bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing clinical outcomes of image-guided percutaneous transperitoneal and transhepatic cholecystostomy for acute cholecystitis
Authors: Kallini Joseph R , Patel Deven C , Linaval Nikhil , Phillips Edward H , Van Allan Richard J
Published: September 2020

Background

Percutaneous cholecystostomy is performed by interventional radiologists for patients with calculous/acalculous cholecystitis who are poor candidates for cholecystectomy. Two anatomical approaches are widely utilized: transperitoneal and transhepatic.

Purpose

To compare the clinical outcomes of transperitoneal and transhepatic approaches to cholecystostomy catheter placement.

Material and Methods

From December 2007 to August 2015, 165 consecutive patients (97 men, 68 women) underwent either transperitoneal (n = 89) or transhepatic (n = 76) cholecystostomy at a single center. Indications were calculous cholecystitis (n = 21), acalculous cholecystitis (n = 35), hydrops (n = 1), gangrenous cholecystitis (n = 1), and other cholecystitis (n = 107). The most common high-risk co-morbidities were sepsis (n = 53) and cardiac (n = 11). Outcomes were compared using univariate and multivariable analysis.

Results

Post-procedure outcomes included tube dislodgement (transperitoneal [n = 6] and transhepatic [n = 3], P = 0.44), bile leak (transperitoneal [n = 5], transhepatic [n = 1], P = 0.14), gallbladder hemorrhage (transperitoneal [n = 2]; transhepatic [n = 3], P = 0.52), duodenal fistula (transperitoneal [n = 0], transhepatic [n = 1], P = 0.27), repeat cholecystostomy (transperitoneal [n = 1], transhepatic [n = 3], P = 0.27), and repeat cholecystitis requiring separate admission (transperitoneal [n = 6], transhepatic [n = 10], P = 0.15). All complications were Common Terminology Criteria for Adverse Events grade <3. Twenty transperitoneal patients underwent post-procedure cholecystectomy: 13 laparoscopic, three open, and four unclear/outside records. The mean time from cholecystostomy to operation was 38 days (range 3–211 days). Twenty-three transhepatic patients underwent cholecystectomy: 14 laparoscopic, eight open, and one unclear/outside records, with the mean time from cholecystostomy being 98 days (range 0–1053 days). One transhepatic and three transperitoneal patients died during admission.

Conclusion

There were no significant differences in short-term complications after transperitoneal and transhepatic approaches to percutaneous cholecystostomy catheter placement.
Measures of gluten-related reactivity in children with autism spectrum disorders in the absence of overt gastrointestinal symptoms: a pilot study from the United Arab Emirates
Authors: Abdel-Maksoud Mohamed , Aly El-Gabry Dina , Al Kayoumi Tahani , Alketbi Jamila , Mohamednour Duaa , Elhassan Elamin Mohamed , Subhash Reddy Marri , Al Yafei Zain Ali , Stip Emmanuel , Abdel Aziz Karim , Arnone Danilo
Published: September 2020

Objectives

The aetiology of autism spectrum disorder (ASD) is multifactorial, sometimes genetic, and may be associated with abnormal immunological responses to peptides from proteins such as gluten. These peptides may cross the blood-brain barrier and affect neurotransmission, resulting in behavioural symptoms consistent with ASD. The aim of this study was to screen for markers of gluten-related immune reactivity in the absence of overt gastrointestinal symptoms in patients with ASD in the United Arab Emirates, a country associated with a high prevalence of ASD but lacking this type of research.

Methods

Patients diagnosed with ASD (using Diagnostic and Statistical Manual of Mental Disorders-IV-based criteria and Autism Diagnostic Observational Schedules) were compared with controls, regarding anti-tissue transglutaminase (tTG) immunoglobulin (Ig) A and anti-deamidated gliadin peptide (DGP) IgA levels.

Results

Sixty-six patients with ASD and 101 controls were included. Patients with ASD showed statistically significant lower anti-DGP IgA levels, but no significant difference in anti-tTG IgA levels, versus healthy controls. Correlations between immunological data and clinical symptoms were synergistic, but not statistically significant.

Conclusion

ASD may be associated with reduced levels of anti-DGP IgA.
Use of medical sodium hyaluronate gel in surgical removal of a glass intraocular foreign body
Authors: Zhang Jun , Mao Hanyan , Zou Xi , Deng Guohua
Published: September 2020

A 38-year-old healthy man presented to our department of ophthalmology after sustaining an ocular injury in a glass explosion more than 10 days prior. A glass intraocular foreign body (IOFB) was found in the left eye. During surgical removal of the IOFB, medical sodium hyaluronate gel was used to detach the IOFB from the retina; this avoided damage to the retina and made it easier for the surgeons to grasp the glass fragment. Multiple surgical instruments have been developed to help remove IOFBs; however, many optic hospitals have limited surgical instruments, thus increasing the difficulty of the operation. The application of sodium hyaluronate gel, a widely used agent, may be a new technique in IOFB surgery.
Pulmonary and pleural metastasis mimicking COVID-19 infection in stage IV ovarian cancer: a case report
Authors: Carbone Fabiana , Palaia Innocenza , Santangelo Giusi , Manganaro Lucia , Perniola Giorgia , Di Donato Violante , Benedetti Panici Pierluigi
Published: September 2020

Background:

The differential diagnosis of lung and pleural metastases and coronavirus disease 2019 (COVID-19) can be challenging.

Case:

We report a case of a 41-year-old woman with FIGO (International Federation of Gynecology and Obstetrics) stage IV ovarian cancer with pleural and pulmonary spread. After primary cytoreduction was performed, she developed a high fever and worsening dyspnea with desaturation (92% in ambient air). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was suspected, but three swabs gave negative results. Computed tomographic scan showed radiologic imaging strongly suspect for COVID-19 and the patient was transferred to a COVID-19 ward. The final diagnosis was paraneoplastic fever.

Conclusion:

Lung and pleural metastases can mimic SARS-CoV-2 infection.
An Infelicitous Feast: Ritualized Consumption and Divine Rejection in Amos 6.1–7
Authors: DeGrado Jessie
Published: September 2020

Previous studies of the marzeaḥ in Amos 6.1-7 have tended to put forth one of two opposing views. Scholars who focus on the religious or ritual aspects of the banquet have claimed that the marzeaḥ was lewd, ‘pagan’, and ‘syncretistic’. Calling into question the assumptions of Israelite exceptionalism underlying this approach, a second group argues that the prophetic critique is economic rather than religious in nature. Both approaches are potentially reductive. This paper analyzes the marzeaḥ of Amos 6 in the context of ancient Middle Eastern banquets, with a focus on commensality as a means for human-divine communication. I conclude that the marzeaḥ functioned as an offertory event, in which participants focalized divine presence through ritualized consumption in honor of a patron deity. Banqueters could hope to accrue divine favor through their own feasting. Amos 6.1–7 condemns the affluent for believing that they can give Yahweh their cake and eat it too.
Strain-based fatigue life analysis of pipelines with external defects under cyclic internal pressure
Authors: Gholami Hojjat , Shahrooi Shahram , shishehsaz Mohammad
Published: September 2020

Gouge and dent are common mechanical defects in oil and gas pipelines. These defects with plastic strain cause stress concentration in the pipelines. Plastic strain is dependent on initial deformation and spring-back behavior of materials. Therefore, they reduce the fatigue life of pipelines. In this paper, the strain-base fatigue life analysis is investigated in pipelines with smooth dent or combination smooth dent and gouge defects under cyclic internal pressure. For this purpose, elastic-plastic multilinear isotropic hardening finite element simulation was used to investigate the effects of various factors, such as residual stress of dent, amplitude internal pressure, pipe geometry, gouge geometry, and smooth dent geometry on stress concentration factor (SCF). Finally, a new method is proposed for predicting the fatigue life of pipelines with uniform dent and uniform dent and gouge combination defects. The model is presented based on the Smith-Watson-Topper (SWT) criterion. A set of fatigue life test specimens with various pipe materials, size and geometry were prepared and tested. The specimens carried a smooth dent, as well as a combination of smooth dent and gouge defects, results of which were collected to validate those obtained based on the proposed model. The results of the predicted tests using the developed formula showed a good correlation to practical experiments.
Perpetrators at First, Victims at Last: Exploring the Consequences of Stigmatization on Ex-Convicts’ Mental Well-Being
Authors: Baffour Frank Darkwa , Francis Abraham P. , Chong Mark David , Harris Nonie , Baffour Portia Darkwa
Published: September 2020

The article investigates ex-convicts’ experiences of stigmatization and its effect on their well-being in selected prisons in Ghana. Qualitative data were collected from 20 male inmates who, after residing for a time in the community, were thereafter reincarcerated. Findings indicate that these men were subjected to stigmatization and degrading treatment in the community, which limited their chances of securing lawful employment, establishing romantic relationships, and even maintaining platonic and family ties. As a result, this negatively impacted upon their mental well-being, leading some to substance abuse and suicide ideation. The article thereafter discusses policy and future research implications that arise from these findings.
Social Isolation and Acceptance of the Learning Management System (LMS) in the time of COVID-19 Pandemic: An Expansion of the UTAUT Model
Authors: Raza Syed A. , Qazi Wasim , Khan Komal Akram , Salam Javeria
Published: September 2020

The COVID-19 Pandemic has led to social isolation; however, with the help of technology, education can continue through this tough time. Therefore, this research attempts to explore the Unified Theory of Acceptance and Use of Technology (UTAUT) through the expansion of the model. Also, make it relevant to investigate the influence of social isolation, and the moderating role of Corona fear on Behavioral Intention of the Learning Management System and its Use Behavior of Learning Management System among students. The data was analyzed using Partial Least Square (PLS) and Structural Equation Modelling (SEM). The findings show a positive link of Performance Expectancy (PE), Effort Expectancy (EE), Social Influence (SI), and Social Isolation on Behavioral Intention of LMS and, also between Behavioral Intention of LMS and its Use behavior. Moreover, the results of the moderation analysis show that Corona fears only moderates the link of Performance Expectancy and Social influence with Behavioral Intention of LMS. The findings imply the need for improving the LMS experience to increase its Behavioral Intention among students. Finally, the author's recommendation for future researchers is to examine the extended model in other countries and territories to analyze Coronavirus's influence on e-learning acceptance.
Freedom and addiction in four discursive registers: A comparative historical study of values in addiction science
Authors: Weinberg Darin
Published: September 2020

Mainstream addiction science is today widely marked by an antinomy between a neurologically determinist understanding of the human brain ‘hijacked’ by the biochemical allure of intoxicants and a liberal voluntarist conception of drug use as a free exercise of choice. Prominent defenders of both discourses strive, ultimately without complete success, to provide accounts that are both universal and value-neutral. This has resulted in a variety of conceptual problems and has undermined the utility of such research for those who seek to therapeutically care for people presumed to suffer from addictions. This article contrasts these two contemporary discourses to two others that played vital historical roles in initiating both scientific and popular concern for addiction. These are the Puritan and civic republican discourses that dominated scholarly discussions of addiction in the early modern era. In each case, the place of values in these discussions is highlighted. By comparing them to their early modern historical antecedents, this article seeks to reflexively explore and develop more intellectually sound and therapeutically relevant alternatives to the troubled attempts at universality and value-neutrality now fettering debates in mainstream addiction science.
A generic integrated approach of assembly tolerance analysis based on skin model shapes
Authors: Yi Yang , Liu Xiaojun , Liu Tingyu , Ni Zhonghua
Published: September 2020

Nowadays, assembly tolerance analysis has become a challenging problem to predict the accuracy of a final assembly and examine whether specified tolerances satisfy assembly functional requirements (AFRs) for ensuring product assembly performance. Skin model shapes can be addressed to represent part geometric tolerances with manufacturing defects, thereby providing high fidelity surfaces that can replace nominal or ideal surfaces and significantly improve the accuracy and reliability of assembly tolerance analysis. However, their application in easy-to-use assembly simulation is limited by the level of detail required for manufacturing defect simulation and the complicated calculation process for integrating these defects into the tolerance analysis. Therefore, to overcome these issues in predicting assembly deviations in the early design stage, we propose a generic integrated approach of assembly tolerance analysis based on skin model shapes. First, two methods are introduced for modelling and generating skin model shapes according to different mate types of assembly key features. Second, a calculation method of assembly deviation propagation is developed by the integration of skin model shapes and stream-of-variation theory with accuracy and efficiency guarantees. Besides, a slightly modified relative contact positioning method is presented, based on different surface and progressive contact method, to obtain deterministic contact points and contact positioning errors between key mating joint surfaces. And then, the deviation values of AFRs are calculated, considering the inevitable manufacturing and assembly process errors. Finally, a typical mechanical assembly on assembly tolerance analysis is used as a case study to demonstrate the effectiveness of the proposed approach.
Multi sensor based strategies for accurate prediction of friction stir welding of polycarbonate sheets
Authors: Sahu Santosh K , Mishra Debasish , Pal Kamal , Pal Surjya K
Published: September 2020

High performance thermoplastic is often used in automotive and aerospace sectors. Friction stir welding (FSW) has been a suitable method for joining these thermoplastic materials. However, the process characteristics vary dynamically, even at same parametric conditions due to process disturbances. While quite a few studies have been reported in experimental investigation, the usage of sensors for the process monitoring during welding has not been explored. Therefore, the present paper focuses on various sensor-based approaches on process monitoring. The study includes an in-depth experimental investigation for joining of polycarbonate sheets using full factorial design of experiments. Three different tool pin profiles like cylindrical, square and triangular have been selected, whereas tool rotational speed and traverse speed are considered as primary process variables. Various statistical time domain features of the force and torque signals starting from average, its deviation and root mean square as well as thermal cycle based weld peak temperature and its cooling rate were found to have a strong correlation with weld bead profile. The axial force and thermal cycles were found to be the major indicators of joint strength efficiency rather than torque as per regression models developed by using response surface methodology. Finally, an attempt has been made for improving the joint strength predictability by using various sensor-based approaches. This work can be used potentially to real time welding process monitoring in industrial sectors.
Partner notification and treatment for sexually transmitted infections among pregnant women in Cape Town, South Africa
Authors: Green Hunter , Taleghani Sophia , Nyemba Dorothy , Myer Landon , Davey Dvora Joseph
Published: September 2020

Curable sexually transmitted infections (STIs) including Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) are associated with adverse pregnancy outcomes. Partner notification is an important component of STI control as it has been shown to prevent re-infection and reduce infectious burden. Between October 2017 and February 2019, we conducted a cohort study of women attending antenatal care in Cape Town, South Africa. Self-collected vulvovaginal swabs were tested for CT, NG, and TV using Xpert® assays at first antenatal visit, during the third trimester, and postpartum. At the visit following a positive diagnosis, women were asked if they notified their partner and if their partner was treated. Among 242 participants, 97% reported being willing to notify partners if they tested positive and 78% thought their partner would be willing to treat the STI. Of the 73 women who were diagnosed with one or more STIs and reported having a sex partner, 93% reported notifying their partner and 63% reported their partner was treated. Younger maternal age was associated with partner notification and treatment (OR = 3.82; 95%CI = 1.34–10.90). Acceptability of partner notification was high in pregnant women, but partner treatment was low. Future interventions to improve partner notification and treatment are needed.
Optimally designed Lyapunov–Krasovskii terminal costs for robust stable–feasible model predictive control of uncertain time-delay nonlinear dynamical systems
Authors: Yaqubi S , Homaeinezhad MR
Published: September 2020

This article details a new Model Predictive Control algorithm ensuring robust stability and control feasibility for uncertain nonlinear multi-input multi-output dynamical systems considering uncertain time-delay effects. The proposed control algorithm is based on construction of a Lyapunov–Krasovskii functional as terminal cost. Incorporation of this terminal cost into the Model Predictive Control optimization problem and calculation of the associated admissible set result in robust feasibility and robust stability of closed-loop system in presence of uncertain time-delay effects and bounded disturbance signals. The Lyapunov–Krasovskii functional term is constructed with respect to predicted sliding functions over the prediction horizon and considers the effects of dynamical variations over the prediction horizon in generation of control inputs. As dynamical variations are investigated in a sample-to-sample basis, feasible sliding regions are updated at each sample as well. Finally, based on expression of sliding functions as a combination of dynamical variations and input-based terms, required control inputs are calculated in the admissible bound by the optimization algorithm. Construction of control scheme on this basis permits straightforward calculation of robust stability and feasibility conditions for a general class of uncertain nonlinear system in finite prediction horizon whereas in the previous works, often-restrictive conditions were considered for the investigated dynamical systems. Numerical illustrations indicate precision and efficiency of control algorithm and improved stability and convergence rate for multivariable nonlinear dynamical systems considering uncertain time-delay effects. Finally, hardware-in-the-loop implementation indicates applicability of the proposed scheme in real-time control applications particularly in case appropriate compromises between optimality and calculation speed are considered.
Wage differentials and segmentation: The impact of institutions and changing economic conditions
Authors: Arranz José M , Fernández-Macías Enrique , García-Serrano Carlos
Published: September 2020

This paper uses data from the European Survey on Income and Living Conditions to offer new empirical evidence on how wage differentials are influenced by the changing economic conditions, that is, before and after the 2008–2010 recession, and shaped by the different institutional frameworks of European Union countries. We examine whether wage changes are homogeneous across groups of workers, as they are classified by their contractual relationship and working time, and by the heterogeneity in institutions that regulate and affect the labour market. Results obtained by estimating ordinary least squares and quantile regressions confirm the existence of contract and working time wage gaps and allow to estimate their different magnitudes along the wage distribution, and their rise during the recession. The impact of labour market institutions on shaping them is diverse, with more intervention of the government in the setting of the minimum wage and stricter regulation for atypical contracts reducing the wage gaps and producing larger positive effects for low-wage employees.
Sildenafil ameliorates Alzheimer disease via the modulation of vascular endothelial growth factor and vascular cell adhesion molecule-1 in rats
Authors: Ibrahim MA , Haleem MASA , AbdelWahab SA , Abdel-Aziz AM
Published: September 2020

Alzheimer disease (AD) is a chronic neurodegenerative disease with multi-pathways pathogenesis. Sildenafil is a selective phosphodiesterase-5 inhibitor with a potential benefit in the treatment of AD. This study investigated the possible mechanisms underlying the effect of sildenafil in AD with emphasis on vascular endothelial growth factor (VEGF), and vascular cell adhesion molecule-1 (VCAM-1). Twenty-four adult male rats were classified into four groups; control group: received vehicles, sildenafil–control: received sildenafil (15 mg/kg/day, p.o.), AD group received Aluminum (25 mg/kg/day, p.o.), AD-treated group: received sildenafil (15 mg/kg/day, p.o.) for 6 weeks. AD was assessed by memory performance test and confirmed by histopathological examination and immunostaining of, neurogenesis marker nestin and α-synuclein. The levels of VEGF-A, VCAM-1, oxidative stress markers and TNF-α in brain tissue were evaluated. AD rats showed histopathological evidences of AD; along with increased latency time in the memory test. There was a decrease in VEGF-A, and an increase in VCAM-1, TNF-α, and oxidative stress markers. Immunohistochemical study showed a significant increase in α-synuclein and a significant decrease in nestin expressions in brain tissues. Sildenafil administration ameliorated the histopathological changes and decreased latency time. Such effect was associated with a decrease in VCAM-1, TNF-α and oxidative stress as well as an increase in VEGF-A. Sildenafil caused a significant increase in nestin and a decrease in α-synuclein immunostaining. These findings suggested a protective effect of sildenafil via modulation of VEGF-A, and VCAM-1.
Impact of a mobile-based (mHealth) tool to support community health nurses in early identification of depression and suicide risk in Pacific Island Countries
Authors: Chang Odille , Patel Vimla L , Iyengar Sriram , May William
Published: September 2020

Objective:

To convert screening tools for depression and suicide risk into algorithmic decision support on smartphones for use by community health nurses (CHNs), and to evaluate the efficiency, effectiveness, and usability of the mHealth tool in providing mental health (MH) care.

Method:

Two scenarios of depression and suicide risk were developed and presented to 48 nurses using paper-based and mobile-based guidelines under laboratory (nonclinical) conditions. Participants read through the case scenarios to provide summaries, diagnoses, and management recommendations. Audiotapes were transcribed and analyzed for accuracy in scoring guidelines, therapy decisions, and time for tasks completion. The validated System Usability Scale (SUS) was used to measure mobile app usability.

Results:

Using mHealth-based guidelines, nurses took significantly less time to complete their tasks, and generated no errors of addition, as compared to paper-based guidelines. Although coding errors were noted when using the mHealth app, it did not influence treatment recommendations. The system usability scores for both guidelines were over 84%.

Conclusions:

Usable mHealth technology can support task-sharing for CHNs in Fiji, for the efficient and accurate screening of patients for depression and suicide risks in a nonclinical setting. Studies on clinical implementation of the mHealth tool are needed and planned.
Finding the Dignity While Dying—Is It Possible?
Authors: Wardle Lisa
Published: September 2020

In the span of five years, my father, brother and mother died. I was close in both emotional and physical proximity to all three. In this role, I witnessed their struggle for dignity at the end of life in whatever manner was left to them. This was made more difficult as they shuffled through the hospital-nursing home-rehabilitation center-home health continuum of care. The patient enters one of those entry points, then seems to ricochet between them. This is an account of how illness and pain erased the life force from my loved ones while I watched helplessly from the sidelines. The emotional toll of seeing their decline was hard to calculate but what of the cost to the one who is dying? And yet each sought to carve some space to imprint their unique spark on their final days even when they had lost the ability to communicate coherently.
The Method of Surgical Lip Repair Affects Speech Outcomes in Children With Bilateral Cleft Lip and Palate
Authors: Peryer Holly , Slator Rona , Thomson Jenny , Richard Bruce
Published: September 2020

Objective:

It was hypothesized that lip repair protocols in children with bilateral cleft lip and palate (BCLP) would affect development of bilabial consonants /m/ /b/ /p/. This study compared speech outcomes in 2 surgical groups.

Design:

A retrospective case note investigation.

Setting:

UK Cleft Centre (2000-2009).

Patients:

Forty-nine children with complete BCLP, of whom 26 had a 1-stage and 23 a 2-stage bilateral cleft lip repair.

Interventions:

One-stage cleft lip repair versus a 2-staged cleft lip repair.

Main Outcome Measures:

Bilabial consonant production at 18 months, 3 and 5 years of age. Cleft Speech Characteristics (CSCs) at age 5.

Results:

At age 18 months, 81% of the 1-stage lip repair group and 4% of the 2-stage lip repair group produced bilabial consonants ( P <·0001, Fisher test). At age 3 years, 81% of the 1-stage and 26% of the 2-stage lip repair groups produced bilabial consonants ( P =·0133, Fisher test). At age 5 years, both groups had similar bilabial consonant production, but children in the 2-stage lip repair group had more frequent and severe CSCs ( P = ·0037, χ2).

Conclusion:

A 1-stage lip repair for children with complete BCLP resulted in better bilabial consonant production at 18 months and 3 years of age than a 2-stage lip repair. At age 5 years both groups had bilabial consonants but children in the 2-stage lip repair group had worse CSCs. The surgical protocol for bilateral cleft lip repair affected speech outcome in children with BCLP.
Enhanced CDM model accounting of stress triaxiality and Lode angle for ductile damage prediction in metal forming
Authors: Zhang Kai , Badreddine Houssem , Hfaiedh Naila , Saanouni Khemais , Liu Jianlin
Published: September 2020

This paper deals with the prediction of ductile damage based on CDM approach fully coupled with advanced elastoplastic constitutive equations. This fully coupled damage model is developed based on the total energy equivalence assumption under the thermodynamics of irreversible processes framework with state variables. In this model, the damage evolution is enhanced by accounting for both stress triaxiality and Lode angle. The proposed constitutive equations are implemented into Finite Element (FE) code ABAQUS/Explicit through a user material subroutine (VUMAT). The material parameters are determined by the hybrid experimental-numerical method using various tensile and shear tests. Validation of the proposed model has been done using different tests of two aluminum alloys (Al6061-T6 and Al6014-T4). Through comparisons of numerical simulations with experimental results for different loading paths, the predictive capabilities of the proposed model have been shown. The model is found to be able to capture the initiation as well as propagation of macro-crack in sheet and bulk metals during their forming processes.
Evaluation of Acute Postoperative Pain Management During an Injectable Opioid Shortage
Authors: Tran Kenneth K. , VanDaele Madeline A. , Tran Sylvia , Stevens Shelley A. , Maltese Dietrich Nicole , Franck Andrew J.
Published: September 2020

Background:

Drug product shortages, including injectable opioids, are common and have the potential to adversely affect patient care.

Objective:

To evaluate the impact of an injectable opioid shortage for hospitalized adult patients in the acute postoperative setting.

Methods:

A single-center, retrospective cohort study of noncritically ill hospitalized, postoperative patients requiring opioids for acute pain management was conducted. Patient cohorts were compared preshortage and postshortage for proportion of total intravenous (IV) opioids used, proportions of specific pain medications used, subjective pain scores, 30-day mortality, respiratory depression, need for opioid reversal, hospital length of stay, and opioid equivalent doses.

Results:

A total of 275 patients were included, 130 patients in the preshortage cohort and 145 in the postshortage cohort. The proportion of total IV opioid doses was lower in the postshortage cohort versus the preshortage cohort (16.6% vs 20.5%; P < 0.01). Specific medications used were significantly different between the cohorts. The proportion of severe pain scores was lower in the postshortage cohort versus the preshortage cohort (55.6% vs 58.5%; P = 0.04). No significant differences were seen in the overall proportion of nonopioid analgesic use, 30-day mortality, respiratory depression, need for emergent opioid reversal, hospital length of stay, or opioid equivalent doses between cohorts.

Conclusion and Relevance:

In hospitalized, postoperative adults, an injectable opioid shortage was associated with significant decreases in IV opioid use and severe pain scores but no significant differences in nonopioid analgesic use, safety outcomes, or opioid equivalent doses. These results may assist clinicians in developing strategies for injectable opioid shortages and generating hypotheses for future studies.
Is Weak Acid Beneficial for Addressing Checkpoint Inhibitor–Triggered Cancer Hyper Progression in Anti-PD1/PD-L1 Immunotherapies?
Authors: Wan Yulin , An Shanshan , Zhou Yanchao , Zhang Jiaming , Zhang Ying , Gan Tao , Liu Qiuyun
Published: September 2020

Numerous cases of checkpoint inhibitor–triggered cancer hyperprogression have been documented. A previous hypothesis attributes cancer onset to the local buildup of hydrogen chloride, jointly mediated by hydrogen bond donors and acceptors and basic amino acids. The anti-PD1/PD-L1 immunotherapies may have caused a surge of protons or chloride ions for the effective treatment of neoplasm, thus giving rise to the local formation of hydrogen chloride and subsequently cancer hyperprogression in some susceptible individuals. It was postulated that the local strength of acidity is critical for tumor growth and metastasis, as the intake of weak organic acids reduces cancer risks. The anti-PD1/PD-L1 immunotherapies can be integrated with weak organic acids to reduce adverse reactions and generate better anticancer outcomes.
A Nomogram Based on Aspartate Aminotransferase/Alanine Aminotransferase (AST/ALT) Ratio to Predict Prognosis After Surgery in Gastric Cancer Patients
Authors: Li Linfang , Zeng Qiuyao , Xue Ning , Wu Miantao , Liang Yaqing , Xu Qingxia , Feng Lingmin , Xing Shan , Chen Shulin
Published: September 2020

Introduction:

Using the TMN classification alone to predict survival in patients with gastric cancer has certain limitations, we conducted this study was to develop an effective nomogram based on aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio to predict overall survival (OS) in surgically treated gastric cancer.

Methods:

we retrospectively analyzed 190 cases of gastric cancer and used Cox regression analysis to identify the significant prognostic factors for OS in patients with resectable gastric cancer. The predictive accuracy of nomogram was assessed using a calibration plot, concordance index (C-index) and decision curve. This was then compared with a traditional TNM staging system. Based on the total points (TPS) by nomogram, we further divided patients into different risk groups.

Results:

multivariate analysis of the entire cohort revealed that independent risk factors for survival were age, clinical stage and AST/ALT ratio, which were entered then into the nomogram. The calibration curve for the probability of OS showed that the nomogram-based predictions were in good agreement with actual observations. Additionally, the C-index of the established nomogram for predicting OS had a superior discrimination power compared to the TNM staging system [0.794 (95% CI: 0.749-0.839) vs 0.730 (95% CI: 0.688-0.772), p < 0.05]. Decision curve also demonstrated that the nomogram was better than the TNM staging system. Based on TPS of the nomogram, we further subdivided the study cohort into 3 groups including low risk (TPS ≤ 158), middle risk (158 < TPS ≤ 188) and high risk (TPS > 188) categories. The differences in OS rate were significant among the groups.

Conclusion:

the established nomogram is associated with a more accurate prognostic prediction for individual patients with resectable gastric cancer.
Commentary on the Special Issue: New Ways of Thinking Theoretically About Violence Against Women and Other Forms of Gender-Based Violence
Authors: Hunnicutt Gwen
Published: September 2020

I contextualize and provide commentary on this special issue that addresses new ways of thinking theoretically about violence against women and other forms of gender-based violence. After extracting key insights from each article, I explore how these contributions might inform our understanding of contemporary challenges related to violence against women. Next, I consider the #MeToo movement in light of the work presented in this volume. Finally, I consider what the #MeToo movement is signaling to scholars about new ways of thinking about violence against women and how this volume of work supports these key areas for focus and change.
Local sensitivity analysis of the “membrane shape equation” derived from the Helfrich energy
Authors: Rangamani P , Behzadan A , Holst M
Published: September 2020

The Helfrich energy is commonly used to model the elastic bending energy of lipid bilayers in membrane mechanics. The governing differential equations for certain geometric characteristics of the shape of the membrane can be obtained by applying variational methods (minimization principles) to the Helfrich energy functional and are well studied in the axisymmetric framework. However, the Helfrich energy functional and the resulting differential equations involve a number of parameters, and there is little explanation of the choice of parameters in the literature, particularly with respect to the choice of the “spontaneous curvature” term that appears in the functional. In this paper, we present a careful analytical and numerical study of certain aspects of parametric sensitivity of Helfrich’s model. Using simulations of specific model systems, we demonstrate the application of our scheme to the formation of spherical buds and pearled shapes in membrane vesicles.
Scrutinising the relationship between major physiological and compositional changes during ‘Merrill O’Henry’ peach growth with brown rot susceptibility
Authors: Baró-Montel Núria , Giné-Bordonaba Jordi , Torres Rosario , Vall-llaura Núria , Teixidó Neus , Usall Josep
Published: September 2020

In the present work, the major physiological and compositional changes occurring during ‘Merrill O’Henry’ peach growth and its relationship with susceptibility to three strains of Monilinia spp. at 49, 77, 126 and 160 days after full bloom were explored. Results of disease incidence indicated wide differences among phenological stages, being 49 and 126 days after full bloom the moment when peaches showed significantly lower susceptibility to brown rot (40 and 23% of rotten fruit, respectively, for strain ML8L). Variation in brown rot susceptibility among different growth stages was also strain-dependent. Lower fruit susceptibility to ML8L at 49 and 126 was accompanied by noticeable changes in the fruit ethylene and respiration patterns, and also in sugars and organic acids content. By employing a partial least squares regression model, a strong negative relationship between citric acid, and a positive association of ethylene with peach susceptibility to Monilinia spp. at diverse phenological stages were observed. The results obtained herein highlight that the content of certain compounds such as citrate, malate and sucrose; the respiratory activity and the fruit ethylene production may mediate in a coordinated manner the fruit resistance to Monilinia spp. at different phenological stages of peach fruit.
CT features of feline lipiduria and renal cortical lipid deposition
Authors: Schwarz Tobias , Shorten Eimear , Gennace Marisa , Saunders Jimmy , Longo Maurizio , Costa Fabiano Séllos , Parys Maciej , Gunn-Moore Danièlle
Published: September 2020

Objectives

The aims of this study were to document the presence and prevalence of feline lipiduria and renal lipid deposition on CT, and to search for associations between the presence of lipiduria and sex, urinary tract abnormalities and urolithiasis.

Methods

The CT examinations of 252 cats were reviewed for the presence of an antigravitational hypodense bubble in the urinary bladder with density values between −180 Hounsfield units (HU) and −20 HU. To identify associations between lipiduria and sex, urinary tract abnormalities and urolithiasis, Fisher’s exact test was used. Renal cortical density measurement was performed in all cats. The Mann−Whitney test was performed to compare renal cortical density between lipiduric and unaffected cats.

Results

A total of 27 domestic cats (10.7%) had CT evidence of lipiduria. Lipiduric cats had a significantly lower renal cortical density than unaffected cats ( P <0.01). Male neutered cats had a significantly higher frequency of lipiduria and lower renal cortical density compared with female neutered cats ( P <0.01). There was no significant difference between the groups regarding renal, ureteral or urethral abnormalities.

Conclusions and relevance

Lipiduria is a common physiological phenomenon in cats that can be detected on routine CT examinations. Decreased renal cortical density is associated with lipiduria. This may aid in the diagnosis of feline lipiduria and help to differentiate its presence from other pathological depositions and excretions.
Short-Term, Large-Area Survey of Container Aedes spp. (Diptera: Culicidae): Presence and Abundance is Associated with Fine-scale Landscape Factors in North Carolina, USA
Authors: Reiskind Michael H , Styers Diane M , Hayes Isaac , Richards Stephanie L , Doyle Michael S , Reed Emily MX , Hollingsworth Brandon , Byrd Brian D
Published: September 2020

Container Aedes mosquitoes are responsible for the transmission of anthroponotic and zoonotic viruses to people. The surveillance and control of these mosquitoes is an important part of public health protection and prevention of mosquito-borne disease. In this study, we surveyed 327 sites over 2 weeks in late June and early July in 2017 in North Carolina, USA for the presence and abundance of Aedes spp. eggs in an effort to better target potential Ae. aegypti collections. We examined the ability of 2 types of landscape data, Light Detection And Ranging (LIDAR) and National Land Cover Database (NLCD) to explain the presence and abundance of eggs using principal component analysis to deal with collinearity, followed by generalized linear regression. We explained variation of both egg presence and abundance for Aedes albopictus (Skuse) and Aedes triseriatus (Say) using both NLCD and LIDAR data. However, the ability to make robust predictions was limited by variation in the data. Increased sampling time and better landscape data would likely improve the predictive ability of our models, as would a better understanding of oviposition behavior.
The framing of the Chinese ambassador’s visit to Malaysia’s Chinatown: A gesture of goodwill or interference in domestic politics?
Authors: Lai Fong Yang
Published: September 2020

The implications of media representations of ethnicity, religion and related issues are significant because they have the potential to fuel nationalism, spreading fear and tensions instead of promoting tolerance and compassion. This study examined the aspects Malaysian newspapers have created for readers’ understanding of the then Chinese ambassador’s visit to Petaling Street (Malaysia’s Chinatown) on September 25, 2015. The then Chinese ambassador’s visit took place a day before the red shirts rally, which was reported as an ‘anti-Chinese demonstration’ by some overseas Chinese-language media. Through framing analysis, this study found that the mainstream and alternative newspapers in Malaysia reported the then Chinese ambassador’s visit with different intensity and prominence. They also employed different news sources and carried dissimilar valence in their coverage. Utusan, a Malay-language daily and a mouthpiece of the United Malay National Organization (UMNO), concentrated on criticisms of the then Chinese ambassador in its coverage. The Star, an English-language daily and also a messenger for the Malaysia Chinese Association (MCA), reported the consequences of the then Chinese ambassador’s visit. Significantly, the more independent and vocal newspapers in the country – Sin Chew (Chinese-language) and Malaysiakini (alternative) – focused on condemning the racist remarks of an UMNO politician.
Causal mediation analysis in instrumental-variables regressions
Authors: Dippel Christian , Ferrara Andreas , Heblich Stephan
Published: September 2020

In this article, we describe the use of ivmediate, a new command to estimate causal mediation effects in instrumental-variables settings using the framework developed by Dippel et al. (2020, unpublished manuscript). ivmediate allows estimation of a treatment effect and the share of this effect that can be attributed to a mediator variable. While both treatment and mediator can be potentially endogenous, a single instrument suffices to identify both the causal treatment and the mediation effects.
Smooth varying-coefficient models in Stata
Authors: Rios-Avila Fernando
Published: September 2020

Nonparametric regressions are powerful statistical tools that can be used to model relationships between dependent and independent variables with minimal assumptions on the underlying functional forms. Despite their potential benefits, these models have two weaknesses: The added flexibility creates a curse of dimensionality, and procedures available for model selection, like crossvalidation, have a high computational cost in samples with even moderate sizes. An alternative to fully nonparametric models is semiparametric models that combine the flexibility of nonparametric regressions with the structure of standard models. In this article, I describe the estimation of a particular type of semiparametric model known as the smooth varying-coefficient model (Hastie and Tibshirani, 1993, Journal of the Royal Statistical Society, Series B 55: 757–796), based on kernel regression methods, using a new set of commands within vc_pack. These commands aim to facilitate bandwidth selection and model estimation as well as create visualizations of the results.
Pairwise meta-analysis of aggregate data using metaan in Stata
Authors: Kontopantelis Evangelos , Reeves David
Published: September 2020

A few years ago, we developed metaan, a package to perform fixedor random-effects meta-analysis. In terms of random-effects meta-analysis, it offered a wide choice of models, including maximum likelihood, profile likelihood, or restricted maximum-likelihood, in addition to the established DerSimonian–Laird method available in metan or Cochrane’s RevMan software. Other unique features included a wide range of reported heterogeneity measures and a plot of the maximum likelihood function. Since then, metaan has been continuously updated to offer improved graphics, more options, and more meta-analysis models. In this necessary update, we describe these additions and discuss the new models and the evidence behind them.
Hypermodern Video Games as Emblems of Empire or How the Gaming Multitude Adapts to Hypermodernity
Authors: Bonenfant Maude
Published: September 2020

To demonstrate how Games of Empire (Dyer-Witheford, N., & de Peuter, G. (2009). Games of empire. Global capitalism and video games, Minneapolis: University of Minnesota) elaborated an important standpoint within critical game studies, this article discusses the thesis that a specific type of video games perfectly converges with our contemporary modes of representation and praxis, which are best situated within the paradigm of hypermodernity (Lipovetsky, G. (1983). L’ère du vide: Essais sur l’individualisme contemporain. Paris. Gallimard, coll. «Folio essais»; Lipovetsky, G. & Charles, S. (2004). Les temps hypermodernes. Paris: Bernard Grasset, «Nouveau collège de philosophie»). Hypermodernity radicalizes modernity because, within hypermodernity, values such as progress, reason, and happiness are overly ( hyper) actualized rather than surpassed ( post) (Aubert, N. (2006) (dir). L’individu hypermoderne. Toulouse: Eres, coll. «Sociologie clinique»; Giddens, A. (1990). The consequences of modernity. Stanford: Stanford University Press). Based on an archetypal account, that is, a theoretical model rather than a case study, this article will show how hypermodern video games' commercialization and use within a capitalist context are emblematic of hypermodernity. We will also evaluate how these games promote adaptation to hypermodernity toward an "ideal" becoming-player for Empire. In conclusion, if playing can be seen as the multitude's escape hatch out of the dominant order, this article will explain how hypermodern video games, as a media, may also be viewed as a key site where asymmetrical and unequal relationships replicate within Empire.