bluuebunny/crossref_metadata_2025 huggingface dataset:
Borehole wall tensile caving instability in the horizontal well of deep brittle shale
Authors: Fan Yu , Cui Shuai , Liu Houbin , Wu Pengcheng , Wang Xudong , Zhong Chengxu , Meng Yingfeng
Published: March 2021

Introduction:

With the increasing drilling depth of shale formation, downhole collapse is a frequent occurrence, which often manifests as borehole wall caving.

Methods:

We used the deep shale of the Longmaxi Formation to conduct the mechanical loading and unloading experiments under different downhole working conditions and a theoretical evaluation method of borehole wall caving and instability was proposed.

Results and discussion:

As the confining pressure and axial load increased, the acoustic velocity increased. When a certain value was reached, the acoustic velocity of the rock mass had minimal changes. As the confining pressure continued to unload and decrease, the acoustic velocity decreased. At the moment of core failure, the acoustic velocity suddenly dropped. When the axial force of loading was constant, the unloading speed of confining pressure increased, and shale could easily be destroyed. The pressure at the well bottom changed rapidly, the likelihood of borehole wall failure increased.

Conclusion:

The deep shale has high brittleness. Under the bottom-hole pressure, the borehole wall rock was prone to brittle fracture failure along the parallel bedding surface. Under different working conditions, obvious changes could be observed in the pressure of the effective fluid column at the well bottom. The pressure changed rapidly, which, in turn, caused the rock at the well bottom to break down, thereby resulting in borehole wall caving. After tripping out and turning the pump off, the shale tensile stress in the upper and lower sidewalls of the horizontal well section was responsible for tensile caving.
‘How to become what you are’: Self-becoming and individuation in Nietzsche’s Ecce Homo and Hesse’s Demian and Steppenwolf
Authors: Crew Thomas
Published: March 2021

In this essay I consider the theme of individuation or self-becoming in Nietzsche’s Ecce Homo (1888) and Hesse’s Demian (1917) and Steppenwolf (1927). Although this task appears inter-disciplinary, Nietzsche’s autobiography can be considered a Bildungsroman in which ‘Nietzsche’ plays the protagonist. After showing the correspondences between Nietzsche’s and Hesse’s diagnoses of contemporary Europe, which can be summed up with the notion of ‘decadence’ or nihilism, I suggest that they both point towards the process of self-becoming as the ultimate remedy for both the individual and society. Self-becoming is a painful yet necessary process that holds the repeated destruction of the individual’s identity as the precondition for attaining the status of human being. It is a process implied by Nietzsche’s ‘formula for human greatness’: amor fati. Resistance to individuation leads to a state of ‘miserable ease’, embodied by what Hesse calls the ‘bourgeois’ and what Nietzsche terms the ‘last men’.
Sylvia Beach and women’s scholarly communities under Occupation: The diary of Madeleine Blaess
Authors: Michallat Wendy
Published: March 2021

In 1939 Madeleine Blaess, a languages graduate, left her home in England for Paris to begin doctoral research at the Sorbonne. Unable to escape Paris before the German invasion in spring 1940, she was trapped in France for the duration of the war. The letters she wrote to her parents during the Phoney War, and the diary she began in October 1940 and continued until after the Liberation, are a fascinating account of her life as a postgraduate scholar in wartime. Through these written traces we glimpse women-run social and intellectual communities and businesses to which many women students turned for scholarly and moral support and, occasionally, practical and financial succour. This article draws on Madeleine’s letters and diary to describe and evaluate the importance of these extra-curricular networks in supporting women students during wartime with a particular focus on the bookshop and library Shakespeare and Company, run by Sylvia Beach.
Impact of Oral Steroids on Tonsillectomy Postoperative Complications and Pain
Authors: Kubala Michael E. , Turner Merit , Gardner James Reed , Williamson Adrian , Richter Gresham T.
Published: March 2021

Objectives:

To analyze the impact of steroids on postoperative tonsillectomy recovery and implement findings for improvement in postoperative management.

Methods:

Institutional review board approved prospective study with retrospective analysis of private practice setting tonsillectomy patients (November 2015 to January 2017). A questionnaire was provided postoperatively to patients undergoing tonsillectomy with or without adenoidectomy. The study population was separated into 2 groups: patients who received steroids (3 days of either dexamethasone or prednisolone), postoperative steroid (POS), versus patients who did not receive steroids (PONS).

Results:

The questionnaire had a return rate of 27.3% (254/931). Nine of the 254 responses were disqualified for lack of information; therefore, the total number of responses was 245. Of these, 115 were POS and 130 were PONS. The groups were similar in mean age (POS: 13.2 ± 10.4 years, PONS: 14.7 ± 12.1 years, P = .32) and sex (POS: Male 40.0%, PONS: Male 40.0%, P = .97). There was an overall decrease of pain and nausea/vomiting (N/V) in the steroid group ( P = .0007). There was reduction in pain ( P < .05) from postoperative day (POD) 2, 3, 4, and 6 in the POS group. Otherwise, there was no significant reduction in pain from POD 7 to 14, day-by-day rate of N/V, bleeding, or rate of emergency department (ED) or clinic visit ( P > .05).

Conclusion:

Postoperative steroid reduced overall pain and N/V, as well as daily pain on POD 2, 3, 4, and 6. Pain from POD 7 to 14, rate of ED or clinic visit, or daily N/V and bleeding rate were not significantly different between cohorts.
Sudden Sensorineural Hearing Loss in 6 Patients Following Dental Procedure
Authors: Tien Chung-Tang , Young Yi-Ho
Published: March 2021

This study investigated the etiology and treatment outcome in sudden sensorineural hearing loss (SSHL) patients following dental procedure. During the past 2 decades, only 6 patients with SSHL following dental procedure were experienced including tooth extraction in 5 and endodontic treatment in 1. Three were males and 3 were females, with ages ranging from 10 to 75 years (median, 47 years). All patients underwent an inner ear test battery. Types of audiogram consisted of total deafness in 3 ears, flat-type loss in 2 ears, and high-tone loss in 1 ear. The pretreatment mean hearing level from 4 frequencies was 76 ± 37 dB for the lesion ears, significantly higher than 23 ± 15 dB for the opposite healthy ears. The treatment outcome is unsatisfactory. Five patients remained hearing unchanged 3 months after treatment. Only 1 (17%) patient had hearing improvement who was proved as having reactivation of the varicella-zoster virus. In conclusion, reactivation of the varicella-zoster virus may be one of the etiologies for SSHL patients following dental procedure. Serological assay coupled with MR imaging may help identify the etiology, determine the medication, and predict the outcome.
COVID-19 Pandemic Response Simulation in a Large City: Impact of Nonpharmaceutical Interventions on Reopening Society
Authors: Lee Serin , Zabinsky Zelda B. , Wasserheit Judith N. , Kofsky Stephen M. , Liu Shan
Published: March 2021

As the novel coronavirus (COVID-19) pandemic continues to expand, policymakers are striving to balance the combinations of nonpharmaceutical interventions (NPIs) to keep people safe and minimize social disruptions. We developed and calibrated an agent-based simulation to model COVID-19 outbreaks in the greater Seattle area. The model simulated NPIs, including social distancing, face mask use, school closure, testing, and contact tracing with variable compliance and effectiveness to identify optimal NPI combinations that can control the spread of the virus in a large urban area. Results highlight the importance of at least 75% face mask use to relax social distancing and school closure measures while keeping infections low. It is important to relax NPIs cautiously during vaccine rollout in 2021.
Comparison of Decision Modeling Approaches for Health Technology and Policy Evaluation
Authors: Graves John , Garbett Shawn , Zhou Zilu , Schildcrout Jonathan S. , Peterson Josh
Published: March 2021

We discuss tradeoffs and errors associated with approaches to modeling health economic decisions. Through an application in pharmacogenomic (PGx) testing to guide drug selection for individuals with a genetic variant, we assessed model accuracy, optimal decisions, and computation time for an identical decision scenario modeled 4 ways: using 1) coupled-time differential equations (DEQ), 2) a cohort-based discrete-time state transition model (MARKOV), 3) an individual discrete-time state transition microsimulation model (MICROSIM), and 4) discrete event simulation (DES). Relative to DEQ, the net monetary benefit for PGx testing (v. a reference strategy of no testing) based on MARKOV with rate-to-probability conversions using commonly used formulas resulted in different optimal decisions. MARKOV was nearly identical to DEQ when transition probabilities were embedded using a transition intensity matrix. Among stochastic models, DES model outputs converged to DEQ with substantially fewer simulated patients (1 million) v. MICROSIM (1 billion). Overall, properly embedded Markov models provided the most favorable mix of accuracy and runtime but introduced additional complexity for calculating cost and quality-adjusted life year outcomes due to the inclusion of “jumpover” states after proper embedding of transition probabilities. Among stochastic models, DES offered the most favorable mix of accuracy, reliability, and speed.
Shear wave elastography evaluation of brachial plexus in multiple sclerosis
Authors: Gürün Enes , Akdulum İsmail , Akyüz Melih , Oktar Suna Özhan
Published: March 2021

Background

Multiple sclerosis (MS) is a chronic neuroinflammatory disease characterized by inflammation involving the peripheral nerves. Shear wave elastography (SWE) is potentially a method of choice for detecting peripheral nerve involvement.

Purpose

To compare the degree of thickening and nerve elasticity of brachial plexus (BP) nerve roots and evaluate the usefulness of sonoelastography in patients with clinically diagnosed MS without brachial plexopathy.

Material and Methods

Thirty-two patients with MS and 32 controls were included in the study. Bilateral C5, C6, and C7 mean nerve root diameters, and mean elasticity values in kiloPascal (kPa) were measured in the patient and control groups. The relationship between the age, height, and weight values and nerve diameter-elasticity values of the patient and control groups was compared.

Results

The elasticity values of the C5 and C6 nerve roots were increased, and the nerve root thickness was decreased in the MS group compared to that in the control ( P < 0.05). There was no difference between the C7 mean nerve root elasticity (kPa) and diameter measurements in the patient and control groups ( P > 0.05).

Conclusion

Our study showed an increase in the BP nerve root elasticity values (kPa) in patients with MS compared to that of the control group and a decrease in diameter values thought to be related to the possible chronic atrophic process. The results are consistent with the demyelinating process of the peripheral nervous system (PNS) due to MS.
Abdominopelvic ectopic spleen with a comprehensive imaging examination: a case report
Authors: Guo Hao , Ba Xinru , Gong Peiyou , Wang Guangzhi , Ma Heng , Wang Liying , Wang Qing
Published: March 2021

Ectopic spleen is a rare clinical malformation in which the spleen is relocated from its normal anatomical position to other parts of the abdomen. We report a rare case of abdominopelvic ectopic spleen caused by splenic ligament deficiency. A patient experienced intermittent pain in the left upper abdomen that was progressively aggravated. This was confirmed by comprehensive imaging examinations and postoperative pathology. We also performed a review of the literature on the current state of the field. Our data may help to improve the diagnosis and treatment of ectopic spleen.
Sleep and circadian rhythm disturbances in intensive care unit (ICU)-acquired delirium: a case–control study
Authors: Sun Ting , Sun Yunliang , Huang Xiao , Liu Jianghua , Yang Jiabin , Zhang Kai , Kong Guiqing , Han Fang , Hao Dong , Wang Xiaozhi
Published: March 2021

Objective

The relationships among sleep, circadian rhythm, and intensive care unit (ICU)-acquired delirium are complex and remain unclear. This study aimed to examine the pathophysiological mechanisms of sleep and circadian rhythm disturbances in patients with ICU-acquired delirium.

Methods

This study included critical adult patients aged 18 to 75 years who were treated in the ICU. Twenty-four-hour polysomnography was performed and serum melatonin and cortisol levels were measured six times during polysomnography. Receiver operating characteristic curves and binomial logistic regression were used to evaluate the potential of sleep, melatonin, and cortisol as indicators of delirium in the ICU.

Results

Patients with delirium (n = 24) showed less rapid eye movement (REM) sleep compared with patients without delirium (n = 24, controls). Melatonin levels were lower and cortisol levels were higher in the delirium group than in the control group. REM sleep, melatonin, and cortisol were significantly associated with delirium. The optimal cutoff values of REM sleep and mean melatonin and cortisol levels that predicted delirium were ≤1.05%, ≤422.09 pg/mL, and ≥212.14 ng/mL, respectively.

Conclusions

REM sleep, and melatonin and cortisol levels are significantly associated with the risk of ICU-acquired delirium. Improved sleep and readjustment of circadian rhythmicity may be therapeutic targets of ICU-acquired delirium.
Diallyl trisulfide inhibited tobacco smoke-mediated bladder EMT and cancer stem cell marker expression via the NF-κB pathway in vivo
Authors: Geng Hao , Guo Wenhao , Feng Lei , Xie Dongdong , Bi Liangkuan , Wang Yi , Zhang Tao , Liang Zhaofeng , Yu Dexin
Published: March 2021

Objective

This study examined the effect of the NF-κB pathway on tobacco smoke-elicited bladder epithelial–mesenchymal transition (EMT) and cancer stem cell (CSC) marker expression in vivo. The effect of diallyl trisulfide (DATS) treatment was also examined.

Methods

BALB/c mice were exposed to tobacco smoke and treated with an NF-κB inhibitor and DATS. Western blotting, quantitative real-time PCR, and immunohistochemical staining were used to detect the changes of relevant indices.

Results

Phosphorylated inhibitor of kappa-B kinase alpha/beta expression and p65 and p50 nuclear transcription were increased by tobacco smoke exposure, whereas inhibitor of kappa-B expression was decreased. In addition, tobacco smoke reduced the expression of epithelial markers but increased that of mesenchymal and CSC markers. Our study further demonstrated that tobacco smoke-mediated EMT and CSC marker expression were attenuated by inhibition of the NF-κB pathway. Moreover, DATS reversed tobacco smoke-induced NF-κB pathway activation, EMT, and the acquisition of CSC properties in bladder tissues.

Conclusions

These data suggested that the NF-κB pathway regulated tobacco smoke-induced bladder EMT, CSC marker expression, and the protective effects of DATS.
Long non-coding RNA NEAT1 regulates ferroptosis sensitivity in non-small-cell lung cancer
Authors: Wu Hongxia , Liu Aiwen
Published: March 2021

Objectives

Ferroptosis is caused by iron-dependent lipid peroxide accumulation, the sensitivity of which might be regulated by acyl-CoA synthetase long chain family member 4 (ACSL4). Non-small-cell lung cancer (NSCLC) can resist oxidative stress and reduce the sensitivity of tumor cells to ferroptosis by changing the expression of some proteins. Mechanisms involving ferroptosis sensitivity in NSCLC are not fully understood.

Methods

A dual-luciferase reporter assay was used to confirm a targeting relationship between long non-coding (lnc)RNA NEAT1 and ACSL4. Overexpression and silencing assays of NEAT1 function were used to determine its roles in cell death (by TUNEL staining) and lipid peroxidation (by malondialdehyde levels). Expression of ferroptosis-related proteins (SLCA11, GPX4, and TFR4) was evaluated by western blot in NSCLC cells treated or not with the ferroptosis inducer erastin.

Results

Erastin-induced cell death was positively correlated with ACSL4 level. NEAT1 regulated levels of ACSL4 and proteins related to the ferroptosis and classical apoptosis pathways. Levels of ACSL4, SLC7A11, and GPX4 were decreased more by NEAT1 silencing plus erastin than by erastin alone.

Conclusion

NEAT1 regulates ferroptosis and ferroptosis sensitivity, with the latter depending on ACSL4, suggesting that targeting NEAT1 or ACSL4 may be a viable therapeutic approach to the treatment of NSCLC.
Ventricular fibrillation storm after revascularization of chronic total occlusion of the left anterior descending artery: is this reperfusion arrhythmia?
Authors: Liu Xingji , Adhikari Binay Kumar , Chen Tianlong , Wang Yonggang , Liu Quan , Wang Shudong
Published: March 2021

Electrical storm is a life-threatening emergency condition defined as three or more episodes of ventricular tachycardia or ventricular fibrillation (VF) within 24 hours requiring anti-tachycardia therapy, electrical cardioversion, or defibrillation. However, studies of the incidence of electrical storm after chronic total occlusion-percutaneous coronary intervention (CTO-PCI) are limited, 7 and post-procedural VF after revascularization of CTO has not been described. The purpose of this article was to present a case of post-operative VF electrical storm after revascularization of CTO of the left anterior descending (LAD) artery to determine whether the electrical storm was caused by reperfusion arrhythmia or compromise of either branch vessels or the collateral circulation during intervention.
Complete cervical inversion and nearly inappropriate stitching with cesarean section during the second stage of labor: a case report
Authors: Zhan Jun , Xing Aiyun , Tan Xi
Published: March 2021

Cesarean section is a common obstetric operation and an important method for saving the lives of mothers and their neonates in dangerous situations. Nevertheless, cesarean section has a higher risk and might have more complications compared with natural delivery. A reasonable choice of delivery method is important for maternal and neonatal health. The incidence of complications after cesarean section for mothers and neonates during the second stage of labor significantly increases compared with planned cesarean section. During the second stage of labor, the fetal head is deep in the pelvic cavity. If a cesarean section is performed at this stage, it is prone to causing complications, including difficult delivery of the fetal head, delayed uterine incision, and massive hemorrhage, which seriously threaten the health of the mother and her neonate. For the first time, we report a case of cesarean section after complete opening of the uterine orifice, which led to almost mistakenly suturing the cervix to the uterus. This report will hopefully help surgeons anticipate such incidents during cesarean section in the future.
Validation of a radiomic approach to decipher NSCLC immune microenvironment in surgically resected patients
Authors: Trentini Francesca , Mazzaschi Giulia , Milanese Gianluca , Pavone Claudio , Madeddu Denise , Gnetti Letizia , Frati Caterina , Lorusso Bruno , Lagrasta Costanza Anna Maria , Minari Roberta , Ampollini Luca , Ledda Roberta Eufrasia , Silva Mario , Sverzellati Nicola , Quaini Federico , Roti Giovanni , Tiseo Marcello
Published: March 2021

Radiomics has emerged as a noninvasive tool endowed with the potential to intercept tumor characteristics thereby predicting clinical outcome. In a recent study on resected non-small cell lung cancer (NSCLC), we identified highly prognostic computed tomography (CT) -derived radiomic features (RFs), which in turn were able to discriminate hot from cold tumor immune microenvironment (TIME). We aimed at validating a radiomic model capable of dissecting specific TIME profiles bearing prognostic power in resected NSCLC. The validation cohort included 31 radically resected NSCLCs clinicopathologically matched with the training set (n = 69). TIME was classified in hot and cold according to a multiparametric immunohistochemical analysis involving PD-L1 score and incidence of immune effector phenotypes among tumor infiltrating lymphocytes (TILs). High- throughput radiomic features (n = 841) extracted from CT images were correlated to TIME parameters to ultimately define prognostic classes. We confirmed PD-1 to CD8 ratio as best predictor of clinical outcome among TIME characteristics. Significantly prolonged overall survival (OS) was observed in patients carrying hot (median OS not reached) vs cold (median OS 22 months; hazard ratio 0.28, 95% confidence interval 0.09 -0.82; p = 0.015) immune background, thus validating the prognostic impact of these two TIME categories in resected NSCLC. Importantly, in the validation setting, three out of eight previously identified RFs sharply distinguishing hot from cold TIME were endorsed. Among signature-related RFs, Wavelet-HHH_gldm_HighGrayLevelEmphasis highly performed as descriptor of hot immune contexture (area under the receiver operating characteristic curve 0.94, 95% confidence interval 0.81 -1.00; p = 0.01). Based on our findings, Radiomics may decipher specific TIME profiles providing a noninvasive prognostic approach in resected NSCLC and an exploitable predictive strategy in advanced cases.
Exploring the Different Patterns for Generation Process of Driving Fatigue Based on Individual Driving Behavior Parameters
Authors: Peng Zhibiao , Rong Jian , Wu Yiping , Zhou Chenjing , Yuan Yuan , Shao Xiansheng
Published: March 2021

Driving fatigue is one of the main causes of traffic accidents in monotonous environments such as grassland highways. However, the process of generation of driving fatigue on grassland highways is still not clear. A driving simulation experiment with 23 participants was performed to collect data on driving behavior, reaction time and electrocardiogram (ECG) results when driving on a grassland highway. The effective feature indicators of driving fatigue based on driving behavior data were calculated by Pearson correlation coefficient and principal component analysis method. The matter-element model based on entropy weight method was used to quantify the generation process of driving fatigue (GPDF). GPDF was classified as different patterns by the eigenvalue of GPDF curves. Reaction time and ECG data were utilized to verify the rationality of GPDF. Results show that there were 13 feature indicators of driving behavior suitable for driving fatigue description. GPDF was not completely consistent among different participants and was classified into three patterns (i.e., mild, moderate and severe fatigue). The mean similarity for GPDF in each pattern was 0.87, 0.61 and 0.50. Validation test demonstrated that driving fatigue detection accuracy by GPDF was 72%. The mean similarity of the GPDF between driving behavior and ECG was 0.72. Driving fatigue tended to occur with driving time of 19 min or 33 min. This study is helpful to understand GPDF on grassland highways from the perspective of individual driving behavior, which would provide suggestions for the reasonable setting of anti-fatigue devices.
Idiopathic bilateral massive perirenal subcapsular effusion: The first case in the literature
Authors: Hacibey Ibrahim , Sahin Yusuf , Serifoglu Ismail , Muslumanoglu Ahmet Yaser
Published: March 2021

Introduction:

Bilateral perirenal subcapsular effusion is a rare clinical condition and is associated with several underlying etiologies. We present a 33 years old male patient with idiopathic bilateral massive subcapsular effusion.

Case presentation:

A 33-year-old male patient presented to our outpatient clinic with bilateral flank pain and fever for 2 weeks. Bilateral perirenal subcapsular effusion was detected in intravenous contrast-enhanced CT and dynamic MRI.

Treatment:

Bilateral ultrasound-guided percutaneous drainage was performed by an expert uroradiologist to reduce the parenchymal pressure, Control CT imaging after 6 weeks demonstrate that bilateral normal kidneys.

Discussion:

It has been reported that subcapsular and perirenal effusion is a rare clinical condition that may develop secondary to causes such as Nephrotic syndrome, Eisenmenger Syndrome, Lymphangiomatosis, and Page Kidney Disease. In our case, the clinical symptoms of the patient regressed after the whole effusion fluid was drained. No underlying pathology was found in further examinations. Therefore, we present the first case of Idiopathic Bilateral Massive Perirenal Subcapsular Effusion in the literature.
Comrades Do Not Always Agree: How to Promote Cooperation between the Followers of Marx and Sraffa?
Authors: Camarinha Lopes Tiago
Published: March 2021

In this note I propose two different levels of analysis for organizing the conversation around the Sraffa/Marx polemic. First, the “pragmatic approach” takes into account the immediate circumstances prevailing in the teaching of economics. In particular, we must understand that there is a systematic denial of Marxism in most economic departments, which are dominated by the mainstream neoclassical school, Keynesian thought, and various minor heterodox currents. Second, the “in-depth approach” leaves aside these circumstances and investigates the frontiers of socialist and radical political economics regardless of how well versed in Marxist theory a typical economist may be. Both levels are necessary, but we need to distinguish clearly so that we know when it is most useful to focus on one or the other.

JEL Classification: B24, B51
Leveraging Telehealth for Delivery of Palliative Care to Remote Communities: A Rapid Review
Authors: Gordon Barbara , Mason Barbara , Smith Shauna L. H.
Published: March 2021

Background: Palliative care encompasses supportive health care for patients at any stage of illness aimed at relieving symptoms, controlling pain, managing stress, offering respite for caregivers, and optimizing the quality of life. Objective: To explore strategies for increasing access to palliative care among individuals living in remote/rural communities, a rapid review was conducted on studies that explored the use of telehealth applications with this population. Methods: From December 2019 to February 2020, the PRISMA methodology was used to gather peer-reviewed studies published in the English language. MedLine, Google Scholar, and EBSCO were searched; no date limitations were set. Given the diversity of study methodologies and outcomes, the findings were synthesized narratively. The Cochrane Collaboration’s tool for assessing the risk of bias was also employed. Lastly, the studies were mapped to clinical guidelines for the various aspects of quality palliative care. Results: The 18 studies found, published between 2004 and 2019, were conducted in seven countries and on five continents. Aims included evaluating feasibility, efficacy, and user satisfaction. Insights draw from a combined pool of 3,313 patients and 250 providers. Most studies involved oncology patients and employed videoconferencing or a web platform/online software with videoconferencing. Three themes emerged: delivery of care, symptom management and quality of life, and patient/caregiver/provider satisfaction levels. Telehealth proved effective for patient and medication monitoring, provider and specialist appointments, and palliative care consultations. Operational benefits included clinician time saved, shorter appointment wait times, and reduced no show rates; implementation challenges also emerged. Statistical improvements in quality of life and symptom management were reported. Nearly two-thirds of the studies reported positive experiences among patients, caregivers, and providers; about half included an interprofessional team. The studies primarily focused on the structure/process and physical aspects of quality palliative care, there was a paucity of insights on the spiritual, cultural, end of life, and ethical/legal aspects of care. Two-thirds (12/18) of the studies employed a descriptive design. Risk for selection, performance, detection, and reporting biases emerged for all the studies; for example, only four of the studies included control groups and less than 20% (3/18) reported on attrition of study participants. Additional limitations include the rapid review methodology which relied heavily on the lead author’s decisions and the restriction of studies published only in the English language. Conclusion: More rigorous research is required to confirm the viability of clinical care delivery and establish best practices for quality, virtual palliative care to remote/rural areas.
How can higher maritime education lead shipping growth? Korea’s experience, 1948–1982
Authors: June Kim S.
Published: March 2021

In January 2019, Koreans controlled 1,647 vessels and 76,701,517 deadweight, placing Korea as the world’s seventh largest shipowning country. In this article, the author reviews the contribution of the education of upper-class marine officers to the development of Korean shipping industry during the period 1948–1982. This study is organized into four main parts. In the first section, the role of human capital in economic development is reviewed, while Section 2 focuses on change in the education for merchant marine officers from 1948 to 1982. Section 3 analyzes the role of marine officers in the development of Korea’s shipping industry, while the final part considers the wider implications of the education of marine officers in the development of shipping.
The wayward path of an American hero: Sailing Master Philip Brum
Authors: Roberts Daniel
Published: March 2021

Sailing Master Philip Brum executed the decisive manoeuvre that won the Battle of Plattburgh. He would later die of wounds he received in the battle. His widow Susan Brum undertook a public campaign for a widow’s pension, but never mentioned her role in nearly destroying her husband’s naval career and getting him dismissed from his post with the New York gunboat flotilla and reassigned to the campaign on the Great Lakes.
Escaping court martial for sodomy: Prosecution and its alternatives in the Royal Navy, 1690-1840
Authors: LeJacq Seth Stein
Published: March 2021

This article reassesses the sailing Royal Navy’s treatment of homoerotic crimes. Historians have argued that same-gender sexual contact was rare and loathed on naval vessels, and that trials were consequently uncommon but produced exceedingly harsh outcomes. Drawing on new archival research, this paper reveals that naval actors had more varied and complex attitudes towards the homoerotic and that courts treated these crimes more moderately on average than has long been assumed. Court martial trials also represented only one – extreme – outcome of an elaborate system that naval actors used to ‘resolve’ detected sex crimes. Summary punishment, flight, dismissal and a range of other routes served as common non-judicial alternatives. Detailed exploration of a protracted late-Georgian dismissal case, that of Lt. Arthur Walter Adair, shows that it is essential to attend to the full range of naval reactions to the homoerotic if we are to fully understand its place in naval history.
Genipin crosslinked chitosan/PEO nanofibrous scaffolds exhibiting an improved microenvironment for the regeneration of articular cartilage
Authors: Ching Kuan Yong , Andriotis Orestis , Sengers Bram , Stolz Martin
Published: March 2021

Towards optimizing the growth of extracellular matrix to produce repair cartilage for healing articular cartilage (AC) defects in joints, scaffold-based tissue engineering approaches have recently become a focus of clinical research. Scaffold-based approaches by electrospinning aim to support the differentiation of chondrocytes by providing an ultrastructure similar to the fibrillar meshwork in native cartilage. In a first step, we demonstrate how the blending of chitosan with poly(ethylene oxide) (PEO) allows concentrated chitosan solution to become electrospinnable. The chitosan-based scaffolds share the chemical structure and characteristics of glycosaminoglycans, which are important structural components of the cartilage extracellular matrix. Electrospinning produced nanofibrils of ∼100 nm thickness that are closely mimicking the size of collagen fibrils in human AC. The polymer scaffolds were stabilized in physiological conditions and their stiffness was tuned by introducing the biocompatible natural crosslinker genipin. We produced scaffolds that were crosslinked with 1.0% genipin to obtain values of stiffness that were in between the stiffness of the superficial zone human AC of 600 ± 150 kPa and deep zone AC of 1854 ± 483 kPa, whereas the stiffness of 1.5% genipin crosslinked scaffold was similar to the stiffness of deep zone AC. The scaffolds were degradable, which was indicated by changes in the fibril structure and a decrease in the scaffold stiffness after seven months. Histological and immunohistochemical analysis after three weeks of culture with human articular chondrocytes (HACs) showed a cell viability of over 90% on the scaffolds and new extracellular matrix deposited on the scaffolds.
Breastfeeding During a Pandemic: The Influence of COVID-19 on Lactation Services in the Northeastern United States
Authors: Schindler-Ruwisch Jennifer , Phillips Kathryn E.
Published: March 2021

Background

Pandemic-related restrictions have limited traditional models of lactation support.

Research Aims

The primary aim of this study was to determine changes to breastfeeding support services during the coronavirus-2019 pandemic according to trained lactation providers. The secondary aim was to assess strengths and limitations of telehealth services.

Methods

A prospective survey was conducted entirely online using the Qualtrics platform during June 2020. Gatekeepers at Connecticut agencies and breastfeeding networks were forwarded an anonymous survey link to distribute to eligible lactation staff.

Results

A variety of participants ( N = 39) completed the survey and the majority (69.2%; n = 27) were providing only telehealth services. More than half (58.1%; n = 18) of the participants who conducting telehealth in any form, found that virtual lactation support was moderately effective compared to in-person support. Weakness of virtual support included technical and logistical difficulties, challenges assisting with latching or reading body language over the phone or online, and accurately assessing infant growth. Strengths related to virtual support included the flexibility and convenience of home-based support, expanded communication strategies, and safety from virus exposure. Further, visits with a lactation professional decreased significantly during the pandemic. Limited in-hospital and pediatrician support were also noted, particularly among groups without access to telehealth resources.

Conclusions

As a result of the pandemic and associated shifts in lactation services, breastfeeding disparities may be further exacerbated among those without equitable access to lactation support. Challenges and innovations in virtual support may influence adaptive options in the field moving forward.
Estimating the Impact of Expulsions, Suspensions, and Arrests on Average School Proficiency Rates in Ohio Using Fixed Effects
Authors: Yaluma Christopher B. , Little Alexis P. , Leonard Michael B.
Published: March 2021

Student removal became an increasingly utilized form of discipline since the implementation of zero-tolerance policies during the early 1990s. Evaluative studies have consistently found negative relationships between student removal and academic success. Majority of cases regarding student removal are for minor and non-violent offenses and literature in this field suggests that teachers’ biases and cultural misreadings widen racial disparities in school discipline and academic performance. Our study estimates the effects of suspensions, school-related arrests, and expulsions under zero-tolerance by exploiting within-school variation in school mean proficiency rates of Asian, Hispanic, Black, and White racial subgroups over a 3-year period. Our findings reaffirm consistent evidence that exclusionary policies have negative effects on academic outcomes. We also find evidence of differential effects by racial subgroup. The paper concludes with a discussion and policy implications.
Clinical performance evaluation of a newly developed sock for people with diabetes
Authors: Cüreklibatır Encan Berna , Marmaralı Arzu , Bayraktar Dilek , Çetinkalp Şevki , Şimşir Ilgın Yıldırım
Published: March 2021

Diabetes mellitus (DM) is a chronic disease that has become a global health problem. As the population of people with diabetes is growing worldwide, the prevalence of complications associated with DM, such as diabetic foot, also increases. Neuropathy and high plantar pressure are the two most frequent causes of foot ulceration. Since diabetic wounds tend to heal slowly, it is crucial to prevent diabetic foot ulcers before they occur. In this study, the efficacy of a sock developed for diabetes in the previous research of the authors was investigated in a clinical study with the participation of patients with diabetes over a 6-month period. At the end of the study, it was observed that none of the participants had experienced any new ulcers, bacterial or fungal infections, or callus formation during this research. Moreover, a slight decrease in pressure was observed for the first, second, and third metatarsal bones when the socks were worn on day 1. On the other hand, pressure reduction was identified for the fourth and fifth metatarsal bones in all following measurements. However, analyses revealed that duration of usage did not have a statistically significant effect on overall plantar pressure. It was also found that pressure on the fourth and fifth metatarsal bones significantly decreased. Assessment of wearing comfort revealed the satisfaction of the patients, as well. Based on the promising outcomes of this clinical evaluation, these socks developed for people with diabetes can be strongly expected to help avoid diabetic foot ulcers.
Moreau de Tours: organicism and subjectivity. Part 2: Moreau as psychopathologist
Authors: Pérez Revuelta José I , Villagrán Moreno José M
Published: March 2021

These two articles analyse the importance of J.J. Moreau de Tours’ work and its influence on the development of descriptive psychopathology from the mid-nineteenth century to the present. The first article focused on biographical aspects and presented Moreau’s main works in their social and cultural contexts. This second article critically analyses Moreau’s contributions from different perspectives: epistemological, psychopathological, clinical, therapeutic, and it also discusses his role as a public figure.
The role of energy types and environmental quality on human health in developing Asian countries
Authors: Alharthi Majed , Hanif Imran
Published: March 2021

The use of dirty (fossil fuel-based) energy in the process of economic growth challenges humanity through different health issues. This research examines the health risks in the form of mortality rates and the occurrence of respiratory illnesses due to energy usage, greenhouse gas discharges, and economic venture in twenty developing countries of Asian. For this objective, the study investigated a panel dataset of twenty-three years (1995–2018) to measure the short and long-term consequences of environmental contamination on health issues. Results of this study generated through the Autoregressive-Distributed lag (ARDL) technique of econometric. Experimental outcomes of the study confirm that dirty energy, carbon emission, and the process of natural resource exhaustion have a significant and positive impact on health risks on the people of the developing region of Asia. On the other hand, the per capita income growth and clean energy usage contributing positively to human health improvement. The high mortality is positively associated with carbon emission in the case of short-run analysis. These results suggest a comprehensive governance policy set to protect people from the negative impact of dirty energy usage and carbon emission discharge.
Impact of COVID-19-related care disruptions on cervical cancer screening in the United States
Authors: Burger Emily A , Jansen Erik EL , Killen James , Kok Inge MCM de , Smith Megan A , Sy Stephen , Dunnewind Niels , G Campos Nicole , Haas Jennifer S , Kobrin Sarah , Kamineni Aruna , Canfell Karen , Kim Jane J
Published: March 2021

Objectives

To quantify the secondary impacts of the COVID-19 pandemic disruptions to cervical cancer screening in the United States, stratified by step in the screening process and primary test modality, on cervical cancer burden.

Methods

We conducted a comparative model-based analysis using three independent NCI Cancer Intervention and Surveillance Modeling Network cervical models to quantify the impact of eight alternative COVID-19-related screening disruption scenarios compared to a scenario of no disruptions. Scenarios varied by the duration of the disruption (6 or 24 months), steps in the screening process being disrupted (primary screening, surveillance, colposcopy, excisional treatment), and primary screening modality (cytology alone or cytology plus human papillomavirus “cotesting”).

Results

The models consistently showed that COVID-19-related disruptions yield small net increases in cervical cancer cases by 2027, which are greater for women previously screened with cytology compared with cotesting. When disruptions affected all four steps in the screening process under cytology-based screening, there were an additional 5–7 and 38–45 cases per one million screened for 6- and 24-month disruptions, respectively. In contrast, under cotesting, there were additional 4–5 and 35–45 cases per one million screened for 6- and 24-month disruptions, respectively. The majority (58–79%) of the projected increases in cases under cotesting were due to disruptions to surveillance, colposcopies, or excisional treatment, rather than to primary screening.

Conclusions

Women in need of surveillance, colposcopies, or excisional treatment, or whose last primary screen did not involve human papillomavirus testing, may comprise priority groups for reintroductions.
Ban the Box in Higher Education: Lessons From Louisiana on Changing Laws and Leading Movements
Authors: Phoenix Annie , Steib Syrita
Published: March 2021

In 2017, Louisiana became the first state to pass legislation to remove criminal history questions from college applications, commonly known as ban the box in higher education. This victory hinged on the work of two advocates, Syrita Steib, Founder and Executive Director of Operation Restoration, and Annie Phoenix, PhD student at Tulane University and Co-founder of Operation Restoration. The following article is a reflection on the process to pass ban the box in higher education in Louisiana and lessons learned to support others to engage in criminal legal system reform. We hope that this article serves as inspiration for other women impacted by incarceration, and nonimpacted supporters to use their voices to fight for liberation and to end the collateral consequences that prevent people with convictions from accessing education and other opportunities.
A Blueprint of Leadership Development for Female Marriage Migrants: A Pilot Exploration in Taiwan
Authors: Han Pi-Chi
Published: March 2021

In 2020, more than 560,617 female marriage migrants (FMMs) live in Taiwan. For over three decades, they have been victims of social, gender, and cultural discrimination and have been considered as an inferior group of “desirable others” from “undeveloped countries.” Until today, literature about FMMs has focused on the problems and challenges they encountered, whereas there is no literature on their leadership development (LD) in Taiwan. By exploring 10 FMM leaders and their LD, this study charts their journey to success. The research has the following aims: (a) to explore life experiences as a pathway to LD, (b) to find an LD blueprint for FMMs, and (c) to bridge the literature gap for FMMs’ LD and provide implications to adult learning (AL) and human resources development (HRD) practitioners in planning and conducting training programs for FMMs’ LD. The theory of transformative learning (TTL) was applied as a theoretical framework whereas the qualitative research design was utilized as the methodology to explore 10 FMM leaders in Taiwan. The LD blueprint was built with seven themes derived from individual interviews and three themes from the focus group discussion. Resilience was found as the salient marker of building a successful mental model in FMMs’ LD. Implications are provided.
Cystic Lesion of Dissected Pararectal Lymph Node in a Female Patient With Rectal Carcinoma: A Rare Pattern of Nodal Metastasis Mimicking a Serous Inclusion Cyst
Authors: Hashimoto Hirotsugu , Miura Sakiko , Kamei Kentaro , Masuda Yoshio , Sakuma Jun , Momiyama Masashi , Noie Tamaki , Morikawa Teppei
Published: March 2021

Nodal metastatic foci of colorectal carcinoma are usually solid nodules. Serous inclusions are occasionally found in lymph nodes, particularly in female patients, and they occasionally form cysts. An 86-year-old woman was treated with laparoscopic low anterior resection and D3 lymph node dissection for advanced rectal carcinoma. A cyst with serous fluid and no necrotic debris was found within one of the dissected pararectal lymph nodes. Histologically, the cyst was lined by low columnar-to-cuboid epithelium with mild nuclear atypia, mimicking a serous inclusion cyst. Immunohistochemically, the epithelial cells were positive for caudal type homeobox 2 and negative for Wilms’ tumor suppressor gene1. Immunohistochemistry for p53 showed a diffuse strong positivity, indicating a mutant TP53 as seen in primary rectal carcinoma. Thus, the nodal cystic lesion was confirmed to be a metastatic lesion. It is important to carefully assess a nodal cystic lesion to confirm whether it is benign or malignant.
Persons With Hemophilia of Generation Y and Their Relatives Attitudes and Expectations From Treatment
Authors: Zulfikar Bulent , Koc Basak , Gumustas Irmak , Zulfikar Haluk
Published: March 2021

This multicenter cohort study aimed to determine the attitudes and expectations of persons with hemophilia of Generation Y (PwH-Y) toward hemophilia and its treatment comparatively with the opinions of their non-hemophiliac relatives. The study was representative regarding quota-control variables of hemophiliacs registered to the provincial representatives of the Hemophilia Society of Turkey in 4 geographic regions and Istanbul. Sixty-four PwH-Y (62 males) and their 56 first-degree relatives (17 males; Generation X/baby boomers) were interviewed face-to-face using mixed data collection method. “Focus Group Study” method was used for qualitative data. Treatment adherence, requirements, and social activities were questioned with a semi-structured form. Treatment adherence rate of the PwH-Y (46.2%) was lower than that perceived by their relatives (71.4%) (p ≤ 0.05). Vascular access problems were the most common reasons for non-adherence (60% in PwH-Y and 25% in relatives). Among the components the hemophiliacs and their relatives needed most, support for accessibility of drugs/treatment ranked first (41.1% and 45%, respectively), followed by emotional support (26.1% and 32.5%, respectively). For increasing treatment success in PwH-Y, treatment should be personalized and shaped based on personal requirements.