bluuebunny/crossref_metadata_2025 huggingface dataset:
Heidegger’s Phenomenological Concept of Violence
Authors: Breazu Remus
Published: November 2021

This article accounts for Heidegger’s phenomenological concept of violence from the period ofBeing and Time. Violence is relevant for Heidegger in two different contexts: (i) methodological, where we speak of hermeneutic violence, and (ii) thematic, where we should speak of existential violence. The former is grounded in the latter. In the first part of the article, I analyze hermeneutic violence, showing that this concept is ambiguous, and one has to distinguish between two different meanings of it. In the second part of the article, I show that at the core of the original sense lies the existential violence of bursting out of senselessness. In the final part, I contextualize Heidegger’s concept in light of the contemporary phenomenological developments of the phenomenon of violence, showing that existential violence is constitutive and has the peculiar character of being at the same time sense‐destroying and sense‐making.
Environment and Engagement in German Studies: Projects and Resources for Critical Environmental Thinking
Authors: Kost Kiley , Peabody Seth
Published: November 2021

Environmental issues have received significant attention in German Studies for a number of years, leading to innovations in both research and pedagogy. More recently, attention has focused on applied pedagogical practices such as service‐learning projects and bilateral exchanges related to environmental sustainability. While these initiatives offer numerous potential benefits, as shown in research on high‐impact practices, and while the topic may attract students to learn German, these forms of teaching entail a range of challenges and questions for educators that are distinct from the work traditionally carried out in German language pedagogy. This co‐authored article offers resources for working through these challenges and introduces a collection of free online materials currently in development. We suggest a model of critical environmental thinking in the classroom that asks students to use the target language to reexamine familiar concepts and daily practices connected to the environment and apply their knowledge of other cultures to multimodal projects.
Building Sustainability into the German Program: “Climate Stories” in Gen‐Ed German and the Advanced Curriculum
Authors: Moser Beverly
Published: November 2021

This article reports on an initiative to enrich the German curriculum at all levels via “Climate Stories,” a student‐centered learning project that capitalizes on the encouraging strides being made in German‐speaking countries to combat global climate change. Students identify a real‐life “climate story” in the news in German that features a solution or important insight into an environmental issue. After digesting three articles, students create original artwork (visual art, collage, podcast, play) which they present to their peers. The project makes valuable cross‐disciplinary connections to popular sustainability courses and is articulated vertically in the German curriculum, starting in general education and moving upward to each level within the German major. It also connects with an initiative in climate‐focused pedagogy in the sustainability community that is active on campus and nationally. German students share their art and the “stories” behind the art, contributing insights and expertise from the German‐speaking world to undergraduates who cannot access these stories themselves in German. In the general education curriculum, the project provides evidence of global learning. In the upper‐level curriculum, projects are more complex, with oral and written components increasing in difficulty as students' proficiency grows.
The Uniqueness of Necessary Truth and the Status of S4 and S5
Authors: Hausmann Marco
Published: November 2021

The aim of this paper is to relate the debate about the status of S4 and S5 as modal logics for metaphysical modality to the debate about the identity of propositions. The necessary truth of the characteristic axioms of S4 and S5 (when interpreted in terms of metaphysical modality) is derived from a view about the identity of propositions, the view that necessarily equivalent propositions are identical.
Invasive pulmonary aspergillosis in solid‐organ transplant patients in the intensive care unit
Authors: Klein Joachim , Rello Jordi , Dimopoulos George , Bulpa Pierre , Blot Koen , Vogelaers Dirk , Blot Stijn
Published: November 2021

Introduction

Solid‐organ transplantation (SOT) is a well‐known risk factor for invasive pulmonary aspergillosis (IPA). We report on the epidemiology and outcome of SOT patients with IPA in an intensive care unit (ICU) setting.

Methods

This is a secondary study based on a subset of SOT patients from a prospective observational multicenter cohort (the AspICU project) including ICU patients with at least oneAspergillusspp. positive culture. Cases were classified as proven, probable, or putative IPA, or asAspergillus‐colonized. Mortality was reported at 12 weeks.

Results

The study included 52 SOT patients (of which 18 lung, 17 liver, 12 kidney, and five heart transplants). Sixteen patients had proven IPA, 28 were categorized as putative IPA (of which only five reached a probable IPA diagnosis according to the European Organization for Research and Treatment of Cancer/Mycosis Study Group and Research Consortium criteria), and eight asAspergillus‐colonization. Among patients with IPA, 20 (45.5%) developed IPA during their ICU stay following transplantation whereas 24 patients (54.5%) had a medical ICU admission. Regarding medical imaging, nearly all IPA cases presented with non‐specific findings as only nine demonstrated robust findings suggestive for invasive fungal disease. Overall, severity of the disease was reflected by a high prevalence of underlying conditions and acute organ derangements. Mortality among patients with IPA was 68%. Lung transplantation was associated with better survival (50%).

Conclusion

IPA in SOT patients in the ICU develops in the presence of overall high severity of the disease. It rarely presents with suggestive medical imaging thereby hampering diagnosis. IPA in ICU patients with SOT carries a grim prognosis.
Reviewer Acknowledgements
Authors: Johnson Patricia
Published: November 2021

Studies in Media and Communication (SMC) would like to acknowledge the following reviewers for their assistance with peer review of manuscripts for this issue. Many authors, regardless of whether SMC publishes their work, appreciate the helpful feedback provided by the reviewers. Their comments and suggestions were of great help to the authors in improving the quality of their papers. Each of the reviewers listed below returned at least one review for this issue.Reviewers for Volume 9, Number 2Andreas Veglis, Aristotle University of Thessaloniki, GreeceAyşe Aslı Sezgin, Çukurova University, TurkeyBernard Naledzani Rasila, University of Venda, South AfricaCamelia Cmeciu, Danubius University of Galati, RomaniaCarmen Pérez-Sabater, Universitat Politècnica de València, SpainImed Ben Labidi, Doha Institute for Graduate Studies, USAJavier Serrano Puche, University of Navarra, SpainJianbo Hou, Xi'an International Studies University, ChinaMaría José Serrano, Universidad de La Laguna, SpainNina Gunnarsson, Jönköping university, SwedenPhilemon Bantimaroudis, University of Cyprus, CyprusRefat Aljumily, Newcastle University, UKYi Luo, Montclair State University, USAYoung Joon Lim, University of Texas Rio Grande Valley, USA Patricia JohnsonEditorial AssistantOn behalf of,The Editorial Board of Studies in Media and CommunicationRedfame Publishing9450 SW Gemini Dr. #99416Beaverton, OR 97008, USAURL: http://smc.redfame.com
Autonomic control of cerebral blood flow: fundamental comparisons between peripheral and cerebrovascular circulations in humans
Authors: Koep Jodie L. , Taylor Chloe E. , Coombes Jeff S. , Bond Bert , Ainslie Philip N. , Bailey Tom G.
Published: November 2021

Understanding the contribution of the autonomic nervous system to cerebral blood flow (CBF) control is challenging, and interpretations are unclear. The identification of calcium channels and adrenoreceptors within cerebral vessels has led to common misconceptions that the function of these receptors and actions mirror those of the peripheral vasculature. This review outlines the fundamental differences and complex actions of cerebral autonomic activation compared with the peripheral circulation. Anatomical differences, including the closed nature of the cerebrovasculature, and differential adrenoreceptor subtypes, density, distribution and sensitivity, provide evidence that measures on peripheral sympathetic nerve activity cannot be extrapolated to the cerebrovasculature. Cerebral sympathetic nerve activity seems to act opposingly to the peripheral circulation, mediated at least in part by changes in intracranial pressure and cerebral blood volume. Additionally, heterogeneity in cerebral adrenoreceptor distribution highlights region‐specific autonomic regulation of CBF. Compensatory chemo‐ and autoregulatory responses throughout the cerebral circulation, and interactions with parasympathetic nerve activity are unique features to the cerebral circulation. This crosstalk between sympathetic and parasympathetic reflexes acts to ensure adequate perfusion of CBF to rising and falling perfusion pressures, optimizing delivery of oxygen and nutrients to the brain, while attempting to maintain blood volume and intracranial pressure. Herein, we highlight the distinct similarities and differences between autonomic control of cerebral and peripheral blood flow, and the regional specificity of sympathetic and parasympathetic regulation within the cerebrovasculature. Future research directions are outlined with the goal to further our understanding of autonomic control of CBF in humans.

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Phase-separated indenofluorene arrays stabilized by hydrogen and halogen bonds on Au(111)
Authors: Park Jong Hwan , Chang Min Hui , Jang Won Jun , Han Seungwu , Kahng Se-Jong
Published: November 2021

Indenofluorene, which consists of a 6-5-6-5-6 fused-ring structure, is a semiconducting molecule with possible applications in optoelectronic devices. Bulk crystal structures, molecular front orbitals, and on-surface polymerized indenofluorene have recently been studied, but self-assembled structures on the surface have not yet been reported. Here, we report the array structure of 2,8-dibromoindeno[1,2-b]fluorene-6,12-dione on Au(111) studied using scanning tunneling microscopy. We proposed an alternating-tread stair structure as the molecular model for the monolayer molecular islands, which show strong shape anisotropy. The model can be explained by four O⋅⋅⋅H hydrogen bonds and one Br⋅⋅⋅Br halogen bond per molecule, as supported by density functional theory calculations. Although they prefer intermixed heteroprochiral structures in bulk layers, our study shows that these molecules can form phase-separated homoprochiral structures on the surface, leading to potential applications in molecular chiral separation.
Supplemental Material: Olivine in komatiite records origin and travel from the deep upper mantle
Authors: Wilson Allan , Bolhar Robert
Published: November 2021

Background, methodology, and modeling.
Hysteresis in Supersonic Flow Past a Plane Cascade of Cylindrical Rods
Authors: Guvernyuk S. V. , Maksimov F. A.
Published: November 2021

Abstract—

The results of numerical simulation of the interaction of supersonic flow with a permeable screen in form of an infinite plane cascade (lattice) of circular cylinders are given. The interaction regime in which the shocks ahead of the cylinders are localized on the scale of the cascade step is considered. The multi-block computational technique in which the viscous boundary layers are resolved by means of local grids using the Navier–Stokes equations, while the effects of inteferrence between the shock-wave structures in supersonic wake are described within the framework of Euler’s equations. The action of shock waves induced by the neighboring elements of lattice to the near-wake region behind the intermediate elements can ambiguously affect the aerodynamic lattice performance as well as generate time-dependent phenomena in the wake. The flow regimes are classified depending on continuous increase and decrease in the free-stream supersonic air flow in the Mach number range from 2.4 to 4.2 with reference to the lattice of the 80% permeability. The sources of the hysteresis behavior of the lattice aerodynamic drag with respect to the Mach number and the mechanisms of the onset of self-oscillating wake flow regimes are discussed.
Cholesteatoma extending into the sternocleidomastoid muscle presenting as a Bezold abscess
Authors: Eswaran Sudhagar , Kumar Sarath , Saravanam Prasanna Kumar
Published: November 2021

Cholesteatoma is a non-neoplastic cystic lesion arising in the middle ear cleft with the propensity to spread and recur after surgery, but it is unusual to find cholesteatoma invading sternocleidomastoid muscle after 15 years of modified radical mastoidectomy and presenting as Bezold abscess. In this report, the authors highlight the fact that cholesteatoma recurrence if neglected can present as a Bezold abscess with the invasion of cholesteatoma from the mastoid tip into the sternocleidomastoid muscle. This requires complete excision of the cholesteatoma sac along with the surrounding soft tissue.
Giant cell arteritis associated with PD-1 inhibition
Authors: Couette Nina , Paul Jisna
Published: November 2021

A 50-year-old woman was referred to rheumatology for new onset polyarthralgia and headache. She had a history of metastatic lung adenocarcinoma and was started on treatment with the programmed death 1 receptor (PD-1) antagonist pembrolizumab 2 months prior. Examination revealed left temporal artery tenderness and hand synovitis. Investigations revealed enlarged temporal artery on ultrasound imaging. On steroid treatment, she had resolution of symptoms, but due to significant steroid side effects required methotrexate and her PD-1 antagonist therapy was continued in consultation with her oncologist. Her malignant disease has remained stable, and she has improved functional status.
Neonatal lupus: a clinical challenge
Authors: Costa Cascais Filipa , Fraga Sofia , Sousa Sandra , Pinto Margarida
Published: November 2021

Neonatal lupus is an uncommon entity. The main manifestations are cutaneous and cardiac. It is caused by transplacental passage of maternal antibodies (anti-Ro/SSA or anti-La/SSB), and the diagnosis is made by its detection in the mother or child. The authors present a case of a 4-month-old female infant, with a cutaneous eruption since she was 2 months old. She had no relevant personal or family history. Analytically she had an increase in liver enzymes. The histological aspect of the skin biopsy led to an autoimmunity study on the mother and infant, both of which had positive anti-Ro/SSA antibodies, confirming the diagnosis of neonatal lupus. Cardiological study was normal. The skin lesions resolved during the first year of life. Skin lesions are the most frequent non-cardiac clinical manifestation of neonatal lupus, and they are self-limited. When there is no family history, nor cardiac involvement, the diagnosis can be challenging.
Timing of dialysis initiation to reduce mortality and cardiovascular events in advanced chronic kidney disease: nationwide cohort study
Authors: Fu Edouard L , Evans Marie , Carrero Juan-Jesus , Putter Hein , Clase Catherine M , Caskey Fergus J , Szymczak Maciej , Torino Claudia , Chesnaye Nicholas C , Jager Kitty J , Wanner Christoph , Dekker Friedo W , van Diepen Merel
Published: November 2021

Objective

To identify the optimal estimated glomerular filtration rate (eGFR) at which to initiate dialysis in people with advanced chronic kidney disease.

Design

Nationwide observational cohort study.

Setting

National Swedish Renal Registry of patients referred to nephrologists.

Participants

Patients had a baseline eGFR between 10 and 20 mL/min/1.73 m2and were included between 1 January 2007 and 31 December 2016, with follow-up until 1 June 2017.

Main outcome measures

The strict design criteria of a clinical trial were mimicked by using the cloning, censoring, and weighting method to eliminate immortal time bias, lead time bias, and survivor bias. A dynamic marginal structural model was used to estimate adjusted hazard ratios and absolute risks for five year all cause mortality and major adverse cardiovascular events (composite of cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) for 15 dialysis initiation strategies with eGFR values between 4 and 19 mL/min/1.73 m2in increments of 1 mL/min/1.73 m2. An eGFR between 6 and 7 mL/min/1.73 m2(eGFR6-7) was taken as the reference.

Results

Among 10 290 incident patients with advanced chronic kidney disease (median age 73 years; 3739 (36%) women; median eGFR 16.8 mL/min/1.73 m2), 3822 started dialysis, 4160 died, and 2446 had a major adverse cardiovascular event. A parabolic relation was observed for mortality, with the lowest risk for eGFR15-16. Compared with dialysis initiation at eGFR6-7, initiation at eGFR15-16was associated with a 5.1% (95% confidence interval 2.5% to 6.9%) lower absolute five year mortality risk and 2.9% (0.2% to 5.5%) lower risk of a major adverse cardiovascular event, corresponding to hazard ratios of 0.89 (95% confidence interval 0.87 to 0.92) and 0.94 (0.91 to 0.98), respectively. This 5.1% absolute risk difference corresponded to a mean postponement of death of 1.6 months over five years of follow-up. However, dialysis would need to be started four years earlier. When emulating the intended strategies of the Initiating Dialysis Early and Late (IDEAL) trial (eGFR10-14veGFR5-7) and the achieved eGFRs in IDEAL (eGFR7-10veGFR5-7), hazard ratios for all cause mortality were 0.96 (0.94 to 0.99) and 0.97 (0.94 to 1.00), respectively, which are congruent with the findings of the randomised IDEAL trial.

Conclusions

Very early initiation of dialysis was associated with a modest reduction in mortality and cardiovascular events. For most patients, such a reduction may not outweigh the burden of a substantially longer period spent on dialysis.
Compact for care: how the Affordable Care Act marketplaces fell short for a vulnerable population in Hawaii
Authors: Ng Kamstra Joshua S , Molina Teresa , Halliday Timothy
Published: November 2021

The Patient Protection and Affordable Care Act (ACA) was passed in 2010 to expand access to health insurance in the USA and promote innovation in health care delivery. While the law significantly reduced the proportion of uninsured, the market-based protection it provides for poor and vulnerable US residents is an imperfect substitute for government programs such as Medicaid. In 2015, residents of Hawaii from three Compact of Free Association nations (the Federated States of Micronesia, Palau and Marshall Islands) lost their eligibility for the state’s Medicaid program and were instructed to enrol in coverage via the ACA marketplace. This transition resulted in worsened access to health care and ultimately increased mortality in this group. We explain these changes via four mechanisms: difficulty communicating the policy change to affected individuals, administrative barriers to coverage under the ACA, increased out of pocket health care costs and short enrolment windows. To achieve universal health coverage in the USA, these challenges must be addressed by policy-makers.
Face-to-face interventions to encourage enrolment in cardiac rehabilitation: a scoping review protocol
Authors: Rasmussen Birgit , Håkonsen Sasja Jul , Toft Bente
Published: November 2021

Introduction

Cardiac rehabilitation has become an integral part of secondary treatment of cardiovascular heart disease. Despite evidence demonstrating that cardiac rehabilitation improves prognoses, reduces disease progression and helps patients to find a new foothold in life, many patients do not enrol. Face-to-face interventions can encourage patients to enrol; however, it is unclear which strategies have been developed, how they are structured in a hospital context and whether they target the life-world of the patients. The objective of this scoping review is to map and evaluate the nature and characteristics of studies that have reported on face-to-face interventions to encourage patients to enrol in cardiac rehabilitation.

Methods and analysis

This review will be guided by the Joanna Briggs Institute Methodology for Scoping Reviews. A search strategy developed in cooperation with a research secretary will be applied in six databases including studies published from 2000 in English, Danish, Norwegian, Swedish and German with no restriction on publication type or study design. Studies involving adult patients with ischaemic heart disease or heart failure will be included. Studies providing the intervention after enrolment in cardiac rehabilitation will be excluded. Study selection will be performed independently by two reviewers. Data will be extracted by two reviewers using predefined data charting forms. The presentation of data will be a narrative summary of the characteristics and key findings to facilitate the integration of diverse evidence, and as we deem appropriate will be supported by a diagrammatic or tabular presentation.

Ethics and dissemination

This scoping review will use data from existing publications and does not require ethical approval. Results will be reported through publication in a scientific journal and presented on relevant conferences and disseminated as part of future workshops with professionals involved in communication with patients about enrolment in cardiac rehabilitation.
Randomised controlled trial comparing rituximab to mycophenolate mofetil in children and young adults with steroid-dependent idiopathic nephrotic syndrome: study protocol
Authors: Lugani Francesca , Angeletti Andrea , Ravani Pietro , Vivarelli Marina , Colucci Manuela , Caridi Gianluca , Verrina Enrico , Emma Francesco , Ghiggeri Gian Marco
Published: November 2021

Introduction

Glucocorticoids induce remission in 90% of children with idiopathic nephrotic syndrome (INS). Some become steroid-dependent (SD) and require the addition of steroid sparing drugs such as calcineurin-inhibitors (CNI) or cyclophosphamide, to maintain remission. Considering the toxicity of these drugs, alternative interventions are needed for long-term treatment. The anti-CD20 antibody rituximab has shown promising steroid-sparing properties, with conflicting results in complicated forms of SD-INS. Mycophenolate mofetil (MMF) resulted effective in maintaining free-steroid remission, however, studies are limited to few uncontrolled trials with reported different dose of MMF.

Methods and analysis

This open-label, two-parallel-arm, superiority controlled randomised clinical trial will enrol children with SD-INS maintained in remission with oral glucocorticoids or CNI. Children and young adults will be randomised to either MMF (1.200 mg/m2) or rituximab (375 mg/m2) infusion. After enrolment, glucocorticoids will be tapered until complete withdrawal. We will enrol 160 children and young adults to detect as significant at the two-sided p value of 0.01 with a power >0.8 a reduction in the risk of 1-year relapse (primary end-point). As secondary endpoints, we will compare the amount of glucocorticoids required to maintain complete remission at 6 and 24 months.

Ethics and dissemination

The trial was approved by the local ethics boards (Comitato Etico Regione Liguria CER Liguria https://www.portalericerca-liguria.it/). We will publish the study results at international scientific meetings.

Trial registration numbers

NCT004585152.
Multicentre cohort study of cochlear implantation outcomes in Thailand
Authors: Piromchai Patorn , Tanamai Napas , Kiatthanabumrung Sivaporn , Kaewsiri Suwicha , Thongyai Kanthong , Atchariyasathian Viraporn , Thanawirattananit Panida , Wacharasindhu Chitsuda , Mukkun Tulakan , Isipradit Permsarp , Yimtae Kwanchanok
Published: November 2021

Objectives

To report the status and outcomes of cochlear implantation in Thailand.

Design

Cohort study.

Setting

Tertiary care and university hospitals.

Participants

Patients who underwent cochlear implant surgery in Thailand.

Interventions

This project collected data from all government and university hospitals in Thailand where cochlear implant surgery was performed between 2016 and 2020.

Primary and secondary outcome measures

Baseline characteristics, operation data, complications, audiological outcomes and quality of life were reported.

Results

This study included 458 patients, and nearly half of the patients were children and adolescents (46.94%). The mean age of the patients was 2.96±5.83 years. At 1 year postoperatively, the mean pure tone average of the hearing threshold in the implanted ear significantly improved from unaided preoperative baseline (mean difference (MD) 64.23 dB HL; 95% CI 59.81 to 68.65; p<0.001). The mean speech recognition threshold also improved (MD 55.96 dB HL; 95% CI 49.50 to 62.42, p<0.001). The quality-of-life scores of the EQ-5D-5L, PedsQL and HUI3 questionnaires at 1 year showed improved mobility (range, 0–5; MD 0.65; 95% CI 0.05 to 1.25; p=0.037), hearing (range, 0–6; MD 0.96; 95% CI 0.30 to 1.61; p=0.006) and speech (range, 0–5; MD 0.44; 95% CI 0.04 to 0.84; p=0.031). Common complications included electrode dislodgement (2.18%), vertigo (1.23%) and meningitis (1.93%).

Conclusions

Excellent audiological outcomes and improvement in the quality of life in the mobility, hearing and speech domains were observed in patients who underwent cochlear implantation in Thailand.
Epidemiology of uterine rupture among pregnant women in China and development of a risk prediction model: analysis of data from a multicentre, cross-sectional study
Authors: Zhan Wenqiang , Zhu Jing , Hua Xiaolin , Ye Jiangfeng , Chen Qian , Zhang Jun
Published: November 2021

Objectives

To describe the epidemiology of uterine rupture in China from 2015 to 2016 and to build a prediction model for uterine rupture in women with a scarred uterus.

Setting

A multicentre cross-sectional survey conducted in 96 hospitals across China in 2015–2016.

Participants

Our survey initially included 77 789 birth records from hospitals with 1000 or more deliveries per year. We excluded 2567 births less than 24 gestational weeks or unknown and 1042 births with unknown status of uterine rupture, leaving 74 180 births for the final analysis.

Primary and secondary outcome measures

Complete and incomplete uterine rupture and the risk factors, and a prediction model for uterine rupture in women with scarred uterus (assigned each birth a weight based on the sampling frame).

Results

The weighted incidence of uterine rupture was 0.18% (95% CI 0.05% to 0.23%) in our study population during 2015 and 2016. The weighted incidence of uterine rupture in women with scarred and intact uterus was 0.79% (95% CI 0.63% to 0.91%) and 0.05% (95% CI 0.02% to 0.13%), respectively. Younger or older maternal age, prepregnancy diabetes, overweight or obesity, complications during pregnancy (hypertensive disorders in pregnancy and gestational diabetes), low education, repeat caesarean section (≥2), multiple abortions (≥2), assisted reproductive technology, placenta previa, induce labour, fetal malpresentation, multiple pregnancy, anaemia, high parity and antepartum stillbirth were associated with an increased risk of uterine rupture. The prediction model including eight variables (OR >1.5) yielded an area under the curve (AUC) of 0.812 (95% CI 0.793 to 0.836) in predicting uterine rupture in women with scarred uterus with sensitivity and specificity of 77.2% and 69.8%, respectively.

Conclusions

The incidence of uterine rupture was 0.18% in this population in 2015–2016. The predictive model based on eight easily available variables had a moderate predictive value in predicting uterine rupture in women with scarred uterus. Strategies based on predictions may be considered to further reduce the burden of uterine rupture in China.
Efficacy and cost-effectiveness of Stem Cell injections for symptomatic relief and strUctural improvement in people with Tibiofemoral knee OsteoaRthritis: protocol for a randomised placebo-controlled trial (the SCUlpTOR trial)
Authors: Liu Xiaoqian , Robbins Sarah , Wang Xia , Virk Sonika , Schuck Karen , Deveza Leticia A , Oo Win Min , Carmichael Kirsty , Antony Benny , Eckstein Felix , Wirth Wolfgang , Little Christopher , Linklater James , Harris Anthony , Humphries David , O"Connell R , Heller Gillian , Buttel Thomas , Lohmander Stefan , Ding Changhai , Hunter David J
Published: November 2021

Introduction

Knee osteoarthritis (KOA) is a highly prevalent disabling joint disease. Intra-articular stem cell therapy is increasingly being used for treating KOA with little high-quality evidence to support its use. The aim of this study is to investigate the efficacy, safety and cost-effectiveness of allogeneic mesenchymal stem cells (Cymerus MSCs) for treating symptomatic tibiofemoral KOA and improving knee structure over 24 months.

Methods and analysis

The Stem Cell injections for symptomatic relief and strUctural improvement in people with Tibiofemoral knee OsteoaRthritis study is a phase III, multi-centre, parallel, superiority, randomised, double-blind, placebo-controlled trial, which will be conducted in Sydney and Hobart, Australia. 440 participants (220 per arm) aged over 40 years with painful KOA and mild to moderate structural change on X-ray (Kellgren and Lawrence grade 2 or 3) with medial minimum joint space width between 1 and 4 mm in the study knee will be recruited from the community and randomly allocated to receive either intra-articular MSCs or saline at baseline, week 3 and week 52. The coprimary outcomes will be the proportion of participants achieving patient-acceptable symptom state for knee pain at 24 months and quantitative central medial femorotibial compartment cartilage thickness change from baseline to 24 months. Main secondary outcomes include change in knee pain, Patient Global Assessment, physical function, quality of life and other structural changes. Additional data for cost-effectiveness analysis will also be recorded. Adverse events will be monitored throughout the study. The primary analysis will be conducted using modified intention-to-treat.

Ethics and dissemination

This protocol has been approved by The University of Sydney (USYD) Human Research Ethics Committee (HREC) #: 2020/119 and The University of Tasmania (UTAS) HREC #: H0021868. All participants will be required to provide informed consent. Dissemination will occur through conferences, social media, and scientific publications.

Trial registration numbers

Australian New Zealand Clinical Trials Registry (ACTRN12620000870954); U1111-1234-4897.
Simplified 0+1 and 1+1 pneumococcal vaccine schedules in Ho Chi Minh City, Vietnam: protocol for a randomised controlled trial
Authors: Temple Beth , Tran Hau Phuc , Dai Vo Thi Trang , Bright Kathryn , Uyen Doan Y , Balloch Anne , Licciardi Paul , Nguyen Cattram Duong , Satzke Catherine , Smith-Vaughan Heidi , Nguyen Thuong Vu , Mulholland Kim
Published: November 2021

Introduction

Reduced-dose schedules offer a more efficient and affordable way to use pneumococcal conjugate vaccines (PCVs). Such schedules rely primarily on the maintenance of herd protection. The Vietnam Pneumococcal Trial II (VPT-II) will evaluate reduced-dose schedules of PCV10 and PCV13 utilising an unvaccinated control group. Schedules will be compared in relation to their effect on nasopharyngeal carriage and immunogenicity.

Methods and analysis

VPT-II is a single-blind open-label randomised controlled trial of 2500 infants in three districts of Ho Chi Minh City, Vietnam. Eligible infants have no clinically significant maternal or perinatal history and are born at or after 36 weeks’ gestation. Participants are recruited at 2 months of age and randomly assigned (4:4:4:4:9) using block randomisation, stratified by district, to one of five groups: four intervention groups that receive PCV10 in a 0+1 (at 12 months) or 1+1 (at 2 and 12 months) schedule or PCV13 in the same 0+1 or 1+1 schedule; and a control group (that receives a single dose of PCV10 at 24 months). Participants are followed up to 24 months of age. The primary outcome is vaccine-type pneumococcal carriage at 24 months of age. Secondary outcomes are carriage at 6, 12 and 18 months of age and the comparative immunogenicity of the different schedules in terms of antibody responses, functional antibody responses and memory B cell responses.

Ethics and dissemination

Ethical approval has been obtained from the Human Research Ethics Committee of the Royal Children’s Hospital Melbourne and the Vietnam Ministry of Health Ethics Committee. The results, interpretation and conclusions will be presented to parents and guardians, at national and international conferences and published in peer-reviewed open access journals.

Trial registration number

NCT03098628.
Determining common variants in patients with haemophilia A in South Vietnam and screening female carriers in their family members
Authors: Nguyen Bang Suong Thi , Le Xuan Thao Thi , Huynh Nghia , Nguyen Huy Huu , Truong Nguyen Cong-Minh , Nguyen Bac Hoang
Published: November 2021

Aims

The aim of this study was to determine common variants inF8, including intron 22 inversion (Inv22), intron 1 inversion (Inv1) and point mutations, the transmission of these variants between patients with haemophilia A (HA) and their family members.

Methods

Genetic analysis was conducted in 71 patients who were clinically diagnosed with HA and 152 related female members in South Vietnam by a combination of inversion PCR (I-PCR), multiplex PCR and direct sequencing.

Results

Variants inF8, including Inv22, point mutations (with 37 genotypes) and two novel variants, occupied 60 patients with HA. Among severe patients, the rate of Inv22 was 44%. Missense was the common point mutation of over 50% in patients with moderate HA and mild HA. Inv1 was absent in all patients.F8variants were also found in 119 female carriers (FCs) (78.3%) from families related to patients with HA. There were 56 mothers (93.3%) carryingF8variants and passing the same variants to their sons.

Conclusions

These findings were the first to provide important information about the presence of Inv22 and point mutation in Vietnamese patients with HA, the mothers and their female family members. It demonstrated that genetic diagnosis and counselling for HA carriers were essential factors for future improvements in comprehensive and equitable healthcare polices for patients with HA and FCs in Vietnam.
Research priorities for mental health in schools in the wake of COVID-19
Authors: Barker Rhiannon , Hartwell Greg , Bonell Chris , Egan Matt , Lock Karen , Viner Russell M
Published: November 2021

Children and young people (CYP) have suffered challenges to their mental health as a result of the COVID-19 pandemic; effects have been most pronounced on those already disadvantaged. Adopting a whole-school approach embracing changes to school environments, cultures and curricula is key to recovery, combining social and emotional skill building, mental health support and interventions to promote commitment and belonging. An evidence-based response must be put in place to support schools, which acknowledges that the mental health and well-being of CYP should not be forfeited in the drive to address the attainment gap. Schools provide an ideal setting for universal screening of mental well-being to help monitor and respond to the challenges facing CYP in the wake of the pandemic. Research is needed to support identification and implementation of suitable screening methods.
Postoperative de novo epilepsy after craniotomy: a nationwide register-based cohort study
Authors: Giraldi Laura , Vinsløv Hansen Jørgen , Wohlfahrt Jan , Fugleholm Kåre , Melbye Mads , Munch Tina Nørgaard
Published: November 2021

Background and objectives

The risks of postoperative risk of epilepsy after a craniotomy is widely believed to be raised. A study is warranted to quantify the risks for any neurosurgical indication. In this unselected register-based nationwide cohort study with virtually complete follow-up, the short-term and long-term cumulative risks of postoperative de novo epilepsy for all major neurosurgical indications were estimated.

Methods

The study was based on 8948 first-time craniotomy patients in Denmark 1 January 2005 to 31 December 2015 with follow-up until 31 December 2016. The patients were classified according to their underlying neurosurgical pathology. Patients with preoperative epilepsy were excluded. The postcraniotomy risks of de novo epilepsy were estimated using the Aalen-Johansen estimator in a multistate model.

Results

The overall cumulative 1-year risk of postcraniotomy de novo epilepsy was 13.9% (95% CI 13.2 to 14.6). For patients with intracranial tumour the cumulative 1-year risk was 15.4% (95% CI 14.4 to 16.5), for spontaneous intracranial haemorrhage 11.3% (95% CI 10.1 to 12.6), for traumatic intracranial haemorrhage 11.1% (95% CI 9.6 to 12.9), for cerebral abscess 27.6% (95% CI 22.8 to 33.5) and for congenital malformations 3.8% (95% CI 1.3 to 11.7). The 6-month, 1-year and 5-year risks for all major indications by specific subtypes are provided.

Conclusions

The cumulative risk of de novo epilepsy following craniotomy is high for patients with any indication for craniotomy, as compared with the background population. The results provide comprehensive data to support future recommendations regarding prophylactic antiepileptic treatment and driving restrictions.
When numbers eclipse narratives: a cultural-political critique of the ‘ethical’ impacts of short-term experiences in global health in Dominican Republic bateyes
Authors: Wilson Brenda K
Published: November 2021

With the rising demand for short-term experiences in global health (STEGH) is an ever-increasing volume of literature that focuses attention on ethics and ethical concerns, such as the effects of STEGH on host populations. Such concerns have driven the development of ethical principles and guidelines, with discussions and debates largely centred around normative questions of positive/negative and benefit/harm for us/them. Using a critical medical humanities lens, this paper blurs these dichotomous framings and offers a more complex understanding of the effects and effectiveness of STEGH on hosts. I explore STEGH that send volunteers from North American universities to the Dominican Republic to participate in service-learning activities aimed at improving the lives of impoverished Haitian migrants living inbateyes. I address the following questions: What perspectives about the impacts of interventions on host communities manifest through STEGH? What tensions emerge through interactions among diverse stakeholders related to those perspectives, and with what effects? Drawing together critical theory and ethnography, I examined the perspectives of three stakeholder groups: student and faculty volunteers, host organisation staff, and hosts inbateycommunities. Data collected from observations and interviews were counterposed; I analysed interactions and interplay between stakeholders. My findings revealed conflicts around an emergent theme: counting efforts, or volunteers’ proclivity for numerical evidence of impactful STEGH for hosts. With attention on power relations, I argue that a preoccupation with quantifiable evidence eclipsed and erased the lived realities of hosts, thereby blocking a fully ethical engagement. These sociopolitical effects, often overlooked in conventional ethics assessments, are no less harmful and may reinforce rather than reduce inequalities that the global health movement seeks to eliminate. My study offers a compelling case for how the critical medical humanities lend critical insights in the name of improving global health.
Development of a delirium predictive model for adult trauma patients in an emergency and critical care center: a retrospective study
Authors: Matsuoka Ayaka , Miike Toru , Miyazaki Mariko , Goto Taku , Sasaki Akira , Yamazaki Hirotaka , Komaki Moe , Higuchi Masahiro , Mori Kosuke , Shinada Kota , Nakayama Kento , Sakurai Ryota , Asahi Miho , Futami Akiko , Yoshitake Kunimasa , Narumi Shougo , Koba Mayuko , Koami Hiroyuki , Kawaguchi Atsushi , Murakawa Toru Hirachi , Monji Akira , Sakamoto Yuichirou
Published: November 2021

Background

Delirium has been shown to prolong the length of intensive care unit stay, hospitalization, and duration of ventilatory control, in addition to increasing the use of sedatives and increasing the medical costs. Although there have been a number of reports referring to risk factors for the development of delirium, no model has been developed to predict delirium in trauma patients at the time of admission. This study aimed to create a scoring system that predicts delirium in trauma patients.

Methods

In this single-center, retrospective, observational study, trauma patients aged 18 years and older requiring hospitalization more than 48 hours were included and divided into the development and validation cohorts. Univariate analysis was performed in the development cohort to identify factors significantly associated with prediction of delirium. The final scoring system for predicting delirium was developed using multivariate analysis and internal validation was performed.

Results

Of the 308 patients in the development cohort, 91 developed delirium. Clinical Frailty Score, fibrin/fibrinogen degradation products, low body mass index, lactate level, and Glasgow Coma Scale score were independently associated with the development of delirium. We developed a scoring system using these factors and calculated the delirium predictive score, which had an area under the curve of 0.85. In the validation cohort, 46 of 206 patients developed delirium. The area under the curve for the validation cohort was 0.86, and the calibration plot analysis revealed the scoring system was well calibrated in the validation cohort.

Discussion

This scoring system for predicting delirium in trauma patients consists of only five risk factors. Delirium prediction at the time of admission may be useful in clinical practice.

Level of evidence

Prognostic and epidemiological, level III.
Phase transitions in the logarithmic Maxwell O(3)-sigma model
Authors: Lima F. C. E. , Almeida C. A. S.
Published: November 2021

We investigate the presence of topological structures and multiple phase transitions in the O(3)-sigma model with the gauge field governed by Maxwell’s term and subject to a so-called Gausson’s self-dual potential. To carry out this study, it is numerically shown that this model supports topological solutions in 3-dimensional spacetime. In fact, to obtain the topological solutions, we assume a spherically symmetrical ansatz to find the solutions, as well as some physical behaviors of the vortex, as energy and magnetic field. It is presented a planar view of the magnetic field as an interesting configuration of a ring-like profile. To calculate the differential configurational complexity (DCC) of structures, the spatial energy density of the vortex is used. In fact, theDCCis important because it provides us with information about the possible phase transitions associated with the structures located in the Maxwell–Gausson model in 3D. Finally, we note from theDCCprofile an infinite set of kink-like solutions associated with the parameter that controls the vacuum expectation value.
Naturalness implications within the two-real-scalar-singlet beyond the SM
Authors: Aali Jamal Ou , Manaut Bouzid , Rahili Larbi , Semlali Souad
Published: November 2021

The aim of this study is to investigate the quadratic divergences using dimensional regularization within the context of the Standard Model (SM) extended by two real scalar singlets (TRSM). This extension provides three neutral scalar fields that mix, after developing itsVEVs, leading to three CP-even Higgs bosons, namely,$$h_1$$h1,$$h_2$$h2and$$h_3$$h3, which would offer a wide phenomenology at the Large Hadron Collider (LHC), as reported recently. Furthermore, to fulfill the Veltman conditions for those three fields, we concentrate on the one-loop level ($$d_L=2$$dL=2) of dimensional regularization calculations, assuming$$R_{\xi }$$RξFeynman–’t Hooft gauge-invariant,$$\xi =1$$ξ=1. We show that the divergence cancellation could take place in the framework of the TRSM for the SM-like Higgs boson predicting a stringent constraint on the space parameters as well as the new physics (NP) scale, and yet remain consistent with current experimental measurements at 13 TeV.
Instability of a liquid sheet with viscosity contrast in inertial microfluidics
Authors: Patel Kuntal , Stark Holger
Published: November 2021

Flows at moderate Reynolds numbers in inertial microfluidics enable high throughput and inertial focusing of particles and cells with relevance in biomedical applications. In the present work, we consider a viscosity-stratified three-layer flow in the inertial regime. We investigate the interfacial instability of a liquid sheet surrounded by a density-matched but more viscous fluid in a channel flow. We use linear stability analysis based on the Orr–Sommerfeld equation and direct numerical simulations with the lattice Boltzmann method (LBM) to perform an extensive parameter study. Our aim is to contribute to a controlled droplet production in inertial microfluidics. In the first part, on the linear stability analysis we show that the growth rate of the fastest growing mode$$\xi ^{*}$$ξ∗increases with the Reynolds number$$\text {Re}$$Reand that its wavelength$$\lambda ^{*}$$λ∗is always smaller than the channel widthwfor sufficiently small interfacial tension$$\Gamma $$Γ. For thin sheets we find the scaling relation$$\xi ^{*} \propto mt^{2.5}_{s}$$ξ∗∝mts2.5, wheremis viscosity ratio and$$t_{s}$$tsthe sheet thickness. In contrast, for thicker sheets$$\xi ^{*}$$ξ∗decreases with increasing$$t_s$$tsormdue to the nearby channel walls. Examining the eigenvalue spectra, we identify Yih modes at the interface. In the second part on the LBM simulations, the thin liquid sheet develops two distinct dynamic states: waves traveling along the interface and breakup into droplets with bullet shape. For smaller flow rates and larger sheet thicknesses, we also observe ligament formation and the sheet eventually evolves irregularly. Our work gives some indication how droplet formation can be controlled with a suitable parameter set$$\{\lambda ,t_{s},m,\Gamma ,\text {Re}\}$${λ,ts,m,Γ,Re}.

Graphical Abstract
Thermophysical and structural properties of manganese ferrite nanoparticles
Authors: Gochuyeva A. F.
Published: November 2021

This paper discusses the results of the research carried out to study the structure, optical properties and thermophysical properties of a sample (nanopowder with a true density of 4.96 g/cm3, a particle size of 60 nm and a purity of 98.5%, SkySpring Nanomaterials, USA) with high purity. Based on the results of X-ray diffraction, the crystalline phase of MnFe2O4ferrite nanoparticles was completely obtained and the values of the lattice parameters were determined. The results of the MID-IR analysis showed that the absorption coefficient [Formula: see text] reaches its maximum value at 748 cm[Formula: see text] wave number. The optical properties of the as-prepared nanostructures were also investigated by VERTEX 70 V diffuse reflectance spectroscopy (DRS). As can be seen from the results of the DSC analysis, the effects occurring in the temperature range up to [Formula: see text]C clearly reflect the nature of the phase transitions and the amount of energy generated in the ferrite samples.
Generating functions on epimorphisms between 2-bridge knot groups
Authors: Suzuki Masaaki
Published: November 2021

We have the generating function which determines the number of [Formula: see text]-bridge knot groups admitting epimorphisms onto the knot group of a given [Formula: see text]-bridge knot, in terms of crossing number. In this paper, we will refine this formula by taking into account genus as well as crossing number. Next, we determine the number of epimorphisms between fibered [Formula: see text]-bridge knot groups. Moreover, we discuss degree one maps and [Formula: see text]-bridge knots with unknotting number one.