bluuebunny/crossref_metadata_2025 huggingface dataset:
(Mis)constructing social construction: Answering the critiques
Authors: Romaioli Diego , McNamee Sheila
Published: October 2020

This article aims to review the main criticisms of social construction (SC) after its formalization as a “movement” in the social sciences. The critiques are organized into six dominant areas that define the relationship between SC and reality, truth, language, human nature, scientific enterprise, and society. For each one of these categories, the more frequent objections raised over time by scholars will be outlined and counterarguments will be offered, centering on common misunderstandings of SC. We show how the major difficulty in embracing SC principles is attributable to the use of incommensurate assumptions and misunderstandings of the aim of social construction.
LncRNA GAS5 Suppresses the Proliferation and Invasion of Osteosarcoma Cells via the miR-23a-3p/PTEN/PI3K/AKT Pathway
Authors: Liu Jianmin , Chen Ming , Ma Longyang , Dang Xingbo , Du Gongliang
Published: October 2020

Accumulating evidence has shown that long noncoding RNA GAS5 is a well-known tumor suppressor in the pathogenesis of a variety of human cancers. However, the detailed role of GAS5 in osteosarcoma is still largely unclear. In this study, we found that GAS5 was downregulated in human osteosarcoma tissues and cell lines compared with matched adjacent tissues and normal osteoblast cells. Overexpression of GAS5 could significantly suppress the growth and invasion of osteosarcoma cells, while downregulation of GAS5 promoted cell proliferation and invasion. We confirmed that GAS5 could directly bind with miR-23a-3p by using luciferase reporter gene and RNA immunoprecipitation and pull-down assay. Downregulation of miR-23a-3p repressed cell proliferation and invasion. Overexpression of miR-23a-3p counterbalanced the inhibition effect of GAS5 on cell proliferation and invasion. Further studies indicated that overexpression of GAS5 inhibited cell proliferation and metastasis by regulating phosphatase and tensin homolog (PTEN). PTEN was authenticated as a target of miR-23a-3p. Upregulation of GAS5 or silence of miR-23a-3p increased the level of PTEN, while downregulation of GAS5 or overexpression of miR-23a-3p suppressed the expression of PTEN. In addition, overexpression of GAS5 could neutralize the effect of downregulating PTEN on osteosarcoma cell functions. We proved that GAS5 regulated the viability and invasion of osteosarcoma cells through the PI3K/AKT pathway. Moreover, overexpression of GAS5 could inhibit tumor growth in a xenograft nude mouse model in vivo. In summary, GAS5 functions as a competing endogenous RNA, sponging miR-23a-3p, to promote PTEN expression and suppress cell growth and invasion in osteosarcoma by regulating the PI3K/AKT pathway.
Mechanical and thermal characterisations of low-density polyethylene/nanoclay composites
Authors: Awad Sameer A
Published: October 2020

The improvements of the thermal, mechanical, morphological properties of low-density polyethylene (LDPE)/nanoclay (NC) composites were investigated. Low-density polyethylene (LDPE) with different NC contents 2 wt.% ( Vf = 8%), 4 wt.% ( Vf = 15), and 8 wt.% ( Vf = 27) with a fixed particle size (300μm) were prepared by the melt mixing process. The thermal tests (thermal gravimetric analysis) were performed to monitor the thermal stability of LDPE composites. The mechanical tests such as tensile strength, Young’s modulus, and strain at break were studied. The results of the thermal gravimetric analysis (TGA) display significant enhancement in thermal stability as the loading of NC increased in pure LDPE. The results showed that the NC fillers could effectively improve the mechanical properties of LDPE by comparison to pure LDPE, the tensile strength of LDPE/8 wt.% of NC are increasing by about 17% while Young’s modulus is increased by about 39%. From DMA results, the storage modulus is enhanced with increasing of NC loading into the LDPE matrix. The results of SEM photographs indicate that the incorporation 8 wt.% of NC displayed the best particles dispersion in the LDPE matrix.
Organ Transplant Recipients’ Experiences of Physical Activity: Health, Self-Care, and Transliminality
Authors: Wiltshire Gareth , Clarke Nicola J. , Phoenix Cassandra , Bescoby Carl
Published: October 2020

Physical activity (PA) is an important lifestyle component of long-term health management for organ transplant recipients, yet little is known about recipients’ experiences of PA. The purpose of this study was to shed light on this experience and to investigate the possible implications of PA in the context of what is a complex patient journey. Phenomenological analysis was used to examine interviews with 13 organ transplant recipients who had taken part in sporting opportunities posttransplantation. Findings illuminate how participants’ experiences of PA were commonly shaped by the transliminal nature of being an organ transplant recipient as well as a sense of duty to enact health, self-care, and donor-directed gratitude. This analysis underlines the potential role of PA in supporting organ transplant recipients’ attempts to live well following transplantation and makes novel connections between PA and our existing knowledge about challenges related to identity, survivorship, obligation, and patient empowerment.
Administrators’ Perception of Their Role in School-wide Positive Behavior Interventions and Supports Implementation
Authors: Scaletta Michael , Hughes Marie Tejero
Published: October 2020

School administrators are called upon to enact and maintain school-wide systems and programs that promote student safety and success. The positive behavioral interventions and supports (PBIS) framework is a popular school-wide approach for teaching, maintaining, and addressing student behavior through a three-tiered framework with the aim of reducing challenging behavior and enhancing opportunities for learning by all students. Thus, the purpose of this study was to learn more about how elementary school administrators set the stage for, and participate in, school-wide PBIS implementation. Ten elementary school administrators who were successfully implementing the PBIS framework were interviewed. Analysis of the interviews revealed that administrators indicated that their primary responsibilities in the PBIS implementation process included maintaining the fidelity of systems, rationalizing system for staff, moving the school-wide implementation forward, and building capacity within and across teams and that, central to the success, was continued communication with stakeholders, including teachers.
Minimal cooperation: insights from autism
Authors: Fiebich Anika
Published: October 2020

In this article, I aim to elucidate minimality in cooperation by drawing on a previously developed multi-dimensional approach to cooperation. This approach provides a useful framework to locate any cooperative phenomenon at a specific point on the continua of different dimensions. That point, in turn, determines the criteria for a particular cooperative phenomenon to emerge. Thus, on one hand, the analysis provides a contribution to the philosophical debate on minimal cooperation by elucidating different kinds of minimalism in cooperation that are characterized by the lowest point of the continua of either dimension, including (1) cognitive minimalism, (2) behavioural minimalism, (3) affective minimalism, (4) social minimalism and (5) contextual minimalism. On the other hand, it facilitates the dialogue among disciplines insofar as it helps determining whether the skills and capacities that are required for particular cooperative activities (e.g. cooperative games like the Joint Simon task or the prisoner’s dilemma) are not only present in typically developing individuals but also individuals with developmental disorders like autism. Drawing on an externalist/internalist distinction, the analysis shows that high-functioning individuals with autism perform particularly well in cooperative activities that amount to externalism and are highly defined by an institutional context, social rules and regularities as well as the roles of the agents.
Age-Related Considerations in Cardio-Oncology
Authors: Screever Elles M. , Meijers Wouter C. , Moslehi Javid J.
Published: October 2020

Cardio-Oncology has blossomed as a new field in cardiovascular medicine, in large part due to new therapies, which may have cardiovascular sequelae. Despite this, anthracyclines still serve as cornerstone therapy for most pediatric cancers, several solid tumors and hematological malignancies. Cardiotoxicity is the main limiting concern with anthracyclines, and this is particularly an issue in patients in extremes of age (both young and old patients). Pediatric hearts are susceptible for cardiotoxicity, while in older patients, concomitant risk factors may contribute to lower threshold for cardiotoxic effects. With increasing patient survival, a significant increase in elderly cancer patients and long-term cardiotoxicity effects of anthracyclines, a better mechanistic understanding of age-dependent processes—that define cardiotoxicity—is needed. This review sheds light on how age affects underlying molecular pathways of anthracycline-associated cardiotoxicity and aims to provide preventive strategies that can be used in clinical practice.
An expanded impedance control scheme for slosh-free liquid transfer by a dual-arm cooperative robot
Authors: Naseri Soufiani Babak , Adli Mehmet Arif
Published: October 2020

The use of robots has been rapidly spreading in different daily applications. The transport of liquids by robot arms without causing any slosh is one of such applications which has recently taken the attention of researchers. Liquid transfer by dual-arm robots causes challenging problems because, in the process of dual-arm cooperation, a closed kinematic chain is formed and a set of constraints appears in motion, which increases the complexity of the process. In this study, an expanded impedance control was proposed for a dual-arm cooperative robot to achieve high speed for the transfer of a liquid-filled cylindrical container without sloshing. The impedance control method provides efficient results in controlling multi-robot interactions. However, a conventional impedance control is incapable of suppressing the slosh during liquid transfer. Therefore, in this study, we expand the impedance control by introducing a slosh suppression term, which leads to suppressing the slosh successfully during the transport of a liquid container. The effectiveness of the proposed controller was demonstrated for liquid transfer in a 2-D plane.
Replaying the Endless Loop
Authors: Tosca Susana
Published: October 2020

On the basis of the author’s participation in the “Massive and Microscopic Sensemaking” autoethnographic experiment, this article suggests that researchers can use videogame rhetoric as a heuristic to think through the timelessness of the pandemic lockdown. The author used her autoethnographic field notes as background material to write a series of short fictional videogame narratives, in the methodological tradition of layered ethnographic accounts.
Impact of embedded medication assistance program specialists on medication access in outpatient oncology clinics
Authors: Fudzie Seyram S , Luong Brandon , Jean Stephanie J , Francart Suzanne J
Published: October 2020

Introduction

Medication prior authorizations (PA) required by insurance payers can be time-consuming to complete and may lead to delays in treatment for cancer patients. The primary objective of this study is to assess the impact of Medication Assistance Program (MAP) specialists embedded in adult hematology and oncology clinics on the PA and financial assistance process.

Methods

This was a retrospective chart review study performed at a large academic medical center that examined medication referrals completed by MAP specialists in four hematology and oncology clinics. The primary outcome was the median PA turnaround time, defined as time from initial referral creation to final referral completion. Secondary outcomes assessed median turnaround time for financial assistance programs and total patient savings.

Results

A total of 176 prior authorization, 92 manufacturer patient assistance program (PAP), and 37 copay assistance referrals were completed. The median turnaround times were 24, 154, and 19 hours for PA, manufacturer PAP, and copay assistance program referrals, respectively. Total cost savings amounted to over $1.8 million for patients approved to receive medications through manufacturer PAPs.

Conclusions

Embedding MAP specialists in adult hematology/oncology clinics supports an efficient and timely process for PA approvals while also providing patient cost-savings.
Intravitreal bevacizumab in cystoid macular edema associated to maternally inherited diabetes and deafness’s macular dystrophy
Authors: Marco-Campmany Amelia , Pacheco-Cervera Jana , Navarrete-Sanchis Javier , Tomás-Torrent Juan Miguel , García-Canet Sara , Cuadrado-Gómez Teresa
Published: October 2020

Introduction:

Maternally inherited diabetes and deafness (MIDD) is a rare and infradiagnosed cause of diabetes which can, in a high number of cases, associate a macular dystrophy.

Case presentation:

We report the case of a 49- year-old man affected of this syndrome, with proven m3243G>A mitochondrial mutation, who developed macular cysts 20 years after the initial presentation of his macular dystrophy. The fluorescein angiography showed no leakage, ruling out a diabetic macular edema. A treatment with intravitreal bevacizumab led to cystic changes resolution and visual acuity recovery.

Conclusion:

Intravitreal bevacizumab can be successfully employed for this complication of MIDD’s macular dystrophy.
Laser-assisted in situ keratomileusis long term outcomes in late adolescence
Authors: Alió del Barrio Jorge L , Canto-Cerdán Mario , Bo María , Subirana Nuria , Alió Jorge L
Published: October 2020

Purpose:

Evaluate the long term outcomes of myopic-LASIK in a late adolescent population (age ⩾17 and <20 at the time of surgery).

Methods:

Monocentric retrospective case series study. Eyes with at least 3 years of follow-up time were included. Primary outcome measures were long term efficacy, safety and stability of the refractive error. Secondary outcome measure was the evaluation of the relation between the postoperative spherical aberration and the long term stability of the refractive error.

Results:

Forty-seven eyes of 25 patients were included. Mean follow-up was 9.23 ± 3.16 years. Mean age at the time of surgery was 18.74 ± 0.44 years. With time, postoperative UDVA showed a mild but significant deterioration of 1–2 Snellen lines ( p = 0.012), in connection with a mild but significant myopization of the SE (mean increase of −0.43 D; p < 0.001), sphere (mean increase of −0.29 D; p = 0.004) and cylinder (mean increase of −0.16 D; p = 0.013). CDVA remained stable over time ( p > 0.05). Efficacy index decreased from 1.01 to 0.87 in the long term (77% UDVA ⩾ 20/32). Safety remained at 1.06. 66% and 74% of eyes presented a SE within ±0.50 D and ±1.00 D respectively. SE changed over 0.50D in 33% of eyes. No correlation could be detected between the SE and the postoperative spherical aberration. No cases of corneal ectasia were detected.

Conclusions:

Myopic-LASIK in late adolescence is safe and effective, but a mild myopic progression occurs. Despite presence of refractive stability is preferable, if necessary, myopic LASIK provides relatively good outcomes in the long term in this young population.
“It’s not like I’m more Indigenous there and I’m less Indigenous here.”: urban Métis women’s identity and access to health and social services in Toronto, Canada
Authors: Monchalin Renée , Smylie Janet , Bourgeois Cheryllee
Published: October 2020

Colonial policies and identity debates have resulted in major gaps in access to culturally safe health and social services for Métis Peoples living in Canada. To address the Métis health service gap, this qualitative study explores urban Métis women’s identity and their experiences with health and social services in Toronto, Canada. Métis women ( n = 11) understand Métis identity as having connection to community, intergenerational identity survival strategies, a learning journey, and connection to land. Building Métis community determined understandings of Métis identity into urban health and social services may be one step toward addressing existing culturally safe health service gaps.
Everyday Indigenous resurgence during COVID-19: a social media situation report
Authors: Corntassel Jeff , Edgar Robynne , Monchalin Renée , Newman Carey
Published: October 2020

For Indigenous Nations on Turtle Island (Canada and the USA), the onset of COVID-19 has exacerbated food insecurity and adverse health outcomes. This situation report examines ways that Indigenous peoples on Turtle Island have met the challenges of the pandemic in their communities and their daily practices of community resurgence through social media. Drawing on the lived experiences of four Indigenous land-based practitioners, we found that social media can offer new forms of connection for Indigenous peoples relating to our foods, lands, waterways, languages, and our living histories.
BEST-MS: A prospective head-to-head comparative study of natalizumab and fingolimod in active relapsing MS
Authors: Cohen Mikael , Mondot Lydiane , Bucciarelli Florence , Pignolet Béatrice , Laplaud David-Axel , Wiertlewski Sandrine , Brochet Bruno , Ruet Aurélie , Defer Gilles , Derache Nathalie , Vermersch Patrick , Zephir Hélène , Debouverie Marc , Mathey Guillaume , Berger Eric , Cappé Chrystelle , Labauge Pierre , Carra Clarisse , De Seze Jérôme , Bigaut Kevin , Brassat David , Lebrun-Frenay Christine
Published: October 2020

Background:

There are few head-to-head studies to compare highly active treatments in multiple sclerosis (MS)

Objective:

The aim of this study was to compare the effectiveness between natalizumab (NTZ) and fingolimod (FTY) in active relapsing–remitting MS

Method:

Best Escalation STrategy in Multiple Sclerosis (BEST-MS) is a multicentric, prospective study with a 12-month follow-up including patients with active MS. Treatment choice was at the discretion of physician. Clinical and magnetic resonance imaging (MRI) data were collected at baseline and at 12 months. The primary outcome was the proportion of patients reaching no evidence of disease activity (NEDA) at 12 months. Secondary outcomes included annualized relapse rate and MRI activity.

Results:

A total of 223 patients were included (NTZ: 109 and FTY: 114). Treatment groups were well balanced at baseline. Proportion of NEDA patients was 47.8% in NTZ group versus 30.4% in FTY group ( p = 0.015). This superiority was driven by annualized relapse rate and MRI activity. In the multivariate analysis, treatment group was the only factor associated with NEDA at 12 months with a lower probability in FTY group (odds ratio (OR) = 0.49, p = 0.029).

Conclusion:

BEST-MS is a prospective study that compared head-to-head the effectiveness of NTZ and FTY in active relapsing–remitting MS. Our results suggest a superiority of NTZ over FTY.
Psychological symptoms of the outbreak of the COVID-19 confinement in Spain
Authors: Odriozola-González Paula , Planchuelo-Gómez Álvaro , Irurtia María Jesús , de Luis-García Rodrigo
Published: October 2020

We studied the short-term psychological effects of the COVID-19 crisis and the quarantine on 3550 adults from the Spanish population in a cross-sectional survey. Symptoms of anxiety, depression, and stress were analyzed using the 21-item version of the Depression Anxiety Stress Scale. Symptoms of posttraumatic stress disorder were analyzed using the Impact of Event Scale. Symptomatic scores of anxiety, depression, and stress were observed in 20% to 30% of respondents. Symptomatic scores indicating psychological stress were found in 47.5% of respondents. Similar to the findings of other multiple studies, confinement has been found to have significant emotional impact in the Spanish population.
“This is what the truth is”: Provider-patient interactions serving as barriers to contraception
Authors: Berndt Virginia Kuulei , Bell Ann V
Published: October 2020

Contraception is a vital component of women’s reproductive health, but not all women use it consistently and effectively. Many studies explore individual-level barriers to contraceptive use, yet interactional barriers are important to understand since contraception is primarily obtained through provider-patient interactions. Thus, through interviews with 86 women and 51 providers in the United States, we employ a framework of biomedicalization to study how such interactions, including the knowledge bases that inform them, shape women’s contraceptive decision-making. We find that when women’s embodied knowledge and providers’ biomedical knowledge differ, providers’ preferences supersede women’s. Providers, however, overlook this hierarchy, instead viewing their relationships with patients as empowering equal partnerships. This pattern precludes women from achieving their desired contraceptive method and highlights the process through which women’s concerns become barriers to contraceptive use. Moreover, these findings reflect how provider-patient hierarchies continue to thrive despite purported patient-centered care models.
Toward discourse involution within China’s Internet: Class, voice, and social media
Authors: Sun Ping , Zhao Guoning , Liu Zhen , Li Xiaoting , Zhao Yunze
Published: October 2020

Despite scholarly concern regarding the online discussion in China’s cyberspace, research tracing the trends in discourse expression on social media remains scant. Revolving around the concept of discursive power, this study explicates how the voices of different social classes have been represented and expressed in social media during the past decade. Employing longitudinal content analysis on class-based voice in 2009 ( n = 1374) and 2018 ( n = 25,330), the results demonstrate that online discussion in China’s social media has displayed a trend for “discourse involution,” where the increasing appropriation of the Internet among different social classes results in a continued divide of the discursive power in cyberspace. We argue that this discourse involution is achieved through the asymmetry of discursive expression, centralization of voice representation, and polarization in the emotional expression online. The study contributes to the current debate on the social effects of online discussions using a discursive and class-based approach.
Co-designing social marketing programs with “bottom of the pyramid” citizens
Authors: Schmidtke David , Rundle-Thiele Sharyn , Kubacki Krzysztof , Burns Georgette Leah
Published: October 2020

The significant challenges associated with adapting and delivering the co-design process with Bottom of the Pyramid (BoP) citizens are considered in this article, which tests a new “Empathy Building” step within the Trischler et al. seven-step co-design process model. A sequential, three-study mixed-method research design was applied to co-design a social marketing program with BoP citizens and experts, focusing on the problem of school dropout in a community in South Africa. Study 1 undertook the empathy-building step of the co-design process, which involved a 4-month ethnography in a community in South Africa. This study informed several subsequent co-design steps, including resourcing, planning, recruiting, and sensitizing. Study 2 engaged 38 participants (schoolchildren and parents) in a co-design session, challenging them to create a social marketing program for them and people like them. Study 3 delivered an evaluation session with seven key experts. This article contributes to understanding by offering a process to demonstrate how three studies used the (enhanced) co-design framework to provide a solution for a social issue, namely, prevention of school dropout. Finally, this article outlines how co-design can overcome challenges faced to work with BoP citizens through the addition of ethnography and involvement of experts at the fuzzy back-end of the co-design process to examine program implementation feasibility.
Utility of Suprasternal Transinnominate Artery for Alternate Access in Transcatheter Aortic Valve Replacement
Authors: Wudel James H. , Damle Sagar , Petty Joseph V. , Tunuguntla Anuradha , Martin Steven L. , Rooney Shari
Published: October 2020

Objective

Despite advancements in transcatheter aortic valve replacement (TAVR) technology, alternate access strategies are still required when transfemoral access is unsuitable. In these often anatomically complex group of patients, we sought to evaluate the safety and feasibility of suprasternal transinnominate (TI) artery access for TAVR.

Methods

At our institution, 652 patients underwent TAVR from November 2011 through February 2020. Of these, 23 patients underwent TI TAVR via a 5-cm suprasternal incision without special instrumentation. Outcomes of interest were technical considerations, postoperative complications, and perioperative recovery in relation to established access strategies.

Results

The mean Society of Thoracic Surgeons risk score was 8.6 ± 4.2 and the average age was 75 ± 8. All patients underwent TI TAVR using a self-expanding (12), or balloon-expandable (11) transcatheter heart valve. Average postoperative stay was 2 ± 0.7 days (range 2 to 4) with most 20/23 (87%) being discharged to home. There was no 30-day mortality or readmission. There was 1 access-site complication and 1 cerebrovascular accident within 30 days, both intraoperative, with excellent recovery. All patients had either trivial (19) or mild (4) aortic regurgitation on 30-day echocardiography.

Conclusions

TAVR via suprasternal TI access is feasible, safe, provides satisfactory perioperative recovery and adds to the options when patients require alternate access. Further data would be optimal to validate this single-center experience.
Complete Abolition of Opioid Prescribing in an Upper Extremity Surgical Practice
Authors: Henry Mark
Published: October 2020

Background

Prescription opioids threaten potential addiction, diversion, and death. Nonopioid regimens have demonstrated similar efficacy for select upper extremity postoperative patients.

Methods

After adopting a practice policy completely abolishing opioid prescriptions, data were collected on all consecutive surgical cases for the next 6 months, without exclusion. There were 800 cases, 61% male and 39% female, with a mean age of 45. Seventy patients (9%) reported already using prescription medications employed in multimodality regimens; no instruction was given to alter consumption. Patients were divided into 5 groups based on the type of surgery: elective soft tissue (24%), trauma wound management (19%), soft tissue structural repairs (9%), hand fracture/bone procedures (34%), and wrist to elbow fracture/bone procedures (14%). Each group was compared directly to each other group with a 2-tailed t-test, P < .05.

Results

Patients reported achieving pain control without the need for further medication assistance by a mean of postoperative day 2.7. Times to pain control by group were as follows: 1.5, 3.1, 2.7, 2.9, and 3.6 days respectively. Mean postoperative daily pain scores (using a 10-point visual analog scale) for days 1 to 5 were as follows: 2.8, 2.1, 1.5, 1.0, and 0.6, respectively, with a sum of 8.0. During the 6-month tracking period, the practice only received 4 calls from patients with questions about pain control (0.5% of cases).

Conclusions

Patients achieved good immediate pain control without opioids and reported rapidly declining pain levels over the next several days to the point of no longer requiring medication.

Type of Study/Level of Evidence

Prospective cohort case series, therapeutic; Level IV.
Hemorrhagic events associated with unfused or twig-like configuration of the Middle cerebral artery: A rare vascular anomaly with clinical relevance
Authors: Viso Rene , Lylyk Ivan , Albiña Pablo , Lundquist Javier , Scrivano Esteban , Lylyk Pedro
Published: October 2020

Introduction

Twig-like middle cerebral artery configuration (Tw-MCA) is a rare and commonly misdiagnosed vascular anomaly characterized by a plexiform arterial network that replaces the normal M1 segment. The prevalence and clinical relevance of this anomaly is not fully established.

Material and methods

We sought to explore the prevalence of Tw-MCA in patients clinically referred to digital angiography in a single academic comprehensive endovascular center and evaluated the radiological and clinical findings among patients with hemorrhagic events.

Results

From 2011 to 2020, a total of 10,234 patients underwent a cerebral angiography at our institution. During this period, 9 (0.088%) Tw-MCAs were identified. Out of these, 5 patients (62.5%) were admitted due to an intracranial hemorrhage. Two patients had a ruptured intracranial aneurysm on the anterior communicating artery, one with multiple brain aneurysms; two patients presented an intraparenchymal hematoma (IPH) due to the presence of a periventricular anastomosis and one patient an intraventricular hemorrhage with unclear origin.

Conclusion

Tw-MCA is a very rare vascular anomaly associated with hemorrhagic events. Adequate identification of this anomaly is essential in order to avoid misdiagnosis as steno-occlusive disorders.
Using Timeline Methodology to Visualize Treatment Trajectories of Youth and Young Adults Following Inpatient Opioid Treatment
Authors: Monico Laura B. , Ludwig Ariel , Lertch Elizabeth , Mitchell Shannon Gwin
Published: October 2020

While the use of visual methods in qualitative research is gaining recognition, there has been less attention to timelines. This paper addresses this gap and contributes to the overall literature on qualitative research design and analysis. In a randomized trial of extended release naltrexone for youth with opioid use disorder timelines were used as a part of the semi-structured interview process. Timelines were constructed in a participatory manner in which both youth and their caregivers were separately asked to recount significant events related to substance use, treatment, and criminal justice involvement that took place between interview time points. This paper suggests that using timelines in qualitative, substance use research offers two main advantages: 1) improving the data collection process, and 2) advancing understandings of temporally contextualized narratives through a visual format. Here, timelines were an integral tool for summarizing and illustrating the complexity of youths’ experiences following residential drug treatment.
Drilling Vibration in a Micro-Drilling Process Using a Gas Bearing Spindle
Authors: Huang Bo-Wun , Tseng Jung-Ge
Published: October 2020

In industry, high-density packaging technology is an unavoidable requirement. Therefore, the drilling hole of printed circuit boards, PCB, requires being much smaller, even down to 0.1 mm or less. Drill fractures are frequently found in the micro drilling process due to the micro scale, hole-location errors, reaming. In all micro drilling failure cases, there existed a large vibration or instability is frequently found because of the insufficient rigidity of supports for a system with a super-high spinning speed. To improve the drilling quality and avoid drill breakage, the effects of support stiffness and high rotational speed of the vibration in the micro drilling process must be studied. Most investigations on the vibration of micro drilling are focused on only drill self-structure. However, in an actual engineering application, the micro drill must be attached in a bearing spindle system. This study considers the vibration of a micro drill with a gas bearing spindle. Hence, it includes the effects of the rotation speed, air pressure, and clearance of gas bearing on the vibration in a micro drilling process. After constructing the governing equations of the system, the numerical analysis by the Fortran programming is performed to solve for the frequency and amplitude response of the spindle system over time. The results indicated that the spindle with the gas bearings effect increased the vibration in the micro-drilling process.
Reliable speed control of a permanent magnet DC motor using fault-tolerant H-bridge
Authors: Ahmed Soban , Amin Arslan Ahmed , Wajid Zaeema , Ahmad Faizan
Published: October 2020

Reliable, smooth, and fault free speed control of a Permanent Magnet (PM) DC motor using an H-bridge is an important need for many industrial applications such as robotics, automotive, and process industry to improve the overall efficiency and productivity. The reliability of H-bridge depends on the semiconductor switches used. The faults in these components can lead to a complete failure of the system. This paper presents a dual redundancy-based fault-tolerant system with a Fault Detection and Isolation (FDI) unit that can detect, isolate, and replace the faulty switch with the standby to prevent the unwanted shut down of the system and support the process continuity thereby increasing reliability. MATLAB/Simulink environment was used for simulation experiments and the results demonstrate the stable operation of the motor in the events of faults while maintaining its speed. The presented work establishes that the dual redundancy-based fault-tolerant H-bridge with the FDI unit is a highly reliable solution for the speed control of a DC motor.
Should parents be asked to consent for life-saving paediatric interventions?
Authors: Gamble Nathan K. , Pruski Michal
Published: October 2020

Informed consent, when given by proxy, has limitations: chiefly, it must be made in the interest of the patient. Here we critique the standard approach to parental consent, as present in Canada and the UK. Parents are often asked for consent, but are not given the authority to refuse medically beneficial treatment in many situations. This prompts the question of whether it is possible for someone to consent if they cannot refuse. We present two alternative and philosophically more consistent frameworks for paediatric proxy consent. The first allows meaningful consent (parents may say ‘yes’ or ‘no’ to treatment), provided that parents are medically informed/competent and intend the health and well-being of their child. In the second solution, medical practitioners or the state consent for treatment, with parents only being consulted to help give insight to the child’s circumstances. While we contend that either of these two options is superior to the insincerity of the present paradigm, we suggest that the first solution is preferable.
Development of secondary bacterial pneumonia in adults presenting with influenza versus noninfluenza viral respiratory infection
Authors: Melamed Kathryn H. , Williams Justin , Wang Xiaoyan , Hu Scott , Nguyen Christopher , Cui Jing , Deng Jane C.
Published: October 2020

Background:

Respiratory viral infections, particularly influenza, are known to cause significant morbidity and mortality, often due to secondary infections. Our aim was to comparatively analyze the incidence, epidemiology, and outcomes of secondary pneumonia in adult patients hospitalized with influenza versus noninfluenza viral infections and determine whether influenza particularly predisposes to secondary infections.

Methods:

This was a retrospective analysis from a single tertiary medical center of adult patients admitted to the hospital between 2008 and 2010 with respiratory viral infections. Microbiological patterns and clinical outcomes were compared between those with influenza (VI, n = 57) and those with noninfluenza (NI, n = 77) respiratory viral infections.

Results:

The NI group was older (60.6 ± 14.0 versus 53.3 ± 19.7 years, p = 0.019) with higher rates of lung transplantation (29% versus 9%, p = 0.009) than VI. Overall, 35% developed secondary pneumonia, higher among NI (44%) than VI (23%, p = 0.017). Staphylococcus aureus was the most common cause of pneumonia in VI, whereas Gram-negative rods were most frequently identified in NI. The NI group had longer hospital [median 10 (interquartile range (IQR) 6–19) versus 6 (IQR 4–15) days, p = 0.019] and intensive care unit [median 4 (IQR 0–12) versus 0 (IQR 0–8) days, p = 0.029] stays compared with VI. Further, the NI group was more likely to be admitted to the intensive care unit compared with VI (62% versus 39%, p = 0.011). A trend towards increased mortality was observed in viral infections complicated by secondary pneumonia than primary viral infections (28% versus 15%, p = 0.122).

Conclusion:

Secondary pneumonia is common among adults hospitalized with viral respiratory infections. Within our population, NI results in more frequent secondary pneumonia and longer hospital stays than those with VI. Given the high number of infections caused by Gram-negative rods, monitoring local epidemiology is critical for guiding initial antibiotic selection in empirical treatment of secondary infections. The reviews of this paper are available via the supplemental material section.
Loss and gain of bone in spondyloarthritis: what drives these opposing clinical features?
Authors: Clunie Gavin , Horwood Nicole
Published: October 2020

The breadth of bone lesion types seen in spondyloarthritis is unprecedented in medicine and includes increased bone turnover, bone loss and fragility, osteitis, osteolysis and erosion, osteosclerosis, osteoproliferation of soft tissues adjacent to bone and spinal skeletal structure weakness. Remarkably, these effects can be present simultaneously in the same patient. The search for a potential unifying cause of effects on the skeleton necessarily focuses on inflammation arising from the dysregulation of immune response to microorganisms, particularly dysregulation of TH17 lymphocytes, and the dysbiosis of established gut and other microbiota. The compelling notion that a common antecedent pathological mechanism affects existing bone and tissues with bone-forming potential (entheses), simultaneously with variable effect in the former but bone-forming in the latter, drives basic research forward and focuses our awareness on the effects on these bone mechanisms of the increasing portfolio of targeted immunotherapies used in the clinic.
Toward a Unified Language (and Application) of Salutogenic Design: An Opinion Paper
Authors: Mazzi Angela
Published: October 2020

This opinion paper posits that there is a misalignment of how the theory of salutogenesis is defined by scholars and the way that salutogenesis is reflected in architectural practice. Many practitioners use this term to describe their work without a clear understanding of the social theory behind it. A background on the original theory, brief review of its subsequent development, and the importance of stress in determining health are explored. Antonovsky, originator of the salutogenesis theory, believed that health was represented by a spectrum ranging from disease to wellness and that stress and an individual’s ability to respond to it determined where they would be on that spectrum. His work indicates that one’s resources determined the impact of a stressor. The elements Antonovsky termed environmental generalized resistance resources (GRR) are considered because they are within the purview of design practitioners to influence. While Antonovsky’s work became focused on an aspect of salutogenesis he termed sense of coherence (SOC), he encouraged exploration of additional aspects. This article proposes an expanded definition of salutogenesis that includes five aspects of environmental GRR that can address or alleviate specific causes of stress—SOC, biophilia, relaxation response, self-empowerment, and prospect and refuge. A more specific language and a common, consistent way of understanding what makes an environment salutogenic emerges with examples of each described. A common language will bring consistency to design practice and make complex social theories more accessible for practitioners, leading to them being more rigorously and universally applied in design.
Active vs. Passive Social Media Engagement with Critical Information: Protest Behavior in Two Asian Countries
Authors: Gainous Jason , Abbott Jason P. , Wagner Kevin M.
Published: October 2020

Passive online media use refers to the act of merely reading and observing political information on a users’ feed. Alternatively, active use refers to the conscious decision to share information, comment, challenge, fact check, or engage in related activity. We argue that these types of social media use have fundamentally different relationships to offline political participation. We use original survey data from Malaysia and the Philippines to test two propositions: (1) active political use, such as online protest or resistance, substitutes for offline protest and (2) passive users who encounter critical information and do not engage in active use will participate in offline protest. Our results confirm these expectations.
Collective Temporal Activism as a Game changer for the Academy: Reframing Conference Hospitalities Among Colleagues Under Pressure
Authors: Hanser Christian H.
Published: October 2020

In this article, I combine an experiential account of creative conference disruptions with conceptual ideas for inclusive formats in researcher–activist gatherings. Decelerated storytelling sessions to “miss out” on conventional conference flows were facilitated around the wood burner of a shepherd’s hut at the European Congress of Qualitative Inquiry (ECQI) 2019 in Edinburgh. Installed as a conference fringe with a counter-temporality, the Welcome Hut entered the program as a “game changer”: a novel pathway for abstract submission offered by ECQI. New ideas to structure events of qualitative research are expressed in order to respond to the challenges for organizers, delegates, and overall conference coherence arising when a major event for nonmainstreamed inquiry grows in scale, popularity, and ambition. As a result of their success, conferences that promise qualitative nonstandardization face the ambiguities that come with growing delegate numbers. I reflect on conference formats that enable rather than disable activist spaces and temporalities. Researcher–activists are invited to explore their personal agency in order to make space for utopian imagination, to allow time for rhythmic contestation, and to experiment with alternative ways to gather, within temporal conference commons. Inclusive pluritemporalities in academia then do not have to remain a privilege for the lucky few.
Oral Disease Prevention for Older People
Authors: Austin Rupert S , Olley Ryan C , Ray-Chaudhuri Arijit , Gallagher Jennifer E
Published: October 2020

This opinion paper reviews trends in oral disease and its management in older people, in response to a challenge, in an editorial in The Lancet, to the traditional curative model of dentistry and the publication of the most recent Adult Dental Health Survey. It highlights the challenge of an ageing population and its oral health needs and management. Professional issues in relation to preventive care are discussed with emphasis on the importance of identifying patient risk and providing preventive care, together with improving the uptake of dental care among older people.
Gross Total Versus Subtotal Surgical Resection in the Management of Craniopharyngiomas
Authors: Grewal Maeher R. , Spielman Daniel B. , Safi Chetan , Overdevest Jonathan B. , Otten Marc , Bruce Jeffrey , Gudis David A.
Published: October 2020

Craniopharyngiomas (CP) are suprasellar tumors that can grow into vital nearby structures and thus cause significant visual, endocrine, and hypothalamic dysfunction. Debate persists as to the optimal treatment strategy for these benign lesions, particularly with regards to the extent of surgical resection. The goals of tumor resection are to eliminate the compressive effect of the tumor on surrounding structures and minimize recurrence. It remains unclear whether a gross total resection (GTR) or subtotal resection (STR) with adjuvant therapy confers a better prognosis. Chemotherapy and radiation therapy (RT) have been explored as both neoadjuvant and adjuvant treatments to decrease tumor burden and prevent recurrence. The objective of this paper is to review the risks and benefits of GTR versus STR, specifically with regard to risk of recurrence and postoperative morbidity. Aggregated data suggest that STR monotherapy is associated with higher rates of recurrence relative to GTR (50.6% ± 22.1% vs 20.2% ± 13.5%), while STR combined with RT leads to recurrence rates similar to GTR. However, both GTR and RT are independently associated with higher rates of comorbidities including panhypopituitarism, diabetes insipidus, and visual deficits. The treatment strategy for CPs should ultimately be tailored to each patient’s individual tumor characteristics, risk, symptoms, and therapeutic goals.
Ways of Restricting the Rights of Taxpayers Under Agreements for the Avoidance of Double Taxation in National Legislation
Authors: Gurinovich Alexander Georgievich , Lapina Marina Afanasyevna , Ivanov Alexey Evgenievich
Published: October 2020

The article analyzes the situations that might limit the rights of a taxpayer under double taxation avoidance agreements. Because of the analysis of the national legislation in the area of taxation, significant differences that lead to the emergence of controversial situations regarding double taxation are revealed. The general analysis of the basic concepts of legal regulation using Russian and foreign sources regarding restrictions on the exercise of taxpayer rights under double taxation avoidance agreements, principles and mechanisms in national legislation is carried out. Because of studying the terms of individual agreements on avoidance of double taxation to test the admissibility of applying national legislation, significant differences in the approaches of different countries and examples of law enforcement based on judicial practice are analyzed. The novelty of the article is the justification of the necessity of establishing the basic principles upon restricting taxpayer rights under double taxation avoidance agreements in national legislation. The practical significance of the work lies in identifying the role of mutual agreement procedures between the competent authorities of the contracting parties under double taxation avoidance agreements, as well as in stating recommendations on the practical application of the rules regarding the limitation of taxpayer rights under double taxation avoidance agreements. System analysis, expert analysis, event analysis, traditionally legal methods (formal and logical, comparative legal), structural analysis, and modeling research methods are used.