bluuebunny/crossref_metadata_2025 huggingface dataset:
Differential Effect of Graft-versus-Host Disease on Survival in Acute Leukemia according to Donor Type
Authors: Konuma Takaaki , Kanda Junya , Kuwatsuka Yachiyo , Yanada Masamitsu , Kondo Tadakazu , Hirabayashi Shigeki , Kako Shinichi , Akahoshi Yu , Uchida Naoyuki , Doki Noriko , Ozawa Yukiyasu , Tanaka Masatsugu , Eto Tetsuya , Sawa Masashi , Yoshioka Satoshi , Kimura Takafumi , Kanda Yoshinobu , Fukuda Takahiro , Atsuta Yoshiko , Kimura Fumihiko
Published: June 2021

Purpose:

The anti-leukemic activity of allogeneic hematopoietic cell transplantation (HCT) depends on both the intensity of conditioning regimen and the strength of the graft-versus-leukemia (GVL) effect. However, it is unclear whether the sensitivity of the GVL effects differs between donor type and graft source.

Experimental Design:

We retrospectively evaluated the effect of acute and chronic graft-versus-host disease (GVHD) on transplant outcomes for adults with acute leukemia (n = 6,548) between 2007 and 2017 using a Japanese database. In all analyses, we separately evaluated three distinct cohorts based on donor type [(8/8 allele-matched sibling donor, 8/8 allele-matched unrelated donor, and unrelated single-cord blood (UCB)].

Results:

The multivariate analysis, in which the development of GVHD was treated as a time-dependent covariate, showed a reductive effect of grade I–II acute GVHD on treatment failure (defined as 1-leukemia-free survival; P < 0.001), overall mortality (OM; P < 0.001), relapse (P < 0.001), and non-relapse mortality (NRM; P < 0.001) in patients receiving from UCB. A reductive effect of limited chronic GVHD on treatment failure (P < 0.001), OM (P < 0.001), and NRM (P < 0.001) was also shown in patients receiving from UCB. However, these effects were not always shown in patients receiving from other donors. The beneficial effects of mild acute and chronic GVHD after UCB transplantation on treatment failure were noted relatively in subgroups of patients with acute myelogenous leukemia and a non-remission status.

Conclusions:

These data suggested that the development of mild GVHD could improve survival after UCB transplantation for acute leukemia.
Tumor-Naïve Multimodal Profiling of Circulating Tumor DNA in Head and Neck Squamous Cell Carcinoma
Authors: Burgener Justin M. , Zou Jinfeng , Zhao Zhen , Zheng Yangqiao , Shen Shu Yi , Huang Shao Hui , Keshavarzi Sareh , Xu Wei , Liu Fei-Fei , Liu Geoffrey , Waldron John N. , Weinreb Ilan , Spreafico Anna , Siu Lillian L. , de Almeida John R. , Goldstein David P. , Hoffman Michael M. , De Carvalho Daniel D. , Bratman Scott V.
Published: June 2021

Purpose:

Circulating tumor DNA (ctDNA) enables personalized treatment strategies in oncology by providing a noninvasive source of clinical biomarkers. In patients with low ctDNA abundance, tumor-naïve methods are needed to facilitate clinical implementation. Here, using locoregionally confined head and neck squamous cell carcinoma (HNSCC) as an example, we demonstrate tumor-naïve detection of ctDNA by simultaneous profiling of mutations and methylation.

Experimental Design:

We conducted CAncer Personalized Profiling by deep Sequencing (CAPP-seq) and cell-free Methylated DNA ImmunoPrecipitation and high-throughput sequencing (cfMeDIP-seq) for detection of ctDNA-derived somatic mutations and aberrant methylation, respectively. We analyzed 77 plasma samples from 30 patients with stage I–IVA human papillomavirus–negative HNSCC as well as plasma samples from 20 risk-matched healthy controls. In addition, we analyzed leukocytes from patients and controls.

Results:

CAPP-seq identified mutations in 20 of 30 patients at frequencies similar to that of The Tumor Genome Atlas (TCGA). Differential methylation analysis of cfMeDIP-seq profiles identified 941 ctDNA-derived hypermethylated regions enriched for CpG islands and HNSCC-specific methylation patterns. Both methods demonstrated an association between ctDNA abundance and shorter fragment lengths. In addition, mutation- and methylation-based ctDNA abundance was highly correlated (r > 0.85). Patients with detectable pretreatment ctDNA by both methods demonstrated significantly worse overall survival (HR = 7.5; P = 0.025) independent of clinical stage, with lack of ctDNA clearance post-treatment strongly correlating with recurrence. We further leveraged cfMeDIP-seq profiles to validate a prognostic signature identified from TCGA samples.

Conclusions:

Tumor-naïve detection of ctDNA by multimodal profiling may facilitate biomarker discovery and clinical use in low ctDNA abundance applications.
Radiopotentiation Profiling of Multiple Inhibitors of the DNA Damage Response for Early Clinical Development
Authors: Gill Sonja J. , Wijnhoven Paul W.G. , Fok Jacqueline H.L. , Lloyd Rebecca L. , Cairns Jonathan , Armenia Joshua , Nikkilä Jenni , Lau Alan , Bakkenist Christopher J. , Galbraith Susan M. , Vens Conchita , O'Connor Mark J.
Published: June 2021

Radiotherapy is an effective anticancer treatment, but combinations with targeted agents that maximize efficacy while sparing normal tissue are needed. Here, we assess the radiopotentiation profiles of DNA damage response inhibitors (DDRi) olaparib (PARP1/2), ceralasertib (ATR), adavosertib (WEE1), AZD0156 (ATM), and KU-60648 (DNA-PK). We performed a radiotherapy combination screen and assessed how drug concentration and cellular DDR deficiencies influence the radiopotentiation ability of DDRi. We pre-selected six lung cancer cell lines with different genetic/signaling aberrations (including mutations in TP53 and ATM) and assessed multiple concentrations of DDRi in combination with a fixed radiotherapy dose by clonogenic assay. The effective concentration of DDRi in radiotherapy combinations is lower than that required for single-agent efficacy. This has the potential to be exploited further in the context of DDR deficiencies to increase therapeutic index and we demonstrate that low concentrations of AZD0156 preferentially sensitized p53-deficient cells. Moreover, testing multiple concentrations of DDRi in radiotherapy combinations indicated that olaparib, ceralasertib, and adavosertib have a desirable safety profile showing moderate increases in radiotherapy dose enhancement with increasing inhibitor concentration. Small increases in concentration of AZD0156 and particularly KU-60648, however, result in steep increases in dose enhancement. Radiopotentiation profiling can inform on effective drug doses required for radiosensitization in relation to biomarkers, providing an opportunity to increase therapeutic index. Moreover, multiple concentration testing demonstrates a relationship between drug concentration and radiotherapy effect that provides valuable insights that, with future in vivo validation, can guide dose-escalation strategies in clinical trials.
TPX-0131, a Potent CNS-penetrant, Next-generation Inhibitor of Wild-type ALK and ALK-resistant Mutations
Authors: Murray Brion W. , Zhai Dayong , Deng Wei , Zhang Xin , Ung Jane , Nguyen Vivian , Zhang Han , Barrera Maria , Parra Ana , Cowell Jessica , Lee Dong J. , Aloysius Herve , Rogers Evan
Published: June 2021

Since 2011, with the approval of crizotinib and subsequent approval of four additional targeted therapies, anaplastic lymphoma kinase (ALK) inhibitors have become important treatments for a subset of patients with lung cancer. Each generation of ALK inhibitor showed improvements in terms of central nervous system (CNS) penetration and potency against wild-type (WT) ALK, yet a key continued limitation is their susceptibility to resistance from ALK active-site mutations. The solvent front mutation (G1202R) and gatekeeper mutation (L1196M) are major resistance mechanisms to the first two generations of inhibitors while patients treated with the third-generation ALK inhibitor lorlatinib often experience progressive disease with multiple mutations on the same allele (mutations in cis, compound mutations). TPX-0131 is a compact macrocyclic molecule designed to fit within the ATP-binding boundary to inhibit ALK fusion proteins. In cellular assays, TPX-0131 was more potent than all five approved ALK inhibitors against WT ALK and many types of ALK resistance mutations, e.g., G1202R, L1196M, and compound mutations. In biochemical assays, TPX-0131 potently inhibited (IC50 <10 nmol/L) WT ALK and 26 ALK mutants (single and compound mutations). TPX-0131, but not lorlatinib, caused complete tumor regression in ALK (G1202R) and ALK compound mutation-dependent xenograft models. Following repeat oral administration of TPX-0131 to rats, brain levels of TPX-0131 were approximately 66% of those observed in plasma. Taken together, preclinical studies show that TPX-0131 is a CNS-penetrant, next-generation ALK inhibitor that has potency against WT ALK and a spectrum of acquired resistance mutations, especially the G1202R solvent front mutation and compound mutations, for which there are currently no effective therapies.
Ultrasonographic 3D Evaluation in the Diagnosis of Bladder Endometriosis: A Prospective Comparative Diagnostic Accuracy Study
Authors: Barra Fabio , Alessandri Franco , Scala Carolina , Ferrero Simone
Published: June 2021

Objective: The use of three-dimensional (3D) transvaginal ultrasonography (TVS) has been investigated for the diagnosis of deep endometriosis (DE). This study aimed to evaluate if 3D reconstructions improve the performance of TVS) in assessing the presence and characteristics of bladder endometriosis (BE). Design: This was a single-center comparative diagnostic accuracy study. Participants/Materials, Setting, Methods: Patients referred to our institution (Piazza della Vittoria 14 Srl, Genova, Italy) with clinical suspicion of DE were included. In case of surgery, women underwent systematic preoperative ultrasonographic imaging; an experienced sonographer performed a conventional TVS; another experienced sonographer, blinded to results of the previous exam, performed TVS, with the addition of 3D modality. The presence and characteristics of BE nodules were described in accord with International DE Analysis group consensus. Ultrasound data were compared with surgical and histological results. Results: Overall, BE was intraoperatively found in 34 out of 194 women who underwent surgery for DE (17.5%; 95% confidence interval: 12.8–23.5%). TVS without and with 3D reconstructions were able to detect endometriotic BE in 82.2% (n = 28/34) and 85.3% (n = 29/34) of the cases (p = 0.125). Both the exams similarly estimated the largest diameter of BE (p = 0.652) and the distance between the endometriotic nodule and the closest ureteral meatus (p = 0.341). However, TVS with 3D reconstructions was more precise in estimating the volume of BE (p = 0.031). In one case (2.9%), TVS without and with 3D reconstructions detected the infiltration of the intramural ureter, which was confirmed at surgery and required laparoscopic ureterovesical reimplantation. Limitations: The extensive experience of the gynecologists performing the ultrasonographic scans, the lack of prestudy power analysis, and the population selected, which may have been influenced by the position of the institution as a referral center specialized in the treatment of severe endometriosis, are limitations of the current study. Conclusion: Our results demonstrated the high accuracy of ultrasound for diagnosing BE. The addition of 3D reconstructions does not improve the performance of TVS in diagnosing the presence and characteristics of BE. However, the volume of BE may be more precisely assessed by 3D ultrasound.
Immune Surveillance by Myeloid-Derived Suppressor Cells in Liver Diseases
Authors: Sehgal Rashi , Kaur Navkiran , Ramakrishna Gayatri , Trehanpati Nirupma
Published: June 2021

Background: Myeloid-derived suppressor cells (MDSCs) are immunosuppressive in nature, originate in the bone marrow, and are mainly found in the blood, spleen, and liver. In fact, liver acts as an important organ for induction and accumulation of MDSCs, especially during infection, inflammation, and cancer. In humans and rodents, models of liver diseases revealed that MDSCs promote regeneration and drive the inflammatory processes, leading to hepatitis, fibrogenesis, and cirrhosis, ultimately resulting in hepatocellular carcinoma. Summary: This brief review is focused on the in-depth understanding of the key molecules involved in the expansion and regulation of MDSCs and their underlying immunosuppressive mechanisms in liver diseases. Key Message: Modulated MDSCs can be used for therapeutic purposes in inflammation, cancer, and sepsis.
Use of the HAVOC Score to Identify Patients at Highest Risk of Developing Atrial Fibrillation
Authors: Elkind Mitchell S.V. , Wachter Rolf , Verma Atul , Kowey Peter R. , Halperin Jonathan L. , Gersh Bernard J. , Ziegler Paul D. , Pouliot Erika , Franco Noreli , Reiffel James A.
Published: June 2021

Background: Recent studies using insertable cardiac monitors (ICMs) show a high incidence of atrial fibrillation (AF). Further identifying subsets of patients who could benefit most from ICMs is desirable. We evaluated whether the HAVOC risk score which predicts AF in patients with cryptogenic stroke also predicts AF detection by ICMs in those without recent stroke. Methods: Participants were included from the prospective, industry-sponsored REVEAL AF study assessing AF incidence in patients with CHADS2 scores ≥3 or =2 with 1 or more additional AF risk factors, who had ICM data and were not receiving anti-arrhythmic drugs. Ischemic stroke occurring less than 1 year prior to enrollment or documented AF were exclusion criteria. AF was defined as an adjudicated ICM-detected episode ≥6 min in duration. HAVOC scores were calculated by assigning 4 points for congestive heart failure, 2 points for each of hypertension, age ≥75 years, valvular disease, and coronary artery disease, and 1 point for each of peripheral vascular disease and obesity (body mass index >30). Scores classified risk as low (0–4), intermediate (5–9), or high (10–14); corresponding AF detection rates were compared using the log-rank test. AF incidence rates in patients with and without a history of remote stroke at baseline were also compared. Results: Among 391 participants, the mean age was 71.5 ± 9.8 years and 186 (47.6%) were women. In total, 130 (33.2%) developed AF over 18 months. Stratification by HAVOC risk score was: 95 (24%) low, 241 (62%) intermediate, and 55 (14%) high. At 18 months, AF incidence in patients with low HAVOC scores (19.5%) was lower than in those with intermediate (32.1%) or high (34.2%) scores. AF incidence was similar among those with (n = 78) versus without (n = 313) remote stroke (27.3% vs. 29.8%; median time from stroke to ICM insertion was 4.2 [2.2–8.2] years). Conclusions: The HAVOC risk score identified a subset of individuals at greatest risk of developing AF, while AF incidence rates were similar among those with and without remote stroke. The use of the HAVOC score could help identify those at greatest likelihood of manifesting AF during long-term monitoring.
Habitar Coletivo: obras diferenciadas contemporâneas em São Paulo
Authors: Zulin Fabricia , Perrone Rafael Antonio
Published: June 2021

Este trabalho apresenta um estudo de obras diferenciadas de habitação coletiva do início do século XXI localizadas na região metropolitana de São Paulo. Denominar esses estudos de caso como diferenciados, revela-se positivo pelo fato de contribuírem com novas possibilidades de agentes, de ocupação de lote urbano, novas técnicas construtivas, novas maneiras de agenciamento do programa entre outras possibilidades reveladas, muitas vezes rebaixadas na produção comercial usual. No artigo será exposta a leitura de um dos casos estudados, Vila Fidalga, da arquiteta Cristina Xavier, projeto em que sua participação efetiva em todo processo reflete na boa arquitetura resultante.
Improving Efficiency of the Barbershop Model of Hypertension Care for Black Men With Virtual Visits
Authors: Blyler Ciantel A. , Ebinger Joseph , Rashid Mohamad , Moy Norma P. , Cheng Susan , Albert Christine M. , Rader Florian
Published: June 2021

Background

The LABBPS (Los Angeles Barbershop Blood Pressure Study) developed a new model of hypertension care for non‐Hispanic Black men that links health promotion by barbers to medication management by pharmacists. Barriers to scaling the model include inefficiencies that contribute to the cost of the intervention, most notably, pharmacist travel time. To address this, we tested whether virtual visits could be substituted for in‐person visits after blood pressure (BP) control was achieved.

Methods and Results

We enrolled 10 Black male patrons with systolic BP ≥140 mm Hg into a proof‐of‐concept study in which barbers promoted follow‐up with pharmacists who initially met each patron in the barbershop, where they prescribed BP medication under a collaborative practice agreement with the patrons' physician. Medications were titrated during bimonthly in‐person visits to achieve a BP goal of ≤130/80 mm Hg. Once BP goal was reached, visits were done by videoconference. Final BP and safety outcomes were assessed at 12 months. Nine patients completed the intervention. Baseline BP of 155±14/83.9±11 mm Hg decreased by −28.7±13/−8.9±15 mm Hg (
P
<0.0001). These data are statistically indistinguishable from prior LABBPS data (
P
=0.8 for change in systolic BP and diastolic BP). Hypertension control (≤130/80 mm Hg) was 67% (6 of 9), numerically greater than the 63% observed in LABBPS (
P
=not significant). As intended, the mean number of in‐person visits decreased from 11 in LABBPS to 6.6 visits over 12 months. No treatment‐related serious adverse events occurred.

Conclusions

Virtual visits represent a viable substitute for in‐person visits, both improving pharmacist efficiency and reducing cost while preserving intervention potency.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT 03726710.
Cognitive Metaphor Theory Integrated into Comparative Theology
Authors: Remias Yesudasan
Published: June 2021

The emergence of the new comparative theology in the west has greatly benefitted from Indian Vedic texts and related ones. Despite their extensive use for western theological reflection, comparative theology, however, has not come to the limelight in India, since most of the western initiatives have been perceived to be camouflaged missionary efforts. This paper proposes the cognitive metaphor theory as a fitting supplement to comparative theology. I argue that combining both has much to offer to study, learn, and relate religions in the multi-religiously coexisting context of India. I explore its possibilities and challenges and address how new comparative theology stays distinct from its nineteenth-century efforts in terms of bridging religious traditions by learning from them. This paper draws much from my own experiences, insights, and studies as a native of Indian culture, brought up in Christian tradition. My studies and researches are focused on comparative theology developed through the lens of cognitive metaphor theory.
Elevation of MicroRNA-126 Levels in Intracranial Aneurysm and Bioinformatic Analysis of Potential Molecular Mechanisms
Authors: Huang Pan , Xu Min , He Xiao-Ying
Published: June 2021

The study is to investigation of microRNA-126 levels in patients with intracranial aneurysm and bioinformatic analysis of the molecular mechanisms involved. A total of 166 patients with ICA who were hospitalized or examined in our hospital from September 2015 to December 2017 were used
as the experimental group (ICA group). This group included 120 patients with unruptured intracranial aneurysm (UICA; UICA group) and 46 patients with ruptured intracranial aneurysm (RICA); RICA group). The UICA group was further subdivided into 42 surgical groups (S group) and 78 nonsurgical
groups (NS group). Sixty-three normal people without intracranial aneurysms were selected as the control group. RT-PCR was used to quantitatively detect the relative expression of microRNA- 126 in peripheral blood mononuclear cells at the time of admission and immediately after surgery. The
UCSC database was used to analyze the gene locus and homology of microRNA-126. The TargetScan database and CoMeTa database were used to predict the potential target genes of microRNA-126. The DAVID database was used to enrich the function of potential target genes of microRNA-126 (GO enrichment)
and KEGG pathway enrichment for analysis. The expression level of microRNA-126 in peripheral blood was significantly higher in the ICA group than in the control group (P <0.01), significantly higher in the RICA group than in the UICA group (P <0.05). Expression was also
higher in the NS group than in the S group but the difference was nonsignificant (P >0.05). A total of 15 potential target genes including ITGA6, CRK, PCDH7, and ADAM9 were identified through the target gene prediction software and GO analysis and KEGG pathway analysis showed that
the function of the microRNA-126 target gene was mainly focused on protein binding and the FAS signaling pathway. In Conclusion the microRNA-126 is up-regulated in ICA patients and affects ICA by regulating multiple target genes in the FAS signaling pathway.
Impact of Seasonality in the North Atlantic Jet Stream and Storm Migration on the Seasonality of Hurricane Translation Speed Changes
Authors: Guo Xi , Kossin James P. , Tan Zhe-Min
Published: June 2021

Tropical cyclone (TC) translation speed (TCTS) can affect the duration of TC-related disasters, which is critical to coastal and inland areas. The long-term variation of TCTS and its relationship to the variability of the midlatitude jet stream and storm migration is discussed here for storms near the North Atlantic coast during 1948–2019. Our results reveal the prominent seasonality in the long-term variation of TCTS, which can be largely explained by the seasonality in the covariations of the midlatitude jet stream and storm locations. Specifically, significant increases of TCTS occur in June and October during the past decades, which may result from the equatorward displacement of the jet stream and poleward migration of storm locations. Prominent slowdown of TCTS is found in August, which is related to the weakened jet strength and equatorward storm migration. In September, the effects of poleward displacement and weakening of the jet stream on TCTS are largely compensated by the poleward storm migration, and therefore no significant change in TCTS is observed. Meanwhile, the multidecadal variability of the Atlantic may contribute to the multidecadal variability of TCTS. Our findings emphasize the significance in taking a seasonality view in discussing the variability and trends of near-coast Atlantic TCTS under climate change.
Projected climate impacts of large artificial reservoir impoundment in Yalong River Basin of southwestern China
Authors: Liang Yanan , Cai Yanpeng , Wang Xuan , Li Chunhui , Liu Qiang
Published: June 2021

Cascade reservoirs were designed for Yalong River Basin, which ranks the 3rd largest hydropower base in China. Reservoir impoundment has certain impacts on local climate, but few researches focus on this field. This paper integrates the spatiotemporal analysis techniques and geostatistical methods to identify the reservoir projected meteorological indices (MIs) variations as well as the impact scope under different circumstances. Results show: The reservoir projected variations of moisture indexes were much more significant than temperatures. Anthropogenic disturbance has led to dramatic decrease of relative humidity in the past decade, far beyond its periodic amplitude range. Moreover, dry valley faced more serious drought risk but reservoir impoundment of this region alleviated the local drought risk. The daily minimum temperature, relative to the maximum temperature, was more sensitive to catchment changes with an earlier appearance of temperature zone variation. Since impounding, the MIs internal relationships in non-dry valley varied significantly more than that in dry valley, with the positive correlation of 0.7 between the relative humidity and precipitation weakened greatly. The severe warming hotspots distributed in the upper reach and had the probability of 0.95- 1 to exceed 1.5℃ IPCC control target. This study provides references for the disturbance of reservoir impoundment to local climate at multiple temporal-spatial scales under different circumstances and contributes to the MIs variation pattern identification and quantitative risk assessment.
Insiders, Outsiders, Skills, and Preferences for Social Protection: Evidence From a Survey Experiment in Argentina
Authors: Menéndez González Irene
Published: June 2021

Standard theories in comparative political economy predict that labor market insiders oppose redistribution to poorer, often informal, labor market outsiders. In contrast, I argue that not all insiders oppose redistribution to outsiders. Extending recent work emphasizing the importance of economic insecurity for insiders, I argue that exposure to risk leads to greater polarization regarding preferences for non-contributory social policy between low- and high-skilled insiders. I test implications of this logic using a survey experiment from a nationally representative sample in Argentina and complement this with analysis of observational data for 16 Latin American countries. I find strong evidence of polarization regarding preferences over social protection among low- and high-skilled insiders. The experiment reveals that low (high)-skilled insiders primed about the risk of becoming outsiders become more supportive of transfers to outsiders (insiders). The article provides new micro-foundations for insider–outsider coalitions in support of social policy expansion in middle-income countries.
Conclusions: Towards a sociology of pandemics and beyond
Authors: Zinn Jens O
Published: June 2021

This conclusion revisits the COVID-19 pandemic from the broader perspective of a changing global world. It raises questions regarding the opportunities for global learning under conditions of global divisions and competition and includes learning from the Other, governing within a changing public sphere, and challenging national cultural practices. Moreover, it exemplifies how the society–nature–technology nexus has become crucial for understanding and reconstructing the dynamics of the coronavirus crisis such as the assemblages of geographical conditions, technological means and the governing of ignorance, the occurrence of hotspots as well as living under lockdown conditions. It finishes with some preliminary suggestions how reoccurring pandemics might contribute to long-term changes in human attitudes and behaviour towards the environment and a technologically shaped lifeworld.
Explosion fatalities in Sweden, 2000–2018
Authors: Junuzovic Mensura
Published: June 2021

Epidemiological aspects of explosion-related deaths in a civilian setting may bring comprehensive knowledge that is important for prevention efforts. This Swedish national study aimed to describe the extent of such deaths, circumstances and fatal injuries. Data, including all explosion-related deaths in Sweden from 2000 through 2018, were retrieved from the register of the National Board of Forensic Medicine. Among all 87 cases found, accidental deaths accounted for 62%, suicides for 21%, homicides for 7% and undetermined manner of death for the remaining 10% of cases. Most victims died on site. Adult males dominated in the study material, but explosions also killed four children. Explosives were most commonly involved in occupational blast deaths, suicides and homicides, followed by flammable gases and fluids. The incidence showed a significant decrease since the 1980s, based on the incidence rate from this study and a previous Swedish study (1979–1984). As already rare occurrences, blast-related deaths are challenging to prevent. Prevention efforts are needed to restrict the availability of explosives and focus on lowering the occupational risk for injury. In addition, child deaths must not be neglected. A vision of no fatalities is an appropriate goal for acting against explosion-related deaths in a civilian setting.
Management of the dead during coronavirus disease 2019 outbreak: Practices and perceptions of forensic practitioners from India
Authors: Meshram Vikas P , Kanchan Tanuj , Shekhawat Raghvendra S
Published: June 2021

The coronavirus disease 2019 pandemic has mandated a response from administrative agencies and the health sector globally, however, the number of cases and deaths continue to rise. While management of the living is paramount, the management of the dead is also important. Guidelines for managing the dead have been issued and implemented by various local administrations, in accordance with national and international guidelines. This questionnaire-based research aims to develop an understanding of the knowledge, perceptions and practices of forensic practitioners from India as regards the management of the dead during the coronavirus disease 2019 pandemic. This Pan-India study included 278 forensic medicine experts (249 males and 29 females) working in various hospitals and medical institutions across the country. The questionnaire included various issues involving the management of dead bodies in cases involving coronavirus disease 2019, such as infection control practices, body screening, handling and autopsy, disposal practices, local administrative policies, and available infrastructure and resources. We found that guidelines are mostly being followed across India, barring disparity in issues relating to testing in the dead bodies, the role of local administration in the body disposal, and the use of personal protective equipment while handling bodies and during autopsies. Mortuaries now need to be upgraded, and general infrastructure requires improvement. Periodic training of all stakeholders and assessment of facilities are recommended.
Media Portrayal of Older Adults Across Five Canadian Disasters
Authors: Oostlander Samantha A. , Champagne-Poirier Olivier , O’Sullivan Tracey L.
Published: June 2021

We conducted a constructivist grounded theory approach in which discourse analysis was used to explore how Canadian news media portrays older adults and aging in a disaster context. We analyzed 119 articles covering five Canadian disasters and identified four themes: (a) stereotypes of older adults are presented on a positive–negative continuum in journalistic coverage of disasters, (b) journalistic coverage tends to exclude perspectives of older adults from relevant discourse, (c) journalists assess the value of losses for older adults—“home” as a central concept, and (d) disasters are framed as disrupting retirement ideals. A model was created to provide an overview of the journalistic coverage of older adults in disaster contexts. Understanding how old age and aging are presented by the media in a disaster context is important because it has further implications for informing and structuring disaster risk reduction policies.
Design of distributed functional interval observers for large-scale networks impulsive systems
Authors: Huong Dinh Cong , Yen Dao Thi Hai , Thuan Mai Viet
Published: June 2021

In this paper, we consider the problem of designing distributed functional interval observers (IOs) for a class of large-scale networks impulsive systems with bounded uncertainties. We first design IOs for linear functions of the state vector of each system of the considered system. We then provide conditions for the existence of such IOs and an effective algorithm for computing unknown observer matrices. Finally, two examples and simulation results are given to illustrate the effectiveness of the proposed design method.
Attitude and height tracking control of unmanned helicopters with disturbances via disturbance observer-based composite dynamic surface control
Authors: Wang Xiangyu , Han Ling , Liu Jiyu
Published: June 2021

In this paper, the attitude and height tracking control problem is studied for unmanned helicopters with disturbances. To solve the problem, a composite control scheme is proposed based on the combination of dynamic surface control and disturbance observer-based control techniques. The control design includes two parts. In the first part, some nonlinear disturbance observers are designed to accurately estimate the helicopter’s disturbances in different channels. In the second part, based on the disturbance estimates and dynamic surface control technique, a composite dynamic surface tracking controller is designed. Under the proposed composite controller, the attitude and height tracking errors are uniformly ultimately bounded and they can be regulated to be very small by selecting proper controller parameters. For one thing, the proposed control scheme avoids “explosion of terms”, which generally exists in conventional backstepping control and provides a simpler control design. For another thing, without sacrificing the nominal control performances, the anti-disturbance ability of the closed-loop helicopter system is enhanced by using disturbance observers and feedforward compensations. Numerical simulations demonstrate the effectiveness and advantages of the proposed composite tracking controller.
From poverty to trust: Political implications of the anti-poverty campaign in China
Authors: (Vera) Zuo Cai , Wang Zhongyuan , Zeng Qingjie
Published: June 2021

Despite the rapid decrease in poverty across the developing world, there have been few attempts to analyze the implication of poverty alleviation on regime legitimacy. Bridging the literature on poverty alleviation and political trust, this analysis examines the mechanisms through which poverty reduction affects trust in local elected and appointed officials. Using an original survey on the Target Poverty Alleviation campaign in China and causal mediation analyses, we find that beneficiary status is positively associated with political trust. The perception of anti-poverty governance quality, rather than economic evaluation, is the mediator through which beneficiary status affects political trust. Moreover, the intensified non-formalistic elite-mass linkage developed in the poverty alleviation campaign enhances political trust through the improvement of perception of governance quality. These findings have implications for mechanisms through which poverty reduction affects political trust and the type of political linkage that sustains regime legitimacy.
Rethinking the Definition of High Risk in Pediatric Salivary Gland Carcinoma
Authors: Acharya Sahaja , Sinard Rebecca N. , Rangel Gustavo , Rastatter Jeffrey C. , Sheyn Anthony
Published: June 2021

Objective

Indications for adjuvant radiation in pediatric salivary gland carcinoma rely on high‐risk criteria extrapolated from adult data. We sought to determine whether adult‐derived high‐risk criteria were prognostic in children aged ≤21 years or young adults aged 22 to 39 years.

Study Design

Cross‐sectional analysis of a hospital‐based national registry.

Setting

Patients were identified from the National Cancer Database between 2004 and 2015.

Methods

High‐risk criteria were defined as adenoid cystic histology, intermediate/high grade, T3/T4, positive margins, and/or lymph node involvement. Exact matching was used to adjust for differences in baseline characteristics between pediatric and young adult patients.

Results

We identified 215 pediatric patients aged ≤21 years, 317 patients aged 22 to 30 years, and 466 patients aged 31 to 39 years. Within the pediatric cohort, there was no significant difference in overall survival (OS) between low‐ and high‐risk groups (5‐year OS, 100% vs 98.5%; P = .29). In contrast, within the young adult cohorts, there was a significant difference in OS between low‐ and high‐risk groups in patients aged 22 to 30 years (5‐year OS, 100% vs 96.1%; P = .01) and 31 to 39 years (5‐year OS, 100% vs 88.5%; P < .001). When high‐risk patients were matched 1:1 on high‐risk criteria and race, pediatric patients were associated with better OS than those aged 22 to 30 years (P = .044) and those aged 31 to 39 years (P = .005).

Conclusion

Children have excellent OS, irrespective of adult‐derived high‐risk status. These findings underscore the need to understand how age modifies clinicopathologic risk factors.
Feeding Tube Placement Following Transoral Robotic Surgery for Oropharyngeal Squamous Cell Carcinoma
Authors: Feng Allen L. , Holcomb Andrew J. , Abt Nicholas B. , Mokhtari Tara E. , Suresh Krish , McHugh Christopher I. , Parikh Anuraag S. , Holman Allison , Kammer Rachael E. , Goldsmith Tessa A. , Faden Daniel L. , Deschler Daniel G. , Varvares Mark A. , Lin Derrick T. , Richmon Jeremy D.
Published: June 2021

Objective

To identify factors that may predict the need for feeding tubes in patients undergoing transoral robotic surgery (TORS) in the perioperative setting.

Study Design

Retrospective chart review.

Setting

Academic tertiary center.

Methods

A retrospective series of patients undergoing TORS for oropharyngeal squamous cell carcinoma (OPSCC) was identified between October 2016 and November 2019 at a single tertiary academic center. Patient data were gathered, such as frailty information, tumor characteristics, and treatment, including need for adjuvant therapy. Multiple logistic regression was performed to identify factors associated with feeding tube placement following TORS.

Results

A total of 138 patients were included in the study. The mean age was 60.2 years (range, 37‐88 years) and 81.9% were male. Overall 82.9% of patients had human papilloma virus–associated tumors, while 28.3% were current or former smokers with a smoking history ≥10 pack‐years. Eleven patients (8.0%) had a nasogastric or gastrostomy tube placed at some point during their treatment. Five patients (3.6%) had feeding tubes placed perioperatively (<4 weeks after TORS), of which 3 were nasogastric tubes. Six patients (4.3%) had feeding tubes placed in the periadjuvant treatment setting for multifactorial reasons; 5 of which were gastrostomy tubes. Only 1 patient (0.7%) was gastrostomy dependent 1 year after surgery. Multiple logistic regression did not demonstrate any significant predictive variables affecting perioperative feeding tube placement following TORS for OPSCC.

Conclusions

Feeding tubes are seldom required after TORS for early‐stage OPSCC. With appropriate multidisciplinary planning and care, patients may reliably avoid the need for feeding tube placement following TORS for OPSCC.
2021 Update on airway management from the Anaesthesia Continuing Education Airway Management Special Interest Group
Authors: Van Zundert André AJ , Endlich Yasmin , Beckmann Linda A , Bradley William PL , Chapman Gordon A , Heard Andrew MB , Heffernan Drew , Jephcott Christopher GA , Khong Geraldine LS , Rehak Adam , Semenov Richard A , Stefanutto Tiscia B , O’Sullivan Ellen ,   the Australian and New Zealand Airway Management Special Interest Group
Published: June 2021

Airway Management is the key for anaesthetists dealing with patients undergoing diagnostic procedures and surgical interventions. The present coronavirus pandemic underpins even more how important safe airway management is. It also highlights the need to apply stringent precautions to avoid infection and ongoing transmission to patients, anaesthetists and other healthcare workers (HCWs). In light of this extraordinary global situation the aim of this article is to update the reader on the varied aspects of the ever-changing tasks anaesthetists are involved in and highlight the equipment, devices and techniques that have evolved in response to changing technology and unique patient and surgical requirements.
Māori health outcomes in an intensive care unit in Aotearoa New Zealand
Authors: Slim M Atif Mohd , Lala Hamish M , Barnes Nicholas , Martynoga Robert A
Published: June 2021

Māori are the indigenous people of New Zealand, and suffer disparate health outcomes compared to non-Māori. Waikato District Health Board provides level III intensive care unit services to New Zealand’s Midland region. In 2016, our institution formalised a corporate strategy to eliminate health inequities for Māori. Our study aimed to describe Māori health outcomes in our intensive care unit and identify inequities. We performed a retrospective audit of prospectively entered data in the Australian and New Zealand Intensive Care Society database for all general intensive care unit admissions over 15 years of age to Waikato Hospital from 2014 to 2018 ( n = 3009). Primary outcomes were in–intensive care unit and in-hospital mortality. The secondary outcome was one-year mortality. In our study, Māori were over-represented relative to the general population. Compared to non-Māori, Māori patients were younger (51 versus 61 years, P < 0.001), and were more likely to reside outside of the Waikato region (37.2% versus 28.0%, P < 0.001) and in areas of higher deprivation ( P < 0.001). Māori had higher admission rates for trauma and sepsis ( P < 0.001 overall) and required more renal replacement therapy ( P < 0.001). There was no difference in crude and adjusted mortality in–intensive care unit (16.8% versus 16.5%, P = 0.853; adjusted odds ratio 0.98 (95% confidence interval 0.68 to 1.40)) or in-hospital (23.7% versus 25.7%, P = 0.269; adjusted odds ratio 0.84 (95% confidence interval 0.60 to 1.18)). One-year mortality was similar (26.1% versus 27.1%, P=0.6823). Our study found significant ethnic inequity in the intensive care unit for Māori, who require more renal replacement therapy and are over-represented in admissions, especially for trauma and sepsis. These findings suggest upstream factors increasing Māori risk for critical illness. There was no difference in mortality outcomes.
Serious Mental Illness and Hospice Care
Authors: Levitt Gwen
Published: June 2021

There are a small number of articles in the literature discussing palliative and end-of-life care in the SMI population. Most tackle the questions relating to competency to refuse care in end-stage anorexia or terminal medical conditions. This is a case review of a 55 year old patient with a complex psychiatric and medical history, who despite extensive treatment and long hospitalizations has failed to regain any ability to care for her basic needs. She has exhausted all available treatment options and her prognosis is extremely poor. The mental health community is resistant to discussing and/ or confronting the fact that such a patient faces with the need for end-of-life care directly related to chronic psychiatric illness.
Cultural Values, Intergenerational Transmission of Internalized Racism, Education, and Career Goals in Chinese American Families
Authors: Hill Daphne J. , Li Danni , Wang Jun , Liew Jeffrey
Published: June 2021

The present study is the first of its kind using a dyadic and prospective research design to test whether traditional Asian cultural values and internalized racism among Chinese American adolescents and their first-generation immigrant parents are influential factors in the educational and vocational goals of the adolescents by the time they become young adults. While results show that traditional Asian cultural values and internalized racism were not related to adolescents’ educational aspiration or young adults’ major choice, results do show an intergenerational correlation in internalized racism. Furthermore, results show that youth who planned to pursue science/health professions had significantly higher levels of internalized racism than those who planned to pursue business/law professions. Findings suggest that internalized racism may restrict parents’ expectations and goals for their children and, in tandem, serve as a barrier for youths’ self-determination or sense of autonomy in their selection of college majors and career development.
A comparison of COVID-19 inpatients by HIV status
Authors: Flannery Sarah , Schwartz Rebecca , Rasul Rehana , Hirschwerk David A , Wallach Frances , Hirsch Bruce , McGowan Joseph
Published: June 2021

COVID-19 in-hospital morbidity and mortality in people living with HIV (PLWH) were compared to HIV-negative COVID-19 patients within a New York City metropolitan health system, the hardest hit region in the United States early in the pandemic. A total of 10,202 inpatients were diagnosed with COVID-19, of which 99 were PLWH. PLWH were younger (58.3 years (SD = 12.42) versus 64.32 years (SD = 16.77), p < 0.001) and had a higher prevalence of men (73.7% versus 57.9%, p = 0.002) and Blacks (43.4% versus 21.7%, p < 0.001) than the HIV-negative population. PLWH had a higher prevalence of malignancies (18% versus 7%, p = < 0.001), chronic liver disease (12% versus 3%, p < 0.001), and end-stage renal disease (11% versus 4%, p = 0.007). Use of a ventilator, admission to the ICU, and in-hospital mortality were not different. Of the 99 PLWH, 12 were virally unsuppressed and 9 had CD4% < 14. Two of the 12 virally unsuppressed patients and 4/9 patients with CD4% < 14 died. Ninety-one of the 99 PLWH were on treatment for HIV, and 5 of the 8 not on treatment died. Among PLWH with prior values, absolute CD4 count decreased an average of 192 cells/mm3 at the time of COVID-19 diagnosis ( p < 0.001). Hospitalized patients with HIV and COVID-19 coinfection did not have worse outcomes than the general population. Among PLWH, those with CD4%<14 or not on treatment for HIV had higher mortality rates. Those PLWH who received IL-6 inhibitors had lower mortality rates. PLWH given antifungal medications, hydroxychloroquine, antibiotics (including azithromycin), steroids, and vasopressors had higher mortality rates.
Hijab Pornography: A Content Analysis of Internet Pornographic Videos
Authors: Mirzaei Yaser , Zare Somayyeh , Morrison Todd G.
Published: June 2021

A content analysis was conducted to explore sexual indicators of aggression, objectification, exploitation, and agency in 50 “hijab” pornographic videos. Our findings suggest that women were the target of aggressive acts in all videos, with gagging (42%) and spanking (38%) being the most common. Also, in comparison with men, women were more likely to be objectified and exploited, and less likely to possess agency. Limitations of the current study and directions for future research are detailed.
Risk Factors for Disability Pension among Young Adults Diagnosed with Attention-deficit Hyperactivity Disorder (ADHD) in Adulthood
Authors: Chen Lingjing , Mittendorfer-Rutz Ellenor , Björkenstam Emma , Rahman Syed , Gustafsson Klas , Taipale Heidi , Tanskanen Antti , Ekselius Lisa , Helgesson Magnus
Published: June 2021

Objective:

To investigate risk factors of disability pension (DP) in young adults diagnosed with ADHD in Sweden.

Method:

In total, 9718 individuals diagnosed with incident ADHD in young adult age (19–29 years) 2006 to 2011, were identified through national registers. They were followed for 5 years and Cox regression models were applied to analyze the DP risk (overall and by sex), associated with socio-demographics, work-related factors, and comorbid disorders.

Results:

Twenty-one percent of all received DP. Being younger at diagnosis (hazard ratio [HR] = 1.54; 95%confidence interval [CI] 1.39–1.71); low educational level (HR = 1.97; 95%CI 1.60–2.43 for <10 years); work-related factors at baseline (no income from work [HR = 2.64; 95%CI 2.35–2.98] and sickness absence >90 days [HR = 2.48; 95%CI2.17–2.83]); and schizophrenia/psychoses (HR = 2.16; 95%CI 1.66–2.80), autism (HR = 1.87; 95%CI 1.42–2.46), anxiety (HR = 1.34; 95%CI 1.22–1.49) were significantly associated with an increased risk of DP. Similar risk patterns were found in men and women.

Conclusion:

Work-related factors and comorbid mental disorders need to be highlighted in early vocational rehabilitation for individuals with ADHD.