bluuebunny/crossref_metadata_2025 huggingface dataset:
Differential white blood cell counts in rabbits: a comparison of the Advia 2120 and a manual method
Authors: Oikonomidis Ioannis L. , Milne Elspeth , Piccinelli Chiara
Published: April 2021

We evaluated the performance of the Advia 2120 (Siemens) differential leukocyte count (A-Diff) compared to the manual method (M-Diff) in rabbits. EDTA-anticoagulated blood samples collected for diagnostic purposes were analyzed within 6 h of collection. The M-Diff was performed blindly by 2 observers on blood smears by counting 200 cells. We initially included 117 samples; 25 samples were excluded because of suboptimal gating of leukocytes in the Advia peroxidase cytogram or poor blood smear quality. The correlation between the A-Diff and M-Diff was very high for heterophils (r = 0.924, p < 0.001) and lymphocytes (r = 0.903, p < 0.001), high for basophils (r = 0.823, p < 0.001), moderate for monocytes (r = 0.645, p < 0.001), and low for eosinophils (r = 0.336, p = 0.001). The Passing–Bablok regression analyses revealed a small-to-moderate constant error for lymphocytes and a slight constant error for basophils. Small proportional errors were detected for heterophils, lymphocytes, and eosinophils. The Bland–Altman analyses revealed that the Advia significantly underestimates heterophils and overestimates lymphocytes compared to M-Diff. The biases for the other leukocytes were minimal and likely clinical insignificant; however, our results, particularly for eosinophils, should be interpreted cautiously given the observed low percentages in our samples. Given the observed biases in heterophil and lymphocyte percentages in the Advia 2120 CBC results in rabbits, method-specific reference intervals should be used. The Advia can recognize leporine basophils. Evaluation of blood smears is still recommended to investigate abnormal results and erroneous cytograms reported by the Advia.
Harvesting Health Knowledge: Breast Cancer Perceptions in the South Florida Latinx Farmworker Community
Authors: Casanova Felicia , Knaul Felicia M. , Rodriguez Natalia M.
Published: April 2021

South Florida agricultural regions, home to Latinx immigrant farmworkers, report higher rates of late-stage breast cancer diagnosis than national, state, and county-level averages. We conducted a community-based qualitative study on the needs, health knowledge gaps, barriers to breast cancer screening, and the role of community health workers (CHWs) in supporting the community’s access to early detection services. We conducted three CHW focus groups (FGs) ( n = 25) and in-depth interviews ( n = 15), two FGs ( n = 18) and in-depth interviews ( n = 3) with farmworker community members, and informal interviews with cancer clinicians ( n = 7). Using a grounded theory approach, five core themes regarding the community’s barriers to accessing health care services emerged: (a) lack of information; (b) social and economic barriers; (c) cultural factors; (d) fears and mistrust; and (e) psychosocial concerns. Findings yield implications for community health practice, the potential impact of CHWs, and the production of breast cancer education to improve health equity along with the care continuum.
“We Are Doing These Things So That People Will Not Laugh at Us”: Caregivers’ Attitudes About Dementia and Caregiving in Nigeria
Authors: Nwakasi Candidus C. , de Medeiros Kate , Bosun-Arije Foluke S.
Published: April 2021

Some Nigerians, in their effort to make sense of dementia symptoms, use descriptions that may stigmatize people with dementia and their families. This qualitative descriptive study focused on the everyday understanding of dementia and the impact of stigma on the caregiving experiences of informal female Nigerian dementia caregivers. Semi-structured interviews were conducted with a purposive sample of 12 adult informal female caregivers in Nigeria and analyzed for themes. Afterward, results were presented to focus groups of 21 adult Nigerians residing in the United States for more contextual insight on the findings. The three major themes were misconceptions about dementia symptoms, caregiving protects against stigmatization, and stigma affects caregiving support. Overall, we argue that knowledge deficit, poor awareness, and traditional spiritual beliefs combine to drive dementia-related stigmatization in Nigeria. Strategies such as culturally appropriate dementia awareness campaigns and formal long-term care policies are urgently needed to help strengthen informal dementia caregiving in Nigeria.
Experimental and numerical assessment of CHS-RHS T-joints with chords subjected to axial tensile forces
Authors: Neto João Batista da Silva , Nunes Gabriel Vieira , Sarmanho Arlene Maria Cunha , Pereira Daniel José Rocha , Guerra Messias Júnio Lopes , Alves Vinícius Nicchio
Published: April 2021

Hollow steel sections are widely used in the construction industry due to their mechanical properties. Joints used in these structures are the subject of research because of their singular and critical behavior. Joints containing chords with more slender cross-sections and axially loaded are still a challenge for design, especially in joints with circular hollow sections (CHS) in the braces and rectangular hollow sections (RHS) in the chords. In this context, this work aimed to study joints formed by a combination of CHS braces subjected to compression loads and RHS chords axially loaded with tension, welded as T-joints. Experimental tests, a numerical model using finite elements, and a parametric analysis were developed. A new equation for the chord stress function was proposed, including joints containing chords with semi-compact sections in tension. The joint resistance values obtained through the numerical models were compared with the equations from ISO 14346:2013 and with the proposed equation. It was observed that, for the numerical models with geometric properties inside the normative validity ranges of ISO 14346:2013, the mean rate of analytical by numerical joint resistance results was equal to 68%, using either the normative or the proposed equation. In the same way, for models outside the current validity ranges, either the proposed equation or the modified equation from ISO 14346:2013 could be used to design CHS-RHS T-joints with the geometric and material properties analyzed.
Deep learning based analysis of sentiment dynamics in online cancer community forums: An experience
Authors: Balakrishnan Athira , Idicula Sumam Mary , Jones Josette
Published: April 2021

Online health communities (OHC) provide various opportunities for patients with chronic or life-threatening illnesses, especially for cancer patients and survivors. A better understanding of the sentiment dynamics of patients in OHCs can help in the precise formulation of the needs during their treatment. The current study investigated the sentiment dynamics in patients’ narratives in a Breast Cancer community group ( Breastcancer.org ) to identify the changes in emotions, thoughts, stress, and coping mechanisms while undergoing treatment options, particularly chemotherapy, radiation, and surgery. Sentiment dynamics of users’ posts was performed using a deep learning model. A sentiment change analysis was performed to measure change in the satisfaction level of the users. The deep learning model BiLSTM with sentiment embedding features provided a better F1-score of 91.9%. Sentiment dynamics can assess the difference in satisfaction level the users acquire by interacting with other users in the forum. A comparison of the proposed model with existing models revealed the effectiveness of this methodology.
Confronted with COVID-19: Migrant live-in care during the pandemic
Authors: Leiblfinger Michael , Prieler Veronika , Rogoz Mădălina , Sekulová Martina
Published: April 2021

In the spring 2020, measures introduced across Europe to limit the spread of COVID-19 included, among others, the temporary closure of borders. For Romanian and Slovakian live-in carers, this meant they were no longer able to commute between the Austrian households they work in and their respective countries of origin. Due to the relatively short cyclical rotas of 2–4 weeks, travel restrictions heavily affected cross-border live-in care between the three countries, which makes them a particular case for studying the effects of pandemic-related measures on transnational care arrangements. Drawing on media reports, relevant laws and policies, and interviews with representatives of care workers’ interests, the article examines how live-in care as a whole and care workers in particular were affected by the pandemic and related policy responses such as specific travel arrangements and financial incentives for workers. It shows that while live-in carers were deemed critical workers and essential for the long-term care system, the inequalities and dependencies already existing in transnational care arrangements were deepened. Care workers’ wants, needs and interests were subordinated to the interests of care recipients, agencies and sending and receiving countries.
Negativity and Political Behavior: A Theoretical Framework for the Analysis of Negative Voting in Contemporary Democracies
Authors: Garzia Diego , Ferreira da Silva Frederico
Published: April 2021

Recent developments in Western societies have motivated a growing consideration of the role of negativity in public opinion and political behavior research. In this article, we review the scant (and largely disconnected) scientific literature on negativity and political behavior, merging contributions from social psychology, public opinion, and electoral research, with a view on developing an integrated theoretical framework for the study of negative voting in contemporary democracies. We highlight that the tendency toward negative voting is driven by three partly overlapping components, namely, (1) an instrumental–rational component characterized by retrospective performance evaluations and rationalization mechanisms, (2) an ideological component grounded on long-lasting political identities, and (3) an affective component, motivated by (negative) attitudes toward parties and candidates. By blueprinting the systematic relationships between negative voting and each of these components in turn, and suggesting multiple research paths, this article aims to stimulate future studies on negative voting in multi-party parliamentary systems to motivate a better understanding of the implications of negativity in voting behavior in contemporary democracies.
Paclitaxel-Coated Balloons for the Treatment of Symptomatic Central Venous Stenosis in Vascular Access: Results From a European, Multicenter, Single-Arm Retrospective Analysis
Authors: Kitrou Panagiotis M. , Steinke Tobias , El Hage Rami , Ponce Pedro , Lucatelli Pierleone , Katsanos Konstantinos , Spiliopoulos Stavros , Spinelli Alessio , Bisdas Theodosios , Stavroulakis Konstantinos , Jaffer Ounali , Mallios Alexandros , Zilahi de Gyurgyokai Simone , Cancellieri Roberto , Coscas Raphael , Karnabatidis Dimitrios
Published: April 2021

Introduction:

This was a European, multicenter, investigator-initiated and run, single-arm retrospective analysis to assess the safety and the clinical benefit of the use of paclitaxel-coated balloon (PCB) for the treatment of symptomatic central venous stenosis (CVS).

Materials and Methods:

Eleven centers from 7 countries across Europe, submitted 86 cases performed during the period between October 2015 and June 2018. Minimum follow-up was 6 months. Patient baseline demographics and procedural details were collected. Mean age was 62.6 years (SD 15.2 years). Median vascular access age was 3.0 years (IQR 1.2–4.8 years). A total of 55 were arteriovenous fistulas (64%) the rest arteriovenous grafts (31/86, 36%). Vessels treated were 43 subclavian veins, 42 brachiocephalic veins and 1 superior vena cava. Median drug-coated balloon diameter was 10 mm (IQR 8–12 mm). Primary outcome measures were clinically assessed intervention-free period (IFP) of the treated segment at 6 months and procedure-related minor and major complications. Secondary outcome measures included access circuit survival, patient survival, and the investigation of independent factors that influence the IFP.

Results:

IFP was 62.7% at 6 months. Median patient follow-up time was 1.0 year (IQR 0.5–2.2 years). There was 1 minor complication (1/86; 1.2%) and no major complications. Access circuit survival was 87.7% at 6 months. Patient survival was 79.7% at 2 years according to Kaplan-Meier survival analysis. Higher balloon diameters significantly favored IFP [HR 0.71 (0.55–0.92), p=0.006; 5–7 mm group vs 8–12 mm group, p=0.025].

Conclusion:

In this analysis, use of PCBs for the treatment of symptomatic CVS was safe. Efficacy was comparable to previous trials. Increased balloon size had a significant effect on patency rates.
Characterization of industrial discarded novel Cymbopogon flexuosus stem fiber: A potential replacement for synthetic fiber
Authors: Raja S , Rajesh R , Indran S , Divya D , Suganya Priyadharshini G
Published: April 2021

In this research article, a leftover of Cymbopogon flexuosus stem (CFS) collected from the oil extraction industry was examined for its ability as a reinforcing agent in a polymer composite. Anatomical, morphological, physical, chemical, mechanical, and thermal characteristics of the CFS ﬁber were examined. Chemical analysis revealed the presence of higher amount of cellulose (68.13%), which offers better bonding properties and higher tensile strength (431.19 ± 23.96 MPa). Moreover, the density of the fiber (1270 kg/m3) found using physical analysis was less than that of synthetic fibers, which paves a path in replacing hazardous synthetic fiber. Solid-state nuclear magnetic resonance and Fourier transform infrared spectrum spectroscopy analyses were conducted to study the functional groups of the extracted CFS fiber. The thermal stability (253.17°C), activation energy (73.01 kJ/mol), and maximum degradation temperature (345.08°C) were investigated by thermogravimetric analysis. X-ray diffraction analysis confirmed the semi-crystalline nature of the fiber with crystallinity index (46.02%) and crystallite size (13.96 nm). The CFS had a smooth surface, as conformed by an atomic force microscopy and scanning electron microscope analysis. Altogether, this study highlights the feasibility of leftover CFS fiber residue as reinforcement in biopolymer matrices replacing synthetic fiber.
Preoperative Physical Activity Predicts Surgical Outcomes Following Lung Cancer Resection
Authors: Billé Andrea , Buxton James , Viviano Alessandro , Gammon David , Veres Lukacs , Routledge Tom , Harrison-Phipps Karen , Dixon Allison , Minetto Marco A.
Published: April 2021

Objectives:

To assess whether preoperative levels of physical activity predict the incidence of post-operative complications following anatomical lung resection.

Methods:

Levels of physical activity (daily steps) were measured for 15 consecutive days using pedometers in 90 consecutive patients (prior to admission). Outcomes measured were cardiac and respiratory complications, length of stay, and 30-day re-admission rate.

Results:

A total of 78 patients’ datasets were analysed (12 patients were excluded due to non-compliance). Based on steps performed they were divided into quartiles; 1 (low physical activity) to 4 (high physical activity). There were no significant differences in age, smoking history, COPD, BMI, percentage predicted FEV1 and KCO and cardiovascular risk factors between the groups. There were significantly fewer total complications in quartiles 3 and 4 (high physical activity) compared to quartiles 1 and 2 (low physical activity) (8 vs 22; P = .01). There was a trend ( P > .05) towards shorter hospital length of stay in quartiles 3 and 4 (median values of 4 and 5 days, respectively) compared to quartiles 1 and 2 (6 days for both groups).

Conclusions:

Preoperative physical activity can help to predict postoperative outcome and can be used to stratify risk of postoperative complications and to monitor impact of preoperative interventions, ultimately improving short term outcomes.
Clinical Outcomes and Complications of Primary Fingertip Reconstruction Using a Reverse Homodigital Island Flap: A Systematic Review
Authors: Xu Joshua , Cao Jacob Y. , Graham David J. , Lawson Richard D. , Sivakumar Brahman S.
Published: April 2021

Background

Reverse homodigital island flaps (RHIFs) are increasingly used to reconstruct traumatic fingertip injuries, but there is limited evidence on the efficacy of this technique. We performed a systematic review of the literature to establish the safety and functional outcomes of RHIF for traumatic fingertip injuries.

Methods

Electronic searches were performed using 3 databases (PubMed, Ovid Medline, Cochrane CENTRAL) from their date of inception to April 2020. Relevant studies were required to report on complications and functional outcomes for patients undergoing RHIF for primary fingertip reconstruction. Data were extracted from included studies and analyzed.

Results

Sixteen studies were included, which produced a total cohort of 459 patients with 495 fingertip injuries. The index and middle fingers were involved most frequently (34.6% and 34.1%, respectively), followed by the ring finger (22%), the little finger (6.7%), and the thumb (2.6%). The mean postoperative static and moving 2-point discrimination was 7.2 and 6.7 mm, respectively. The mean time to return to work was 8.4 weeks. The mean survivorship was 98.4%, with the pooled complication rate being 28%. The pooled complication rate of complete flap necrosis was 3.6%, of partial flap necrosis was 10.3%, of venous congestion was 14.6%, of pain or hypersensitivity was 11.5%, of wound infection was 7.2%, of flexion contractures was 6.3%, and of cold intolerance was 17.7%.

Conclusions

Reverse homodigital island flaps can be performed safely with excellent outcomes. To minimize complications, care is taken during dissection and insetting, with extensive rehabilitation adhered to postoperatively. Prospective studies assessing outcomes of RHIF compared with other reconstruction techniques would be beneficial.
WALANT Technique versus Sedation for Endoscopic Carpal Tunnel Release
Authors: Wellington Ian , Cusano Antonio , Ferreira Joel V. , Parrino Anthony
Published: April 2021

Background

This study sought to investigate complication rates/perioperative metrics after endoscopic carpal tunnel release (eCTR) via wide-awake, local anesthesia, no tourniquet (WALANT) versus sedation or local anesthesia with a tourniquet.

Methods

Patients aged 18 years or older who underwent an eCTR between April 28, 2018, and December 31, 2019, by 1 of 2 fellowship-trained surgeons at our single institution were retrospectively reviewed. Patients were divided into 3 groups: monitored anesthesia care with tourniquet (MT), local anesthesia with tourniquet (LT), and WALANT.

Results

Inclusion criteria were met by 156 cases; 53 (34%) were performed under MT, 25 (16%) under LT, and 78 (50%) under WALANT. The MT group (46.1 ± 9.7) was statistically younger compared with LT (56.3 ± 14.1, P = .007) and WALANT groups (53.5 ± 15.8, P = .008), F(2, 153) = 6.465, P = .002. Wide-awake, local anesthesia, no tourniquet had decreased procedural times (10 minutes, SD: 2) compared with MT (11 minutes, SD: 2) and LT (11 minutes, SD: 2), F(2, 153) = 5.732, P = .004). Trends favored WALANT over MT and LT for average operating room time (20 minutes, SD: 3 vs 32 minutes, SD: 6 vs 23 minutes, SD: 3, respectively, F(2, 153) = 101.1, P < .001), postanesthesia care unit time (12 minutes, SD: 7 vs 1:12 minutes, SD: 26 vs 20 minutes, SD: 22, respectively, F(2, 153) =171.1, P < .001), and door-to-door time (1:37 minutes, SD: 21 vs 2:51 minutes, SD: 40 vs 1:46 minutes, SD: 33, respectively, F(2, 153) = 109.3, P < .001). There were no differences in complication rates.

Conclusions

Our data suggest favorable trends for patients undergoing eCTR via WALANT versus MT versus LT.
Threaded Intramedullary Nails Are Biomechanically Superior to Crossed K-wires for Metacarpal Neck Fractures
Authors: Patel Midhat , Castañeda Paulo , Campbell David H. , Putnam Jill G. , McKee Michael D.
Published: April 2021

Background

Intramedullary nail (IMN) fixation of metacarpal fractures is an alternative to Kirschner wire (K-wire) fixation. The goal of this study was to compare the biomechanical properties of K-wire fixation with a threaded IMN (InNate; ExsoMed, Aliso Viejo, California).

Methods

The study design was based on previously described biomechanical models for evaluating metacarpal fractures. Sixteen fresh frozen small finger–matched and ring finger–matched pairs were randomized to either IMN or 0.045 in K-wire fixation after receiving a standardized neck osteotomy. Proper implant placement was confirmed with plain radiographs. Specimens then underwent loading in a 3-point bend configuration. Load to failure (LTF), stiffness, and fracture displacement were recorded. Mechanical failure was defined by a sharp change in the load-displacement curve.

Results

Age, sex, sidedness (left or right), and digit (ring or small finger) were evenly distributed between groups. The IMN had a significantly higher LTF than K-wires (546 N vs 154 N, P < .001). The K-wire fixation demonstrated plastic deformation between 75 and 150 N. Intramedullary nail stiffness was higher than that of K-wires (155.89 N/mm vs 59.28 N/mm, P < .001).

Conclusions

When surgical fixation is indicated for metacarpal neck and shaft fractures, the threaded IMN is biomechanically superior to crossed K-wires with the application of 3-point bend.
Capturing Stories of How Young Adults Experience Entry Into the Workforce: A Qualitative Research Protocol on Data Collection During the Ongoing Coronavirus Pandemic
Authors: Wall Erika , Jansson Anna Berg , Svensson Sven
Published: April 2021

Background:

In present research protocol, the project entitled “A sustainable working life for young adults—leadership, learning, and insecurity” is presented and discussed. The study which aims to describe and analyze the expectations of young adults in the retail workforce in terms of leadership, learning and development and how these aspects can be understood from a health promotion perspective. The project is limited to young adults (18–28 years) employed in a retail setting.

Methods:

The project is based on qualitative data collected through focus group interviews and individual interviews made during the ongoing coronavirus pandemic (COVID-19) in year 2020 what here will be reflected upon.

Discussion:

It is concluded data collection carried out during the ongoing spread of the coronavirus, may be significant to what interviewees highlighted in the interviews, but also to what was not discussed in the interviews. It may be the case that the increased focus on the coronavirus meant that other issues that are important to young adults as they establish themselves in the labor market were overshadowed.
Robot-assisted transthoracic first rib resection for venous thoracic outlet syndrome
Authors: Hoexum Frank , Jongkind Vincent , Coveliers Hans ME , Yeung Kak K , Wisselink Willem
Published: April 2021

Background

Venous thoracic outlet syndrome (vTOS) is caused by external compression of the subclavian vein at the costoclavicular junction. It can be subdivided in McCleery Syndrome and Paget-Schroetter Syndrome (PSS). To improve the venous outflow of the arm and to prevent recurrent thrombosis, first rib resection with venolysis of the subclavian vein can be performed. Open transaxillary, supraclavicular, infraclavicular or combined paraclavicular approaches are well known, but more recent robot-assisted techniques are introduced. We report our short- and long-term results of a minimal invasive transthoracic approach for resection of the anteromedial part of the first rib using the DaVinci surgical robot, performed through three trocars.

Methods

We analyzed all patients with vTOS who were scheduled to undergo robot-assisted transthoracic first rib resection in the period July 2012 to May 2016. Outcomes were: technical success, operation time, blood loss, hospital stay, 30-day complications and patency. Functional outcomes were assessed using the “Disability of the Arm, Shoulder and Hand” (DASH) questionnaire.

Results

Fifteen patients (8 male, 7 female; mean age 32.9 years, range 20–54 years) underwent robot-assisted transthoracic first rib resection. Conversion to transaxillary resection was necessary in three patients. Average operation time was 147.9 min (range 88–320 min) with a mean blood loss of 79.5 cc (range 10–550 cc). Mean hospital stay was 3.5 days (range 2–9). In three patients, complications were reported (Clavien-Dindo grade 2–3a). Patency was 91% at 15.5 months’ follow-up. DASH scores at one and three years showed excellent functional outcomes (7.1 (SD= 6.9, range 0–20.8) and 6.0 (SD= 6.4, range 0–25)) and are comparable to the scores of the normative general population.

Conclusion

Robot-assisted transthoracic first rib resection with only three trocars is a feasible minimal invasive approach for first rib resection in the management of vTOS. This technique enables the surgeon to perform venolysis under direct 3D vision with good patency and long-term functional outcome. Studies with larger cohort size are needed to compare the outcomes of this robot-assisted technique with other more established approaches.
CLT construction without weather protection requires extensive moisture control
Authors: Olsson Lars
Published: April 2021

This study examines how cross-laminated timber (CLT) constructions, including joints, connections and attachment points, are affected by precipitation during construction. The case studies are based on moisture content measurements and material sampling as well as microbiological analysis during the structure’s construction stage. The study does not include remediation control. The field measurements show microbiological growth in all buildings and almost all floor structures that were investigated. Of a total of 200 measuring points analysed, half had mould growth and around a third had moderate or extensive growth. The moisture content measurements for one of the locations with the largest percentage of elevated or high moisture content was at the top of the floor structure in the bottom gap between timbers in the CLT top layer. This is one example of several materials or construction components where there is limited possibility of dry out. Based on the outcome, it would appear difficult, or impossible, to avoid the appearance of microbial growth during construction with CLT without weather protection. Previous studies indicate that microbiological analysis of CLT is extremely rare in both laboratory and field studies, which implies that there are obvious shortcomings in the scientific work. The fact that mould growth is often invisible needs to be disseminated, especially in practical studies. However, there seems to be a good level of awareness in the literature that theoretical studies often conduct mould growth risk evaluations. There do not appear to be any moisture safety assembly methods or solutions for CLT construction that do not have weather protection or a declaration of the critical moisture conditions for CLT products.
Behavior skills training for teaching and generalizing self-instruction skills for students with intellectual disability
Authors: Ethington Amber T , Spriggs Amy D , Shepley Sally B , Bausch Margaret E
Published: April 2021

Research demonstrates that combining video modeling and visual activity schedules into video activity schedules has been effective in increasing independence for students with disabilities. However, the instructional procedures used to teach students to acquire the necessary skills to navigate those tools vary among existent research. In this study, a behavior skills training package was investigated within a multiple probe design across participants, to determine if four elementary aged participants with intellectual disability could acquire self-instruction skills to navigate a video activity schedule. Three participants acquired the self-instruction skills using behavior skills training. After learning how to navigate the video activity schedules, the same three participants generalized and maintained the self-instruction skills to perform additional novel behaviors. The results suggest that behavior skills training may be an effective instructional strategy for teaching self-instruction skills and a means to program for generalized behavior change for students with intellectual disability.
Update on the role of copanlisib in hematologic malignancies
Authors: Le Thuy , David Jerel , Bryan Locke J.
Published: April 2021

Clinical research in hematologic malignancies is continually advancing with emerging concepts in therapy and evolving results from clinical protocols. Targeting of the PI3K pathway remains a valuable treatment across both hematologic and solid malignancies. There are currently four United States Food and Drug Administration (FDA)-approved PI3K inhibitors, with several others in development. Copanlisib is a pan-PI3K inhibitor currently FDA-approved for the treatment of relapsed/refractory follicular lymphoma (FL) following two lines of therapy. Since FDA approval, there have been further investigations into the long-term safety profile of copanlisib, as well as treatment of FL and other lymphoma subtypes, both indolent and aggressive. Here, we review the most recent available data from clinical trials, describe the management of the most common side effects, and explore future concepts. The use of copanlisib as part of a combination therapy for various hematologic malignancies will also be discussed. Copanlisib is a unique drug compared with other PI3K inhibitors, with remarkable potential to improve our armamentarium in cancer treatment.
The granularity of sand: Analogies of production, consumption, and distribution
Authors: Arnez Monika
Published: April 2021

Due to high global demand, sand is known as a scarce and controversial resource. Jamieson’s article, ‘For Granular Geography’, starts from this premise, presenting force chains, friction, and phase transitions to illustrate production, consumption, and distribution processes of sand from upstream to downstream by means of analogies. This commentary is divided into two parts. The first section discusses how these three elements are used as analogies, with particular attention to Singapore. The second part reflects on the added value and limitations of such an approach, drawing on a specific case study of land reclamation.
Mental health experiences of mothers in Jos, Nigeria: An interpretative phenomenological analysis
Authors: Jidong Dung Ezekiel , Husain Nusrat , Francis Christopher , Murshed Maisha , Roche Ayesha , Ike Tarela J , Karick Haruna , Dagona Zubairu K , Pwajok Juliet Y , Nyam Pam P , Mwankon Shadrack B , Gumber Anil
Published: April 2021

Objectives:

There is an increasing mental health disease burden in mothers with infants and young children, especially in low- and middle-income countries such as Nigeria. Children of distressed mothers suffer early-life exposure from the effects of maternal distress which contributes to the risk of physical and mental health problems in their childhood and beyond. This study explored mental health lived experiences of mothers in Jos, Nigeria.

Methods:

Purposive and Snowball sampling techniques were adopted, and a total of 40 mothers participated with 8 to 11 participants in one of the four focus group discussions. Participants were between the ages of 18 and 43 years, self-identified as mothers with each having a child between the ages of 3 and 48 months. Each focus group lasted approximately 60 minutes and was audio-recorded. Interviews were transcribed verbatim and analysed using interpretative phenomenological analysis.

Results:

Three overarching themes emerged from the data set such as (1) experience of persisting psychological distress from the time of labour/birth; (2) cultural practices that influence feelings; and (3) anxiety due to limited knowledge about childcare, access to support and healthy food.

Conclusion:

Maternal mental health in Nigeria is under-researched and distressed mothers have limited knowledge about evidence-based early child development. The study recommends developing and testing culturally appropriate parenting interventions in Jos, Nigeria. This is likely to be beneficial for the mother and may also improve child health outcomes.
Improved image quality in abdominal computed tomography reconstructed with a novel Deep Learning Image Reconstruction technique – initial clinical experience
Authors: Njølstad Tormund , Schulz Anselm , Godt Johannes C , Brøgger Helga M , Johansen Cathrine K , Andersen Hilde K , Martinsen Anne Catrine T
Published: April 2021

Background

A novel Deep Learning Image Reconstruction (DLIR) technique for computed tomography has recently received clinical approval.

Purpose

To assess image quality in abdominal computed tomography reconstructed with DLIR, and compare with standardly applied iterative reconstruction.

Material and methods

Ten abdominal computed tomography scans were reconstructed with iterative reconstruction and DLIR of medium and high strength, with 0.625 mm and 2.5 mm slice thickness. Image quality was assessed using eight visual grading criteria in a side-by-side comparative setting. All series were presented twice to evaluate intraobserver agreement. Reader scores were compared using univariate logistic regression. Image noise and contrast-to-noise ratio were calculated for quantitative analyses.

Results

For 2.5 mm slice thickness, DLIR images were more frequently perceived as equal or better than iterative reconstruction across all visual grading criteria (for both DLIR of medium and high strength, p < 0.001). Correspondingly, DLIR images were more frequently perceived as better (as opposed to equal or in favor of iterative reconstruction) for visual reproduction of liver parenchyma, intrahepatic vascular structures as well as overall impression of image noise and texture (p < 0.001). This improved image quality was also observed for 0.625 mm slice images reconstructed with DLIR of high strength when directly comparing to traditional iterative reconstruction in 2.5 mm slices. Image noise was significantly lower and contrast-to-noise ratio measurements significantly higher for images reconstructed with DLIR compared to iterative reconstruction (p < 0.01).

Conclusions

Abdominal computed tomography images reconstructed using a DLIR technique shows improved image quality when compared to standardly applied iterative reconstruction across a variety of clinical image quality criteria.
The efficacy of meniscus posterior root tears repair: A systematic review and meta-analysis
Authors: Wang Lifu , Zhang Kun , Liu Xuening , Liu Zhongcheng , Yi Qiong , Jiang Jin , Xia Yayi
Published: April 2021

Purpose:

To report of efficacy repair treatment for meniscus posterior root tears repair.

Methods:

We systematically searched databases including PubMed, Embase, and Cochrane Library for relevant articles. Coleman Methodology Score was used for a quality assessment of the included studies. A meta-analysis was performed to analyze for efficacy of MMPRTs repair.

Results:

Twenty-two studies, 14 level III and 8 level IV, were included in this systematic review, with a total of 926 cases. Studies comparing repair with either meniscectomy or conservative treatment found greater improvement and slower progression of Kellgrene–Lawrence grade with meniscal repair. Decreased meniscus extrusion is beneficial to the prognosis of patients undergoing MMPRTs repair. As treatment efficacy, the Lysholm score increased 28.87 (P < 0.001), IKDC score increased 31.73. The overall pooled event rates of progression of K-L grade is 0.200. Difference of Lysholm score and IKDC score between repair and meniscectomy were 8.72 and 9.67.

Conclusions:

The clinical subjective score after MMPRT repair was significantly improved compared with the preoperative status. Considering the progression of joint K-L grade, it can prevent the progression of arthrosis to some extent, but not completely. Decreased meniscus extrusion is beneficial to the prognosis of patients undergoing MMPRTs repair. Based on these results, MMPRTs repair cloud result favorable outcomes.
Gender Pay Gap in India: A Reality and the Way Forward—An Empirical Approach Using Quantile Regression Technique
Authors: Sengupta Pooja , Puri Roma
Published: April 2021

There is a growing body of empirical work on gender studies that mostly focus on the gender-wise representation of individuals in different sectors. One such study is the wage gap attributed to gender. In this article, we have tried to focus on a detailed study of the gender wage gap in the Indian context. The study was carried out on the most recent Employment–Unemployment Survey carried out by NSS for the year 2012. The study was based on the personal characteristics as well as the characteristics of the job undertaken by the employees. Ordinary least square regression and linear quartile regression model were used for analysis. In our study we have come up with a few interesting determinants of wage inequality based mostly on the personal traits. For women, personal characteristic like age was highly significant determinant of wage whereas in case of men more industry specific determinants were significant.

JEL Classifications: C01, C10, J16, J31
Primary Neuroendocrine Tumor of the Scrotum: An Uncommon Site for a Rare Tumor
Authors: Akhtar Komal , Vyas Vrinda , Ashok Kumar Prashanth , Corines James , de la Roza Gustavo , Basnet Alina
Published: April 2021

Neuroendocrine tumors (NETs) are a heterogeneous group of tumors developing from neural crest cells, with numerous sites of origin, commonly the gastrointestinal and genitourinary tracts. NETs of the genitourinary tract are more common in women. Small cell carcinoma of the prostate or testicular carcinoid are the NETs in male. In this article, we present a rare case of NET of the scrotum. Our patient was a 47-year-old male with a history of complicated pilonidal cysts resulting in chronic scrotal wounds. Biopsy of a large nonhealing scrotal wound revealed a high-grade neuroendocrine carcinoma with features most suggestive of small cell carcinoma. Presenting with advanced disease at diagnosis, he was started on systemic therapy and unfortunately progressed through multiple lines of treatment, including CAPTEM (capecitabine and temozolomide). Unfortunately, due to multiple logistical reasons, the patient was unable to receive the then off-label immunotherapy based on DART (Dual Anti-CTLA-4 and Anti-PD-1 Blockade in Rare Tumors) trial. He, unfortunately, succumbed to his disease within months of diagnosis.
Fluoroscopically Guided Subacromial Spacer Implantation for Massive Rotator Cuff Tears: Two Years of Prospective Follow-up
Authors: Gervasi Enrico , Maman Eran , Dekel Assaf , Markovitz Elana , Cautero Enrico
Published: April 2021

Background:

Massive rotator cuff tears (MRCTs) are common and have been estimated to account for nearly 40% of all rotator cuff tears. An evolving strategy for management of MRCTs has been the implantation of a degradable subacromial spacer balloon that attempts to restore normal shoulder biomechanics.

Purpose:

To assess the safety and efficacy of fluoroscopically guided balloon spacer implantation under local anesthesia in a cohort of patients with 2 years of postoperative follow-up.

Study Design:

Case series; Level of evidence, 4.

Methods:

The safety and efficacy of using fluoroscopically guided subacromial spacer implantation was assessed in 46 patients. Follow-up visits were scheduled according to routine clinical practice. Shoulder function was evaluated using Constant and American Shoulder and Elbow Society (ASES) scores.

Results:

Overall, 87.5% (35/40) of patients saw clinically significant improvement in the total Constant and ASES scores from 6 weeks postoperatively, with improvement maintained up to 24 months postoperatively.

Conclusion:

The data suggest that fluoroscopically guided subacromial spacer implantation under local anesthesia is a low-risk, clinically effective option, especially for the elderly population and those patients who have multiple comorbidities or a contraindication to general anesthesia. Patients undergoing subacromial spacer implantation for the treatment of MRCTs had satisfactory outcomes at 2-year follow-up, with a low rate of complications.
Challenges in the definition of input motions for forensic ground-response analysis in the near-source region
Authors: Ntritsos Nikolaos , Cubrinovski Misko , Bradley Brendon A
Published: April 2021

This article scrutinizes the determination of input motions for forensic ground-response analysis in the near-source region, based on recorded surface ground motions at strong-motion station sites, from the same event. The first part of the article draws upon observed ground motions from the 22 February 2011 6.2 Mw Christchurch earthquake to discuss key challenges of the problem associated with the strong spatial variation of ground motion in the near-source region. Effects from the complexity of the rupture, propagation of seismic waves through complex geological structures, and site characteristics are explored. It is argued that, because of the strongly varying source-path “signature” on near-source ground motions, “reference” input motions for ground-response analysis must be specific to, and have similar signature characteristics (be “compatible”) with, the target site which is subject to the analysis. The second part of the article presents a four-step procedure for the derivation of site-specific input motions involving (1) determination of the reference layer where the input motion is to be applied in the analysis, (2) record selection considering the appropriateness of the recording station site for deconvolution and its compatibility with the target site, (3) deconvolution of the selected record to remove local site effects from the recorded ground motion, and (4) scaling of the deconvolved motion to account for differences in the source-to-site distance between the recording station and the target site. As part of the proposed procedure, a novel (amplitude-duration) scaling method is presented. Results from one-dimensional (1D) effective-stress analysis of two target Christchurch sites using input motions from the proposed procedure are used to critically evaluate the procedure and discuss essential requirements for its successful application.
Cognitive leisure activity and all-cause mortality in older adults: a 4-year community-based cohort
Authors: Liu Xin , Ruan Ye , Huang Limei , Guo Yanfei , Sun Shuangyuan , Chen Hao , Gao Junling , Shi Yan , Xiao Qianyi
Published: April 2021

Background

Cognitive leisure activity, such as reading, playing mahjong or cards and computer use, is common among older adults in China. Previous studies suggest a negative correlation between cognitive leisure activity and cognitive impairment. However, the relationship between cognitive leisure activity and all-cause mortality has rarely been reported.

Objectives

This study aims to explore the relationships between cognitive leisure activity and all-cause mortality in a community-based older people cohort in China.

Methods

The current study sample comprised 4003 community residents aged ≥60 y who were enrolled in June 2015, and were followed up every year from 2015 to 2018. Reading, playing mahjong or cards and computer use were measured by questionnaires and summed into a cognitive leisure activity index (CLAI) score. Time-Dependent Cox Regression Model and Kaplan-Meier survival analysis were used to examine the association of cognitive leisure activity with all-cause mortality.

Results

During the 4-year follow-up of 4003 participants, 208 (5.2%) deaths were registered. Of all participants, 66.8, 26.7, 6.1 and 0.35% reported CLAI scores of 0, 1, 2 and 3, respectively. A strong association was noted between the CLA score and all-cause mortality (adjusted hazard ratio [HR] = 0.72, 95% confidence intervals [CI]: 0.54–0.97, P = 0.028). Stratified analysis suggested that a higher CLAI score was significantly associated with a decreased risk of all-cause mortality mainly among those who were male, aged ≥80 y, cognitively impaired, and not diagnosed with cancer (P < 0.05).

Conclusion

Cognitive leisure activity was positively associated with reduced risk of death from all cause among the older people in major city of China, which helped promote a comprehensive understanding of health characteristics at advanced ages.
The predictive value of absolute lymphocyte counts on tumor progression and pseudoprogression in patients with glioblastoma
Authors: Xi Jing , Hassan Bilal , Katumba Ruth G. N. , Khaddour Karam , Govindan Akshay , Luo Jingqin , Huang Jiayi , Campian Jian L.
Published: April 2021

Background

Differentiating true glioblastoma multiforme (GBM) from pseudoprogression (PsP) remains a challenge with current standard magnetic resonance imaging (MRI). The objective of this study was to explore whether patients’ absolute lymphocyte count (ALC) levels can be utilized to predict true tumor progression and PsP.

Methods

Patients were considered eligible for the study if they had 1) GBM diagnosis, 2) a series of blood cell counts and clinical follow-ups, and 3) tumor progression documented by both MRI and pathology. Data analysis results include descriptive statistics, median (IQR) for continuous variables and count (%) for categorical variables, p values from Wilcoxon rank sum test or Fisher’s exact test for comparison, respectively, and Kaplan-Meier analysis for overall survival (OS). OS was defined as the time from patients’ second surgery to their time of death or last follow up if patients were still alive.

Results

78 patients were included in this study. The median age was 56 years. Median ALC dropped 34.5% from baseline 1400 cells/mm3 to 917 cells/mm3 after completion of radiation therapy (RT) and temozolomide (TMZ). All study patients had undergone surgical biopsy upon MRI-documented progression. 37 had true tumor progression (47.44%) and 41 had pseudoprogression (52.56%). ALC before RT/TMZ, post RT/TMZ and at the time of MRI-documented progression did not show significant difference between patients with true progression and PsP. Although not statistically significant, this study found that patients with true progression had worse OS compared to those with PsP (Hazard Ratio [HR] 1.44, 95% CI 0.86–2.43, P = 0.178). This study also found that patients with high ALC (dichotomized by median) post-radiation had longer OS.

Conclusion

Our results indicate that ALC level in GBM patients before or after treatment does not have predictive value for true disease progression or pseudoprogression. Patients with true progression had worse OS compared to those who had pseudoprogression. A larger sample size that includes CD4 cell counts may be needed to evaluate the PsP predictive value of peripheral blood biomarkers.