-L1 Expression in Bladder Cancer
Authors: Gordetsky Jennifer B. , Montgomery Kathleen W. , Giannico Giovanna A. , Rais-Bahrami Soroush , Thapa Prabin , Boorjian Stephen , Frank Igor , Cody Craig J. , Cheville John
Published: June 2021

Objectives. To compare the clinicopathologic characteristics of urothelial carcinoma (UC), urothelial carcinoma with squamous differentiation (UCSD), and squamous cell carcinoma (SCC) of the bladder, which have been suggested to differ in terms of risk factors, immunophenotype, and prognosis. Methods. We evaluated the clinicopathologic features of radical cystectomy specimens between 1980 and 2015 with a diagnosis of SCC, UCSD, and UC. PD-L1 immunohistochemistry (clinically available clones 22C3, SP142, and SP263) was performed on SCC and UCSD. Multivariate Cox regression was used to identify prognostic factors. Kaplan–Meier curves were plotted to assess cancer-specific survival (CSS). Results. Of the 1478 cases, there were 1126 UC (76%), 217 UCSD (15%), and 135 SCC (9%). Bladder cancer was more common in men than women (80% vs 20%, P < .0001). However, a higher proportion of SCC and UCSD occurred in women (SCC-36%, UCSD-22%, UC-18%). Women were significantly more likely to be never smokers in all 3 cohorts (UC: 45% vs 16%, UCSD: 44% vs 12%, SCC: 40% vs 18%, P < .0001). Patients with SCC and UCSD were at a higher pathologic stage (>pT2) at the time of cystectomy (UCSD-74%, SCC 71%, UC-44%, P < .0001) and had worse CSS compared to patients with UC ( P = 0.006). SCC had higher PD-L1 scores (all clones) than UCSD ( P < .0001). PD-L1 22C3 ( P = .02, HR: 0.36) and SP142 scores ( P = .046, HR: 0.27) predicted CSS on Kaplan–Meier analysis for SCC cases. Conclusions. UC, UCSD, and SCC are associated with different risk factors, gender distributions, and clinical outcomes. PD-L1 is expressed in SCC and UCSD, suggesting some patients may benefit from targeted therapy.
Aggressive Cyclin D1 Negative Blastoid Variant Mantle Cell Lymphoma—A Case Report
Authors: Loungani Lavina , Mundhe Rajesh , Chinoy Roshan
Published: June 2021

A 68-year-old male presents with generalized lymphadenopathy and fever of short duration. Axillary lymph node excision was performed and was sent for histopathological evaluation. Microscopic evaluation of the submitted lymph node revealed diffuse proliferation of intermediate-sized atypical lymphoid cells with round nuclei, irregular membranes, finely dispersed chromatin, and inconspicuous nucleoli. Mitotic figures were frequently seen. Immunohistochemical evaluation revealed diffuse expression of CD20, CD5, CD10, B-cell lymphoma 2 (Bcl2), and B-cell lymphoma 6 (Bcl6). Atypical lymphoid cells were negative for cyclin D1; however, showed diffuse and strong nuclear expression of SOX11. MIB1 proliferation index was high (Ki67: 90%-95%). Based on morphological features and immunohistochemical findings a diagnosis of “cyclin D1 negative aggressive blastoid variant of mantle cell lymphoma (MCL)” was offered. The classic morphology of MCL is seen in 90% of cases, while the remaining (∼10%) are considered as variants. A blastoid variant is an aggressive subtype that can lack expression of CD5 as well as cyclin D1, but instead expresses CD10, Bcl6, and CD23. SOX11 expression is seen in 90% cases of MCL and in almost 100% cases of cyclin D1 negative MCL. The current case highlights the unusual morphologic and aggressive variant of MCL and a significant role of SOX11 in its diagnosis.
How Social Media Influence TV Newsrooms Online Engagement and Video Distribution
Authors: García-Perdomo Víctor
Published: June 2021

This research takes a socio-technical approach and uses participant observation and in-depth interviews to explain how two major TV news organizations from Colombia utilize social media to distribute video and engage TV audiences in online settings. Findings show that social media, particularly Facebook, are changing how television channels think of videos and their perceptions of audience engagement at the organizational level. Social media not only play a dominant role for distributing video but they influence with their recommendations and metrics TV decisions regarding content production. Finally, this research discusses the implication of these findings for the future of TV journalism.
Extensive Perivillous Fibrin and Intervillous Histiocytosis in a SARS-CoV-2 Infected Placenta From an Uninfected Newborn: A Case Report Including Immunohistochemical Profiling
Authors: Roberts James , Cheng Jeanette D , Moore Elizabeth , Ransom Carla , Ma Minhui , Rogers Beverly B
Published: June 2021

Placental infection by SARS-CoV-2 with various pathologic alterations reported. Inflammatory findings, such as extensive perivillous fibrin deposition and intervillous histiocytosis, have been postulated as risk factors for fetal infection by SARS-CoV-2. We describe the placental findings in a case of a 31-year-old mother with SARS-CoV-2 infection who delivered a preterm female neonate who tested negative for SAR-CoV2 infection. Placental examination demonstrated a small for gestational age placenta with extensive intervillous histiocytosis, syncytiotrophoblast karyorrhexis, and diffuse intervillous fibrin deposition. Immunohistochemical staining demonstrated infection of the syncytiotrophoblasts by SARS-CoV-2 inversely related to the presence of intervillous histiocytes and fibrin deposition. Our case demonstrates that despite extensive placental pathology, no fetal transmission of SARS-CoV-2 occurred, as well as postulates a relationship between placental infection, inflammation, and fibrin deposition.
Writing for Impact in Service Research
Authors: Gonsalves Chahna , Ludwig Stephan , de Ruyter Ko , Humphreys Ashlee
Published: June 2021

For service researchers, contributing to academic advancement through academic publications is a raison d’être. Moreover, demand is increasing for service researchers to make a difference beyond academia. Thus, service researchers face the formidable challenge of writing in a manner that resonates with not just service academics but also practitioners, policy makers, and other stakeholders. In this article, the authors examine how service research articles’ lexical variations might influence their academic citations and public media coverage. Drawing on the complete corpus of Journal of Service Research ( JSR) articles published between 1998 and 2020, they use text analytics and thereby determine that variations in language intensity, immediacy, and diversity relate to article impact. The appropriate use of these lexical variants and other stylistic conventions depends on the audience (academic or the public), the subsection of this article in which they appear (e.g., introduction, implications), and article innovativeness. This article concludes with an actionable “how-to” guide for ways to increase article impacts in relation to different JSR audiences.
Challenges of personal protective equipment use among ophthalmologists during the COVID-19 pandemic: A multicenter international study
Authors: Ashour Doaa Maamoun , Elkitkat Rania Serag , Gabr Hesham , Yosef Mostafa , Singh Grewal Dilraj , Saleh Mohamed Ibrahim
Published: June 2021

Purpose:

To explore the possible challenges and difficulties of using Personal Protective Equipment (PPE) in ophthalmic practice during the Coronavirus disease 2019 (COVID-19) pandemic.

Methods:

This is a multicenter, international survey among practicing ophthalmologists across different countries. The survey was conducted from September 9th to October 24th, 2020. It included a total of 23 questions that navigated through the currently adopted recommendations in different clinical situations. The survey also assessed the convenience of using various PPE in ophthalmic practice and addressed the clarity of the examination field while using various PPE during clinical or surgical procedures.

Results:

One hundred and seventy-two ophthalmologists completed the survey (101 from Egypt, 50 from the USA, and 21 from four other countries). The analysis of the responses showed that most ophthalmologists use face masks without significant problems during their examinations, while face shields followed by protective goggles were the most inconvenient PPE in the current ophthalmic practice. Moreover, most of the participants (133, 77.3%) noticed an increase in their examination time when using PPE. Furthermore, a considerable percentage of the respondents (70, 40.7%) stopped using one or more of the PPE due to inconvenience or discomfort.

Conclusions:

Due to the unique nature of the ophthalmic examination, certain PPE are not ophthalmologist-friendly. Innovative PPE should be tailored for prompt, more convenient, and clearer ophthalmological practice.
Longitudinal study of serpiginous choroiditis and serpiginous like choroiditis using wide field OCT angiography
Authors: Brar Manpreet , Sharma Mansi , Grewal SPS , Grewal Dilraj , Dogra Mangat Ram
Published: June 2021

Purpose:

To assess the ability of wide field Swept Source OCTA (SS-OCTA) imaging to detect morphological variations in Serpiginous Choroiditis (SC) and Serpiginous Like Choroiditis (SLC) in response to treatment and also analyze these findings quantitatively using Image J software.

Methods:

Retrospective observational case series of nine eyes with clinical diagnosis of active SC and SLC, who underwent SS-OCTA and fundus autofluorescence (FAF) imaging at baseline and each follow up visit till 6 months. Morphological analysis was done by two independent graders and quantitative analysis to measure the size and intensity of lesion was done using publicly available Image J software at baseline and each follow up visit.

Design:

Retrospective observational case series.

Results:

Using SS-OCTA, all the active lesions followed a characteristic healing pattern. Active lesions appear well defined hypo flow void patches and as healing progressed, lesion became more ill-defined and iso-hyper- intense. Significant increase in mean intensity of the lesion could be apparent after 1 and 6 month of treatment. There was reduction in the size of lesions during follow up however this difference was not statistically significant.

Conclusion:

SS-OCTA could be a useful noninvasive tool to study the treatment response in SC/SLC both morphologically as well as quantitatively. Quantitative parameters need to be designed in further research studies to aid in uniform management and follow up of uveitis cases.
Reliability and sensitivity of radiographic measures of hip dysplasia in childhood Charcot-Marie-Tooth disease
Authors: Dwan Leanne N , Gibbons Paul , Jamil Kamal , Little David , Birke Oliver , Menezes Manoj P , Burns Joshua
Published: June 2021

Background:

Hip dysplasia is a lack of femoral head coverage and disruption of hip and acetabular alignment and congruency, with severity ranging from mild subluxation in nascent at-risk hips to complete dislocation. Presentation of hip dysplasia in neuromuscular conditions can be sub-clinical or associated with a limp with or without hip pain, abductor and flexor weakness and reduced hip range of motion. Untreated hip dysplasia leads to early onset osteoarthritis requiring hip arthroplasty in early adulthood. Hip dysplasia occurs in 6–20% of children with Charcot-Marie-Tooth disease, however little is known about the reliability and sensitivity of detection on plain film pelvic radiographs.

Methods:

14 common measures of hip dysplasia on anteroposterior pelvis radiographs were independently assessed by 2 orthopaedic specialists in 30 ambulant children with Charcot-Marie-Tooth disease. Hip health was also categorised based on clinical impression to assess the sensitivity of radiographic measures to identify hip dysplasia status.

Results:

8 measures (acetabular index, head width, lateral centre-edge angle, lateral uncoverage, medial joint width, migration percentage, neck shaft angle, triradiate status) exhibited ‘excellent’ reliability between clinical evaluators. 5 of the 30 patients (17%) were identified as having nascent hip dysplasia. Reliable radiographic measures that significantly distinguished between nascent hip dysplasia and healthy hips were acetabular index, lateral centre edge angle, medial joint width and migration percentage.

Conclusions:

We have identified a subset of reliable and sensitive radiographic hip measures in children with Charcot-Marie-Tooth disease to prioritise during hip screening to mitigate the deleterious effects of hip dysplasia, pain and disability in adulthood.
Korean travel selfies as contested placemaking practices
Authors: Halegoua Germaine R , Moon Ghiyong Patrick
Published: June 2021

Selfies allow us to exert control over how we are seen and to construct our identity through the people, places, and activities that we imbue with value. The composition of the image, situation, and location photographed indicate aesthetic and ontological choices that reveal cultural values, performances of identity and social position of the person taking the selfie. When read as digital placemaking practices, travel selfies become salient to producers and audiences as political and performative expressions of identity and one’s place in the world. This article examines the travel selfie within the South Korean context and argues that thinking about selfies as placemaking practices informs the productive and potentially empowering nature of these photographs, which simultaneously conform to and contest neoliberal consumerist ideologies. The authors analyze a case study in which the placemaking practices of selfies are represented and critiqued. We argue that these digital placemaking practices become sites where young people’s imaginations, aspirations, and frustrations about social hierarchies, national imaginaries, and class status are expressed and debated through representations of international travel. Through textual and discourse analysis of the images and virulent public criticism faced by South Korean females who travel abroad and document their experiences on Instagram and Naver, we examine the tensions that emerge regarding expressions of the ‘spatial self’ online.
Transition from a renal paediatric clinic to an adult clinic: Perspectives of adolescents and young adults, parents and health professionals
Authors: Crawford Kimberley , Low Jac Kee , Le Page Amelia K , Mulley William , Masterson Rosemary , Kausman Joshua , Cook Natasha , Mount Peter , Manias Elizabeth
Published: June 2021

The management of chronic kidney disease is complex. With disease management being the responsibility of parents in the paediatric renal clinic, the responsibility is gradually shifted to adolescents and young adults during the transition to adult care. This multi-perspective qualitative study aimed to explore the experiences of adolescents and young adults, their parents and health professionals to gain an insight into transitional care. Focussing on the transition process and transfer to adult care, 18 adolescents and young adults and eight mothers participated in individual semi-structured interviews. Additionally, three focus groups were conducted with 20 multidisciplinary health professionals. Data were transcribed verbatim and analysed thematically. Similar responses from adolescents and young adults and mothers included the reluctance to leave the paediatric health service. Mothers found the transition to adult care more challenging than the adolescents and young adults. While health professionals acknowledged that engaging adolescents and young adults in their own care was challenging, they believed parents had an important role in facilitating their child’s independence. This study highlights that health professionals in both paediatric and adult health services need to work collaboratively. However, importantly, health professionals need to be mindful that parents require an equal amount of engagement as adolescents and young adults, if not more, to mitigate parental barriers in achieving a successful transfer.
The effects of long-term physical activity interventions in communities: Scoping review in the Nordic countries
Authors: Haverinen Elsi H. , Elonheimo Hanna M. , Tolonen Hanna K. , Jousilahti Pekka J. , Wennman Heini J.C.
Published: June 2021

Aims: Physical activity (PA) is an important part of maintaining good overall health. Currently, the number of insufficiently physically active adults and children is alarmingly high worldwide. To tackle the challenge, several interventions have been conducted, however, current knowledge on intervention effectiveness is still inconclusive. This scoping review aimed to summarize the effects of long-term PA interventions across all age groups in the Nordic countries. Methods: A scoping review was conducted by including all age groups and interventions lasting more than 12 months. The aims of the interventions had to focus on increasing PA and/or fitness. The Behaviour Change Wheel framework was used to describe components of the intervention functions. Results: Initially, 1937 studies were identified. Twelve intervention studies fulfilled the inclusion criteria and were included in the analysis. From the included studies, seven focused on children and/or their parents and five on working-age adult populations. Most of the studies built on theoretical backgrounds and included several behaviour change functions. A hindering factor for synthesis was variation in measurement methods: both subjective and objective outcome measures were reported. Among all age groups, intervention effects on PA were modest. Conclusions: There was no clear evidence of increased PA or fitness from long-term interventions in communities. However, even small improvements in PA are important for increasing PA at a population level and enhancing public health. More research is required for evidence-based community and public health planning.
Asymmetric adjustment: Partisanship and correcting misinformation on Facebook
Authors: Jennings Jay , Stroud Natalie Jomini
Published: June 2021

Across two studies, we test two of Facebook’s attempts to fight misinformation: labeling misinformation as disputed or false and including fact checks as related articles. We propose hypotheses based on a two-step model of motivated reasoning, which provides insight into how misinformation is corrected. For study 1 ( n = 1,262) and study 2 ( n = 1,586), we created a mock Facebook News Feed consisting of five different articles—four were actual news stories and the fifth was misinformation. Both studies tested (a) the effect of misinformation without correction, (b) Facebook’s changes to its platform, and (c) an alternative we theorized could be more effective. The findings, in line with the two-step model of motivated reasoning, provide evidence of symmetric party effects for the belief in misinformation. In both studies, we find partisan differences in responses to fact checking. We find modest evidence that our improvements to Facebook’s attempts at correcting misinformation reduce misperceptions across partisan divides.
Synthetic versus human voices in audiobooks: The human emotional intimacy effect
Authors: Rodero Emma , Lucas Ignacio
Published: June 2021

Human voices narrate most audiobooks, but the fast development of speech synthesis technology has enabled the possibility of using artificial voices. This raises the question of whether the listeners’ cognitive processing is the same when listening to a synthetic or a human voice telling a story. This research aims to compare the listeners’ perception, creation of mental images, narrative engagement, physiological response, and recognition of information when listening to stories conveyed by human and synthetic voices. The results showed that listeners enjoyed stories narrated by a human voice more than a synthetic one. Also, they created more mental images, were more engaged, paid more attention, had a more positive emotional response, and remembered more information. Speech synthesis has experienced considerable progress. However, there are still significant differences versus human voices, so that using them to narrate long stories, such as audiobooks do, is difficult.
Investigation of mechanical and tribological behaviour of expanded perlite particle reinforced polyphenylene sulphide
Authors: Sahin Alp Eren , Cetin Beysim , Sinmazcelik Tamer
Published: June 2021

In this study, polyphenylene sulphide was used as a matrix material due to its superior engineering properties. Expanded perlite is formed substantially from silica oxides, and it is a volcanic based and porous structure material. Its low price and low density make it very usable as a filler material. For this reason, expanded perlite reinforced polyphenylene sulphide matrix composites were prepared at various weight ratios (0, 1, 3, 5, and 10 wt%). Mechanical and tribological characterizations were done with tensile tests, hardness measurements, solid particle erosion, ball on disc, and scratch tests. According to the tensile test results, a synergistic effect was observed in mechanical properties by using perlite as a reinforcing agent. As expected, perlite reinforcement resulted in an increase in the modulus of 54% in composites. As well as tensile strength of the composite increased by approximately 13%. Furthermore, the perlite particle reinforcement improved the adhesion resistance by 73% and the scratch resistance by 30%. On the other hand, especially at low impact angles, perlite particle reinforcement decreased the erosive wear resistance of the pure polyphenylene sulphide polymer by 50%. Furthermore, expanded perlite reinforcement decreased the plastic deformation ability of polyphenylene sulphide. In consequence of this study, it has been found that expanded perlite particles can be used as an alternative filler instead of conventional reinforcing particles.
Multi-degree-of-freedom liner development: Concept to flight test
Authors: Sutliff Daniel L , Nark Douglas M , Jones Michael G
Published: June 2021

The emphasis on increased turbofan fuel efficiency requires advanced turbofan designs that will integrate higher engine bypass ratios and shorter nacelles. The resulting acoustic signature of these designs will have a more broadband character as well as a smaller available area for liner installation. This two-fold impact compels a need for an improvement in the state of the art in liner technology. Increasing the acoustic absorption efficacy over a broader frequency range is a means to address this need. An acoustic liner development and optimization process was conceived and employed to achieve and demonstrate an improved broadband liner design concept. A series of increasing technology readiness level liner studies were conducted to enhance the optimization methodology while validating the concept. This progression spanned several NASA Aeronautics Research Mission Directorate programs/projects due to its relevance. This article reviews the development and evaluation process of the multi-degree-of-freedom liner technology concept from formation through simple experimental models to a flight test over an approximate 10-year period, focusing on the discrete tests comprising the development.
Understanding Constraints and Enablers of Turnaround Time for Ethics Review: The Case of Institutional Review Boards in Tanzania
Authors: Mrisho Mwifadhi , Essack Zaynab
Published: June 2021

Background. Independent ethics review of research is required prior to the implementation of all health research involving human participants. However, ethics review processes are challenged by protracted turnaround times, which may negatively impact the implementation of socially valuable research. Previous research has documented delays in ethics review in developed and developing countries. This study aimed to determine the extent of variability in turnaround times for protocol review among different institutional review boards (IRBs) within Tanzania. Methods. This descriptive cross-sectional study employed a mixed-method approach, with qualitative and quantitative components. Seven IRBs were purposively sampled from the 15 accredited IRBs operational in Tanzania during the study period, April 2017–April 2018. Quantitative data were analysed using STATA software and qualitative data were analysed thematically. Results. The median time for review across all IRBs was 32 days, with a range of 1–396 days. Qualitative results identified five key themes related to turnaround time from interviews with participants. These included: (1) procedures for receiving and distribution of protocols, (2) number of reviewers assigned to protocols, (3) duration of reviewing protocols, (4) reasons for delayed feedback, and (5) training of research ethics committee members. Conclusion. The study showed that the median days for ethical approval in Tanzania was 32 days. We observed from this study that electronic submission systems facilitated faster turnaround times. Failure to adhere to the submission checklists and guidelines was a major obstacle to the turnaround time.
Fallen Between the Cracks: Protecting Research Staff From Participant-Perpetrated Harassment
Authors: Goodwin Christina L. , Driver Jane A. , Shipherd Jillian C. , Yeterian Julie D. , Mori DeAnna L.
Published: June 2021

There has been a call to identify populations who are at-risk for harassment. At our institution, participant-perpetrated harassment led to the development of an institution-wide program called Cultivating Respect in Research Environments (CuRRE). In this article, we describe the proactive and multipronged approach used to promote and implement the CuRRE program. We describe a policy created to set guidelines and expectations for research participants and discuss the educational and skills-based trainings delivered to principal investigators and research staff members. Research staff members completed anonymous surveys before and after the training. Over half of the attendees reported having been harassed by a participant/patient. Attendees responded favorably to the training; they felt more confident and better equipped to address participant-perpetrated harassment at the conclusion of the training. Given the dearth of literature in this area, we offer our experiences to encourage others to address this issue within their own research environment and institution.
LVD-NMPC: A learning-based vision dynamics approach to nonlinear model predictive control for autonomous vehicles
Authors: Grigorescu Sorin , Ginerica Cosmin , Zaha Mihai , Macesanu Gigel , Trasnea Bogdan
Published: June 2021

In this article, we introduce a learning-based vision dynamics approach to nonlinear model predictive control (NMPC) for autonomous vehicles, coined learning-based vision dynamics (LVD) NMPC. LVD-NMPC uses an a-priori process model and a learned vision dynamics model used to calculate the dynamics of the driving scene, the controlled system’s desired state trajectory, and the weighting gains of the quadratic cost function optimized by a constrained predictive controller. The vision system is defined as a deep neural network designed to estimate the dynamics of the image scene. The input is based on historic sequences of sensory observations and vehicle states, integrated by an augmented memory component. Deep Q-learning is used to train the deep network, which once trained can also be used to calculate the desired trajectory of the vehicle. We evaluate LVD-NMPC against a baseline dynamic window approach (DWA) path planning executed using standard NMPC and against the PilotNet neural network. Performance is measured in our simulation environment GridSim, on a real-world 1:8 scaled model car as well as on a real size autonomous test vehicle and the nuScenes computer vision dataset.
The value of circulating fibrinogen-to-pre-albumin ratio in predicting survival and benefit from chemotherapy in colorectal cancer
Authors: Ying Hou-Qun , Sun Fan , Liao Yu-Cui , Cai Dan , Yang Ying , Cheng Xue-Xin
Published: June 2021

Background:

To evaluate the prognostic role of circulating fibrinogen-to-pre-albumin (FPR) in colorectal cancer (CRC) with different tumor locations, and its involvement in chemosensitivity and chemoresistance.

Patients and methods:

A total of 2917 eligible CRC patients from multiple centers were enrolled in this prospective study, and 3 years follow-up was carried out to obtain the outcome of these patients. Circulating fibrinogen (Fib), pre-albumin (pAlb), carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA19-9) were detected, and we calculated FPR according to the detected results. Kaplan–Meier curves, Cox proportional regression, time-dependent receiver operating characteristic curves, Harrell’s concordance index, calibration, and decision curves were used to investigate the role of FPR in predicting chemotherapy efficacy and prognosis of CRC patients.

Results:

Our results showed that cancer bulk, its infiltrating depth, and the distal metastasis status of CRC determined circulating FPR levels. A high FPR was associated with a significantly inferior prognosis, while the outcomes of right-sided patients with stage III and IV CRC were worse than left-sided cases. Only FPR was found to be a reliable and independent prognostic factor for each stage of CRC. In addition, the prognostic FPR-contained nomograms were superior to the non-FPR nomograms and FPR in predicting the outcomes in both localized and metastatic CRC patients. The circulating FPR was significantly associated with chemotherapeutic efficacy in stage III and IV CRC patients. In particular, low-grade (FPR < 15) and medium-grade (15 ⩽ FPR < 20) FPR patients exhibited a complete response to chemotherapy and attenuated chemosensitivity, respectively; in contrast, high-grade inflammation (FPR ⩾ 20) conferred resistance to the treatment.

Conclusion:

Circulating FPR is a robust and independent prognostic factor, a simple and economically-friendly predictor of chemotherapy efficacy within cases of localized and metastatic CRC. FPR-contained nomograms are more effective in predicting the prognosis of these patients. FPR and the nomogram can be recommended for the evaluation of chemotherapy efficacy and to aid decision-making associated with the management of these patients.
Quantifying Wire Snares as a Threat to Leopards in Karnataka, India
Authors: Gubbi Sanjay , Kolekar Aparna , Kumara Vijaya
Published: June 2021

Though large felids are flagship species for wildlife conservation they are threatened due to various anthropogenic impacts. Mapping spatial patterns and quantification of threats to large felines can help conservation planning and resource allocation. The Leopard Panthera pardus, is categorized as Vulnerable by the IUCN as it faces a variety of threats. However, quantified data on the threats faced by leopards is scant. Hunting of wildlife using wire snares is one of the severest threats in India and elsewhere. Snaring, one of the simplest and most effective hunting techniques impacts other non-target species like the leopard. In this study, we document the spatial and temporal trends of snaring of leopards from India. Through content analysis of newspapers and news portals for the period January 2009-December 2020, we documented 113 incidents of leopards caught in snares of which 59.3% (5.5 leopards/year) resulted in mortality of leopards. Most snares (97.5%) were set to catch wild prey. Of the 84 incidents for which exact location details were available, the proportion of leopards caught in snares (54.7%, n = 46) and resulted in mortality (50%) in human-dense areas was significantly higher depicting an elevated threat from snares in these landscapes. Results from Generalised Additive Model indicated that snaring incidences increased with human population density. Percentage of protexted area to the geographical area within a district had little impact on the number of snaring incidents. The study results could help threat monitoring and conservation programs for leopards, especially outside the protexted area system.
Making the Long March Online: Some Cultural Dynamics of Digital Political Participation in Three Chinese Societies
Authors: Lu Yuanhang , Huang Yi-Hui C. , Kao Lang , Chang Yu-tzung
Published: June 2021

This study examines the authoritarian conditioning of political expression on social media in three Chinese societiesby analyzing three parallel surveys comprising 6942 respondents from mainland China, Hong Kong, and Taiwan. Results demonstrate that the use of social media to gather political information triggers politically expressive use of social media and indirectly predicts offline non-institutionalized political participation. Individuals' authoritarian orientation, however, moderates such indirect effects. Only people who demonstrate low or moderate adherence to authoritarian value systems exemplify this mediation model. Those with high levels of authoritarian orientation are not exemplary. Furthermore, the extent to which social media use interacts with authoritarian orientation to build a relationship with political participation presents two different patterns across three Chinese societies. The moderated mediating effect described here exists in Hong Kong and Taiwan but not in mainland China. Finally, we discuss the implications of these findings.
Intraosseous ancient Schwannoma: A rare case in the mandible and a literature review
Authors: Kardouni Khoozestani Neda , Motiee-Langroudi Maziar , Salehi Ali , Ranji Paniz
Published: June 2021

Schwannoma, otherwise known as neurilemmoma, is a benign tumor that originates from Schwann cells. Ancient Schwannoma is a long-standing Schwannoma with degenerative and xanthomatous changes. The Head and neck region is one of the most common sites for nerve sheath tumors but Involvement of the jaw is a considerably infrequent event. We report a rare case of intraosseous ancient Schwannoma of the mandible in a 24-year-old male patient which was initially misdiagnosed with carcinoma. The clinical features, radiographic findings, and treatment plan are discussed. Furthermore, a thorough literature review demonstrated nine published cases of intra-osseous ancient Schwannoma with their summarized features. Recognition of various histopathologic features of ancient Schwannoma is essential to prevent over-treatment.
Occult primary breast cancer presenting with brachial plexopathy: A case report
Authors: Zhao Karen L , Liu Yusha , Scherpelz Kathryn P , Kao Dennis S , Friedrich Jeffrey B
Published: June 2021

Breast cancer affects about one in eight women over the course of her lifetime. Occult breast cancer, in which primary breast cancer is detected without evidence of disease in the breast itself, comprises up to 1% of new diagnoses; this is typically detected from abnormal axillary lymph nodes, and distant metastases are rare. Here, we present an unusual case of occult breast cancer presenting as upper extremity pain, edema, and weakness, with a metastatic mass to the brachial plexus being the only site of disease.
Surgical management of vesicoureteral reflux in adults
Authors: Eli Nnaemeka , Phan Yih Chyn , Kujawa Magda
Published: June 2021

Vesicoureteral reflux (VUR) is the retrograde flow of urine from the bladder into the upper urinary tract with or without upper-tract dilatation. This diagnosis is commonly made in childhood, affecting 1% of all births. In adults, its prevalence and incidence are not known. Presentation in adults could be with loin pain associated with voiding or a full bladder, recurrent urinary tract infections, a diagnosis carried over from childhood or an incidental finding. Most of the works on VUR have been done in the paediatric population. There are limited publications addressing VUR in adults. Unsurprisingly, the management of VUR in adults is extrapolated from the knowledge that we have gained from paediatric urology. Herein, we recap on the pathophysiology and review the surgical management of VUR in adults as published over the years.
The urology 2021 curriculum
Authors: Harvey Neil J , Savvides Georgia , Cornford Philip A
Published: June 2021

A new urology curriculum has been approved by the General Medical Council and will be rolled out from August 2021. Major changes include phasing of training with a hard checkpoint at ST5 that facilitates focussed development on core skills during phase 2 (ST3–5) and the development of a special interest during phase 3 (ST6–7). While the syllabus remains unchanged, supervision levels will replace many of the workplace-based assessments currently used in wider clinical practice, learning agreements will transition from placement to placement, and indicative numbers have been replaced with index procedures, in a move from box-ticking to a professional assessment of competency and totality of practice. While change can be daunting, the 2021 urology curriculum can be viewed positively as a move away from the arbitrary collection of records of workplace-based assessments and exposure to indicative numbers, and towards the holistic professional judgements of competency that are more in keeping with lifelong consultant practice.

Level of evidence: Not applicable.
The utility of instruments and disposables during endourologic practice among Egyptian urologists
Authors: Omar Mohamed , Garabawey Mohamed El , Sayedahmed Khalid , Aboutaleb Hamdy , Noureldin Yasser
Published: June 2021

Objective:

We aimed to investigate the prevalence of utilization of different endourological instruments and disposables among Egyptian urologists and to see how availability could affect the deviation from the universal standards that might result in reduced patient safety.

Patients and method:

We surveyed members of the Egyptian Urological Association by a questionnaire evaluating the importance of different instruments and disposables used during ureteroscopy and percutaneous nephrolithotomy. All responses were collected by a commercially available Internet-based survey host ( www.surveymonkey.com ) over 8 weeks.

Results:

One hundred and fifty-two responses were received. For ureteroscopy, the most mandatory instruments and disposables included the C-arm device (83%), Dormia basket (61%), ureteral stone forceps (58%), pneumatic lithotripter (50%), and regular PTFE guide wire (49%). The instruments and disposables described as optional included 4.5 Fr ureteroscope (74%), flexible ureteroscope (70%), and hydrophilic guidewire (67%). For percutaneous nephrolithotomy, the most mandatory instruments and disposables were pneumatic lithotripter (78%), Alken metal dilator (75%), fascial dilator (45%), and regular PTFE guidewire (42%); while instruments and disposables described as optional included flexible cystoscope (70%), hydrophilic guidewire (67%), balloon dilator (57%), and laser machine (52%).

Conclusion:

The prevalence of the utilization of newly introduced instruments and disposables is low among Egyptian urologists.
The aftereffects of the UK national lockdown – could the reduction in urgent referrals, diagnostic and surgical capacities result in increased cancer morbidity and mortality?
Authors: Maresca Gianluca , Siddiqui Saad , Wardlaw Kevin , Royle Justine
Published: June 2021

Background:

The COVID-19 pandemic has cause major disruption to daily life in the United Kingdom in 2020. The national lockdown and mobilization of healthcare resources to areas with increased demand has resulted in a historical shift in referral, diagnostic and surgical capabilities in most healthboards. This regional, retrospective study aimed to shed light on the potential consequences of the UK national lockdown, the resultant decrease in referrals and diagnostic capacity on surgical services and patients during the recovery phase.

Methods:

Urgent referrals for suspected (USC) prostate cancer ( N =1430) from primary care in the north-east of Scotland and the number of diagnostic prostate biopsies performed in the region were reviewed to assess trends between January 2018 and December 2020. The data was anonymized and charted to highlight the differences between the period of national lockdown and other times.

Results:

The number of USC referrals for prostate cancer dropped significantly between March 2020 and June 2020 (a mean of 25 per month from 45 per month in the same period in 2018 and 2019). The number of diagnostic procedures also decreased significantly, with 74 fewer biopsies having been performed during the lockdown period compared with the same period in 2019.

Conclusions:

The shifts in USC referrals and diagnostics during the lockdown period have led to a backlog which may put patients at risk of cancer stage migration, leading to increased morbidity and mortality. This study indicates that reestablishment of surgical services should take priority during the recovery phase. Level of evidence: 3