bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic and clinicopathological significance of PD-1 expression in hepatocellular carcinoma: a meta-analysis
Authors: Zhang Qian , Zhou Kexiang , Liang Wei , Xiong Wei
Published: October 2020

Objective

We performed a meta-analysis to evaluate the prognostic and clinicopathological significance of programmed cell death-1 (PD-1) expression in patients with hepatocellular carcinoma (HCC).

Methods

We searched the Wanfang, Chinese Biomedical Literature, CNKI, PubMed, Embase, and Web of Science databases for relevant articles from inception to 1 July 2020. Statistical analysis was performed using RevMan 5.3 (Cochrane, London, UK) and Stata 14.0 software (StataCorp LP, College Station, TX, USA).

Results

Eight studies involving 732 patients with HCC were included. Higher expression of PD-1 predicted longer disease-free survival [hazard ratio (HR) 0.53, 95% confidence interval (CI): 0.38–0.72]. No significant correlation was observed between PD-1 expression and overall survival (HR 0.89, 95% CI: 0.58–1.35). PD-1 expression was correlated with age [odds ratio (OR) 0.66, 95% CI: 0.46–0.94] and alpha-fetoprotein level (OR 2.27, 95% CI: 1.45–3.55); no correlation was observed with sex, tumor size, tumor metastasis, hepatitis B virus history, tumor stage, or tumor multiplicity. Sensitivity analysis demonstrated no excessive effect on stability of the pooled results. No significant publication bias was found among the identified studies.

Conclusion

PD-1 overexpression predicted better disease-free survival in patients with HCC. Moreover, PD-1 expression was associated with age and alpha-fetoprotein level.
Customized Orthodontic Triage During COVID-19 Pandemic
Authors: Aziz Sana Bint , Kapoor Priyanka
Published: October 2020

COVID-19 pandemic necessitates streamlining patient influx in orthodontic office to avoid cross infection between patients, clinicians, and dental health care workers. A customized orthodontic triage has been proposed in this article to schedule patient appointments through priority triaging and, at the same time, provide self-care advice, virtual assistance, and remote monitoring for patient management in elective circumstances.
Making sense of ‘maker’: Work, identity, and affect in the maker movement
Authors: Marotta Steve
Published: October 2020

This paper investigates the affective dimensions of entrepreneurial and creative work with the goal of making sense of the emergent collective identity of ‘maker.’ Relying on qualitative research in Detroit, MI, and Portland, OR, with small, entrepreneurial craft producers affiliated with the ‘maker movement,’ I forward two broad suppositions. First, as a work-related identity, ‘maker’ is emergent from a collective frustration with globalization and corporate/professional work. From the perspective of affective labor, the suggestion is that this negative association with globalized forms of work might be productive of a politically oppositional subjectivity. Second, as an identity term ‘maker’ is vague and oftentimes rejected by the people it ostensibly describes, and as such, the politics of ‘maker’ are not oriented toward collective political action. Why does ‘maker’ appear coherent as a response to globalization and corporate culture, but incoherent as a form of solidarity or collective identity? The paper utilizes affect theory to make sense of this contradiction, finding that the ambiguity and negation of ‘maker’ help shape a non-rigid form of belonging that allows makers to express various dissatisfactions (e.g. of globalization) while maintaining feelings of autonomy and avoiding overtly political positions. Lastly, I contend that ‘making’ is an adjustment to the turbulence of capitalism rather than a confrontation against it and is best understood in terms of the sense of mooring and purpose it provides for those within its milieu.
Alzheimer’s Disease Screening Tools for Asian Americans: A Scoping Review
Authors: Lim Sahnah , Chong Stella , Min Deborah , Mohaimin Sadia , Roberts Timothy , Trinh-Shevrin Chau , Kwon Simona C.
Published: October 2020

With growing numbers of aging Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPIs), the availability of culturally and linguistically appropriate screening tools for Alzheimer’s disease and its related dementias (ADRD) is needed. The aim of this scoping review is to summarize the tools that have been adapted for and validated among the AANHPI population. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol for systematic reviews, six databases were searched for peer-reviewed articles describing ADRD among AANHPIs. Among 1,477 articles screened for inclusion, 15 articles were included in the final analysis. Results showed a paucity of studies that psychometrically validate tools among this population. Furthermore, studies that culturally adapted and/or translated existing tools mostly targeted East Asian American populations. Our review provides a first step in mapping the extant literature on ADRD screening tools for this underresearched population and will serve as a guide for future research, policy, and intervention.
Exploring the N95 and Surgical Mask Supply in U.S. Nursing Homes During COVID-19
Authors: Li Yumeng , Fang Fang , He Mengying
Published: October 2020

U.S. health care facilities have been encountering a recurrence of medical supply shortage since COVID-19 exploded in March 2020. There is an urgent need for important Personal Protective Equipment (PPE) such as N95 and surgical masks. This project examined the factors that were associated with nursing homes’ N95 and surgical mask supply. We analyzed data from the Nursing Home COVID-19 Public File and conducted a multivariate logistic regression estimating the association between nursing home characteristics and county-level demographic parameters with mask supply. We found that a high number of resident COVID-19 cases contributed to the supply of N95, but not surgical masks, whereas a high number of staff cases did not lead to an adequate supply of either N95 or surgical masks. Compared with not-for-profit (NFP) facilities, for-profit (FP) nursing homes were less likely to get enough masks. A better supply distribution plan is needed to prepare for future possible PPE shortage.
“Newspaper Funerals” and popular protest in the early Meiji period
Authors: Joos Joël
Published: October 2020

This article takes a closer look at the “newspaper funerals” held in 1882 in the city of Kōchi, protesting government censorship. The funerals were an early example of newspaper editors’ awareness of their medium as a tool to energize and steer a movement toward specific political aims, as well as an instrument to gain a foothold within the newly emerging “public sphere” in modern Japan.
Editors’ introduction: Alive and Kicking: French and Francophone Feminisms Now
Authors: Schaal Michèle , Angelo Adrienne
Published: October 2020

This article provides an overview of the diversity of feminist activism throughout the world over the last decade and situates these contributions to a transnational feminist (re)surge(ence) within the context of French and Francophone cultures. This article also offers a synopsis of the seven articles in this special issue, each of which engages with specific aspects of feminisms spanning diverse French and Francophone regions including Algeria, Canada, France, Haiti, Kanaky/New Caledonia, Te Ao Mā’ohi/French Polynesia, and Senegal. These contributors’ articles focus on the work of writers who share a demonstrated commitment to social change or who attest to the power of writing to heal personal and collective trauma, to raise critical awareness of social injustices, to inspire social and political transformations, and to imagine more pro-feminist, expansive, inclusive, and equal societies.
Structural design and parameter optimization on a waste valve for hydraulic ram pumps
Authors: Li Jiazhen , Yang Kailin , Guo Xinlei , Huang Wei , Wang Tao , Guo Yongxin , Fu Hui
Published: October 2020

Hydraulic ram pump is an automatic water-lifting machinery, which converts the low-head potential energy of a large volume of water into a small high-head potential energy through the periodic open and close of waste valve and delivery valve. The pump would run inefficiently or even fail if the valves are poorly designed. In this paper, a novel and reliable waste valve of lift-check-valve structure has been developed. The sealing mode integrating soft and rigid sealing rings, the equation for the valve disc thickness and the equation for the flow passage in terms of the diffuser length, the larger radius and the smaller radius, are presented to guide future design. Major factors influencing the hydraulic performance, including the flow passage, valve opening and valve clack mass, are discussed with model experiments and numerical simulations. The optimized configuration for a 100-mm hydraulic ram pump includes a curved diffuser, 25–30-mm valve opening and 1.2-kg valve clack mass. The proposed waste valve can decrease the head loss coefficient of the system by 45%, achieve relatively higher working efficiency, and lift the largest water when the delivery head is lower than 30 m.
Book review: Zarina Bhatty, From Purdah to Piccadilly: A Muslim Woman’s Struggle for Identity
Authors: Chakravarti Uma
Published: October 2020

Zarina Bhatty, From Purdah to Piccadilly: A Muslim Woman’s Struggle for Identity. New Delhi: SAGE Publication, 2016, 196 pages, ₹595 (Paperback), ISBN: 9789352806652.
Book review: Bidyut Mohanty and Victor Faessel (Eds.), Our Money, Our Lives: Microcredit and Women’s Empowerment in Cross Cultural Perspective
Authors: Sudarshan Ratna M.
Published: October 2020

Bidyut Mohanty and Victor Faessel (Eds.), Our Money, Our Lives: Microcredit and Women’s Empowerment in Cross Cultural Perspective. Delhi: Aakar Books, 2018, 280 pages, ₹795 (Hardcover). ISBN 978-93-5002-555-0.
Disconnect between psychiatric and addiction services: a review of patients’ attendances at Alcohol Tobacco and Other Drug Services after a psychiatric admission
Authors: Mohiuddin Syed Mushtaq , McDermott Brett , Dillon John
Published: October 2020

Objective:

To investigate the rate of attendance at Alcohol Tobacco and Other Drug Services (ATODS) for patients discharged from an acute mental health unit with a primary/secondary diagnosis of substance use disorder (SUD); and describe factors, demographics, diagnoses and service provision that relate to their attendance.

Method:

All inpatients between 1 November 2016 and 31 October 2017 with a diagnosis of SUD were compared for their attendance at ATODS within 30 days of discharge. Other measures included their admission data (e.g. demographics, diagnosis), and indices of their illness severity.

Results:

Of 1295 admissions for a total of 900 patients, 32.4% of patients had an SUD diagnosis. Only 10.3% of these patients attended ATODS. There were no significant differences by gender, age, indigenous status, illness severity or dual diagnosis intervention during their inpatient stay on attendance. Relative to the SUD-only group, individuals with any psychiatric comorbidity were three–four times less likely to attend ATODS.

Conclusion:

Despite the ongoing emphasis on dual diagnosis treatment, the rate of engagement with ATODS remains low. Further review is needed to determine whether enhanced information sharing or case management models may improve attendance rates.
COVID-19: In the Eyes of a Filipino Child
Authors: Agbing Lourdes Urbano , Agapito Josephine Dionela , Baradi Ann Marie Albano , Bernadette C. Guzman M. , Ligon Clarissa Mariano , Lozano Arsenia Tuazon
Published: October 2020

Objectives

explore thoughts and feelings of children on COVID-19, find out how they cope, and what they did during lockdown. It was total lockdown in Luzon, Philippines, April 2020 – when survey was conducted; pre-tested open-end questionnaire was administered to children who answered either by paper and pen, or through social media, with parents’ cooperation.

Participants

200 boys and girls, 6-12 years old, public and private schools in NCR-Luzon.

Results

Participants heard COVID-19, pandemic and lock down from media and family; described as deadly, dangerous, contagious, world-wide, death-causing virus; about 90% expressed sadness, fear, boredom, anger, disappointments and difficult time; employed self-enhanced coping mechanisms, and engaged in hobbies and interests to assuage thoughts and feelings; family appeared as saving grace. Recommendations: develop strategies to assist children during critical events; studies – find out effects of pandemic on participants’ health; visit participants after two years to find out reminiscence of pandemic experience.
Making Video Glitter in the Time of COVID-19
Authors: Luka Mary Elizabeth
Published: October 2020

In this article, I explore how two research-creation projects helped me to process the stresses of the 2020 COVID-19 lockdown using a critical autoethnographic approach. Video editing weaves the two projects together, providing both a descriptive and abstract engagement with ideas about glitter as method and media making as a form of analysis. The article starts with Prompt #3 from the Massive Micro Sensemaking undertaking led by Annette Markham and Anne Harris in May and June, 2020, and is punctuated by the text and links to the videos produced by media artist Midi Onodera between April and July 2020.
Flat-dose granulocyte colony-stimulating factor evaluation after autologous hematopoietic stem cell transplant in multiple myeloma patients: Does one dose fit all?
Authors: Kim Olivia M , Jared Jason R , Hennes Emily R , Ninos Cameron L , Przybylski Daniel J , Callander Natalie S
Published: October 2020

Introduction

The current recommended granulocyte-colony stimulating factor (G-CSF) dose after autologous hematopoietic stem cell transplant (autoHSCT) in multiple myeloma patients is 5 mcg/kg/day administered subcutaneously until engraftment. Recently, our institution changed practice from weight-based to flat-dose G-CSF. The purpose of this study was to assess the impact of flat-dose G-CSF on time to engraftment among multiple myeloma patients of different weight groups.

Methods

Retrospective chart review was completed for adult patients with multiple myeloma who underwent autoHSCT from March 2018 through August 2019. Data collected included time to neutrophil engraftment, total length of hospitalization, length of stay post-transplant, time to platelet engraftment, use of intravenous fluconazole or acyclovir, parenteral nutrition use, incidence of febrile neutropenia, antibiotic use, and death. Differences in outcomes were compared between patients ≤80 kg versus those >80 kg. A secondary analysis was completed for patients ≤100 kg versus those >100 kg.

Results

There was no difference in time to neutrophil engraftment between weight groups (≤80 kg versus >80 kg: median = 12 days, p = 0.22; ≤100 kg versus >100 kg: median = 12 days, p = 0.52). There was a significant difference in intravenous fluconazole and acyclovir use between groups, with more use in the lower weight groups (≤80 kg versus >80 kg: 12 patients versus 10 patients p = 0.02; ≤100 kg versus >100 kg: 19 patients versus 3 patients p = 0.04). No significant differences were found for any other outcomes.

Conclusion

Utilizing a flat-dose of G-CSF for patients after autoHSCT does not appear to negatively affect patient outcomes. Institutions may benefit from using the 300 mcg dose of G-CSF for multiple myeloma patients after autoHSCT.
Assessment of hospitalization rates for immune-related adverse events with immune checkpoint inhibitors
Authors: Nice Laura , Bycroft Ryan , Wu Xiaoyong , Rai Shesh N , Figg Lindsay , Bhandari Shruti , Burd Megan
Published: October 2020

Introduction

Immune checkpoint inhibitors (ICIs) have become the standard of care in many cancer types. As the number of patients receiving ICIs for various cancers continues to expand, patients and practitioners should be aware of potentially severe immune-related adverse events (irAEs). Despite reports of the incidence of grade 3/4 toxicities, the proportion of patients whose symptoms were clinically severe enough to warrant hospitalization for adverse event management is unknown.

Methods

This single center, retrospective, observational study was designed to determine the impact of irAEs on patients and the hospital. Patients who started ICIs from May 2016 through May 2019 for melanoma or lung cancer were included. The primary outcome was incidence of hospitalization for irAE. Secondary outcomes included median length of hospitalization, time to onset of irAE, rates of hospitalization for irAE per each checkpoint inhibitor regimen, organ system affected, progression free survival, and overall survival.

Results

Of 384 patients with melanoma or lung cancer, 27 (7%) were hospitalized at our institution for an irAE. The most common irAE leading to hospitalization was colitis for patients with melanoma and pneumonitis for patients with lung cancer. The median length of stay across all hospitalizations was 10 days. Twenty-five patients required the use of corticosteroids while hospitalized, while eight of these patients required second line irAE treatment. For the total patient population, 34.7% experienced a grade 1/2 irAE and 13.1% experienced a grade 3/4 irAE.

Conclusion

Our cohort of patients experienced similar rates irAEs as reported in clinical trials and published reports.
Surface and interfacial anti-plane waves in micropolar solids with surface energy
Authors: Chaki Mriganka Shekhar , Eremeyev Victor A , Singh Abhishek K
Published: October 2020

In this work, the propagation behaviour of a surface wave in a micropolar elastic half-space with surface strain and kinetic energies localized at the surface and the propagation behaviour of an interfacial anti-plane wave between two micropolar elastic half-spaces with interfacial strain and kinetic energies localized at the interface have been studied. The Gurtin–Murdoch model has been adopted for surface and interfacial elasticity. Dispersion equations for both models have been obtained in algebraic form for two types of anti-plane wave, i.e. a Love-type wave and a new type of surface wave (due to micropolarity). The angular frequency and phase velocity of anti-plane waves have been analysed through a numerical study within cut-off frequencies. The obtained results may find suitable applications in thin film technology, non-destructive analysis or biomechanics, where the models discussed here may serve as theoretical frameworks for similar types of phenomena.
Adolescent Gender Identity, Sexual Orientation, and Cannabis Use: Potential Mediations by Internalizing Disorder Risk
Authors: Buttazzoni Adrian , Tariq Ulaina , Thompson-Haile Audra , Burkhalter Robin , Cooke Martin , Minaker Leia
Published: October 2020

Background/Aims

Adolescents who identify as nonbinary gender or as not heterosexual report higher levels of mental illness than their counterparts. Cannabis use is a commonly employed strategy to cope with mental illness symptoms among adolescents; however, cannabis use can have many deleterious health consequences for youth. Within the frame of minority stress theory, this study investigates the relationships between gender identity and sexual orientation, internalizing disorder symptoms, and cannabis use among adolescents.

Method

A national cross-sectional survey of a generalizable sample of high school students in Canada from the 2017 wave ( N = 15,191) of the Cancer Risk Assessment in Youth Survey was analyzed in spring 2019. Mediation analyses were completed to examine risk of internalizing disorder symptoms as a potential mediator of the association between (1) gender identity and (2) sexual orientation, and cannabis use.

Results

Indirect effects in all models show significantly higher levels of reported internalizing disorder symptoms for female (OR = 3.44, 95% CI [2.84, 4.18]) and nonbinary gender (OR = 3.75, 95% CI [2.16, 6.51]) compared with male students. Sexual minority adolescents had higher odds of internalizing disorder risk relative to non–sexual minority adolescents (OR = 3.13, 95% CI [2.63, 3.74]). Students who reported higher rates of internalizing disorder symptoms were more likely to have ever used cannabis. Patterns of partial mediation are also present among all groups.

Discussion/Conclusions

Findings can be used to better inform mental health interventions for adolescents. Future study should explore specific mental health stressors of vulnerable adolescent groups with respect to cannabis use as a coping mechanism.
Response heterogeneity in a randomized controlled trial of telerehabilitation interventions among adults with multiple sclerosis
Authors: Plow Matthew , Motl Robert W , Finlayson Marcia , Bethoux Francois
Published: October 2020

Introduction

Telerehabilitation may be effective on average but is not equally effective among all people with multiple sclerosis (MS). Thus, the purpose of this secondary analysis of a randomized controlled trial was to explore whether baseline characteristics of participants with MS influence fatigue and physical activity outcomes of three telerehabilitation interventions.

Methods

Participants were randomized to contact-control intervention (CC), physical activity-only intervention (PA-only), and physical activity plus fatigue self-management intervention (FM+). The 12-week interventions were delivered over the phone. Sociodemographic (age and income), clinical (comorbidities, mental function and physical function), psychosocial (self-efficacy, outcome expectations and goal-setting), and behavioural baseline characteristics (step count and fatigue self-management behaviors) were used in a moderated regression analysis and a responder analysis to examine their influence on the Fatigue Impact Scale (FIS) and Godin Leisure-Time Exercise Questionnaire (GLTEQ) at post-test (i.e. immediately post-interventions).

Results

No interactions terms were statistically significant in the moderation analysis. However, the responder analysis showed that baseline psychosocial characteristics and mental function were significantly different ( p < 0.05) between responders and non-responders. Specifically, non-responders on the FIS at post-test in the PA-only intervention had significantly lower baseline scores in goal setting for engaging in fatigue self-management behaviours. Also, non-responders on the GLTEQ at post-test in the FM+ intervention had significantly worse baseline scores in mental function.

Discussion

Further research is needed to understand the complex relationship among baseline characteristics, telerehabilitation and response heterogeneity. We discuss how research on examining response heterogeneity may be advanced by conducting mega-clinical trials, secondary analyses of big data, meta-analyses and employing non-traditional research designs.

Trial registration

Clinicaltrials.gov (NCT01572714).
Impact of a large-scale telemedicine network on emergency visits and hospital admissions during the coronavirus disease 2019 pandemic in Brazil: Data from the UNIMED-BH system
Authors: Nascimento Bruno R , Brant Luisa CC , Castro Ana Cristina T , Froes Luiz Eduardo V , Ribeiro Antonio Luiz P , Cruz Larissa V , Araújo Cynthia B , Souza Charles F , Froes Eduardo T , Souza Soraya D
Published: October 2020

Introduction

Triage by on-demand telemedicine is a strategy for healthcare surge control in the COVID-19 pandemic. We aimed to assess the impact of a large-scale COVID-19 telemedicine system on emergency department (ED) visits and all-cause and cardiovascular hospital admissions in Brazil.

Methods

From March 18, 2020–May 18, 2020 we evaluated the database of a cooperative private health insurance, with 1.28 million clients. The COVID-19 telemedicine system consisted of: a) mobile app, which redirects to teleconsultations if indicated; b) telemonitoring system, with regular phone calls to suspected/confirmed COVID-19 cases to monitor progression; c) emergency ambulance system (EAS), with internet phone triage and counselling. ED visits and hospital admissions were recorded, with diagnoses assessed by the Diagnosis Related Groups method. COVID-19 diagnosis and deaths were identified from the patients’ registries, and outcomes assessed until June 1st.

Results

In 60 days, 24,354 patients accessed one of the telemedicine systems. The most frequently utilized was telemonitoring (16,717, 69%), followed by teleconsultation (13,357, 55%) and EAS (687, 3%). The rates of ED and hospital admissions were: telemonitoring 19.7% (3,296) and 4.7% (782); teleconsultation 17.3% (2,313) and 2.4% (318) and EAS: 55.9% (384) and 56.5% (388) patients. At total 4.1% (1,010) had hospital admissions, 36% (363) with respiratory diseases (44 requiring mechanical ventilation) and 4.4% (44) with cardiovascular diagnoses. Overall, 277 (1.1%) patients had confirmed COVID-19 diagnosis, and 160 (0.7%) died, 9 with COVID-19.

Conclusion

Telemedicine resulted in low rates of ED visits and hospital admissions, suggesting positive impacts on healthcare utilization. Cardiovascular admissions were remarkably rare.
Effect of roof and ceiling configuration on energy performance of a metamaterial-based cool roof for low-rise office building in China
Authors: Tang Saihong , Akkurt Nevzat , Zhang Kai , Chen Lufang , Ma Mingquan
Published: October 2020

Cool roofs with higher solar reflectance and emittance can effectively reduce building energy consumption. However, it is still limited to use at night on account of the development of roof materials during the past decades. The newly proposed metamaterial-based cool roof (MCR) greatly improves the possibility of the radiative cooling in the daytime. To study the influence of MCR on the energy consumption for the office building, a small single-floor office was adopted to analyse the cooling performance of MCR by using EnergyPlus. In this study, the optimization analysis was conducted based on the proposed dimensionless thermal resistance ( θRTR) and roof pitch (Δ). Then the annual electricity saving potential of the office building with MCR was evaluated in details based on the selected cities from all five climate zones in China. The results show that more annual electricity saving can be achieved under the optimized values of θR7 = 1.53 and Δ = 20°. Furthermore, more than 15.7% of annual cooling electricity saving can be achieved while the optimized θRTR and Δ are applied.
Light reflection spectra as a tool for direct and real-time determination of biomass and pigments in the microalgae Microchloropsis salina
Authors: Vinh Trinh Quang , Trung Tran Nam , Balasus Jens , Sharma Sulabha , Hegemann Tim , Greulich Simon , Khanh Tran Quoc , Kaldenhoff Ralf
Published: October 2020

To meet the increasing demand for mass-produced microalgae, production processes must be optimised and monitored. The herein described optical sensors provide an instantaneous and direct opportunity to monitor biological and biochemical information for microalgae cultivation. Combination of expertise in natural science and engineering, as well as the application of novel data acquisition and analysis methods, are required to develop an appropriate system for industrial purpose. Prior to this, the correlation between biological and physical parameters must be determined. In this work, we combined colour science with the experimentally determined dataset from the cultivation of Microchloropsis salina. Our results indicate a resilient correlation between algal biomass and its specific pigment concentration with the determined reflection spectrum. Data evaluation allowed us to establish identification models for contactless quantification of the respective biological parameter in large-scale automated bioreactors.
Factors Associated With the Quality of Life of Patients With Venous Leg Ulcers in Primary Care: Cross-Sectional Study
Authors: Folguera-Álvarez Carmen , Garrido-Elustondo Sofia , Rico-Blázquez Milagros , Verdú-Soriano José
Published: October 2020

The presence of venous leg ulcers (VLU) is associated with emotional disorders in individuals who have conditions, such as depression, anxiety, and sleeping problems, which result in a reduced perceived quality of life by these individuals. The study aim was to describe the perceived quality of life and associated factors for individuals with VLU. We conducted a cross-sectional study in 22 primary care health centers with a sample of 93 individuals with VLU. The variables collected were the following: perceived quality of life measured with Spanish version of the Charing Cross Venous Ulcer Questionnaire (CCVUQ-e), ulcer severity measured with the RESVECH 2.0 Score, demographic variables, and those related to the healing process. The results showed a mean CCVUQ-e score of 47.4 ± 11.8 points (Mean ± SD), with the most affected dimension being the emotional status, followed by cosmesis, social interaction, and domestic activities. The mean RESVECH 2.0 score was 11.1 ± 3.7 points. An association was found between ulcer-related pain and poorer quality of life ( P < .05, t test) and between erythema in perilesional skin and poorer quality life ( P < .05, t test). The signs of infection and inflammation in the VLUs were as follows: increasing exudate, friable tissue, and biofilm-compatible tissue, which were associated with a poorer quality of life ( P < .05, t test). The multivariate model was statistically significant and explained a variability of 26% in the CCVUQ-e score. This study confirms that wound severity, pain, and signs of infection in VLU decrease the perceived quality of life of individuals with these wounds.
To Collect or Not to Collect, That is the Question. . . But Where’s the Point?
Authors: Krug Ronald S. , Pilles Peter J.
Published: October 2020

Many land managing agencies have policies that forbid the collection of artifacts during archaeological survey and, even under controlled situations, collection is determined to be an “Adverse Effect” under Section 106 compliance interpretations of the National Historic Preservation Act. The main rationale is that removal destroys the contextual information of the artifact in relation to the rest of the site. This paper argues that such “non-collecting policies” are short-sighted and do not “protect” artifacts from unauthorized removal. In these days of technology, when sub-meter GPS instruments and other tools are available to pinpoint the location of artifacts, we submit that not collecting artifacts with important information potential is deleterious to interpreting the archaeological record. This point will be made by a case study from the Coconino National Forest in northern Arizona that illustrates the excuse “if I don’t pick it up, someone else will,” is a correct assumption. Surface collections, properly documented, provide useful information that justifies their collection and curation for present-day and future research.
Designing for Disability: Evaluating the State of Accessibility Design in Video Games
Authors: Brown Mark , Anderson Sky LaRell
Published: October 2020

This project evaluates the current state accessibility of video games, specifically in terms of designing for disability. We evaluate 50 games chosen for their sales data, critical reception, awards won, and other criteria to examine the widest possible sample of the most prominent games released in 2019. This approach to selecting games allows for identifying design trends as they emerge from the most widely played or influential games. The results highlight design pitfalls and innovations regarding accessibility in four key areas: auditory, visual, motor, and difficulty. As a feed-forward project, the aim is not simply to catalog what games include which accessibility features, a nearly impossible feat considering how varied the design features are, depending on the game. This report also attempts to point to future directions for how games can continue to innovate in accessibility.
Analysis of Hand Surgery Questions on Orthopedic In-training Examination From 2014 to 2019
Authors: LeBrun Drake G. , Premkumar Ajay , Ellsworth Bridget , Shen Tony S. , Cross Michael B. , Fufa Duretti T.
Published: October 2020

Background:

The orthopedic in-training examination (OITE) continues to evolve over time. It is important for orthopedic residents and residency programs to have an up-to-date understanding of the content and resources being used on the OITE to study and tailor curricula accordingly. This study presents an updated analysis of the OITE hand domain from 2014 to 2019.

Methods:

All OITE questions related to hand surgery from 2014 to 2019 were analyzed for topic, subtopic, taxonomy, imaging modalities, and bibliometric factors related to cited references.

Results:

Of the 1600 OITE questions, there were 113 hand surgery questions (7.1%) over a 6-year period. The most commonly tested topics were nerve (n = 22; 19%), fracture/dislocation (n = 21; 19%), and tendon/ligament (n = 19; 17%). Complex clinical management questions were the most common taxonomic category (n = 66; 58%). Two hundred fifty-two references were cited, the most common of which were from the Journal of Hand Surgery (American Volume) (n = 76; 30%), Journal of the American Academy of Orthopaedic Surgeons (n = 27; 11%), and Hand Clinics (n = 21; 8%). Publication lag decreased over the study period ( P = .009). Twenty-five questions (22%) used imaging modalities, and 21 (19%) used clinical photos. Compared with a prior analysis from 2002 to 2006, there were more questions related to nerves (19.5% vs 9.8%, P = .041).

Conclusions:

Residents and residency programs can benefit from an updated understanding of OITE hand surgery content and resources. The current analysis identifies high-yield topics and resources that can guide resident preparation for the OITE.
Sterilisation
Authors: Varma Rajesh
Published: October 2020

Sterilisation is one of many methods of contraception available to men and women. Primary care has a key role in sterilisation counselling and referral. This article outlines the risks and benefits of male (vasectomy) and female (laparoscopic tubal occlusion) sterilisation and how they compare to similarly effective methods, particularly long-acting reversible contraception. The article provides an innovative decision-aid algorithm and sterilisation counselling checklist to promote a ‘best practice’ approach.
Pectoralis minor syndrome: diagnosis with Botulinum injection and treatment with tenotomy – a prospective case series
Authors: Howard Matthew , Jones Michael , Clarkson Richard , Donaldson Oliver
Published: October 2020

Background

Pectoralis minor syndrome involves pain, paraesthesia and weakness in the arm due to compression of the brachial plexus passing beneath pectoralis minor; this paper reports the results of a single centre’s treatment pathway in affected patients.

Methods

During a four-year period, patients exhibiting symptoms of pectoralis minor syndrome without significant improvement following physiotherapy proceeded to Botulinum injection. Those with good response to injection but subsequent recurrence of symptoms were offered pectoralis minor tenotomy. Oxford shoulder Scores were collected at baseline and after interventions.

Results

Twenty-one patients received Botulinum injection; at six weeks following injection, mean change in Oxford Shoulder Score was +12.4, with only one patient reporting a worsening of symptoms. Of the 17 patients with clinically significant response to injection, 12 have subsequently undergone tenotomy; three months following tenotomy, mean change in Oxford Shoulder Score from baseline was +22.3. Improvement was maintained in all patients at prolonged follow-up (average 20 months post-tenotomy).

Discussion

This pathway has shown to be extremely effective in patients not responding to first-line treatment for pectoralis minor syndrome, with 85% of patients post-injection and 100% of patients post-tenotomy showing significant (greater than published minimal clinically important difference value of six points) improvements in Oxford Shoulder Score, maintained at follow-up.
Tax Compliance After the Implementation of Tax Amnesty in Indonesia
Authors: Inasius Fany , Darijanto Giri , Gani Engelwati , Soepriyanto Gatot
Published: October 2020

The Slippery Slope Framework argues that taxpayers’ trust in government and their perceptions of government’s power explain the extent of their tax compliance. This study empirically examines such influences on taxpayers’ perceptions of tax compliance (either voluntary or enforced) in Indonesia after the implementation of a tax amnesty. In 2018, data were collected through a face-to-face questionnaire survey of 410 small business taxpayers and analyzed using a stepwise linear regression model. Trust in government was positively related to agreement with/support of voluntary tax compliance; however, perceptions of government’s power were only marginally significant. Neither trust in government nor perceptions of government’s power influenced taxpayers’ perceptions of enforced tax compliance. These findings partly support the Slippery Slope Framework. This study contributes to the literature on the influence of trust and power on voluntary or enforced tax compliance in developing countries, particularly Asia, after the implementation of a tax amnesty.
An extra year of Onco-Nephrology fellowship training is required for the subspecialty: PRO
Authors: Latcha Sheron , Kala Jaya , Kitchlu Abhijat , Leung Nelson
Published: October 2020

Recent advances in the fields of hematology and oncology over the past decades are truly astounding. Higher response rates have increased the overall and progression free survival, and for certain cancers, have brought the possibility of a cure within reach. While this represents great news for many cancer patients, their longer survival is creating new challenges. Cancer patients can now live long enough to develop chronic kidney disease (CKD), receive long term dialysis, and even a kidney transplantation. There are important and significant knowledge gaps in the care of the cancer patient with CKD or end stage renal disease (ESRD). The subspecialty of Onco-Nephrology was created with the goal of optimizing the care of cancer patients with CKD or ESRD by (1) identifying crucial knowledge gaps in the proper care of these patients by (2) engaging in basic science and clinical research independently and in partnership with cancer specialists to attenuate these gaps, and (3) by educating future onco-nephrologists.
Phase 2 study of ruxolitinib and decitabine in patients with myeloproliferative neoplasm in accelerated and blast phase
Authors: Mascarenhas John O. , Rampal Raajit K. , Kosiorek Heidi E. , Bhave Rupali , Hexner Elizabeth , Wang Eunice S. , Gerds Aaron , Abboud Camille N. , Kremyanskaya Marina , Berenzon Dimitry , Odenike Olatoyosi , Farnoud Noushin , Krishnan Aishwarya , Weinberg Rona Singer , McGovern Erin , Salama Mohamed E. , Najfeld Vesna , Medina-Martinez Juan S. , Arango Ossa Juan E. , Levine Max F. , Zhou Yangyu , Sandy Lonette , Heaney Mark L. , Levine Ross L. , Mesa Ruben A. , Dueck Amylou C. , Hoffman Ronald
Published: October 2020

Myeloproliferative neoplasms (MPN) that have evolved into accelerated or blast phase disease (MPN-AP/BP) have poor outcomes with limited treatment options and therefore represent an urgent unmet need. We have previously demonstrated in a multicenter, phase 1 trial conducted through the Myeloproliferative Neoplasms Research Consortium that the combination of ruxolitinib and decitabine is safe and tolerable and is associated with a favorable overall survival (OS). In this phase 2 trial, 25 patients with MPN-AP/BP were treated at the recommended phase 2 dose of ruxolitinib 25 mg twice daily for the induction cycle followed by 10 mg twice daily for subsequent cycles in combination with decitabine 20 mg/m2 for 5 consecutive days in a 28-day cycle. Nineteen patients died during the study follow-up. The median OS for all patients on study was 9.5 months (95% confidence interval, 4.3-12.0). Overall response rate (complete remission + incomplete platelet recovery + partial remission) was 11/25 (44%) and response was not associated with improved survival. We conclude that the combination of decitabine and ruxolitinib was well tolerated, demonstrated favorable OS, and represents a therapeutic option for this high-risk patient population. This trial was registered at www.clinicaltrials.gov as #NCT02076191.
Daytime sleepiness predicts inflammation and ambulatory blood pressure in sleep apnoea
Authors: Pak Victoria M. , Butts Brittany , Hertzberg Vicki , Collop Nancy , Quyyumi Arshed A. , Cox John , Rogers Ann , Dunbar Sandra B.
Published: October 2020

Introduction

Sleepiness in obstructive sleep apnoea is associated with cardiovascular risk; however, the biological mechanisms are not known. This study explored whether those with subjective sleepiness have increased plasma tumour necrosis factor-related protein 1 (C1qTNF1), a novel adipose-derived hormone (adipokine), and 24-h ambulatory blood pressure (ABP) compared to those without sleepiness in newly diagnosed, treatment-naïve participants with obstructive sleep apnoea.

Methods

Overall, 94 participants were included in the analysis. Participants completed the Epworth Sleepiness Scale (ESS), 24-h ABP was monitored, and plasma C1qTNF1 was measured. Sleepy participants were defined as ESS≥10 and nonsleepy as ESS<10. Multiple linear regression was used to explore differences in C1qTNF1, and 24-h mean arterial pressure (MAP) between sleepy and nonsleepy participants, adjusting for age, sex, body mass index, apnoea–hypopnoea index, and smoking status.

Results

C1qTNF1 was significantly higher in sleepy participants (n=57) compared to nonsleepy participants (n=37) (β=0.41 NPX, 95% CI 0.02, 0.80; p=0.04). The 24-h MAP was significantly higher in sleepy participants compared to nonsleepy participants (β=4.06 mmHg, 95% CI 0.36, 7.77; p=0.03).

Conclusions

Our findings show that sleepiness is associated with inflammation and higher 24-h MAP in sleep apnoea.
Validation of a composed COVID-19 chest radiography score: the CARE project
Authors: Giraudo Chiara , Cavaliere Annachiara , Fichera Giulia , Weber Michael , Motta Raffaella , Pelloso Michela , Tosato Francesca , Lupi Amalia , Calabrese Fiorella , Carretta Giovanni , Cattelan Anna Maria , De Conti Giorgio , Cianci Vito , Navalesi Paolo , Plebani Mario , Rea Federico , Vettor Roberto , Vianello Andrea , Stramare Roberto
Published: October 2020

Objectives

The aim of this study was to validate a composed coronavirus disease 2019 (COVID-19) chest radiography score (CARE) based on the extension of ground-glass opacity (GG) and consolidations (Co), separately assessed, and to investigate its prognostic performance.

Methods

COVID-19-positive patients referring to our tertiary centre during the first month of the outbreak in our area and with a known outcome were retrospectively evaluated. Each lung was subdivided into three areas and a three-grade score assessing the extension of GG and Co was used. The CARE was derived from the sum of the subscores. A mixed-model ANOVA withpost hocBonferroni correction was used to evaluate whether differences related to the referring unit (emergency room, COVID-19 wards and intensive care unit (ICU)) occurred. Logistic regression analyses were used to investigate the impact of CARE, patients’ age and sex on the outcome. To evaluate the prognostic performance of CARE, receiver operating characteristic curves were computed for the entire stay and at admission only.

Results

A total of 1203 chest radiographs of 175 patients (120 males; mean age 67.81±15.5 years old) were examined. On average, each patient underwent 6.8±10.3 radiographs. Patients in ICU as well as deceased patients showed higher CARE scores (p<0.05, each). Age, Co and CARE significantly influenced the outcome (p<0.05 each). The CARE demonstrated good accuracy (area under the curve (AUC)=0.736) using longitudinal data as well as at admission only (AUC=0.740). A CARE score of 17.5 during hospitalisation showed 75% sensitivity and 69.9% specificity.

Conclusions

The CARE was demonstrated to be a reliable tool to assess the severity of pulmonary involvement at chest radiography with a good prognostic performance.
Multicentre feasibility of multiple-breath washout in preschool children with cystic fibrosis and other lung diseases
Authors: Stahl Mirjam , Joachim Cornelia , Kirsch Ines , Uselmann Tatjana , Yu Yin , Alfeis Nadine , Berger Christiane , Minso Rebecca , Rudolf Isa , Stolpe Cornelia , Bovermann Xenia , Liboschik Lena , Steinmetz Alena , Tennhardt Dunja , Dörfler Friederike , Röhmel Jobst , Unorji-Frank Klaudia , Rückes-Nilges Claudia , von Stoutz Bianca , Naehrlich Lutz , Kopp Matthias V. , Dittrich Anna-Maria , Sommerburg Olaf , Mall Marcus A.
Published: October 2020

Background

Multiple-breath washout (MBW)-derived lung clearance index (LCI) detects early cystic fibrosis (CF) lung disease. LCI was used as an end-point in single- and multicentre settings at highly experienced MBW centres in preschool children. However, multicentre feasibility of MBW in children aged 2–6 years, including centres naïve to this technique, has not been determined systematically.

Methods

Following central training, 91 standardised nitrogen MBW investigations were performed in 74 awake preschool children (15 controls, 46 with CF, and 13 with other lung diseases), mean age 4.6±0.9 years at investigation, using a commercially available device across five centres in Germany (three experienced, two naïve to the performance in awake preschool children) with central data analysis. Each MBW investigation consisted of several measurements.

Results

Overall success rate of MBW investigations was 82.4% ranging from 70.6% to 94.1% across study sites. The number of measurements per investigation was significantly different between sites ranging from 3.7 to 6.2 (p<0.01), while the mean number of successful measurements per investigation was comparable with 2.1 (range, 1.9 to 2.5; p=0.46). In children with CF, the LCI was increased (median 8.2, range, 6.7–15.5) compared to controls (median 7.3, range 6.5–8.3; p<0.01), and comparable to children with other lung diseases (median 7.9, range, 6.6–13.9; p=0.95).

Conclusion

This study demonstrates that multicentre MBW in awake preschool children is feasible, even in centres previously naïve, with central coordination to assure standardised training, quality control and supervision. Our results support the use of LCI as multicentre end-point in clinical trials in awake preschoolers with CF.
Correction to: Deep user identification model with multiple biometric data
Authors: Song Hyoung-Kyu , AlAlkeem Ebrahim , Yun Jaewoong , Kim Tae-Ho , Yoo Hyerin , Heo Dasom , Chae Myungsu , Yeun Chan Yeob
Published: October 2020

An amendment to this paper has been published and can be accessed via the original article.