bluuebunny/crossref_metadata_2025 huggingface dataset:
The combination of fibrinogen concentrations and the platelet-to-lymphocyte ratio predicts survival in patients with advanced lung adenocarcinoma treated with EGFR-TKIs
Authors: He Qiong , Li Yamin , Zhou Xihong , Zhou Wen , Xia Chunfang , Zhang Ruzhe , Zhang Zhengjie , Hu Aiyang , Peng Siyin , Li Jing
Published: April 2021

Objective

This study aimed to identify a predictive marker of response to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in patients with EGFR-mutant advanced lung adenocarcinoma.

Methods

A cohort of 190 patients with EGFR-mutant advanced lung adenocarcinoma was analyzed. Receiver operating characteristic curve analysis was used to evaluate the optimal cutoffs for fibrinogen levels, the neutrophil-to-lymphocyte ratio (NLR), and the platelet-to-lymphocyte ratio (PLR) for predicting progression-free survival (PFS). Univariate and multivariate survival analyses were performed to identify factors correlated with PFS and overall survival (OS).

Results

High NLR was associated with worse performance status. In univariate analysis, fibrinogen levels, NLR, and PLR were correlated with OS and PFS. In multivariate analysis, all three variables remained predictive of OS, whereas only fibrinogen levels and PLR were independent prognostic factors for PFS. Furthermore, the combination of fibrinogen levels and PLR (F-PLR score) could stratify patients into three groups with significantly different prognoses, and the score was independently predictive of survival.

Conclusion

The F-PLR score predicted the prognosis of patients with EGFR-mutant advanced lung adenocarcinoma who received EGFR-TKIs, and this score may serve as a convenient blood-based marker for identifying high-risk patients.
Successful application of burst spinal cord stimulation for refractory upper limb pain: a case series
Authors: Lee Kuen Su , Jang Yoo Kyung , Park Gene Hyun , Jun In Jae , Koh Jae Chul
Published: April 2021

Spinal cord stimulation (SCS) has been used to treat sustained pain that is intractable despite various types of treatment. However, conventional tonic waveform SCS has not shown promising outcomes for spinal cord injury (SCI) or postamputation pain. The pain signal mechanisms of burst waveforms are different to those of conventional tonic waveforms, but few reports have presented the therapeutic potential of burst waveforms for the abovementioned indications. This current case report describes two patients with refractory upper limb pain after SCI and upper limb amputation that were treated with burst waveform SCS. While the patients could not obtain sufficient therapeutic effect with conventional tonic waveforms, the burst waveforms provided better pain reduction with less discomfort. However, further studies are necessary to better clarify the mechanisms and efficacy of burst waveform SCS in patients with intractable pain.
Role of TLR4/MyD88/NF-κB signaling in heart and liver-related complications in a rat model of type 2 diabetes mellitus
Authors: Tian Jiajia , Zhao Yanyan , Wang Lingling , Li Lin
Published: April 2021

Aims

To analyze expression of members of the Toll-like receptor (TLR)4/myeloid differentiation primary response 88 (MyD88)/nuclear factor (NF)-κB signaling pathway in the heart and liver in a rat model of type 2 diabetes mellitus (T2DM). Our overall goal was to understand the underlying pathophysiological mechanisms.

Methods

We measured fasting blood glucose (FBG) and insulin (FINS) in a rat model of T2DM. Expression of members of the TLR4/MyD88/NF-κB signaling pathway as well as downstream cytokines was investigated. Levels of mRNA and protein were assessed using quantitative real-time polymerase chain reaction and western blotting, respectively. Protein content of tissue homogenates was assessed using enzyme-linked immunosorbent assays.

Results

Diabetic rats had lower body weights, higher FBG, higher FINS, and higher intraperitoneal glucose tolerance than normal rats. In addition, biochemical indicators related to heart and liver function were elevated in diabetic rats compared with normal rats. TLR4 and MyD88 were involved in the occurrence of T2DM as well as T2DM-related heart and liver complications. TLR4 caused T2DM-related heart and liver complications through activation of NF-κB.

Conclusions

TLR4/MyD88/NF-κB signaling induces production of tumor necrosis factor-α, interleukin-6, and monocyte chemoattractant protein-1, leading to the heart- and liver-related complications of T2DM.
Failure mode and effect analysis (FMEA) to improve collaborative project-based learning: Case study of a Study and Research Path in mechanical engineering
Authors: Bartolomé Elena , Benítez Paula
Published: April 2021

Failure Mode and Effect Analysis (FMEA) is a powerful quality tool, widely used in industry, for the identification of failure modes, their effects and causes. In this work, we investigated the utility of FMEA in the education field to improve active learning processes. In our case study, the FMEA principles were adapted to assess the risk of failures in a Mechanical Engineering course on “Theory of Machines and Mechanisms” conducted through a project-based, collaborative “Study and Research Path (SRP)” methodology. The SRP is an active learning instruction format which is initiated by a generating question that leads to a sequence of derived questions and answers, and combines moments of study and inquiry. By applying the FMEA, the teaching team was able to identify the most critical failures of the process, and implement corrective actions to improve the SRP in the subsequent year. Thus, our work shows that FMEA represents a simple tool of risk assesment which can serve to identify criticality in educational process, and improve the quality of active learning.
Making occupational therapy research visible: amplifying and elevating the contribution and impacts
Authors: Jones Natalie Louise , Cooke Jo , Holliday Judith
Published: April 2021

Researchers are increasingly required to be accountable for research findings and demonstrating outputs from research findings. A review of occupational therapy research promotes the use of impact assessments to make visible research outcomes ( Sainty, 2013 ). However, not all impacts are visible to those who are trying to balance the management of clinical services, along with delivering research and enabling clinical academic careers. Nationally and internationally research organisations are increasingly demanding researchers to be open, accountable and transparent in demonstrating the value research adds to healthcare organisations and the way the research impacts are reported are increasingly scrutinised. To capture research impacts we need to have a suitable measure which provides meaningful data for the context and type of project. Research impact frameworks enable organisations and researchers to tell their research impact stories by providing a systematic structure for organising evidence, achievements and case studies. This editorial shares the experience of developing a research impact tool for capturing research impacts within an organisation and discusses the importance of using research impact tools to amplify and elevate outcomes of clinical research in occupational therapy.
Applications of 3D printing in critical care medicine: A scoping review
Authors: Abeysekera Natasha , Whitmore Kirsty A , Abeysekera Ashvini , Pang George , Laupland Kevin B
Published: April 2021

Although a wide range of medical applications for three-dimensional printing technology have been recognised, little has been described about its utility in critical care medicine. The aim of this review was to identify three-dimensional printing applications related to critical care practice. A scoping review of the literature was conducted via a systematic search of three databases. A priori specified themes included airway management, procedural support, and simulation and medical education. The search identified 1544 articles, of which 65 were included. Ranging across many applications, most were published since 2016 in non – critical care discipline-specific journals. Most studies related to the application of three-dimensional printed models of simulation and reported good fidelity; however, several studies reported that the models poorly represented human tissue characteristics. Randomised controlled trials found some models were equivalent to commercial airway-related skills trainers. Several studies relating to the use of three-dimensional printing model simulations for spinal and neuraxial procedures reported a high degree of realism, including ultrasonography applications three-dimensional printing technologies. This scoping review identified several novel applications for three-dimensional printing in critical care medicine. Three-dimensional printing technologies have been under-utilised in critical care and provide opportunities for future research.
Empirical Study of the Impacts of Bicycles on Passenger Car Speeds on Urban Roads without Bicycle Lanes
Authors: Schaefer Jaclyn S. , Figliozzi Miguel A. , Unnikrishnan Avinash
Published: April 2021

Higher bicycle mode share has been suggested as part of a solution to reduce the burden of congestion in urban areas. As strategies to promote cycling are implemented, concerns have been raised by some road users and stakeholders citing simulation-based traffic studies that indicate that an increase in the bicycle mode share generates major travel time delays via reduced vehicle speeds unless bicycle lanes are provided. The current research investigates the effects bicycles may have on motorized vehicle speeds on a variety of lower speed and volume urban roads without bicycle lanes. A detailed comparative analysis of passenger car speeds was performed using two vehicle scenarios: (i) a passenger car that was preceded by a bicycle; and (ii) a passenger car that was preceded by another passenger car. The mean and 85th percentile speeds of scenarios (i) and (ii) were analyzed using t-tests. Relationships between speed and gap times with oncoming (opposite direction) traffic were also investigated. The results indicate that, at most sites (92%), bicycles do not reduce passenger car mean speeds by more than 1 mph. Speed reductions are not generally observed in local streets or facilities with adequate gaps in oncoming traffic for overtaking.
Learnings from the Field Implementation of a Novel Ultra-High Performance Concrete Beam End Repair on a Corroded Steel Girder Bridge in Connecticut
Authors: Hain Alexandra , Zaghi Arash E.
Published: April 2021

Corrosion at steel beam ends is one of the most pressing challenges in the maintenance of aging bridges. To tackle this challenge, the Connecticut Department of Transportation (DOT) has partnered with the University of Connecticut to develop a repair method that benefits from the superior mechanical and durability characteristics of ultra-high performance concrete (UHPC) material. The repair involves welding shear studs to the intact portions of the web and encasing the beam end with UHPC. This provides an alternate load path for bearing forces that bypasses the corroded regions of the beam. The structural viability of the repair has been extensively proven through small- and full-scale experiments and comprehensive finite element simulations. Connecticut DOT implemented the repair for the first time in the field on a heavily trafficked four-span bridge in 2019. The UHPC beam end repair was chosen because of the access constraints and geometric complexities of the bridge that limited the viable repair options. Four of the repaired beam ends were fully instrumented to collect data on the performance of the repaired locations before casting, during curing, and for approximately 6 months following the application of the repair. This paper provides an overview of the successful repair implementation and presents the lessons learned during construction. Select data from the monitored beam ends are presented. It is expected that this information will provide engineers with a better understanding of the repair implementation process, and thus provide an additional repair option for states to enhance the safety of aging steel bridges.
Systematic Safety Evaluation of Diverging Diamond Interchanges Based on Nationwide Implementation Data
Authors: Abdelrahman Ahmed , Abdel-Aty Mohamed , Yuan Jinghui , Al-Omari Ma’en M. A.
Published: April 2021

Diverging diamond interchanges (DDIs) are designed as an alternative to the conventional diamond interchanges to enhance operational and safety performance. As the popularity of the DDI is increasing and more DDIs are being constructed and proposed, the need has arisen to measure the actual safety benefits of DDIs as compared with the traditional diamond interchanges. This study evaluates the safety of DDIs using three methods: before–after study with comparison group, Empirical Bayes before–after method, and cross-sectional analysis. This study collected a nationwide sample of 80 DDIs in 24 states. The estimated crash modification factors indicated that converting conventional diamond interchange to DDIs could significantly decrease the total, fatal-and-injury, rear-end, and angle/left-turn crashes by 14%, 44%, 11%, and 55%, respectively. Moreover, the developed safety performance functions implied that a longer distance between crossovers/ramp terminals and a lower speed limit on freeway exit ramps are significantly associated with lower crash frequency at diamond interchanges. This study contributes to the existing literature using a relatively large representative sample size, which provides more reliable evaluation results. In addition, this study also explored the effects of different traffic and geometric characteristics on the safety performance of DDIs.
The Fate of Bone Marrow Lesions After Open Wedge High Tibial Osteotomy: A Comparison Between Knees With Primary Osteoarthritis and Subchondral Insufficiency Fractures
Authors: Choi Han Gyeol , Kim Joo Sung , Yoo Hyun Jin , Jung You Sun , Lee Yong Seuk
Published: April 2021

Background:

Subchondral insufficiency fracture of the knee (SIFK) is characterized by a subchondral lesion that may lead to end-stage osteoarthritis (OA). In patients who have SIFK in a precollapse state with varus malalignment, a joint-preserving technique such as open wedge high tibial osteotomy (OWHTO) should be considered.

Purpose:

To evaluate the efficacy of OWHTO in primary OA and SIFK-dominant OA by clinical and radiological evaluations including magnetic resonance imaging (MRI).

Study Design:

Cohort study; Level of evidence 3.

Methods:

A total of 33 SIFK-dominant OA knees and 66 with primary OA that underwent biplanar OWHTO between March 2014 and February 2016 were included after 1:2 propensity score matching. The MRI Osteoarthritis Knee Score was used to assess bone marrow lesions (BMLs) preoperatively and at follow-up. The weightbearing line ratio, the hip-knee-ankle angle, and the joint line convergence angle were measured. The clinical outcomes assessed were range of motion, the American Knee Society Score, and the Western Ontario and McMaster University (WOMAC) score.

Results:

The mean follow-up period was 41.2 ± 12.6 months. The distribution of preoperative BML grade in the SIFK-dominant OA group was significantly higher in both the femur and tibia ( P < .001 and <.001, respectively) than that in the primary OA group. However, the difference was not significant postoperatively (femur, P = .425; tibia, P = .462). In both groups, postoperative BMLs showed significant improvement compared with preoperative BMLs (primary OA [femur, P < .001; tibia, P = .001] and SIFK-dominant OA [femur, P < .001; tibia, P < .001]). The WOMAC pain score was higher in the SIFK-dominant OA group preoperatively (primary OA, 7.0 ± 3.73; SIFK-dominant OA, 9.17 ± 2.6; P = .032) even though it was not different at the final follow-up (primary OA, 2.11 ± 1.7; SIFK-dominant OA, 1.79 ± 1.32; P = .179).

Conclusion:

OWHTO is an effective procedure not only for primary OA but also for SIFK-dominant OA. OWHTO can improve BMLs, which represent the main pathological feature of SIFK. Therefore, in patients who have SIFK with varus malalignment, OWHTO can be an attractive treatment option for preserving the joint and enhancing subchondral bone healing.
Effect of High Tibial Osteotomy on the Distribution of Subchondral Bone Density Across the Proximal Tibial Articular Surface of the Knee With Medial Compartment Osteoarthritis
Authors: Iwasaki Koji , Kondo Eiji , Matsubara Shinji , Matsuoka Masatake , Endo Kaori , Yokota Isao , Onodera Tomohiro , Iwasaki Norimasa
Published: April 2021

Background:

The effect of high tibial osteotomy (HTO) on the stress distribution across the knee joint is not completely understood. Subchondral bone density is considered to reflect the pattern of stress distribution across a joint surface.

Purpose:

To assess the distribution of subchondral bone density across the proximal tibia in nonarthritic knees and in the knees of patients with osteoarthritis (OA) before and after HTO.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

We retrospectively collected radiological and computed tomography data from 16 patients without OA (control group) and 17 patients with OA. Data from the OA group were collected before and 1.5 years after HTO. Subchondral bone density of the proximal tibia was assessed with computed tomography–osteoabsorptiometry. The locations and percentages represented by high-density areas (HDAs) on the articular surface were quantitatively analyzed.

Results:

The ratio of the HDA of the medial compartment to the total HDA (medial ratio) was significantly higher in the preoperative OA group (mean, 80.1%) than in the control group (61.3%) ( P < .001). After HTO, the medial ratio decreased significantly to 75.1% ( P = .035 in comparison with preoperative values) and was significantly correlated with the hip-knee-ankle angle in both groups: control ( r = −0.551; P = .033) and OA ( r = −0.528; P = .043). The change in medial ratio after HTO was significantly correlated with the change in hip-knee-ankle angle ( r = 0.587; P = .035). In the medial compartment, the HDA in the most lateral region of 4 subregions increased after HTO, but that in 3 medial subregions decreased.

Conclusion:

In this exploratory study, HTO shifted the HDA of the medial compartment of the proximal tibial articular surface toward the lateral compartment. In contrast, the HDA of the most lateral region of the medial compartment increased after HTO. This change in subchondral bone density may result from the change in stress distribution.
Identification of Candidate Synovial Fluid Biomarkers for the Prediction of Patient Outcome After Microfracture or Osteotomy
Authors: Hulme Charlotte H. , Peffers Mandy J. , Harrington Gabriel Mateus Bernardo , Wilson Emma , Perry Jade , Roberts Sally , Gallacher Pete , Jermin Paul , Wright Karina T.
Published: April 2021

Background:

Biomarkers are needed to predict clinical outcomes for microfracture and osteotomy surgeries to ensure patients can be better stratified to receive the most appropriate treatment.

Purpose:

To identify novel biomarker candidates and to investigate the potential of a panel of protein biomarkers for the prediction of clinical outcome after treatment with microfracture or osteotomy.

Study Design:

Descriptive laboratory study.

Methods:

To identify novel candidate biomarker proteins, we used label-free quantitation after liquid chromatography–tandem mass spectrometry of dynamic range-compressed synovial fluids (SFs) from individuals who responded excellently or poorly (based on change in Lysholm score) to microfracture (n = 6) or osteotomy (n = 7). Biomarkers that were identified in this proteomic analysis or that relate to osteoarthritis (OA) severity or have predictive value in another early OA therapy (autologous cell implantation) were measured in the SF of 19 and 13 patients before microfracture or osteotomy, respectively, using commercial immunoassays, and were normalized to urea. These were aggrecanase-1 (ADAMTS-4), cartilage oligomeric matrix protein (COMP), hyaluronan (HA), lymphatic vessel endothelial hyaluronan receptor 1 (LYVE-1), matrix metalloproteinase 1 and 3, soluble CD14, S100 calcium binding protein A13, and 14-3-3 protein theta (YWHAQ). Levels of COMP and HA were also measured in the plasma of these patients. To find predictors of postoperative function, multivariable regression analyses were performed.

Results:

Proteomic analyses highlighted YWHAQ and LYVE-1 as being differentially abundant between the clinical responders/improvers and nonresponders after microfracture. A linear regression model after backward variable selection could relate preoperative concentrations of SF proteins (HA, YWHAQ, LYVE-1), activity of ADAMTS-4, and patient demographic characteristics (smoker status and sex) with Lysholm score 12 months after microfracture. Further, a generalized linear model with elastic net penalization indicated that lower preoperative activity of ADAMTS-4 in SF, being a nonsmoker, and being younger at the time of operation were indicative of a higher postoperative Lysholm score (improved joint function) after osteotomy surgery.

Conclusion:

We have identified biomarkers and generated regression models with the potential to predict clinical outcome in patients treated with microfracture or osteotomy of the knee.

Clinical Relevance:

Candidate protein biomarkers identified in this study have the potential to help determine which patients will be best suited to treatment with microfracture or osteotomy.
Long-term National Trends of Arthroscopic Meniscal Repair and Debridement
Authors: Wasserburger Jory N. , Shultz Christopher L. , Hankins David A. , Korcek Lucas , Martin David F. , Amendola Annunziato , Richter Dustin L. , Schenck Robert C. , Treme Gehron P.
Published: April 2021

Background:

Optimal treatment of meniscal pathology continues to evolve in orthopaedic surgery, with a growing understanding of which patients benefit from which procedure and which patients might be best treated nonsurgically. In 2002, Moseley et al found no difference between arthroscopic procedures, including meniscal debridement and sham surgery, in patients with osteoarthritis of the knee. This called into question the role of routine arthroscopic debridement in these patients. Additionally, an increased interest in understanding and maintaining the function of the meniscus has more recently resulted in a greater focus on meniscal preservation procedures.

Study Design:

Descriptive epidemiology study.

Purpose/Hypothesis:

The purpose was to evaluate the trends of arthroscopic meniscal debridement and repair and the characteristics of the patients receiving these treatments, compare the differences in practice between newly trained orthopaedic sports medicine specialists and those of other specialties, and analyze if there are differences in practice by region. It was hypothesized that the American Board of Orthopaedic Surgery (ABOS) database would evaluate practice patterns of recent graduates as a surrogate for current treatment and training and, consequently, demonstrate a decreased rate of meniscal debridement.

Methods:

Data from ABOS Part II examinees from 2001 to 2017 were obtained from the ABOS Case List. Current Procedure Terminology (CPT) codes related to arthroscopic meniscal treatment were selected. The examination year, age of the patient, practice region, and examinee subspecialty were analyzed. Patient age was stratified into 4 groups: <30, 30 to 50, 51 to 65, and >65 years. Examinee subspecialty was stratified into sports medicine and non–sports medicine. Statistical regression analysis was performed.

Results:

Between 2001 and 2017, ABOS Part II examinees submitted 131,047 cases with CPT codes 29880 to 29883. Meniscal debridement volume decreased for all age groups during the study period, while repair increased. Sports medicine subspecialists were more likely than their counterparts to perform repair over debridement in patients aged younger than 30 years ( P = .0004) and between 30 and 50 years ( P = .0005).

Conclusion:

This study provides insights into arthroscopic meniscal debridement and repair practice trends among ABOS Part II examinees. Meniscal debridement is decreasing and meniscal repair is increasing. Younger patient age and treatment by a sports medicine subspecialty examinee are associated with a higher likelihood of repair over debridement.
Arthroscopic Repair of the Hip Abductor Musculotendinous Unit: The Effect of Microfracture on Clinical Outcomes
Authors: Kocaoglu Baris , Paksoy Ahmet Emre , Cerciello Simone , Ollivier Matthieu , Seil Romain , Safran Marc
Published: April 2021

Background:

Endoscopic surgical repair has become a common procedure for treating patients with hip abductor tendon tears. Considering that retear rates are high after the repair of gluteus medius and minimus tendons, exploring alternative strategies to enhance structural healing is important.

Purpose/Hypothesis:

The purpose of this study was to evaluate the effect of adding microfracture to single-row repair (SR) on outcomes after the surgical repair of gluteus medius and minimus tendons and compare with SR and double-row repair (DR) without microfracture. We hypothesized that microfracture of the trochanteric footprint with SR would lead to superior clinical outcomes and lower clinically evident retear rates compared with SR and DR without the addition of microfracture.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A total of 50 patients who underwent primary arthroscopic repair of hip gluteus medius and minimus tendon tears were investigated. Patients were divided into 3 groups: DR, 16 patients; SR, 14 patients; and SR with microfracture (SRM), 20 patients. Patients were evaluated with a visual analog scale (VAS) for pain as well as the Hip Outcome Score–Activities of Daily Living (HOS-ADL), Hip Outcome Score–Sport Specific (HOS-SS), and modified Harris Hip Score (mHHS) both preoperatively and at a minimum 2-year follow-up (mean, 30 months).

Results:

Among the SR, SRM, and DR groups, the greatest decrease in VAS scores and increase in mHHS, HOS-ADL, and HOS-SS scores were seen in the SRM group, and all the differences were significant ( P < .001 to P = .006). The abductor tendon retear rates were 31.3%, 35.7%, and 15.0% in the DR, SR, and SRM groups, respectively. Retear rates were lower in the SRM group compared with the SR and DR groups ( P = .042); however, there was no significant difference between the SR and DR groups ( P = .32) in terms of retear rates.

Conclusion:

Endoscopic SR with microfracture was a safe, practical, and effective technique and had the potential advantage of enhancing biological healing at the footprint. The addition of microfracturing the trochanteric footprint significantly lowered the retear rate and provided better functional outcomes than SR and DR without microfracture.
The feasibility of multimodal fiber optic spectroscopy analysis in bladder cancer detection, grading, and staging
Authors: Morselli Simone , Baria Enrico , Cicchi Riccardo , Liaci Andrea , Sebastianelli Arcangelo , Nesi Gabriella , Serni Sergio , Pavone Francesco Saverio , Gacci Mauro
Published: April 2021

Objective:

To prove the feasibility of Multimodal Fiber Optic Spectroscopy (MFOS) analysis in bladder cancer (BCa) detection, grading, and staging.

Materials and methods:

Bladder specimens from patients underwent TURBT or TURP were recorded and analyzed with MFOS within 30 min from excision. In detail, our MFOS combined fluorescence, Raman spectroscopy, and diffuse reflectance. We used these optical techniques to collect spectra from bladder biopsies, then we compared the obtained results to gold standard pathological analysis. Finally, we developed a classification algorithm based on principal component analysis-linear discriminant analysis.

Results:

A total of 169 specimens were collected and analyzed from 114 patients, 40 (23.7%) healthy (from TURP), and 129 (76.3%) with BCa. BCa specimens were divided according to their grade—34 (26.4%) low grade (LG) and 95 (73.6%) high grade (HG) BCa—and stage—64 (49.6%) Ta, 45 (34.9%) T1, and 20 (15.5%) T2. MFOS-based classification algorithm correctly discriminated healthy versus BCa with 90% accuracy, HG versus LG with 83% accuracy. Furthermore, it assessed tumor stage with 75% accuracy for Ta versus T1, 85% for T1 versus T2, and 86% for Ta versus T2.

Conclusions:

Our preliminary results suggest that MFOS could be a reliable, fast, and label-free tool for BCa assessment, providing also grading and staging information. This technique could be applied in future for in vivo inspection as well as of ex vivo tissue biopsies. Thus, MFOS might improve urothelial cancer management. Further studies are required.
Futures of sustainability: Trajectories and conflicts
Authors: Adloff Frank , Neckel Sighard
Published: April 2021

The increased awareness of the exploitation of resources, as well as the negative ecological consequences of the modern way of life, has made sustainability a central guiding concept of social change in the 21st century. Sustainability has taken the form of a largely undisputed normative model of development, behind which, however, very different conceptions of the future are concealed: from the attempt to initiate a major socio-ecological transformation, through modernization processes, to control practices in a state of emergency. This special issue aims at these practices but is not primarily concerned with sustainability as a normative guiding idea that can just be pursued. However, a sociology of sustainability has to ask which conflictual spaces of possibility for socioeconomic change open up when very different ideas of a sustainable future are in conflict with each other. Three ideal-typical trajectories or futures of sustainability emerge, which can be theoretically grasped with the terms modernization, transformation and control. These three concepts of a sustainable future can also be found in the ambivalent imaginations, practices and structures of various constellations of actors.
Practices of sustainability and the enactment of their natures/cultures: Ecosystem services, rights of nature, and geoengineering
Authors: Adloff Frank , Hilbrich Iris
Published: April 2021

Possible trajectories of sustainability are based on different concepts of nature. The article starts out from three trajectories of sustainability (modernization, transformation and control) and reconstructs one characteristic practice for each path with its specific conceptions of nature. The notion that nature provides human societies with relevant ecosystem services is typical of the path of modernization. Nature is reified and monetarized here, with regard to its utility for human societies. Practices of transformation, in contrast, emphasize the intrinsic ethical value of nature. This becomes particularly apparent in discourses on the rights of nature, whose starting point can be found in Latin American indigenous discourses, among others. Control practices such as geoengineering are based on earth-systemic conceptions of nature, in which no distinction is made between natural and social systems. The aim is to control the earth system as a whole in order for human societies to remain viable. Practices of sustainability thus show different ontological understandings of nature (dualistic or monistic) on the one hand and (implicit) ethics and sacralizations (anthropocentric or biocentric) on the other. The three reconstructed natures/cultures have different ontological and ethical affinities and conflict with each other. They are linked to very different knowledge cultures and life-worlds, which answer very differently to the question of what is of value in a society and in nature and how these values ought to be protected.
Perceived Stress among Iranians during COVID-19 Pandemic; Stressors and Coping Mechanisms: A Mixed-methods Approach
Authors: Faghankhani Masoomeh , Sodagari Faezeh , Shokrani Marjan , Baradaran Hamid Reza , Adabi Alimohammad , Zabihi Masoud , Adeli Aliyeh Mahdavi , Fathimakvand Mahdi , Golalipour Elahe , Aghdasi Sina , Javanbakht Arash , Nadoushan Amir Hossein Jalali
Published: April 2021

Objective

New coronavirus (COVID-19) pandemic socioeconomically affected the world. In this study, we measured the perceived stress in response to the COVID-19 pandemic among Iranians to determine the groups at both extremes of the spectrum followed by identifying the stressors and coping mechanisms.

Methods

This study was a mixed-methods study. We distributed a web-based 10-item perceived stress scale (PSS-10), to measure perceived stress score (PSS), through social networks from March 12 to 23, 2020. Then, we interviewed 42 students, 31 homemakers, 27 healthcare providers, and 21 male participants to identify the sources of stress and coping mechanisms.

Results

Finally, 13,454 participants completed the questionnaires. The median and interquartile range (IQR) of the participants’ PSS was 21 (15-25). Students, homemakers, and healthcare workers (HCWs) showed a higher median (IQR) of PSS compared to other groups (23 [18 to 27], 22 [16 to 26], and 19 [14 to 24], respectively). Male participants showed a lower median (IQR) PSS (17 [12 to 23]). Content analysis of 121 participants’ answers showed that the most common stressors were school-related issues mentioned by students, family-related issues mentioned by homemakers, and COVID-19-related issues mentioned by healthcare providers. Male participants’ coping mechanisms were mostly related to the perception of their abilities to cope with the current crisis.

Conclusion

Our participants clinically showed a moderate level of PSS. The main stressors among students, homemakers, and HCWs were related to their principal role in this period, and male participants’ coping mechanisms were inspired by the self-image retrieved from the social perspectives.
Google, Tell Me. Is He Gay? Masculinity, Heterosexuality, and Gendered Anxieties in Google Search Queries about Sexuality
Authors: Mishel Emma , Bridges Tristan , Caudillo Mónica L.
Published: April 2021

It is difficult to gauge people’s acceptance about same-sex sexualities, as responses to questionnaires are prone to social desirability bias. We offer a new proxy for understanding popular concern surrounding same-sex sexualities: prevalence of Google searches demonstrating concern over gay/lesbian sexual identities. Using Google Trends data, we find that Google searches about whether a specific person is gay or lesbian show patterned bias toward masculine searches, in that such searches are much more frequently conducted about boys and men compared with girls and women. We put these findings into context by comparing search frequencies with other popular Google searches about sexuality and otherwise. We put forth that the patterned bias toward masculine searches illustrates support for the enduring relationship between masculinity and heterosexuality and that it does so on a larger scale than previous research has been able to establish.
Prediction of statistical life time for unidirectional CFRTP under cyclic loading
Authors: Nakada Masayuki , Miyano Yasushi , Kageta Soshi , Nishida Hirofumi , Hayashi Yutaka , Uzawa Kiyoshi
Published: April 2021

Recently, the Innovative Composite Center of Kanazawa Institute of Technology developed a thermoplastic epoxy resin (TP-EP). Resin-impregnated carbon fiber reinforced TP-EP (CF/TP) strands molded by pultrusion were developed by Komatsu Matere Co., Ltd., for use as tension rods. This study examines the prediction of the statistical life time for these developed CF/TP strands under cyclic tension loading with comparison to our earlier report of similar predictions for carbon fiber reinforced thermoset epoxy resin (CF/TS) strands having a thermoset epoxy resin (TS-EP) as a matrix. First, test methods for static and fatigue strengths at elevated temperatures were developed for CF/TP strands. Second, static and fatigue tensile strengths of CF/TP strands were measured statistically at various constant temperatures under a constant strain rate and frequency. The master curves of statistical fatigue tensile strengths for CF/TP strands were constructed by substituting the measured data into the formulations of these strengths based on the matrix resin viscoelasticity. The fatigue strength characteristics of CF/TP strands were discussed through comparison to those of CF/TS strands with thermosetting epoxy resin as the matrix.
Can Fall Risk Screening and Fall Prevention Advice in Hospital Settings Motivate Older Adult Patients to Take Action to Reduce Fall Risk?
Authors: Barmentloo Lotte M. , Erasmus Vicki , Olij Branko F. , Haagsma Juanita A. , Mackenbach Johan P. , Oudshoorn Christian , Schuit Stephanie C. E. , van der Velde Nathalie , Polinder Suzanne
Published: April 2021

Objective:

We investigated whether an in-hospital intervention consisting of fall risk screening and tailored advice could prompt patients to take preventive action.

Method:

Patients (≥70) attending the emergency department and nephrology outpatient clinic in a Dutch hospital were screened. Patients at high risk received tailored advice based on their individual risk factors. Three months after screening, preventive steps taken by patients were surveyed.

Results:

Two hundred sixteen patients were screened. Of the 83 patients completing a 3-month follow-up, 51.8% took action; among patients who received tailored advice ( n = 20), 70% took action. Patients most often adhered to advice on improving muscle strength and undergoing vision checkups (20%). Tailored advice and a reported low quality of life were associated with consulting a health care provider.

Discussion:

Patients at risk in these settings are inclined to take action after screening. However, they do not always adhere to the tailored prevention advice.
Impact of COVID-19 pandemic on medical waste management in Lebanon
Authors: Maalouf Amani , Maalouf Hani
Published: April 2021

Worldwide, there is a growing concern about the negative effects of infectious medical waste produced during the COVID-19 pandemic and the contamination risks associated with waste management. Therefore, measures to ensure that medical waste is managed safely and in an environmentally sound manner will avoid negative health and environmental effects from such waste, thus protecting the health of patients, health workers and the public in general. Despite that infectious medical waste generation rate is important for management planning and policy development, there is a limitation on national data availability and its accuracy, particularly in developing economies. This study analyses the infectious healthcare waste generation rates and management patterns in Lebanon before and after the COVID-19 pandemic. The estimated average of COVID-19-related infectious healthcare waste generation in this study is 39,035 kg per month or 1.3 tonnes per day, which constitute between 5% and 20% of total infectious healthcare waste in Lebanon. This study illuminates on the impact of COVID-19 on the existing challenges of waste management in Lebanon. It highlights the need for proper management and disposal of the amounts of medical waste generated to reduce contamination risks or related environmental threats, particularly during the pandemic. It also shows that Lebanon has a defective system for monitoring of waste from healthcare institutions and gaps in waste statistics. Finally, the study summarizes recommendations related to medical waste management, which can provide valuable insight for policymakers.
Dimensionality and Reliability Assessment of a Field Implementation of the Big Five in Mexican Children
Authors: Peralta Yadira , Aguilar-Rodriguez Adriana , González Dávila Osiel , Miranda Alfonso
Published: April 2021

According to the literature, the use of the Berkeley Puppet Interview (BPI) to measure Big Five personality traits in children provides reliable and valid scores. However, the implementation of the BPI could be costly, especially when working with large sample sizes. Big Five self-reports were collected from 1118 Mexican children aged 7–8 years using a modified version of the BPI protocol and a Spanish version of the Big Five questionnaire. The main objective of this study was to inquire whether some modifications in the application protocol of the BPI could still provide reliable personality scores for the population under study. We report item–rest correlation, Cronbach’s alpha and omega as reliability measures, and confirmatory factor analytic models to investigate dimensionality. The results show that the personality trait scores are markedly reliable and that the dimensionality of the instrument holds for the Mexican sample.
Having the Lower Hand—Investigating Interaction in the Life Course Narratives of Immigrant Women Exposed to Partner Abuse
Authors: Liversage Anika
Published: April 2021

Research has documented the considerable hardships immigrant women often face if they want to leave abusive relationships, but the cumulative impacts of such experiences have received insufficient scholarly attention. In response, this study investigates women’s difficulties leaving abusive relationships based on life story interviews with 35 immigrant women who experienced partner abuse. Almost all the women originated from “patriarchal belt” countries in, for example, the Middle East and all arrived in Denmark as adults. Using a model of gendered geographies of power, this study examines key interview passages in which the women use dramatized speech to tell about their younger selves’ interactions with significant others. These dramatized episodes of interactions emerge as crucial for the interviewees to communicate why they remained in abusive relationships for years and how most finally managed to leave their husbands. The narrated episodes reveal how the women’s frequent lack of success in various interactional situations can be attributed to women “having the lower hand”—holding disadvantaged positions in the familial, social, and national hierarchies of power. These hierarchies reinforce each other, for example, when insecure residency status limits immigrant women’s options to solicit help from Danish society. The analysis demonstrates that—in contrast to the stereotype of the abused immigrant woman as a passive victim—micro- and macro-level processes may work together to undermine immigrant women’s possibilities to act independently at important junctures in their lives. The results also stress the importance that frontline workers have sufficient understanding of immigrant women’s predicament and the ability to extend qualified and timely support. Such support can be crucial for abused immigrant women to become able to move away from their violent home environments.
Lower Levels of Classroom Aggression Predict Stronger Relations Between Peer Victimization and Reactive Versus Proactive Aggression
Authors: Morrow Michael T. , Hubbard Julie A. , Bookhout Megan K. , Docimo Marissa A. , Swift Lauren E. , Grassetti Stevie N. , Cabanas Katherine L.
Published: April 2021

We examined the concurrent relations of children’s reactive and proactive aggression with their experience of peer victimization. Extending previous research, we assessed these relations at both the child and classroom levels. We predicted that reactive aggression would relate positively to peer victimization, proactive aggression would relate negatively to peer victimization, and that these relations would vary with classroom levels of aggression. Participants included 1,291 fourth- and fifth-grade children (681 girls; M age = 10.14 years) and their 72 teachers from 9 schools in one public school district in the Mid-Atlantic United States. Children completed self-report measures of peer victimization and teachers completed measures of aggression for each child in their classrooms. Via two-level regression (level 1 = child; level 2 = classroom), reactive aggression related positively to peer victimization and proactive aggression related negatively to peer victimization. The positive relation between reactive aggression and peer victimization was only significant in classrooms with low levels of reactive aggression. The negative relation between proactive aggression and peer victimization was only significant in classrooms with low levels of proactive aggression. Our hypotheses were supported and offered further evidence for differential relations of reactive and proactive aggression with peer victimization at the child level, while demonstrating the important role of classroom norms for aggression in moderating these relations.
In Vitro Stimulation of Whole Milk Specimens: A Field-Friendly Method to Assess Milk Immune Activity
Authors: Wander Katherine , Fujita Masako , Spathis Rita , Li Shanita , Armstrong Daniel , Pechera Jane , Anyim Rachael , Manganello Morgan , Torres Cruz , Herbin Camilla , Cradin Brooke , Margolin Farrah
Published: April 2021

Background

The immune system of milk protects against infections and guides immune system development. A system-level understanding of milk immune activity is critical for research into infant infectious disease risk and lifelong health.

Research aim

To describe a protocol to characterize immune activity in human milk via in vitro stimulation for use in population-based (rather than clinical) research.

Methods

This study proceeded in two phases, each with a cross-sectional design. Human milk specimens were incubated for 24 hr at 37 °C in mammalian cell culture medium with stimuli (e.g., Salmonella enterica) in a CO2-enriched environment. Immune responses to stimuli were characterized as the change in cytokine: [stimulated]/[baseline]. Predictors of cytokine responses were evaluated with generalized linear models.

Results

Patterns were detectable across mother–child dyads: Interleukin-6 responses to stimuli were generally positively associated with child age and with maternal autoimmune disease.

Conclusions

Our method allows characterization of pro-inflammatory milk immune activity in vitro in population-based (rather than clinical) research settings. In vitro activity has a system-level interpretation and is likely to be of broad utility in global health research in settings with high infectious disease risk, where understanding the immune system of milk is critical to understanding maternal and child health.
Longitudinal Association Between Self-Reported Sensory Impairments and Episodic Memory among Older Adults in China: A Prospective Cohort Study
Authors: Ma Xiaochen , Wei Jingkai , Congdon Nathan , Li Yan , Shi Lu , Zhang Donglan
Published: April 2021

Sensory impairments, such as visual and hearing impairments, and cognitive decline are prevalent among mid-age and older adults in China. With 4-year longitudinal data from the China Health and Retirement Longitudinal Study, we assessed the association between self-reported sensory impairments and episodic memory. Multivariate linear mixed-effects models were used to estimate the association of baseline sensory impairment in 2011-2012 with cognitive decline at 2- and 4-year follow-up visits. Among the 13,097 participants, longitudinal associations were identified between having hearing loss (β = -0.14, 95% CI: -0.22, -0.05), having both poor hearing and vision (β = -0.14, 95% CI: -0.23, -0.04) and decline in immediate word recall over 4 years, compared to those without self-reported sensory impairment. In addition, these associations were more significant among those aged 60 and older and among women. Further research is needed to investigate these associations in the longer term, providing evidence to support interventions that can prevent or delay sensory impairments and preserve cognitive functions in older adults.