bluuebunny/crossref_metadata_2025 huggingface dataset:
Social interaction in males of the Amazon river prawn Macrobrachium amazonicum (Heller, 1862) (Decapoda, Palaemonidae)
Authors: Ibrahim Adriana N. A. F. , Karplus Ilan , Valenti Wagner C.
Published: March 2021

The large size variation of Macrobrachium amazonicum reflects a complex population structure that consists of four morphotypes, called TC (Translucent Claw), CC (Cinnamon Claw), GC1 (Green Claw 1), and GC2 (Green Claw 2). The effect of the largest morphotype (GC2) claws on development and behaviour of the smallest male morphotype (TC) was analysed through manipulations of the large prawn’s second pair of claws. TC males were paired for 75 days in aquaria with (a) an intact GC2, (b) a GC2 with immobilized dactyls, and (c) a GC2 without chelipeds. Isolated TC males served as a control. The maintenance activities of TC males and social interactions with the GC2 morphotype were monitored. Survival and growth of TC males was lower in relation to the control when they were paired with intact GC2 males. Aggressive interactions were carried out almost exclusively by GC2 and strongly affected the behaviour of the small prawns. The absence of chelipeds and immobilization of dactyls in GC2 prawns reduced the negative effect on the development of TC males and agonistic behaviour. The social interactions between GC2 and TC prawns reflect a stable dominance hierarchy. The large claw of the GC2 morphotype plays a major role in the social interaction.
C-Reactive Protein to Albumin Ratio in Patients With Saphenous Vein Graft Disease
Authors: Yayla Cagri , Gayretli Yayla Kadriye
Published: March 2021

Atherosclerosis plays an important role in saphenous vein graft disease (SVGD). Previous studies showed that inflammatory blood cells play an active role in this process. C-reactive protein to albumin ratio (CAR) is considered as a novel predictor for cardiovascular risk and an indicator of inflammation. We aimed to assess the relationship between SVGD and CAR. A total of 711 participants with saphenous vein graft (SVG) were included; 348 patients had SVGD and 363 patients had patent (no stenosis) SVG. C-reactive protein to albumin ratio was higher in patients with SVGD ( P < .001). There was a significant positive correlation between CAR and the age of SVG (r = 0.123; P = .001) and SYNTAX score (r = 0.568; P < .001). Multivariate logistic regression analyses showed that lymphocyte count, CAR, and SYNTAX score were independent predictors of SVGD ( P < .05). C-reactive protein to albumin ratio may be a useful marker after bypass surgery to predict SVGD.
National Movements with and without Religion: The Nation and Religion in a Historical Perspective
Authors: Hroch Miroslav
Published: March 2021

In order to understand the role of religion in the formation of European nations, we need to differentiate the terms we are using when we analyse their relationship. In the case of nation formation, my point of departure is to distinguish two basic types of process: the case of nation-states, i. e. nations with “their own” state and high culture since the Middle Ages, and the case of “smaller nations”, which emerged through national movements, where the ethnic communities tried to achieve all attributes of a fully formed nation. My reflections focus on the second type of nation formation. Speaking about the “religion”, we have to distinguish the role of the Church as an institution, the participation (or not participation) of the clergy, the degree of integration of the religious teaching into the national programme, and finally the presence of religious arguments in the everyday national thought of small nations. There existed no general model of interaction of these four factors in the study of smaller nations.
How Political Careers affect Prime-Ministerial Performance: Evidence from Central and Eastern Europe
Authors: Grotz Florian , Müller-Rommel Ferdinand , Berz Jan , Kroeber Corinna , Kukec Marko
Published: March 2021

Even though Prime Ministers (PMs) are the central actors in parliamentary democracies, little comparative research explores what makes them perform successfully in office. This article investigates how the political careers of PMs affect their performance. For this purpose, we make use of a unique expert survey covering 131 cabinets in 11 Central and Eastern European countries between 1990 and 2018. Performance is defined as a two-dimensional set of tasks PMs ought to fulfill: first, managing the cabinet and directing domestic affairs as tasks delegated to their office, second, ensuring support of parliament and their own party, who constitute the direct principals. The findings indicate that a simple political insider career is not sufficient to enhance prime-ministerial performance. Rather, PMs who served as party leaders have the best preconditions to succeed in office.
He aronga takirua: Cultural double-shift of Māori scientists
Authors: Haar Jarrod , Martin William John
Published: March 2021

Can cultural identity be a disadvantage for indigenous employees? Can it lead to critical issues around workload and pressures? This article explores the role of cultural identity for Māori, the indigenous people of Aotearoa/New Zealand, and the findings are telling. We target Māori scientists, given their limited number but growing legislated sector demands around cultural engagement. We conducted several studies. Study one (12 interviews) identified cultural themes of whakawhanaungatanga (relationship management), kawenga (responsibilities) and taumaha (workload). Study two (wave one and wave two) focused on a large cohort of Māori scientists (between 41 and 60), and themes showed commonality with study one. Also, other themes emerged specifically āheinga tangata (human capacity), tikanga (correct practice), hauora (well-being), and umanga takaware (career disruption). Ultimately, we classify these pressures as aronga takirua (cultural double-shift) and present a theoretical model for understanding the drivers and consequences of this cultural double-shift for Māori scientists. Finally, study two (wave three) and study three were conducted to examine job descriptions/contracts and, overall, we find limited employer support for adequate engagement in cultural roles. These findings reinforced the themes from the previous studies. We discuss implications for employers and the sector.
A clean and efficient processing system to improve the fluffiness of down fibers based on multi-enzymes
Authors: Qiang Taotao , Pu Yadong , Zhang Qi
Published: March 2021

Down fiber – a natural and environmentally recyclable insulation material – is applied mainly in the area of natural-filled products. However, owing to its natural deficiencies of low fluffiness and thermal stability, large-scale application is limited. In our work, an enzyme preparation (transglutaminase (TGase)) was used as a fluffy agent to improve the fluffy degree of down. With fluffy as the main index, the single factor condition of only using TGase enzyme was optimized, and fluffiness was increased by 22%. On the basis of this optimum condition, the compound dosage of papain and TGase was further optimized. The fluffy degree of down was improved by hydrolysis of papain and crosslinking of TGase. Amino group content, thermogravimetry (TG), differential scanning calorimetry (DSC), moisture absorption, tensile strength, and elongation at break of down treated with different enzyme reagents were tested. The results showed that the thermal stability of down fiber treated with the multi enzyme increased significantly, the denaturation temperature was increased from 53.7°C to 77.4°C, and the moisture absorption was also improved. The elastic property also exhibited a great enhancement; elongation at break increased from 12.4% to 37.7%, nearly three times higher than the original property, and the tensile strength increased from 180 MPa to 370 MPa, almost 2.1 times as much as before, increased by 105.6%.
Challenges for Non-COVID Patients with Chronic Kidney Disease in Bangladesh: An Observation during Coronavirus Disease Pandemic
Authors: Al Amin Saif , Morrison Sharon D. , Kabir Maheen , Sajib Md. Refat Uz-Zaman
Published: March 2021

The coronavirus disease pandemic has created a crisis for patients with chronic kidney disease, as far as getting treatment facilities are concerned. The crisis is more intense in developing countries where the health system is more vulnerable due to poor infrastructures and insufficient health professionals. Bangladesh, being a developing nation, is also facing similar challenges to provide sufficient services to patients with chronic kidney disease. In this short report, we have discussed the challenges and barriers non-COVID chronic kidney disease patients are facing in terms of healthcare access along with getting proper medical interventions and suggested probable strategies to minimize the suffering.
Towards implementing an indoor environmental quality standard in buildings: A pilot study
Authors: Sansaniwal Sunil Kumar , Kumar Shailendra , Jain Nikhil , Mathur Jyotirmay , Mathur Sanjay
Published: March 2021

This paper demonstrates the implementation methodology for India’s first IEQ standard (ISHRAE Standard-10001:2016) in actual buildings. The IEQ standard encompasses the definitions of IEQ elements (i.e. thermal comfort, indoor air quality, visual comfort, and acoustic comfort), threshold values of IEQ parameters determining these elements, specifications of measuring instruments, and methodology to undertake IEQ assessments in buildings. The pilot study identified the preliminary findings to understand and evaluate the practical implementation of the IEQ standard through field measurements. The quantitative measurements of IEQ elements were carried out in two academic buildings in the Jaipur climate (warm and humid as well as hot and dry and cold). The occupant’s subjective evaluation was made through a questionnaire survey administrated concurrently with physical measurements of IEQ parameters. This study provides the clarity of method for taking IEQ measurements and comments on the availability of instruments and their specifications as recommended by the standard.

Practical application: The present study is the practical implementation of the IEQ standard in buildings. This standard provides the threshold limits of IEQ parameters by classifying them into three classes covering international and local benchmarking. The standard also specifies the research methodology including field measurement protocol and specification of monitoring devices for IEQ assessment. This standard is useful for evolving IEQ rating of buildings in India where the majority of the building stocks are yet to be built.
An analysis of the public administration curricula in Turkey: Realities, expectations, and attitudes toward novel courses
Authors: Karkin Naci , Gurses Fatih
Published: March 2021

The public sector gets through a big transformation in many dimensions lately. The volume and extent of this transformation influence institutionalization, organization, and execution of the public sector as a whole, irrespective of either a developed or a developing country case is at stake. There is a growing inclination to capture and direct this transformation in public administration scholarship. However, there is a void concerning whether and how the curricula of public administration are designed to capture and drive this transformation. This paper aims to address this void by analyzing the curricula in a developing country case, namely Turkey. This bidirectional motive of the study is served by evaluating first to analyze the attitudes, expectations, and opinions of public administration academics working and studying in the field of public affairs on several educational issues. Then, we aim to analyze the curricula of some selected public administration departments. After analyzing all the study findings, it is seen that departments in Turkey are mainly framed to represent the traditional dimensions of statehood. No matter how hard are the challenges that the governments face, public administration departments are still stuck to structural, organizational, and legal perspectives. We argue that the public sector needs curious public administrators rather than institutional ones, thus we plea for curricula that reflect meeting this need.
Direct Tissue PCR and Genotyping for Species Identification in a Case of Laryngeal Blastomycosis
Authors: Fritsche Thomas R. , Anderson Jennifer L. , Bassi Deepa , Hall Matthew C. , Boyle Timothy R. , Meece Jennifer K.
Published: March 2021

Otolaryngologic manifestations of infection with Blastomyces species are extremely rare and restricted geographically to recognized endemic regions. Here, we describe a case of laryngeal blastomycosis that presented as slowly progressive dysphonia. While a preliminary diagnosis was made using routine histopathology, a species identification of Blastomyces dermatitidis was made using polymerase chain reaction amplification and rapid genotyping without the need for fungal culture. All symptoms resolved following 1 month of antifungal therapy. Rapid molecular differentiation of B dermatitidis from Blastomyces gilchristii provides important insights into pathogenesis given recent recognition of differences in clinical spectra.
Do online reviews have different effects on consumers’ sampling behaviour across product types? Evidence from the software industry
Authors: Li Shengli , Li Fan , Xie Shiyu
Published: March 2021

Previous research shows that online reviews may have different effects for search goods and experience goods. However, as a typical type of experience goods, software can be further divided into different categories based on product characteristics. Little research has been conducted regarding the different effects of online reviews for different types of software. Furthermore, to offer free samples is another common practice of software firms to alleviate consumer uncertainty prior to purchase. To fill the corresponding research gap, this research focuses on the interaction effects between online reviews and free samples for different types of software. Through our empirical analysis, we find that user ratings significantly increase consumers’ sample downloads. Furthermore, consumers download more samples for some categories than for others. Finally, user and editor ratings might have differential effects for different types of software.
Management of records at Statistics South Africa: Challenges and prospects
Authors: Tintswalo Shiphamele , Mazenda Adrino , Masiya Tyanai , Shava Elvin
Published: March 2021

In South Africa, government departments are under legislative obligations to adopt a systematic and organised approach to the management of records. This is because sound records management is fundamental for good governance and effective and efficient administration of government units. This article analyses records management trends at Statistics South Africa (StatsSA). Qualitative desktop research was used with key legislative and policy sources, StatsSA documents and international literature. The study revealed that numerous challenges existed in the organisation’s records management. These challenges include: creation of the record retention and disposal authority granted by the Archivist; stakeholder relations and engagement; compliance with the National Archives and Records Services of South Africa (NARSSA) Act No. 43 of 1996 as the primary legislation for records and archives management in South Africa; and digitalization and transformation. The article recommends that the resource centre be digitalized by adopting the Millennium and Sierra Integrated Library Systems software for records management, skills development archiving and enhanced stakeholder relations. An effective and efficient records and archives management system promotes good governance, accountability, and transparency.
Lnc-NEAT1 induces cell apoptosis and inflammation but inhibits proliferation in a cellular model of hepatic ischemia/reperfusion injury
Authors: Wang Liu , Qu Pan , Yin Wanling , Sun Jiao
Published: March 2021

Objective

We aimed to investigate the effect of long non-coding RNA nuclear-enriched abundant transcript 1 (lnc-NEAT1) on regulating hepatocyte proliferation, apoptosis, and inflammation during hepatic ischemia/reperfusion (I/R) injury.

Methods

Human liver cells (HL-7702) were cultured under glucose-free and oxygen-free conditions to construct the I/R injury model. Expression of lnc-NEAT1 was detected in this model and in normal cells. Plasmids of control overexpression [NC(+)], lnc-NEAT1 overexpression [NEAT1(+)], control short hairpin (sh)RNA [NC(−)], and lnc-NEAT1 shRNA [NEAT1(−)] were transfected into HL-7702 cells and subsequently subjected to I/R treatment. Cell proliferation, apoptosis, apoptosis-related proteins, and inflammatory cytokines were assessed.

Results

Lnc-NEAT1 expression was elevated in the I/R group compared with the normal group. Cell proliferation was decreased in the NEAT1(+) group compared with the NC(+) group but increased in NEAT1(−) compared with NC(−). The apoptosis rate increased in the NEAT1(+) group compared with the NC(+) group but decreased in NEAT1(−) compared with NC(−). Western blot assay (detection of apoptosis-related proteins) showed similar results. Expression of interleukin-1β, interleukin-6, and tumor necrosis factor-α increased in the NEAT1(+) group compared with NC(+) but decreased in NEAT1(−) compared with NC(−).

Conclusion

Lnc-NEAT1 is overexpressed, induces cell apoptosis and inflammation, and inhibits proliferation during hepatic I/R injury.
Successful ablation of a left anterior accessory pathway from the left coronary sinus of Valsalva near the aortic–mitral continuity
Authors: Wang Fan , Song Xuelian , Dang Yi , Shu Shangzhi , Li Shuyan
Published: March 2021

Catheter ablation of accessory pathways can be challenging depending on the location of these pathways, and accessory pathways are rare through the aortic cusps. We report a patient who underwent radiofrequency catheter ablation for manifestation of a left anterior accessory pathway from the left coronary sinus of Valsalva near the aortic–mitral continuity. Anterior accessory pathways can be safely and effectively ablated from the aortic cusps with favorable long-term outcomes.
Feasibility of quantitative and volumetric enhancement measurement to assess tumor response in patients with breast cancer after early neoadjuvant chemotherapy
Authors: Ding Jie , Xiao Hongyan , Deng Weiwei , Liu Fengjiao , Zhu Rongrong , Ha Ruoshui
Published: March 2021

Objective

To evaluate the feasibility of quantitative enhancing lesion volume (ELV) for evaluating the responsiveness of breast cancer patients to early neoadjuvant chemotherapy (NAC) using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).

Methods

Seventy-five women with breast cancer underwent DCE-MRI before and after NAC. Lesions were assessed by ELV, response evaluation criteria in solid tumors 1.1 (RECIST 1.1), and total lesion volume (TLV). The diagnostic and pathological predictive performances of the methods were compared and color maps were compared with pathological results.

Results

ELV identified 29%, 67%, and 4% of cases with partial response, stable disease, and progressive disease, respectively. There was no significant difference in evaluation performances among the methods. The sensitivity, specificity, positive predictive value, negative predictive value (NPV), and accuracy of ELV for predicting pathologic response were 72%, 92%, 81.8%, 86.8%, and 85.3%, respectively, with the highest sensitivity, NPV, and accuracy of the three methods. The area under the receiver operating characteristic curve was also highest for ELV. Pre- and post-NAC color maps reflecting tumor activity were consistent with pathological necrosis.

Conclusions

ELV may help evaluate the responsiveness of breast cancer patients to NAC, and may provide a good tumor-response indicator through the ability to indicate tumor viability.
Correlation of radiomic features on dynamic contrast-enhanced magnetic resonance with microvessel density in hepatocellular carcinoma based on different models
Authors: Liang Hongwei , Hu Chunhong , Lu Jian , Zhang Tao , Jiang Jifeng , Ding Ding , Du Sheng , Duan Shaofeng
Published: March 2021

Objective

To explore the correlations of radiomic features of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with microvessel density (MVD) in patients with hepatocellular carcinoma (HCC), based on single-input and dual-input two-compartment extended Tofts (SITET and DITET) models.

Methods

We compared the quantitative parameters of SITET and DITET models for DCE-MRI in 30 patients with HCC using paired sample t-tests. The correlations of SITET and DITET model parameters with CD31-MVD and CD34-MVD were analyzed using Pearson’s correlation analysis. A diagnostic model of CD34-MVD was established and the diagnostic abilities of models for MVD were analyzed using receiver operating characteristic curve (ROC) analysis.

Results

There were significant differences between the quantitative parameters in the two kinds of models. Compared with SITET, DITET parameters showed better correlations with CD31-MVD and CD34-MVD. The Ktrans and Ve radiomics features of the DITET model showed high efficiency for predicting the level of CD34-MVD according to ROC analysis, with areas under curves of 0.83 and 0.94, respectively.

Conclusion

Compared with SITET, the DITET model provides a better indication of the microcirculation of HCC and is thus more suitable for examining patients with HCC.
Mapping the inequality of the global distribution of seasonal influenza vaccine
Authors: Yau Yen Ching , Gastner Michael T
Published: March 2021

With an estimated annual worldwide death toll of between 290 000 and 650 000, seasonal influenza remains one of the deadliest respiratory diseases. Influenza vaccines provide moderate to high protection and have been on the World Health Organization’s Model List of Essential Medicines since 1979. Approximately 490 million doses of influenza vaccine are produced per year, but an investigation of geographic allocation reveals enormous disparities. Here, we present two maps that visualise the inequality of the distribution across 195 countries: a conventional choropleth map and a cartogram. In combination, these two maps highlight the widespread lack of coverage in Africa and many parts of Asia. As COVID-19 vaccines are now being distributed in developed countries, data for seasonal influenza vaccine distribution emphasises the need for policymakers to ensure equitable access to COVID-19 vaccines.
Change in Posterior Tibial Slope in Skeletally Immature Patients With Anterior Cruciate Ligament Injury: A Case Series With a Mean 9 Years’ Follow-up
Authors: Martin R. Kyle , Ekås Guri R. , Benth JūratėŠaltytė , Kennedy Nicholas , Moatshe Gilbert , Krych Aaron J. , Engebretsen Lars
Published: March 2021

Background:

Increased lateral posterior tibial slope (LPTS) is associated with increased rates of anterior cruciate ligament (ACL) injury and failure of ACL reconstruction. It is unknown if ACL deficiency influences the developing proximal tibial physis and slope in skeletally immature patients through anterior tibial subluxation and abnormal force transmission.

Purpose:

To assess the natural history of LPTS in skeletally immature patients with an ACL-injured knee.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 38 participants from a previous study on nonoperative management of ACL injury in skeletally immature patients were included. During the initial study, bilateral knee magnetic resonance imaging (MRI) was performed within 1 year of enrollment and again at final follow-up. All patients were younger than 13 years at the time of enrollment, and final follow-up occurred a mean 10 years after the injury. MRI scans were retrospectively reviewed by 2 reviewers to determine bilateral LPTS for each patient and each time point. Linear mixed models were used to assess LPTS differences between knees, change over time, and association with operational status. Subgroup analyses were performed for patients who remained nonoperated throughout the study.

Results:

A total of 22 patients had ACL reconstruction before final follow-up and 16 remained nonoperated. In the entire study population, the mean LPTS was higher in the injured knee than in the contralateral knee at final follow-up by 2.0° ( P < .001; 95% CI, 1.3°–2.6°). The mean LPTS increased significantly in the injured knee by 0.9° ( P = .042; 95% CI, 0.03°–1.7°), while the mean LPTS decreased in the contralateral knee by 0.4° ( P = .363; 95% CI, –0.8° to 0.4°). A significant difference in LPTS was also observed in the nonoperated subgroup. No significant association was observed between LPTS and operational status.

Conclusion:

Lateral posterior tibial slope increased more in the ACL-injured knee than in the contralateral uninjured knee in a group of skeletally immature patients. Lateral posterior tibial slope at baseline was not associated with the need for surgical reconstruction over the study period.
Pulmonary Hemodynamics and Ventilation in Patients With COVID-19-Related Respiratory Failure and ARDS
Authors: Becker André , Seiler Frederik , Muellenbach Ralf M. , Danziger Guy , Kamphorst Maren , Lotz Christopher ,   PACovid Study Group, Bals Robert , Lepper Philipp M.
Published: March 2021

Background:

It has been suggested that COVID-19-associated severe respiratory failure (CARDS) might differ from usual acute respiratory distress syndrome (ARDS) due to failing autoregulation of pulmonary vessels and higher shunt. We sought to investigate pulmonary hemodynamics and ventilation properties in patients with CARDS compared to patients with ARDS of pulmonary origin.

Methods:

This was a retrospective analysis of prospectively collected data from consecutive adults with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 patients treated in our ICU in 04/2020 and a comparison of the data to matched controls with ARDS due to respiratory infections treated in our ICU from 01/2014 to 08/2019 for whom pulmonary artery catheter data were available.

Results:

CARDS patients (n = 10) had ventilation characteristics similar to those of ARDS (n = 10) patients. Nevertheless, mechanical power applied by ventilation was significantly higher in CARDS patients (23.4 ± 8.9 J/min) than in ARDS (15.9 ± 4.3 J/min; P < 0.05). COVID-19 patients had similar pulmonary artery pressure but significantly lower pulmonary vascular resistance, as cardiac output was higher in CARDS vs. ARDS patients ( P < 0.05). Shunt fraction and dead space were similar in CARDS compared to ARDS ( P > 0.05) and were correlated with hypoxemia in both groups. The arteriovenous pCO2 difference (▵pCO2) was elevated (CARDS 5.5 ± 2.8 mmHg vs. ARDS 4.7 ± 1.1 mmHg; P > 0.05), as was the P(v-a)CO2/C(a-v)O2 ratio (CARDS mean 2.2 ± 1.5 vs. ARDS 1.7 ± 0.8; P > 0.05).

Conclusions:

Respiratory failure in COVID-19 patients seems to differ only slightly from ARDS regarding ventilation characteristics and pulmonary hemodynamics. Our data indicate microcirculatory dysfunction. More data need to be collected to assure these findings and gain more pathophysiological insights into COVID-19 and respiratory failure.
2D X-ray diffraction and molecular modelling of the crystalline structure of polyesters under uniaxial stress
Authors: Abou-Kandil Ahmed I , Goldbeck Gerhard
Published: March 2021

Studying the crystalline structure of uniaxially and biaxially drawn polyesters is of great importance due to their wide range of applications. In this study, we shed some light on the behaviour of PET and PEN under uniaxial stress using experimental and molecular modelling techniques. Comparing experiment with modelling provides insights into polymer crystallisation with extended chains. Experimental x-ray diffraction patterns are reproduced by means of models of chains sliding along the c-axis leading to some loss of three-dimensional order, i.e. moving away from the condition of perfect register of the fully extended chains in triclinic crystals of both PET and PEN. This will help us understand the mechanism of polymer crystallisation under uniaxial stress and the appearance of mesophases in some cases as discussed herein.
Pandemic-Led Disruptions in Asia: Tracing the Early Economic Impacts on Sri Lanka and Thailand
Authors: Marwah Reena , Ramanayake Sanika Sulochani
Published: March 2021

This study focuses on tracing the early economic impacts of COVID-19. The pandemic has unleashed a global shock impacting all economies in several ways. The lockdowns have brought economic activity to a standstill, with the closure of businesses and halting of travel, trade and commerce. Even as the impact on sensitive sectors as trade, tourism and remittances are already becoming visible, it is imperative to understand how these are impacting economies in Asia. This article studies these impacts on Thailand and Sri Lanka, both of which being wired to the globalised world, are witnessing adverse impacts on earnings through exports and tourism as well as a huge decline in inward remittances. Even as countries beef up their health infrastructure, they also seek to restart international travel and trade. Hence, the role of the state is critical to pull the economies out of the de-globalisation trends that are expected to gain pace in and beyond 2020.
Trump, truth and the 25th Amendment: Australian reflections on presidential inability and removal
Authors: Roberts Jemimah
Published: March 2021

This article critically assesses a key question raised repeatedly during the tenure of US President Donald Trump – could (or should) the 25th Amendment to the US Constitution have been invoked to suspend him from office? Although moot in a practical sense following the 2020 US presidential election, exploring this question from an Australian perspective provides the opportunity to reflect on fundamental questions of constitutional design and the capacity of our own democratic institutions to respond when tested. The article suggests that the US experience with President Trump highlights some advantages offered by Australia’s parliamentary system.
Adjunctive Phenobarbital for Alcohol Withdrawal Syndrome: A Focused Literature Review
Authors: Murphy Julie A. , Curran Brittany M. , Gibbons William A. , Harnica Holly M.
Published: March 2021

Objective:

To review the literature describing the use of adjunctive phenobarbital in the treatment of severe alcohol withdrawal syndrome (AWS).

Data Sources:

PubMed and EMBASE were searched using the following terms: phenobarbital, adjunct, refractory or treatment resistant, severe or complicated, and alcohol withdrawal delirium or alcohol withdrawal seizures.

Study Selection and Data Extraction:

The search was limited to randomized controlled trials (RCTs) and cohort studies published in English.

Data Synthesis:

Seven studies were identified in the emergency department (ED; RCT, n = 1; cohort, n = 2), general medicine ward (cohort, n = 1), and intensive care unit (ICU; cohort, n = 3) settings. For all studies set in the ED and general medicine ward and for 1 ICU study, phenobarbital plus symptom-guided benzodiazepine therapy was compared to symptom-guided benzodiazepine monotherapy. The other 2 ICU studies examined adjunctive phenobarbital before and after implementation of a protocol, meaning patients in both arms could have received phenobarbital. Overall risk of bias across all studies was low to moderate.

Relevance to Patient Care and Clinical Practice:

The specific role of adjunctive phenobarbital in AWS is not clear because a majority of studies are retrospective cohorts with varying primary outcomes in different patient care settings.

Conclusions:

In the ED and general medicine ward, phenobarbital demonstrated benzodiazepine-sparing effects. In the ICU, when a protocol guides phenobarbital use, the need for mechanical ventilation may be reduced. Adjunctive phenobarbital was well tolerated. Because of study limitations, it is challenging to provide specific recommendations for adjunctive phenobarbital use in severe AWS.
Dis/organising visibilities: Governmentalisation and counter-transparency
Authors: Weiskopf Richard
Published: March 2021

This paper situates organisational transparency in an agonistic space that is shaped by the interplay of ‘mechanisms of power that adhere to a truth’ and critical practices that come from below in a movement of ‘not being governed like that and at that cost’ (Foucault, 2003: 265). This positioning involves an understanding of transparency as a practice that is historically contingent and multiple, and thus negotiable and contested. By illustrating the entanglement of ‘power through transparency’ and ‘counter-transparency’ with reference to the example of Edward Snowden’s whistleblowing, the paper contributes to the critique of transparency and to debates on the use of Foucauldian concepts in post-panoptic contexts of organising. By introducing the notion of ‘counter-transparency’, the paper expands the conceptual vocabulary for understanding the politics and ethics of managing and organising visibility.
Between legality and legitimacy: The courtroom as a site of resistance in the criminalization of migration
Authors: Haddeland Hanna B , Franko Katja
Published: March 2021

The criminalization of migration-related acts, rather than simply strengthening state authority, also represents a risk of exposing legal legitimacy deficits. By drawing on juridical analysis of court judgements, legal documents, and case law, together with ethnographic observation in court and analysis of media coverage, the article argues for acknowledging the extra-legal aspects of criminalization. By employing the concept of legal consciousness, we bring attention to how bordering processes are challenged from below by using the courtroom to expose potential legitimacy deficits concerning crimmigration enforcement. The article shows how the courtroom is not merely a place for convictions but also a site for resistance and social mobilization: a platform that may give marginalized groups voice and visibility, invoking a complex picture of state power, involving the ability to use force as well as reluctance and ambivalence connected to the questionable legitimacy of criminalization strategies.
Positioning new identities for appeal: Configurations of optimal distinctiveness amid ancestral identities
Authors: Topaler Başak , Koçak Özgecan , Üsdiken Behlül
Published: March 2021

The theory of strategic balance argues that organizations that are neither too similar to nor too distinct from their rivals will be best positioned to meet competing demands for legitimacy and competition. This is because a similar identity to other organizations signals conformity, thus generating legitimacy, while adopting a distinctive identity through differentiation provides competitive advantage. Recent studies have noted that various combinations of conformity and differentiation tactics can achieve “optimal distinctiveness,” which, depending on the particular competitive landscape, may be low, moderate, or high. This study disentangles the effect of distinctiveness in a landscape from the effects of conformity to and differentiation from ancestral identities that serve as templates for new identities. Taking a configurational approach, we explore whether distinctiveness, proximity to an ancestral identity, hybridization of multiple ancestral identities, and vertical or horizontal differentiation are necessary or sufficient, alone or in combination, to generate appeal for new identities.
Motor Competence in Children with CHARGE Syndrome
Authors: Perreault Melanie , Haibach-Beach Pamela , Lieberman Lauren , Foster Elizabeth
Published: March 2021

Children with Coloboma, Heart defects, Atresia choanae, Restricted growth, Genital hypoplasia, and Ear abnormalities (CHARGE) syndrome have many sensory impairments that can cause delays in motor development impacting physical activity, health, and quality of life. However, only one limited study has investigated motor competence in children with CHARGE syndrome. The purpose of this study was to examine differences in motor competence between children with and without CHARGE syndrome and the relationship between motor competence and age at independent walking, an important motor milestone. Thirty-three children with CHARGE syndrome and 38 typically developing peers were assessed on 13 motor skills using the Test of Gross Motor Development–Third Edition. Parents completed a demographic questionnaire about their child’s age, sex, and motor milestones. Results indicated that the children with CHARGE syndrome were significantly behind their typically developing peers for all motor skills ( p < .001). Age at independent walking in children with CHARGE syndrome was significantly later than their typically developing peers ( p < .001) and had significant negative correlations with all motor skills ( p < .01). The results of the study demonstrate a clear need for interventions focused on improving motor competence in children with CHARGE syndrome. Intervention planning should include a multidisciplinary team of relevant service providers to ensure the individualized needs of the child are met.
Effects of boundary conditions on stress distribution of hydraulic support: A simulation and experimental study
Authors: Lin Junzhe , Yang Tianrui , Ni Kaixuan , Han Chenyi , Ma Hui , Gao Ang , Xiao Chunliang
Published: March 2021

This paper analyzed the effects of boundary conditions on the stress distribution of hydraulic support with the static finite element (FE) model. Five loading conditions are considered in this study, including: 1) canopy torsional loading, 2) canopy eccentric loading, 3) base torsional loading, 4) base diagonal loading, and 5) base symmetrical loading. In order to verify the simulation results obtained from the FE model, the corresponding experiments have also been performed. Based on the comparison between simulation and experimental results, the effects of pin-joint simplified methods and boundary conditions are evaluated in terms of accuracy and efficiency. Moreover, the new elastic-support boundary is also proposed to improve the simulation accuracy under conditions 2, 3, 4, and 5. The results show that bonded contact between the pin and shaft hole has high efficiency and accuracy compared with the frictional contact. The frictional contact boundary is reasonable under condition 1. However, the elastic-support boundary is suggested to be adopted to improve calculation accuracy for the stress distribution of the constraint components (canopy or base) under conditions 2, 3, 4, and 5.
A case study of ascertainment bias for the primary outcome in the Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) trial
Authors: Esserman Denise A , Gill Thomas M , Miller Michael E , Greene Erich J , Dziura James D , Travison Thomas G , Meng Can , Peduzzi Peter N
Published: March 2021

Background/Aim

In clinical trials, there is potential for bias from unblinded observers that may influence ascertainment of outcomes. This issue arose in the Strategies to Reduce Injuries and Develop Confidence in Elders trial, a cluster randomized trial to test a multicomponent intervention versus enhanced usual care (control) to prevent serious fall injuries, originally defined as a fall injury leading to medical attention. An unblinded nurse falls care manager administered the intervention, while the usual care arm did not involve contact with a falls care manager. Thus, there was an opportunity for falls care managers to refer participants reporting falls to seek medical attention. Since this type of observer bias could not occur in the usual care arm, there was potential for additional falls to be reported in the intervention arm, leading to dilution of the intervention effect and a reduction in study power. We describe the clinical basis for ascertainment bias, the statistical approach used to assess it, and its effect on study power.

Methods

The prespecified interim monitoring plan included a decision algorithm for assessing ascertainment bias and adapting (revising) the primary outcome definition, if necessary. The original definition categorized serious fall injuries requiring medical attention into Type 1 (fracture other than thoracic/lumbar vertebral, joint dislocation, cut requiring closure) and Type 2 (head injury, sprain or strain, bruising or swelling, other). The revised definition, proposed by the monitoring plan, excluded Type 2 injuries that did not necessarily require an overnight hospitalization since these would be most subject to bias. These injuries were categorized into those with (Type 2b) and without (Type 2c) medical attention. The remaining Type 2a injuries required medical attention and an overnight hospitalization. We used the ratio of 2b/(2b + 2c) in intervention versus control as a measure of ascertainment bias; ratios > 1 indicated the likelihood of falls care manager bias. We determined the effect of ascertainment bias on study power for the revised (Types 1 and 2a) versus original definition (Types 1, 2a, and 2b).

Results

The estimate of ascertainment bias was 1.14 (95% confidence interval: 0.98, 1.30), providing evidence of the likelihood of falls care manager bias. We estimated that this bias diluted the hazard ratio from the hypothesized 0.80 to 0.86 and reduced power to under 80% for the original primary outcome definition. In contrast, adapting the revised definition maintained study power at nearly 90%.

Conclusion

There was evidence of ascertainment bias in the Strategies to Reduce Injuries and Develop Confidence in Elders trial. The decision to adapt the primary outcome definition reduced the likelihood of this bias while preserving the intervention effect and study power.
Fontan-Associated Anatomical Variants and Hepatic Fibrosis
Authors: Evans William N. , Acherman Ruben J. , Mayman Gary A. , Galindo Alvaro , Rothman Abraham , Ciccolo Michael L. , Lehoux Juan , Winn Brody J. , Yumiaco Noel S. , Restrepo Humberto
Published: March 2021

Objective:

We hypothesized that a relationship between post-Fontan hepatic fibrosis and anatomical variants might exist.

Methods:

Attempting to limit confounding variables, we analyzed data from living, stable, post-extracardiac Fontan patients who underwent cardiac catheterization and transvenous hepatic biopsy procedures between March 2012 and June 2020.

Results:

We identified 120 patients who met the inclusion criteria. Of the 120, 35 (29%) had pulmonary artery stents. For the 35 with pulmonary artery stents, the average total fibrosis score was 3.2 ± 1.9 and the fibrosis progression rate was 0.36 ± 0.33, and for those with no pulmonary artery stents, the total fibrosis score was 2.6 ± 1.8 and the fibrosis progression rate was 0.27 ± 0.33 ( P = .13 and P = .11, respectively). Of the 120, 65 had functional univentricles of right ventricular type. Of these 65, 27 had pulmonary artery stents. For the 27 with pulmonary artery stents, the average total fibrosis score was 3.4 ± 1.8 and the average fibrosis progression rate was 0.39 ± 0.30, and for the 38 without pulmonary artery stents, the average fibrosis score was 2.3 ± 1.5 and the average fibrosis progression rate was 0.23 ± 0.21 ( P = .01 for comparison of both values).

Conclusions:

This study’s findings suggest that a post-extracardiac Fontan with a functional univentricle of right ventricular type plus a pulmonary artery stent may have more advanced liver pathology than those without a pulmonary artery stent at similar Fontan duration years and ages at liver biopsy.
Patient-Specific Patch for an Intra-Atrial Rerouting Procedure Developed Through Surgical Simulation
Authors: Nakamura Yuki , Romans Charles , Ashwath Ravi
Published: March 2021

Background:

In pediatric cardiac surgery, an application of three-dimensional (3D) modeling to develop custom-made prostheses is limited, and currently surgeons use their intraoperative visual estimation to develop 3D complex structures from 2D patch materials. Contemporary 3D designers are developing complex surfaces using surface modeling in other industries, which can be applied to pediatric cardiac surgery. However, its free-form nature may lead to intradesigner variability.

Methods:

A patient with a body weight of 4 kg with partial anomalous pulmonary venous connection and preoperative computed tomography data was selected, and a patient-specific 3D heart model was obtained. Through collaboration with a pediatric cardiologist and a pediatric cardiac surgeon, a 3D designer developed two patient-specific 3D patches for an intra-atrial rerouting procedure (IAR) for the patient using different methods of surface modeling. The shape and size of two flattened patches were analyzed using a geometric morphometrics (GM) approach. Computational fluid dynamics (CFD) analysis was also performed to calculate pressure drop across streamlines and flow energy loss in the right atrium for both patches.

Results:

The GM analysis showed that the size and shape of the two patches around the systemic vein orifice, crucial to prevent systemic venous obstruction, were almost equivalent. However, the CFD analysis showed that the pressure drop and flow energy loss were almost twice for one patch compared with the other.

Conclusions:

Our platform of developing a patient-specific 3D patch for an IAR procedure using surface modeling seemed promising, although intradesigner patch variability was not neglectable in our small-sized patient.
Eyes-Open Versus Eyes-Closed Somatosensory Motor Balance in Professional Soccer Players With Chronic Ankle Instability: A Case-Control Study
Authors: Rodríguez-Sanz David , García-Sánchez Antonio , Becerro-de-Bengoa-Vallejo Ricardo , Martínez-Jiménez Eva María , Calvo-Lobo César , Fernández-Carnero Josué , Losa-Iglesias Marta Elena , López-López Daniel
Published: March 2021

Background:

Chronic ankle instability (CAI) is a condition defined by certain structural and functional deficits in the ankle joint complex after acute ankle injury. These deficits include pathological joint laxity, impaired postural control, and decreased strength and neuromuscular control.

Purpose:

To compare an eyes-open versus an eyes-closed balance training protocol in professional soccer players with CAI.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

For this study, we evaluated 19 players from 2 professional soccer teams in Madrid, Spain, all of whom had CAI. Participants from both teams were randomly assigned to an eyes-open group (n = 9) or eyes-closed group (n = 10). All participants completed 4 weeks of a supervised exercise protocol consisting of 3 sessions per week. Members of both the eyes-open and eyes-closed groups performed the same exercise protocol in the same order of execution. At the end of the protocol, the participants were assessed for pain (visual analog scale), ankle dorsiflexion range of motion (weightbearing lunge test), dynamic stability (Star Excursion Balance Test), and fear of movement and reinjury (Tampa Scale for Kinesiophobia). We compared results both before and after balance training and between the eyes-open and eyes-closed balance training groups.

Results:

Statistically significant differences were found for all of the assessed variables before and after balance training. No statistically significant differences were found between the eyes-closed and eyes-open groups on any variable.

Conclusion:

In the current study, eyes-closed balance training was not more effective than eyes-open balance training for CAI in professional soccer players.