bluuebunny/crossref_metadata_2025 huggingface dataset:
Preclinical Characterization of HPN536, a Trispecific, T-Cell–Activating Protein Construct for the Treatment of Mesothelin-Expressing Solid Tumors
Authors: Molloy Mary Ellen , Austin Richard J. , Lemon Bryan D. , Aaron Wade H. , Ganti Vaishnavi , Jones Adrie , Jones Susan D. , Strobel Kathryn L. , Patnaik Purbasa , Sexton Kenneth , Tatalick Laurie , Yu Timothy Z. , Baeuerle Patrick A. , Law Che-Leung , Wesche Holger
Published: December 2020

Purpose:

Mesothelin (MSLN) is a glycophosphatidylinositol-linked tumor antigen overexpressed in a variety of malignancies, including ovarian, pancreatic, lung, and triple-negative breast cancer. Early signs of clinical efficacy with MSLN-targeting agents have validated MSLN as a promising target for therapeutic intervention, but therapies with improved efficacy are still needed to address the significant unmet medical need posed by MSLN-expressing cancers.

Experimental Design:

We designed HPN536, a 53-kDa, trispecific, T-cell–activating protein-based construct, which binds to MSLN-expressing tumor cells, CD3ϵ on T cells, and to serum albumin. Experiments were conducted to assess the potency, activity, and half-life of HPN536 in in vitro assays, rodent models, and in nonhuman primates (NHP).

Results:

HPN536 binds to MSLN-expressing tumor cells and to CD3ϵ on T cells, leading to T-cell activation and potent redirected target cell lysis. A third domain of HPN536 binds to serum albumin for extension of plasma half-life. In cynomolgus monkeys, HPN536 at doses ranging from 0.1 to 10 mg/kg demonstrated MSLN-dependent pharmacologic activity, was well tolerated, and showed pharmacokinetics in support of weekly dosing in humans.

Conclusions:

HPN536 is potent, is well tolerated, and exhibits extended half-life in NHPs. It is currently in phase I clinical testing in patients with MSLN-expressing malignancies (NCT03872206).
The Joint Dynamics of Stock and Bond Risk-Returns in Japan
Authors: Lee Changmin , Kang Hyoung-Goo
Published: December 2020

We examine the joint dynamics of stocks and bonds in the Japanese marker by computing the prices of risks and their relationship in stock and bond factors. We deconstruct market factors into industry factors and incorporate bond factors such as the level. Slope, and curvature of yield curves. This paper contributes to the: literature by identifying the risk-return relationship in Japanese financial market in explaining the cross-sectional variations of stock returns in consideration of the bond market, and illustrating the importance of macro information in stock returns. Our approach and results provide practical implications to hedge fund managers, mutual fund managers, and basket traders.
MTrack: Improved Center Fix of Tropical Cyclones from SMAP Wind Observations
Authors: Mayers David , Ruf Christopher
Published: December 2020

MTrack is an automated algorithm that determines the center location (latitude and longitude) of a tropical cyclone from a scalar wind field derived from satellite observations. Accurate storm centers are useful for operational forecasting of tropical cyclones and for their reanalysis (e.g., research on storm surge modeling). Currently, storm center fixes have significantly larger errors for weak, disorganized storms. The MTrack algorithm presented here improves storm centers in some of those cases. It is also automated and, therefore, less subjective than manual fixes made by forecasters. The MTrack algorithm, which was originally designed to work with CYGNSS wind speed measurements, is applied to SMAP winds for the first time. The average difference between MTrack and Best Track storm center locations is 21, 36, and 46 km for major hurricanes, category 1–2 hurricanes, and tropical storms, respectively. MTrack is shown to operate successfully when a storm is only partially sampled by the observing satellite and when the eye of the storm is not resolved.
The Amazon Water Cycle: Perspectives from Water Budget Closure and Ocean Salinity
Authors: Reeves Eyre J. E. Jack , Zeng Xubin
Published: December 2020

Global and regional water cycle includes precipitation, water vapor divergence, and change of column water vapor in the atmosphere, and land surface evapotranspiration, terrestrial water storage change, and river discharge, which is linked to ocean salinity near the river mouth. The water cycle is a crucial component of the Earth system, and numerous studies have addressed its individual components (e.g., precipitation). Here we assess, for the first time, if remote sensing and reanalysis datasets can accurately and self-consistently portray the Amazon water cycle. This is further assisted with satellite ocean salinity measurements near the mouth of the Amazon River. The widely used practice of taking the mean of an ensemble of datasets to represent water cycle components (e.g., precipitation) can produce large biases in water cycle closure. Closure is achieved with only a small subset of data combinations (e.g., ERA5 precipitation and evapotranspiration plus GRACE satellite terrestrial water storage), which rules out the lower precipitation and higher evapotranspiration estimates, providing valuable constraints on assessments of precipitation, evapotranspiration, and their ratio. The common approach of using the Óbidos stream gauge (located hundreds of kilometers from the river mouth) multiplied by a constant (1.25) to represent the entire Amazon discharge is found to misrepresent the seasonal cycle, and this can affect the apparent influence of Amazon discharge on tropical Atlantic salinity.
Need, competence and compliance: Selective empowering in the distribution of medical technologies in the Norwegian health care system
Authors: Øversveen Emil
Published: December 2020

The development of medical technologies is often assumed to improve medical treatment, but may also reproduce health inequalities if their benefits are unequally distributed. Sociological studies have shown that social and moral evaluations matter for medical decision making, and that inequalities in access and outcome exist even in universal health care systems. This article uses the distribution of medical technologies in the treatment of type 1 diabetes as a case for examining the social production of health care inequalities. Drawing on observational data and in-depth interviews with physicians and nurses working in a Norwegian hospital, I demonstrate that medical staff evaluate patients based on a combination of medical, social and moral criteria. The concept of selective empowering is then elaborated and refined as a term for the practice in which medical professionals steer resources towards patients based on evaluations of need, competence and compliance. While previous studies of inequalities in medical care have often focused on medical staff’s cognitive dispositions, I argue that selective empowering may be interpreted as a reflexive response to increasing health care costs and a structural dependency on expensive and commercially produced medical technologies.
Neoliberalism: Unpacking Limited Employment Success for Persons with SMI
Authors: Gruhl Karen Lynn Rebeiro
Published: December 2020

Background.

A mixed-methods case study exploring access to competitive employment for persons with serious mental illness (SMI) revealed limited access to work and low employment success across two northern communities.

Purpose.

To explore possible explanations for why low employment rates persist despite existing employment services and supports.

Methods.

A total of 46 individual or group interviews were conducted with persons with SMI, vocational providers, and decision-makers regarding access to competitive employment in the case communities. Data were systematically analysed for dominant ideas, interests and institutions using a neo-institutional framework.

Findings.

Participants described access to employment to be constrained by provider competition, limited supports, and a lack of consideration of difference—ideas and interests associated with neoliberal influences within provincial employment supports policy.

Implications.

Enabling participation in meaningful employment for people with SMI will require occupational therapists to appreciate and contest the oppressive nature of neoliberal policies on local programs and services.
In Dialogue: How Writing to the Dead and the Living Can Increase Self-Awareness in Those Bereaved by Addiction
Authors: Thatcher Christina
Published: December 2020

This article examines how writing can increase the self-awareness of a socially isolated and often stigmatized population: those bereaved by addiction. Writing about a traumatic event has been shown to increase self-awareness which can improve health and regulate negative behaviors. Using narrative analysis on the writing of individuals bereaved by addiction, this study found that participants were able to increase their self-awareness through writing to the dead, the living and themselves. Participants’ writing also demonstrated their attempts to make sense and make meaning out of their loss which are both strong predictors of positive health outcomes. All participants in this study demonstrated increased self-awareness as well as sense-making and/or meaning-making which can lead to improvements in behavior regulation, psychological health and physical heath. This suggests that writing may be a uniquely beneficial therapeutic intervention for those experiencing disenfranchised grief as a result of bereavement by addiction.
Prognostic Significance of HPV Status in Laryngeal Squamous Cell Carcinoma: A Large‐Population Database Study
Authors: Panuganti Bharat A. , Finegersh Andrey , Flagg Mitchell , Tu Xin , Orosco Ryan , Weissbrod Philip A. , Califano Joseph
Published: December 2020

Objective

To explore the survival implications of human papillomavirus (HPV) positivity and subtype in larynx cancer through a national cancer database. To investigate staging discrepancies in larynx cancer associated with HPV status.

Study Design

Retrospective observational cohort study.

Setting

National Cancer Database.

Methods

Data were extracted concerning adults with known HPV status who were treated between 2010 and 2016 for laryngeal squamous cell carcinoma. Patients without known HPV subtype were excluded. Cox multivariable regression models were fit to evaluate the survival impact of HPV status, characterized as a binary variable (HPV+ vs HPV–) and by subtype. Two‐ and 5‐year survival rates were calculated via the Kaplan‐Meier method and compared by stage between the HPV+ and HPV– cohorts per the log‐rank test.

Results

Patients with HPV+ larynx cancer were younger (60.5 vs 64.3 years, P <. 001), more likely to have private insurance (37.2% vs 31.2%, P <. 001), more commonly White (84.6% vs 82.4%, P =. 013), and more likely to present with nodal disease (42.6% vs 33.0%, P <. 001). HPV positivity and HPV subtype 16 were associated with improved overall survival. One‐stage discrepancies in 5‐year survival were observed between the HPV+ and HPV– cohorts: stage II HPV+ (69.45%) vs stage I HPV– (65.77%); stage IV HPV+ (47.67%) vs stage III HPV– (46.80%).

Conclusions

HPV positivity and infection with HPV subtype 16 are correlated with improved overall survival in patients with laryngeal squamous cell carcinoma, manifesting with a 1‐stage incremental survival advantage. Future prospective studies are indicated to corroborate the findings from this large‐population database retrospective study.
Selecting Bolt-on Dimensions for the EQ-5D: Testing the Impact of Hearing, Sleep, Cognition, Energy, and Relationships on Preferences Using Pairwise Choices
Authors: Finch Aureliano Paolo , Brazier John , Mukuria Clara
Published: December 2020

Background

Generic preference-based measures (GPBMs) such as the EQ-5D are valid across many conditions, but in some cases, “bolting on” additional dimensions may improve validity. The selection of “bolt-ons” has been based on the psychometric impact of individual dimensions, but preferences provide another important way to select them. This study aims to test the potential of using pairwise choices to inform the selection of bolt-ons for the EQ-5D-5L.

Methods

General population preferences were collected using an online survey of 1040 UK residents. Three EQ-5D-5L health state pairs were selected based on pairs that had a 50:50 split in respondent preferences from a previous pairwise survey. Participants were presented with pairwise choices of EQ-5D-5L health states without and with bolt-ons of hearing, sleep, cognition, energy, and relationships, each added individually. Logistic models were used to assess the impact of bolt-ons, as well as bolt-ons at different severity levels, on the log odds of responders choosing between health states.

Results

Preferences varied according to the bolt-ons and their severity level (only levels 1, 3, and 5 were used). Additions of bolt-ons at level 1 generally resulted in nonstatistically significant differences while additions of bolt-ons at level 3 and level 5 produced a negative and statistically significant impact on preferences for the health state with the bolt-on. At level 5, hearing had the largest impact, followed by cognition, relationships, energy, and sleep. At level 3, cognition produced the largest impact, followed by hearing and sleep with similar impacts, energy, and relationships. This ordering offers information for bolt-on selection, with hearing and cognition appearing as the most important. The weight placed on the different health problems is not constant across severity levels between bolt-ons.

Conclusions

Pairwise choices provide a cost-effective approach of generating information on preferences to support bolt-on selection.
Venovenous ECMO treatment, outcomes, and complications in adults according to large case series: A systematic review
Authors: Kim Jun Hyun , Pieri Marina , Landoni Giovanni , Scandroglio Anna Mara , Calabrò Maria Grazia , Fominskiy Evgeny , Lembo Rosalba , Heo Min Hee , Zangrillo Alberto
Published: December 2020

Background:

Venovenous extracorporeal membrane oxygenation (VV ECMO) has gained popularity for the treatment of refractory respiratory failure during and after the 2009 influenza pandemic, and still represents a precious therapeutic resource for severe novel coronavirus 2019 infection. However, most of the published studies are small case series, and only two randomized trials exist in literature.

Aim:

Aim of this systematic review is to describe trends in VV ECMO treatment outcomes according to large studies only.

Methods:

We searched and included studies with more than 100 VV ECMO cases dated up to August 1st, 2019.

Results:

Thirty-three studies published in the period 2011–2019 met inclusion criteria, for a total of 12,860 patients (age 46.3 ± 17.4 years). ARDS was mainly by pneumonia, in 3126 (37%) cases; further 401(7%) patients had H1N1 Influenza A infection. Cannulation-related complications occurred in 502 (7%) cases. Weighted mean (95% confidence interval) of VV ECMO duration was 8.9 (8.7–9.1) days, and ICU stay was 23.6 (22.4–24.8) days. Mortality at the longest follow up available was 40%. Data collection in 70% of the studies had a duration of >5 years.

Conclusion:

This study reveals the characteristics of large case VV ECMO studies.
Acute Flaccid Myelitis: A Multidisciplinary Protocol to Optimize Diagnosis and Evaluation
Authors: Vawter-Lee Marissa , Peariso Katrina , Frey Mary , Bolikal Priya , Schaffzin Joshua K. , Schwentker Ann , O’Brien William T. , Zamor Ronine , Kerrey Benjamin T.
Published: December 2020

Acute flaccid myelitis is an emerging neurologic disease, first described in 2014 and predominantly affecting young children. Acute flaccid myelitis cases tend to spike every 2 years, in the late summer to fall, and the next peak is expected in 2020. The diagnosis of acute flaccid myelitis is often delayed, leading to suboptimal evaluation, including incomplete laboratory assessment. Acute and chronic morbidity are high, and a standardized, multidisciplinary approach to evaluation and treatment is essential to optimizing outcomes. In a review of acute flaccid myelitis patients treated in 2018 at our institution, we noted considerable variability in days to presentation, evaluation, and treatment. In response, the authors developed a protocol for the evaluation and management of pediatric patients suspected of having acute flaccid myelitis. The protocol was developed using local experience/case review, expert consensus, and the relevant literature. The protocol spans the spectrum of care, from initial evaluation in a primary care or emergency setting, to acute hospital management and evaluation and long-term inpatient and rehabilitation settings. The purpose of this report is both to share the findings from our 2018 case review and to disseminate our acute flaccid myelitis protocol. Our hope is that publication of our protocol will both inform the development of a standardized approach to acute flaccid myelitis and to encourage other centers to form a multidisciplinary acute flaccid myelitis team to provide expert care throughout the disease process, from presentation to recovery.
Applying experimental micro-tool wear measurement techniques to industrial environments
Authors: Alhadeff Lisa , Marshall Matthew , Curtis David , Slatter Tom
Published: December 2020

Productivity in micro-milling is hindered by premature fracture of tools and difficulty predicting wear. This work builds upon previous investigations into tool wear mechanisms and coatings for micro-mills.The technology readiness level of this work exceeds previous studies by investigating the micro-mills for practical applications and comparing this data. 0.5 mm micro end mills are tested with different coatings on CuZn38, and wear curves produced both in the case of simple straight slot testing and milling of complex parts representing industrial applications. The results show that curves produced using straight slots can be used to predict the behaviour of tools used to machine industrial parts. Due to interrupted cutting, tools used in straight slot tests reach the end of steady state wear after approximately 12 s of cutting as compared with 170 s in continuous milling. Typical cutting forces seen for the tools are in the order of 2–4 N. Catastrophic failure is seen towards the end of tool life for a TiAlN tool with a cutting force of over 30 N seen. For the first time a comparison has been made between fundamental tool wear studies and tool wear observed when producing test pieces representative to micro-industrial parts. This presents a novel perspective on tool wear and facilitates the integrating of existing micro-milling research into industry
Resilience unwanted: Between control and cooperation in disaster response
Authors: Krüger Marco , Albris Kristoffer
Published: December 2020

This article conceptualizes resilience as an emergent and contingent practice that shapes societal relationships in unexpected ways. It focuses on the case of the 2013 floods in Dresden, a city that witnessed three major floods within 11 years. Emergent volunteer activities on the ground and on social media played a significant role during the flood emergency response efforts. Drawing on Philippe Bourbeau’s definition of resilience as a process of patterned adjustment, the article regards these emergent structures as incidents of resilience. In the case of Dresden, not only was resilience not explicitly requested by the state, but it was in several incidents actively not wanted. While most of the volunteering activities arising from social media platforms intended to support the disaster management authorities, the case shows how subversive forms of resilience were mobilized to resist official plans. They finally urged authorities to adapt to a new social and technological reality in order to render unaffiliated volunteering governable. Resilience thus emerges as an adaptive process that shapes and is shaped by societal relations. The article thus seeks to add another facet to the debate on resilience by demonstrating how resilience helps us to make sense of complex and interdependent adaptation processes.
Indian Fertility Transition
Authors: Radkar Anjali
Published: December 2020

Fighting to curb the population growth, India’s reduction in fertility rate (58%) in 35 years is evident; total fertility rate (TFR) declined from 5.2 to 2.2 meaning three children less. According to the National Family Health Survey (NFHS-4), 2015–2016, TFR has dropped to 2.18 from 3.39 in 1992 (NFHS-1).

Proximate determinants indicate that over a period, index of marriage and contraception contribute lesser towards fertility, and postpartum amenorrhoea shows marginal variation. When total fecundity remains constant, share of abortion does not remain one but contribute towards fertility reduction.

Benefits of fertility decline include lowering population growth and its positive effects on overall development. As fertility declines, maternal mortality declines; maternal mortality ratio (MRR) declined by 67 per cent in past 13 years. Sharp decline in fertility gives rise to demographic dividend. India is passing through it.

Fertility drop is not without consequences.

Fertility decline makes pregnancies precious; giving rise to upswing to C-section deliveries and hysterectomy even for a minor cause or is it a response to cancer threat?

Preference for sons is universal here. With fertility reduction, it surfaces with unruly consequences of missing girls.

Drop in fertility has changed the shape of the population pyramid. Share of elderly is reaching 10 per cent, of which share of women and more so share of oldest women is more. In the absence of social security and low rates of workforce participation, women are getting more dependent on the required care, increasing their vulnerability.

Fertility reduction has achieved with moderate level of development. Now the right response to effects of fertility decline is the biggest social challenge.
Health and Safety in the Legal Cannabis Industry Before and During COVID-19
Authors: Otañez Marty , Grewal Jassy
Published: December 2020

In 2020, medical cannabis is legal in thirty-six states and adult use (“recreational”) cannabis is legal in fifteen, despite cannabis remaining illegal at the federal level. Up to 250,000 individuals work as full-time employees in cannabis. During the COVID-19 pandemic, California, Colorado, and other states deemed medical cannabis business as essential, raising occupational challenges and safety issues for cannabis employees. In 2020, interviews were conducted with Ethan, an extraction lab assistant in Las Vegas; Haylee, a trainer with a cannabis company in Sacramento; and Belinda, a Wisconsin-based occupational health and safety trainer, to showcase concerns and experiences in cannabis workplaces and training programs. Findings from interviews reveal pro-worker activities to promote workplace safety and labor unionism while large multistate operators seek to optimize profits and obstruct workers' rights. Knowledge gained through the interviews contributes to discussions to lessen the potential exposure of the cannabis workforce to COVID 19.
A softer kind of hard news? Data journalism and the digital renewal of public service news in Sweden
Authors: Widholm Andreas , Appelgren Ester
Published: December 2020

Over the past decade, data journalism has received considerable attention among scholars, pointing to novel forms of investigative reporting as well as new daily practices of news production. This study contributes to existing scholarship by conceptualizing data journalism through distinctions between hard and soft news in relation to service journalism. We analyze news produced by specialized data desks in Swedish public service organizations over a 5-year period (2015–2019) and propose a model for how service journalism attributes can be used as a bridge between the binary categories of hard and soft in data journalism. With this model, we point to how data journalism in public service organizations challenges established notions of soft and hard news and how hybrid production practices open up new research trajectories concerning the societal significance of news in the digital age.
Evaluation of topical morphine for treatment of oral mucositis in cancer patients
Authors: Nielsen Bettina Nygaard , Friis Susanne Molin , Schmiegelow Kjeld , Henneberg Steen , Rømsing Janne
Published: December 2020

Introduction:

Oral mucositis is a painful side effect to chemotherapy. Orally applied opioids may offer analgesia with fewer side effects than systemic opioids.

Methods:

A randomized trial comparing the analgesic effect of a morphine oromucosal solution (OM) to placebo and a positive control group receiving intravenous (IV) morphine as an add-on treatment to morphine patient-controlled analgesia (PCA) in a mixed population of paediatric and adult haematology patients. All patients in the study were equipped with a morphine PCA pump and the participating patients were instructed to use this pump as an escape. Primary outcome was morphine consumption (mg/kg/hour) on the PCA pump. Secondary outcomes included pain intensity difference at rest and when performing oral hygiene, time to first PCA bolus, nutrition intake and adverse events.

Findings:

A total of 60 patients (38 children <18 years) were randomized. Thirty patients were allocated to morphine OM/placebo IV (group MO), 15 patients to placebo OM/morphine IV (group MI) and 15 patients to placebo OM/placebo IV (group P). The median morphine consumption in the MO group (22.7 mcg/kg/hour 95% confidence interval (CI) 19.4–29.4 mcg/kg/hour, p = 0.38) was not significantly different from the placebo group (24.6 mcg/kg/hour 95% CI 16.8–34.4 mcg/kg/hour, p = 0.44) or the MI group (13.7 mcg/kg/hour 95% CI 9.7–37.8 mcg/kg/hour). For the secondary outcomes, the analysis of summed pain intensity difference after the first, third and fourth administrations of study medication indicated a reduction in pain for the MI group compared to the P and MO groups. No serious adverse events were reported.

Conclusion:

The findings indicate that the analgesic effect of peripherally applied morphine is not significantly different from placebo, and parenteral opioids should continue to be the standard of care.
The penal narratives of community sentence and the role of probation: The case of the Wrocław model of community service
Authors: Matczak Anna
Published: December 2020

This article draws on Robinson, McNeill and Maruna’s argument about the adaptability of community sanctions and measures, observed through four distinctive penal narratives, in order to shed light on the regional development of community service in Wrocław, Poland. While the managerial adaptation of community sanctions is underpinned by an inter-agency cooperation to fulfil the goals of the system, the contemporary rehabilitation iteration has become a toolkit of measures predominantly phrased around risk management, the reparative discourse seeks various means to repair harm and the punitive orientation represents the turn to desert-based and populist sentencing frameworks. In this article, the first three are reflected upon along with the emerging, restorative adaptation of community sanctions. The last one is added to expand on the findings of this author’s previous research, which suggests the viability of the restorative orientation for community service in Poland. A brief discussion of how punishment, probation and restorative justice can be reconciled is followed by the introduction of Polish probation and the role of probation officers in delivering community service in Poland. Although the penal narratives are visible in the Wrocław model to different degrees and in various combinations, more research is required to evaluate the viability of a progressive orientation to punishment during a gradual optimisation of community orders.
Exploring Behavioral Competencies for Effective Medical Practice in Nigeria
Authors: Chukwuma Adanna , Obi Uche , Agu Ifunanya , Mbachu Chinyere
Published: December 2020

Introduction:

Clinical performance varies due to academic, clinical, and behavioral factors. However, in many countries, selection of medical professionals tends to focus on exclusively academic ability and clinical acumen. Appropriate selection processes for medical professionals should consider behavioral factors, which may vary across contexts. This study was conducted to identify behavioral competencies considered relevant for effective medical practice in Nigeria, by medical students and doctors, and compared with other contexts.

Methods:

This mixed methods study draws on a scoping review and nominal group technique exercises. We undertook a scoping review to develop a list of behavioral attributes that may correlate with effective service provision in the empirical literature, across contexts. Drawing on nominal group technique exercises with 17 medical students and 11 physicians, this starting list was modified through scoring and ranking of selected competencies. We compared the list of competencies and rankings between medical students, doctors, and the scoping review.

Results:

The scoping review identified 9 articles for full-text review, resulting in a starting list of 21 behavioral competencies defined in studies, all of which had been conducted in non-African countries. The nominal group technique exercises conducted with medical students and doctors yielded a condensed list of 32 and 27 behavioral competencies respectively. For doctor-client interactions, effective communication and patient-centeredness were ranked highly, while for doctor-colleague interactions, teamwork, respectfulness, and management ability were ranked highly. There were also divergences in the condensed list of behavioral competencies and the scoping review, which may be explained by cultural and non-cultural factors.

Discussion:

This study is one of the few to examine the perspectives of medical students and physicians on behavioral competencies for effective medical practice in an African country. We found differences in the perspectives of medical physicians and students, and in the prioritized competencies across countries. Our study illustrates the need for careful consideration in identifying subject matter experts and in generalizing competencies across contexts. Future research in this field in Nigeria should examine effective ways of testing for key behavioral competencies among medical students and for residency programs. Also, investigating the perspectives of medical faculty and administrators on important competencies, and exploring the generalizability of these competencies across cultures in Nigeria should be considered.
Alternative Factors Associated With Failure of Mandibular Distraction Osteogenesis
Authors: Ramirez-Garcia Richard , Humphries Laura S. , Reid Russell R.
Published: December 2020

Introduction: Mandibular Distraction Osteogenesis (MDO) is an alternative to tracheostomy and works via lengthening the mandible in order to reduce glossoptosis and airway obstruction. While many patients who undergo mandibular distraction avoid the use of a tracheostomy, some patients will require re-distraction or tracheostomy, often due to recurrence of sleep apnea. This paper explores the potential factors that are associated with MDO failure, defined as requiring re-distraction or tracheostomy over other patients who succeed with the initial procedure. Methods: A retrospective review of all patients who had an obstructed airway, 0 to 18 years of age, and underwent MDO at a single institution from 2008 to 2019 was performed. Fisher’s exact analysis, log-rank analysis, and Kaplan-Meier estimates were used to identify associated factors to failure post-MDO. Results: Forty-five patients satisfied the inclusion criteria, of which 11 patients required re-distraction or tracheostomy post-MDO. Of the parameters assessed, postoperative complications and age >1 month were associated with increased odds of failure ( P < .05). Syndromic status trended toward significance as an associated factor ( P < .1). Tonsillectomy & adenoidectomy before initial MDO was associated with postoperative complications ( P < .05). Conclusion: Our retrospective analysis not only corroborates the results of others in regards to the natural association of postoperative complications and syndromic status with MDO failure, but also suggest that prior tonsillectomy & adenoidectomy, and age at surgery in our series may play a role as well.
Intravesical holmium laser fragmentation and removal of a retained piece of tree branch from the urinary bladder of a young male
Authors: Afolayan Peter O. , Abdel Goad E. H. , Singh Avikar , Pillay Shaun
Published: December 2020

Background

Holmium laser has been used primarily for lithotripsy, and on soft tissue and tumor. Its effect on wood has never been described in the literature. Here-in case we were able to successfully laser intravesical wood particles in a young male.

Case presentation

A 12-year-old boy was referred to our urology center following a history of recurrent urinary tract infection to which an intravesical foreign body was picked up upon investigation. Imaging studies of an abdominal ultrasound had revealed an intravesical foreign body. He was found to have a piece of wood in the bladder that was too big to be extracted through the cystoscope and was lasered into fragments.

Conclusion

Our case showed a more versatile use of the holmium laser and concluded that it can be used successfully on wood.
A rather dry subject; investigating the study of arid-associated microbial communities
Authors: Osborne Peter , Hall Lindsay J. , Kronfeld-Schor Noga , Thybert David , Haerty Wilfried
Published: December 2020

Almost one third of Earth’s land surface is arid, with deserts alone covering more than 46 million square kilometres. Nearly 2.1 billion people inhabit deserts or drylands and these regions are also home to a great diversity of plant and animal species including many that are unique to them. Aridity is a multifaceted environmental stress combining a lack of water with limited food availability and typically extremes of temperature, impacting animal species across the planet from polar cold valleys, to Andean deserts and the Sahara. These harsh environments are also home to diverse microbial communities, demonstrating the ability of bacteria, fungi and archaea to settle and live in some of the toughest locations known. We now understand that these microbial ecosystems i.e. microbiotas, the sum total of microbial life across and within an environment, interact across both the environment, and the macroscopic organisms residing in these arid environments. Although multiple studies have explored these microbial communities in different arid environments, few studies have examined the microbiota of animals which are themselves arid-adapted. Here we aim to review the interactions between arid environments and the microbial communities which inhabit them, covering hot and cold deserts, the challenges these environments pose and some issues arising from limitations in the field. We also consider the work carried out on arid-adapted animal microbiotas, to investigate if any shared patterns or trends exist, whether between organisms or between the animals and the wider arid environment microbial communities. We determine if there are any patterns across studies potentially demonstrating a general impact of aridity on animal-associated microbiomes or benefits from aridity-adapted microbiomes for animals. In the context of increasing desertification and climate change it is important to understand the connections between the three pillars of microbiome, host genome and environment.
Pleuroperitoneal communication after bacterial peritonitis and total gastrectomy for gastric neuroendocrine tumors: a case report and brief literature review
Authors: Ino Jun , Kaneko Haruna , Kasama Eri , Kodama Mio , Sato Keitaro , Eizumi Hitoshi , Nitta Kosaku
Published: December 2020

Background

Peritoneal dialysis (PD) is associated with various complications, some of which may result in its discontinuation. Pleuroperitoneal communication (PPC) is commonly recognized by the presence of a diaphragmatic defect and pressure elevation in the abdominal cavity due to the dialysate. PPC is unpredictable and its presence prevents the continuation of PD. We present the clinical course and pathological findings of PPC in a PD patient after bacterial peritonitis and total gastrectomy for gastric neuroendocrine tumors. We provide a brief review of PD-related complications that develop due to a non-infectious pathology, including those related to catheter use and an elevated intra-abdominal pressure.

Case presentation

A 65-year-old Japanese man, who had been receiving PD treatment for 1 year, visited our hospital owing to a cloudy dialysate. Bacteria were detected in the dialysate. He had been previously diagnosed with gastric neuroendocrine tumors and gastrectomy had been planned. On admission, we started a 14-day antibiotic treatment for PD-related peritonitis. The patient showed a good clinical course. Gastrectomy was performed as planned, and the postoperative course was uneventful. During the perioperative period, PD was temporally changed to hemodialysis. Five weeks after the gastrectomy, PD treatment was resumed with gradual increase in the exchange volume. After returning to PD overnight, using an automated peritoneal dialysis machine, the patient complained of breathing difficulty and he gained weight. Right-sided pleural effusion was observed on a chest radiograph, and PPC was confirmed by scintigraphy when a mixture of technetium-99m and dialysate was seen entering the right hemithorax within 120 min. The patient did not consent to surgery for the PPC and he hoped to continue to receive PD treatment conservatively. We advised the patient to undergo dialysate exchange in a semi-seated position, and he was prohibited from lying down during the daytime. He continued PD treatment without signs of pleural effusion and over-volume.

Conclusions

This case of PPC occurring after bacterial peritonitis and total gastrectomy for gastric neuroendocrine tumors in a PD patient demonstrates the necessity of recognizing the PPC pathology in PD management and establishing methods for preventing PPC development after bacterial peritonitis or surgical procedures.
A novel method for locating the source of sustained oscillation in power system using synchrophasors data
Authors: Zuhaib Mohd , Rihan Mohd , Saeed Mohd Tayyab
Published: December 2020

Large interconnected power systems are usually subjected to natural oscillation (NO) and forced oscillation (FO). NO occurs due to system transient response and is characterized by several oscillation modes, while FO occurs due to external perturbations driving generation sources. Compared to NO, FO is considered a more severe threat to the safe and reliable operation of power systems. Therefore, it is important to locate the source of FO so corrective actions can be taken to ensure stable power system operation. In this paper, a novel approach based on two-step signal processing is proposed to characterize FO in terms of its frequency components, duration, nature, and the location of the source. Data recorded by the Phasor Measurement Units (PMUs) in a Wide Area Monitoring System (WAMS) is utilized for analysis. As PMU data usually contains white noise and appears as multi-frequency oscillatory signal, the first step is to de-noise the raw PMU data by decomposing it into a series of intrinsic mode functions (IMF) using Improved Complete Ensemble Empirical Mode Decomposition with Adaptive Noise (ICEEMDAN) technique. The most appropriate IMF containing the vital information is selected using the correlation technique. The second step involves various signal processing and statistical analysis tools such as segmented Power Spectrum Density (PSD), excess kurtosis, cross PSD etc. to achieve the desired objectives. The analysis performed on the simulated two-area four-machine system, reduced WECC-179 bus 29 machine system, and the real-time power system PMU data set from ISO New England, demonstrates the accuracy of the proposed method. The proposed approach is independent of complex network topologies and their characteristics, and is also robust against measurement noise usually contained in PMU data.
Sequential CT arterioportography-arteriosplenography depicts individual haemodynamic changes in children with portal hypertension without cirrhosis
Authors: Hammer Simone , Schlitt Hans Jürgen , Knoppke Birgit , Huf Veronika Ingrid , Wohlgemuth Walter Alexander , Uller Wibke
Published: December 2020

We evaluated sequential computed tomography (CT) arterioportography-arteriosplenography for the assessment of venous pathways in children with portal hypertension without cirrhosis. Institutional Review Board approval was obtained for this retrospective, single-centre study. CT was performed after contrast application via catheters placed in the superior mesenteric artery (CT arterioportography) and the splenic artery (CT arteriosplenography) consecutively. Venous pathways in 22 children were evaluated. In all patients, the detailed haemodynamic consequences of portal hypertension could be characterised. The supply of varices at different locations could be assigned to the superior mesenteric vein or splenic vein system. Retrograde blood flow through the splenic vein and inferior mesenteric vein, portosystemic shunting, and patency of splanchnic veins were determined. CT arterioportography-arteriosplenography allowed a complete evaluation of individual haemodynamic pathways in children with portal hypertension.
Semi-quantitative CT imaging in improving visualization of faint ground glass opacities seen in early/mild coronavirus (covid-19) cases
Authors: Ali Rasha Mostafa Mohamed , Ghonimy Mai Bahgat Ibrahim
Published: December 2020

Background

Chest CT is an essential and simple diagnostic method for early detection of pulmonary changes in COVID-19 patients. Semi-quantitative technique depending on both visual and color coded images helps to improve the early detection of COVID-19 chest affection and thus help to control spread of infection.

Results

From first of May to July 15, 2020, 30 patients in Cairo, Egypt who have positive RT-PCR tests and positive pulmonary manifestation were included in our study, 26 patients (86.6%) with faint ground glass opacities were detected by both visual and color coded images, while in 4 patients (13.3%) were only visualized by color coded images and confirmed by CT density assessment.

Conclusion

The combined use of visual and color coded images enhance and improve the early detection of faint ground glass opacities seen in early COVID-19 affection.
Chest CT in COVID-19 pneumonia: a correlation of lung abnormalities with duration and severity of symptoms
Authors: Dawoud Mohammed Mahmoud , Dawoud Tamer Mahmoud , Ali Noha Yousef Amin , Nagy Hanan Ahmad
Published: December 2020

Background

After the spread of COVID-19 pneumonia, chest CT examination was used as a substantial non-invasive complement to RT-PCR for diagnosing and as a rapid screening tool when RT-PCR results are unavailable. Our study aimed at the analysis of the lung abnormalities detected by chest CT in COVID-19 pneumonia according to the severity and duration of symptoms.

Results

In the early phase (n = 60), 32 patients had negative CT findings and 28 patients had positive findings with a mean total lung severity score of 2.13. In the intermediate phase (n = 116), 4 patients had negative CT findings and 112 patients had positive findings with a mean total lung severity score of 16.08. In the late phase (n = 36), all patients had positive findings with a mean total lung severity score of 17.83. CT lung abnormalities were progressed on follow-up CT studies. We found a high total lung severity score in many patients with mild symptoms with a mean of 14.77 and a low total lung severity score in many patients with moderate to severe symptoms with a mean of 9.14.

Conclusion

Chest CT should be used as a routine examination for diagnosing COVID-19 pneumonia and follow-up of disease advance. The progression of lung abnormalities was related to the duration more than the severity of symptoms.
The Welfare Magnet Hypothesis: Evidence from an Immigrant Welfare Scheme in Denmark
Authors: Agersnap Ole , Jensen Amalie , Kleven Henrik
Published: December 2020

We study the effects of welfare generosity on international migration using reforms of immigrant welfare benefits in Denmark. The first reform, implemented in 2002, lowered benefits for non-EU immigrants by about 50 percent, with no changes for natives or EU immigrants. The policy was later repealed and reintroduced. Based on a quasi-experimental research design, we find sizable effects: the benefit reduction reduced the net flow of immigrants by about 5,000 people per year, and the subsequent repeal of the policy reversed the effect almost exactly. The implied elasticity of migration with respect to benefits equals 1.3. This represents some of the first causal evidence on the welfare magnet hypothesis. (JEL F22, H53, I38, J15)
Mitochondrial misreading in skeletal muscle accelerates metabolic aging and confers lipid accumulation and increased inflammation
Authors: Shcherbakov Dimitri , Duscha Stefan , Juskeviciene Reda , Restelli Lisa M. , Frank Stephan , Laczko Endre , Böttger Erik C.
Published: December 2020

We have recently reported on an experimental model of mitochondrial mistranslation conferred by amino acid exchange V338Y in mitochondrial ribosomal protein MrpS5. Here we used a combination of RNA-seq and metabolic profiling of homozygous transgenic Mrps5V338Y/V338Y mice to analyze the changes associated with the V338Y mutation in postmitotic skeletal muscle. Metabolome analysis demonstrated enhanced levels of age-associated metabolites in the mutant V338Y animals accompanied by increased glycolysis, lipid desaturation and eicosanoid biosynthesis, and alterations of the pentose phosphate pathway. In addition, transcriptome signatures of aged V338Y mutant muscle pointed to elevated inflammation, likely reflecting the increased levels of bioactive lipids. Our findings indicate that mistranslation-mediated impairment of mitochondrial function affects specific bioenergetic processes in muscle in an age-dependent manner.
High extinction ratio optical pulse characterization method via single-photon counting
Authors: Vanus Benoit , Baker Chams , Chen Liang , Bao Xiaoyi
Published: December 2020

We present the characterization of high extinction ratio (

ε

) square optical pulses using a photon
counting technique, as other techniques only offer a limited range of
measurement up to 60 dB. High-

ε

pulses are generated by applying a
square pulse modulation on sinusoidally modulated optical signals,
then inducing self-phase modulation (SPM) using the nonlinear Kerr
effect and extracting an SPM-generated sideband. We measured a 10 ns
Kerr-generated optical pulse exhibiting a 120.1 dB extinction ratio,
originating from a conventional electro-optic modulator delivering a
pulse with a 20-dB extinction ratio, by counting the number of photons
at the peak and the pedestal of the generated pulse. These proven high-

ε

pulses allow for long-range
distributed vibration sensing in optical time-domain reflectometry
systems and open new horizons in high-Q microring sensors.