bluuebunny/crossref_metadata_2025 huggingface dataset:
‘Saying goodbye’ during the COVID-19 pandemic: A document analysis of online newspapers with implications for end of life care
Authors: Selman Lucy E , Sowden Ryann , Borgstrom Erica
Published: May 2021

Background:

News media create a sense-making narrative, shaping, reflecting and enforcing cultural ideas and experiences. Reportage of COVID-related death and bereavement illuminates public perceptions of, and responses to, the COVID-19 pandemic.

Aim:

We aimed to explore British newspaper representations of ‘saying goodbye’ before and after a COVID-related death and consider clinical implications.

Design:

Document analysis of UK online newspaper articles published during 2 week-long periods in March–April 2020.

Data sources:

The seven most-read online newspapers were searched: The Guardian, The Daily Mail, The Telegraph, The Mirror, The Sun, The Times and The Metro. Fifty-five articles discussed bereavement after a human death from COVID-19, published during 18/03–24/03/2020 (the UK’s transition into lockdown) or 08/04–14/04/2020 (the UK peak of the pandemic’s first wave).

Results:

The act of ‘saying goodbye’ (before, during and after death) was central to media representations of COVID bereavement, represented as inherently important and profoundly disrupted. Bedside access was portrayed as restricted, variable and uncertain, with families begging or bargaining for contact. Video-link goodbyes were described with ambivalence. Patients were portrayed as ‘dying alone’ regardless of clinician presence. Funerals were portrayed as travesties and grieving alone as unnatural. Articles focused on what was forbidden and offered little practical guidance.

Conclusion:

Newspapers portrayed COVID-19 as disruptive to rituals of ‘saying goodbye’ before, during and after death. Adaptations were presented as insufficient attempts to ameliorate tragic situations. More nuanced and supportive reporting is recommended. Clinicians and other professionals supporting the bereaved can play an important role in offering alternative narratives.
Early stopping in clinical PET studies: How to reduce expense and exposure
Authors: Svensson Jonas E , Schain Martin , Knudsen Gitte M , Ogden R Todd , Plavén-Sigray Pontus
Published: May 2021

Clinical positron emission tomography (PET) research is costly and entails exposing participants to radioactivity. Researchers should therefore aim to include just the number of subjects needed to fulfill the purpose of the study. In this tutorial we show how to apply sequential Bayes Factor testing in order to stop the recruitment of subjects in a clinical PET study as soon as enough data have been collected to make a conclusion. By using simulations, we demonstrate that it is possible to stop a study early, while keeping the number of erroneous conclusions low. We then apply sequential Bayes Factor testing to a real PET data set and show that it is possible to obtain support in favor of an effect while simultaneously reducing the sample size with 30%. Using this procedure allows researchers to reduce expense and radioactivity exposure for a range of effect sizes relevant for PET research.
Shear wave elastography evaluation in predicting the success of ultrasound-guided saline enema hydrostatic reduction technique in ileocolic intussusception
Authors: Akdulum İsmail , Gürün Enes , Akyüz Melih , Tiken Ramazan , Oral Hayrunnisa , Kaya Cem , Boyunaga Öznur Leman
Published: May 2021

Background

Intussusception is the invagination of the proximal intestinal segment into the distal portion. Reduction procedures with fluid or air have been used as the primary treatment of choice in clinically stable children.

Purpose

To evaluate the role of intestinal wall elasticity measurements by shear wave elastography (SWE) to predict the success of ultrasound-guided saline enema (USGSE) reduction.

Methods

USGSE was performed, if not contraindicated otherwise, after the diagnosis of ileocecal intussusception via the ultrasound (US). The length and diameter of the intussusception and the median stiffness of the intestine were measured before USGSE.

Results

Seventeen children were diagnosed with ileocolic intussusception via grayscale US assessment. Two children whose SWE images became artifacts due to inadaptability were excluded from the study. Thus, the study involved 15 patients (9 boys, 6 girls; age range = 11–48 months). There was no statistically significant association between age and median stiffness measurement in kilopascal (kPa). ( P > 0.05). A moderate positive correlation was observed between the median stiffness measurement (kPa) and the length of intussusception (r = 0.547; P = 0.035). There was no statistically significant relationship between median stiffness measurement (kPa) and short-axis diameter of intussusception ( P > 0.05).

Conclusions

Stiffness assessment of the intestinal wall in ileocolic intussusception during the US examination, which is the gold standard in the intussusception assessment, can be used as a new criterion for predicting the performance of the USGSE technique and might be useful in making decisions regarding the clinical management of ileocolic intussusception.
Dentate nucleus signal intensity changes on T1-weighted MRI after repeated administrations of linear and macrocyclic gadolinium-based contrast agents: a pediatric intraindividual case-control study
Authors: Ozturk Kerem , Nascene David
Published: May 2021

Background

An association between consecutive administrations of macrocyclic gadolinium-based contrast agent (mcGBCA) gadobutrol and linear (L)-GBCA gadopentetate dimeglumine and gadolinium retention in the pediatric brain remains incompletely understood.

Purpose

To compare signal intensity (SI) changes in the dentate nucleus (DN) on unenhanced T1-weighted imaging (T1WI) in children who obtained mcGBCA gadobutrol with those who had previously received L-GBCA gadopentetate dimeglumine.

Material and Methods

This retrospective study included 27 children who received L-GBCA gadopentetate dimeglumine followed by mcGBCA gadobutrol and two different control groups matched for age and sex for both periods, each involving 27 individuals with no GBCA administration from January 2010 to January 2020. DN-to-middle cerebellar peduncle (MCP) SI ratios on T1WI were determined. A repeated-measures ANOVA was performed to compare the T1WI SI ratio between children exposed to GBCA in each of the two periods and controls. Pearson correlation analysis was conducted to determine any correlation between SI ratios and confounding parameters.

Results

T1WI SI ratio was significantly higher in those who had only L-GBCA (1.005±0.087) or subsequent mcGBCA gadobutrol (1.002±0.104) than in control groups 1 (0.927±0.041; P<0.001) and 2 (0.930±0.041; P=0.002), respectively, but no significant difference of the T1WI SI ratio was noted between L-GBCA period and subsequent mcGBCA gadobutrol period ( P=0.917). T1WI SI ratios and the L-GBCA administration number revealed a modest but significant correlation (correlation coefficient=0.034; P=0.016).

Conclusion

Previous administration of gadopentetate dimeglumine is associated with increased T1WI SI in the DN, while subsequent administration of gadobutrol does not demonstrate any additional SI increase in the pediatric brain.
Agrin expression is correlated with tumor development and poor prognosis in cholangiocarcinoma
Authors: He Meimei , Cheng Chen , Tu Junxue , Ji Sha-Sha , Lou Dan , Bai Binglong
Published: May 2021

Objective

This study examined the role of agrin in the development of cholangiocarcinoma (CCA).

Methods

Western blotting was performed to detect the expression of target genes. The correlation between agrin expression and prognosis was analyzed using the Kaplan–Meier method. Proliferation, migration, invasion, and tumorigenesis were examined in CCA cells and tissues using the Cell Counting Kit-8 assay, cell cycle analysis, transwell migration assay, and nude mouse tumorigenicity assay in vivo, respectively.

Results

Agrin expression was significantly upregulated in CCA tissues compared with that in adjacent non-tumor tissues, and agrin expression was correlated with poorer tumor characteristics such as portal vein tumor thrombus, intrahepatic metastasis, and worse survival. Forced agrin expression in CCA cells apparently promoted proliferation, colony formation, migration, invasion, and cell cycle progression, but agrin depletion had the opposite effects. Furthermore, agrin-depleted CCA cells developed fewer and smaller tumors than control cells in vivo. Mechanistic analyses indicated that agrin activated the Hippo signaling pathway and induced the translocation of YAP to the nucleus.

Conclusions

Agrin promoted CCA progression by activating the Hippo signaling pathway, suggesting its promise as a target for CCA therapy.
Assessing Cultural Experiences in Historic Urban Centres: Built Forms and Qualities
Authors: Jeyaraj Godwin Emmanuel , Sundaram Meenatchi
Published: May 2021

Human settlements evolved over time and the historic towns of yesterday are the growing urban centres of today. The built environment in historic areas is undergoing such rapid transformation that visitors are no longer able to experience cultural values of the past. Identifying the cultural values that people experience in terms of the qualities of what, where and how may support a more realistic form of conservation planning. To assess one’s cultural experience in a historic centre, it is important to delineate the significant architectural heritage and its multiple qualities across time. For the purposes of this heritage value study, the historic city of Tiruchirappalli in southern India is chosen. The city, one of the oldest in India, is situated on the banks of a river and comprises an age-old hillock and many other important built forms. Using rapid ethnographic assessment methods, 12 characteristic forms were found and these were categorised according to eight qualities: historical, sacred, visual, spatial, functional, physical, memorable and sensitive. The validity of these qualities from peoples’ experiences on cultural values require further examination on a few sample streets with special focus on where and how visitors and residents feel the strongest sense of place.
Examining the Usage of Stylus or Lekhan̄ı in a Historical Space: Evidence of Its Finds from the Literary and Archaeological Sources of India
Authors: Bhoi Panchanan
Published: May 2021

The study analyses the findings of writing instrument and its nomenclature through literary and archaeological sources. Certainly, writing instruments and materials were linked to the appearance of letters and scripts, but we should remind ourselves that the Harappan people did have their own script and left their inscriptions, which we have yet to decipher. Even prior to the Harappan civilisation we have innumerable findings, like graffiti or decorative designs on potsherds, symbols, incised potteries, multi-grooved designs on pots, stamped decorations, pictographs or art and paintings on various materials. If we consider these to be the primal form of a script or primordial form of writing, then definitely these exhibit some kind of communication. And there must have existed some kind of instrument used for the purpose of marking or incising on various materials, which were later on instrumental in the evolution of a script or writing system. This tool or device or instrument could be made of stone, bone, ivory, horn, copper or iron. Again various archaeological terms have been used for these instruments though no one is certain about the nomenclature of these instruments. Whatever the epithets or name tags used for the instruments, there is a certain kind of correlation between the findings of these tools from the various excavation sites, as evident from the many excavation reports referred to. Although these tools were used for various purposes in diverse ways, still it is not adequate reason to exclude them from the discussion of the writing instrument.
Relationship between occupational exposure to whole-body vibration and noise with sex hormone levels: An empirical assessment in an automobile parts manufacturing plant
Authors: Mohammadi Hamzeh , Golbabaei Farideh , Dehghan Somayeh Farhang , Ardakani Soheila Khodakarim , Imani Hossein , Tehrani Fahimeh Ramezani
Published: May 2021

The present study investigated the relationship between occupational exposure to noise and whole-body vibration (WBV) with the levels of sex hormones in an automobile parts manufacturing plant. The level of workers’ exposure ( n = 162) to each of the mentioned stressors was measured through standard methods, and the time-weighted average of exposure was calculated for each person. In order to determine serum sex hormones (free testosterone, luteinizing hormone, and follicle-stimulating hormone), blood samples were taken from all participants after 8–10 h of fasting between 7 and 9 am and then the blood samples were analyzed by an enzyme-linked immunosorbent assay method. In general, regarding testosterone as the main male sex hormone, only 49% of the participants were in the normal range. In a total of three sections, the lowest mean testosterone levels were observed in the third exposure group (WBV > 1.93 m/s2; noise >92.69 dB) of the studied stressor; however, only the difference in testosterone levels between the three different groups of exposure to noise was statistically significant ( p = 0.001). The relationship between demographic variables and levels of noise and WBV exposure with sex hormones was not linear and only the relationship between noise exposure and testosterone levels was statistically significant ( R = −0.201, p = 0.013). According to the results of logistic regression, the WBV had the greatest effect on testosterone levels. However, according to the results of the correlation test, only the relationship between noise exposure and testosterone levels was statistically significant.
An Environmental Scan of Indigenous Cultural Safety in Canadian Baccalaureate Nursing and Midwifery Programs
Authors: Metheny Nicholas , Dion Fletcher Claire
Published: May 2021

Background

The Truth and Reconciliation Commission (TRC) TRC has called to increase the number of Indigenous practitioners and include cultural competency education in their curricula. However, it remains unknown how nursing and midwifery programs are progressing towards these goals.

Purpose

To examine the extent to which baccalaureate nursing and midwifery programs are creating culturally safe spaces for Indigenous students, responding to TRC-recommended curricular changes, and including Indigenous content.

Methods

A digital environmental scan of accredited baccalaureate nursing and midwifery programs in Canada was conducted. Analysis was conducted using descriptive statistics.

Results

Of the 107 programs, less than one-fifth (n = 19, 17.8%) met all three cultural safety criteria. More than half (n = 59, 55.1%) included culturally safe spaces for Indigenous students, 20 (18.7%) satisfied TRC call #24 to require Indigenous-relevant coursework, and one-third (n = 36, 33.6%) were seen as infusing their curricula with Indigenous-related content.

Conclusions

This represents the first attempt to systematically catalog nursing and midwifery programs’ response to the TRC Calls to Action. Most schools have not made substantial progress towards cultural safety. Nursing and midwifery programs should commit to expanding their cultural safety programming to incorporate multiple ways of knowing and being in their curricula.
Fit gets better: A longitudinal study of changes in interest fit in educational and work environments
Authors: Hanna Alexis , Briley Daniel , Einarsdóttir Sif , Hoff Kevin , Rounds James
Published: May 2021

Theories of person–environment fit describe a dynamic process in which fit should improve over time due to changes in a person’s attributes, the environment, or both. Although these ideas are central in several theoretical perspectives, they have largely gone untested. Here, we report a longitudinal examination of interest congruence (i.e. interest fit) across 12 years during the transition from education to the workforce. The study uses four methods to capture interest congruence and the drivers of fit change: growth models, latent congruence models, person and environment latent difference scores, and piecewise growth models based on environmental transitions. Each method uses a different lens to understand interest congruence in educational and work domains. Across methods, three results were typically found: (1) interest congruence improved over time in school and at work, (2) participants’ interests often predicted educational and work changes, and (3) participants’ interests rarely changed in response to their environment. These results support a dynamic conceptualization of fit and suggest that selection—rather than socialization—is the main mechanism through which individuals achieve better interest fit during young adulthood. Other implications are discussed for theory development and the applied use of interest assessments.
Student Pharmacists Self-Perceived Confidence in Communication Skills With Healthcare Practitioners Before and After a Seminar Course
Authors: Barefield Kimberly L. , Champion Caroline , Yang Lucy , Rollins Brent
Published: May 2021

Introduction:

Competent pharmacy practice requires the ability to critically evaluate the medical literature and communicate pharmacotherapy information and recommendations to healthcare practitioners. Given the limited research on how these skills are taught, a seminar course in the third year of the pharmacy curriculum was designed to strengthen these skills and abilities.

Methods:

This was a prospective, pre- and post-cohort survey design. Students were informed of the study’s intent with participation being voluntary and not affecting their course grade. Students received the same survey at the beginning and end of the semester. The 20-question survey assessed self-perceived confidence in the domains of communication and literature evaluation using a 5-point, Likert-type Strongly Disagree-Strongly Agree Scale. Demographic information and students’ previous pharmacy work and internship experience were collected as a part of the survey. Descriptive statistics and Student’s t-test were used to assess the research question and comparisons of student demographics.

Results:

Sixty-eight of a possible 91 students (75% response rate) completed both the pre- and post-survey. There was no statistically significant differences between any of the measured demographics. Overall, students slightly agreed they were confident in their communication and literature evaluation skills in the pre-course evaluation, with communicating drug interactions as the least confident area. Post-course, students were significantly more confident in all but 5 of 20 measured areas.

Conclusion:

The Seminar course resulted in a positive change in students’ perception of confidence to communicate with healthcare professionals and ability to evaluate drug literature.
The Socio-Materiality of Dirty Work: A Critical Realist Perspective
Authors: Galazka Anna , O’Mahoney Joe
Published: May 2021

New materialist applications in ‘dirty work’ studies have rightly emphasised the importance of materiality alongside symbolism. However, these approaches have neglected important themes irreducible to the material world, such as temporality, reflexivity and social structure. This article develops an alternative critical realist perspective on socio-materiality in dirty work which emphasises these themes. It draws on 2016–2017 ethnographic data on the work of clinical photographers of wounds in a UK specialist outpatient wound healing clinic. First, it shows how photographers’ reflexivity mediates the relationship between their embodied materiality and their agency in the physical domain. Second, it highlights the temporal dynamics between reflexive agents, their material environment, and the context of their operation. Finally, it emphasises the non-conflationary relationship between the social structures of the medical hierarchy and photographers’ agency in dirty work. Together, these contributions highlight the utility of an emergent, realist ontology in understanding the dynamics of dirty work.
Unintentional teaching of entrepreneurial competences
Authors: Stenholm Pekka , Ramström Joachim , Franzén Riikka , Nieminen Lenita
Published: May 2021

Research on entrepreneurship education (EE) emphasizes the role of learning environments, contexts and pedagogical choices in developing students’ entrepreneurial competences. EE has assumed that it solely carries the task of improving entrepreneurial competences. Yet, the objectives, content and methods of teaching vary, and hence non-entrepreneurship teachers’ classrooms can also provide a learning environment for entrepreneurial competences. However, whether or not this kind of unintentional teaching of entrepreneurial competences takes place has not been widely addressed. In this study, the authors investigate how business school non-entrepreneurship teachers’ teaching methods unintentionally match the known framework of entrepreneurial competences. The findings indicate that non-entrepreneurship teachers do unintentionally expose their students to entrepreneurial competences such as creativity, learning from experience and financial literacy. However, competences such as opportunity recognition, perseverance and mobilizing resources do not receive similar attention. The findings indicate that some entrepreneurial competences are not solely owned by EE, but can be embedded in non-entrepreneurship education. Accordingly, the study extends the current understanding of EE and which “niche” competences should be emphasized in it, but also demonstrates how non-entrepreneurship teachers can expose students to entrepreneurial competences while teaching in their own subject areas.
A probabilistic-based extendable quantitative evaluation method for 3D printing service in cloud manufacturing
Authors: Cui Jin , Zhang Lin
Published: May 2021

By enabling consumer products to be produced on demand and eliminating waste caused by excessive production and transportation, 3D Printing Cloud Services (3DPCSs) are increasingly welcomed by non-professional customers. With more and more 3D printers becoming available on various 3DPCS platforms, the evaluation and selection problem of 3DPCS has attracted much attention for both novices and experienced users. In this paper, we propose a probabilistic-based extendable quantitative evaluation method for 3DPCS evaluation. This method combines the advantages of the information transformation technique, the multinomial distribution probabilistic model, and the uncertainty based weighting method. Evaluation factors, the major attributes that significantly affect the performance of a 3DPCS, are modeled using probabilistic models. At the same time, historical service data is introduced to dynamically identify and update the evaluation factors. Based on these parameters, the proposed quantitative evaluation method can support the evaluation and comparison of 3DPCSs. Numerical simulation experiments are designed and implemented. The corresponding results verify the effectiveness of the proposed evaluation model. The presented evaluation method can serve as the basis of service evaluation and selection on a 3DPCS platform. Although the focus of this work is on 3DPCS, the idea can apply to other types of cloud manufacturing services.
Performance analysis of asymmetric toothed strain wave gear
Authors: Routh Bikash , Sahoo Vineet , Sobczyk Andrzej
Published: May 2021

Strain Wave Gear (SWG) or Harmonic Drive (HD) shows moderate performance under symmetrical involute teeth. Teeth interference, excessive teeth meshing, vibration due to improper teeth engagement are the major drawbacks of strain wave gear under symmetrical involute teeth. In the present paper, an attempt has been made to improve the performance of strain wave gear by replacing the symmetrical involute teeth with asymmetrical involute teeth. Present investigation finds that under ‘asymmetric toothed strain wave gear’, aspects such as teeth interference, teeth engagement and teeth contact stress of strain wave gear are improving clearly and as a consequence some other aspects such as individual teeth strength, load carrying capacity, tooth endurance are also improving inherently. In the present analysis for symmetrical teeth 20°–20° pressure angle and for asymmetrical teeth, three different combinations of pressure angles such as 25°–20°, 30°–20° and 35°–20° are taken.
Investigation of the use of silicone pads to reduce the effects on the human face of classical face masks used to prevent from COVID-19 and other infections
Authors: Gok Kadir
Published: May 2021

Viruses spreads very quickly and has a fatal risk in people with chronic disease. As the virus vaccine and medications to be used for treatment are not fully developed, alternative ways to protect it from the virus are being investigated. In this study, the effects of a classical face mask on human face were investigated and computer-aided analyses were performed. Three-dimensional model of the classical face mask was performed with the SolidWorks software. The analyses were performed using AnsysWorkbench Static Structural module. The load, boundary conditions and material were defined in the AnsysWorkbench. As a result of the analyses, it has been determined that classical masks influence human face. The classical masks have a negative effective in terms of irritation on the human face. The occurred stresses cause irritation on one's skin. The use of silicone pads has been shown to reduce these effects. It was proved by this study that silicon pads can be used as an alternative method to reduce these stresses. In the future, it is planned to conduct studies investigating mask materials that do not irritate the human face.
How Candidates’ Age and Gender Predict Voter Preference in a Hypothetical Election
Authors: Shen Yiqin Alicia , Shoda Yuichi
Published: May 2021

Are preferences for political candidates influenced by how old they appear to be? Amazon Mechanical Turk workers and undergraduate students were shown photos of 93 state legislators as candidates in hypothetical elections. Other information about the candidates (e.g., party affiliation) was held constant, randomized, or not presented. For very young candidates (< 35 years old), participants favored women over men. However, participants’ intention to vote for male candidates increased with age until candidates were about 45 years old and then slightly decreased. In contrast, participants’ intention to vote for female candidates consistently decreased with candidates’ age. Perceived attractiveness and warmth accounted for some of the gender differences in the effect of candidates’ perceived age.
The Foreground Bias: Initial Scene Representations Across the Depth Plane
Authors: Fernandes Suzette , Castelhano Monica S.
Published: May 2021

When you walk into a large room, you perceive visual information that is both close to you in depth and farther in the background. Here, we investigated how initial scene representations are affected by information across depth. We examined the role of background and foreground information on scene gist by using chimera scenes (images with a foreground and background from different scene categories). Across three experiments, we found a foreground bias: Information in the foreground initially had a strong influence on the interpretation of the scene. This bias persisted when the initial fixation position was on the scene background and when the task was changed to emphasize scene information. We concluded that the foreground bias arises from initial processing of scenes for understanding and suggests that scene information closer to the observer is initially prioritized. We discuss the implications for theories of scene and depth perception.
Regenerative flow pumps, blowers and compressors – A review
Authors: Sreekanth M , Sivakumar R , Sai Santosh Pavan Kumar M , Karunamurthy K , Shyam Kumar MB , Harish R
Published: May 2021

This paper presents a detailed and objective review of regenerative flow turbomachines, namely pumps, blowers and compressors. Several aspects of turbomachines like design and operating parameters, working principle, flow behaviour, performance parameters and analytical and Computational Fluid Dynamics (CFD) related details have been reviewed and summarized. Experimental work has been put in perspective and the most useful results for optimized performance have been presented. Consolidated plots of specific speed-specific diameter have been plotted which can be helpful in the early stages of design. Industrial outlook involving details of suppliers from various parts of the world, their product description and applications too are included. Finally, future research work to be carried out to make these machines widespread is suggested. This review is targeted at designer engineers who would need quantitative data to work with.
Pediatric allergic rhinitis with functional gastrointestinal disease: Associations with the intestinal microbiota and gastrointestinal peptides and therapeutic effects of interventions
Authors: Hu B , Kuang Y , Jing Y , Li Y , Zhao H , Ouyang H
Published: May 2021

Children are susceptible to allergic rhinitis (caused by external allergens) accompanied by functional gastrointestinal disease, which seriously affects physical and mental health. Antihistamines and nasal spray hormones are commonly used in clinical treatment, but these drugs often have unsatisfactory efficacy and result in high recurrence rates. Therefore, understanding the pathogenesis of allergic rhinitis with functional gastrointestinal disease and seeking safer treatment and prevention methods is essential. Herein, molecular ecology and immunoassays were used to analyze correlations between pediatric allergic rhinitis with functional gastrointestinal disease and both the intestinal microbiota and gastrointestinal peptide levels. Fifty healthy children (healthy group) and 80 children with allergic rhinitis with functional gastrointestinal disease (case group: evenly divided into a control group (conventional drug therapy) and an intervention group (conventional drug therapy + glutamine+probiotics)), were enrolled. Bifidobacterium and Lactobacillus counts and the gastrin and motilin levels were lower in the case group than in the healthy group, whereas Enterobacter, yeast, and Enterococcus counts and the somatostatin, serotonin, and vasoactive intestinal peptide levels were higher. Post treatment, intestinal microbiota indices, gastrointestinal peptide levels, and intestinal barrier function were better in the intervention group than in the control group ( p < 0.05). The intervention group had a significantly higher total therapeutic response rate (95.00%) than the control group (77.50%). The intestinal microbiota was closely associated with gastrointestinal peptide levels. Treatment with glutamine and probiotics regulated these levels, re-established balance in the intestinal microbiota, and restored intestinal barrier function.
An Ecosocial Perspective on Barriers to the Management of Polycystic Ovary Syndrome Among Women in Urban India
Authors: Pathak Gauri
Published: May 2021

Polycystic ovary syndrome (PCOS) is a hormonal disorder associated with increased risks of type II diabetes and cardiovascular disease. It is also the leading cause of female infertility worldwide. Both lifestyle and genetic factors have been tied to the condition, and in the last couple of decades, it has been affecting a growing number of urban Indian middle-class women; whereas global prevalence is in the 4–11% range, studies in India suggest a prevalence of around one in four urban middle-class women. In this article, I focus on the lived experiences of women with the condition. Drawing from ethnographic fieldwork in Mumbai, India, I use an ecosocial approach to examine barriers to the management of PCOS commonly experienced by women. Such an examination reveals potential bases for intervention to improve management outcomes, particularly as they relate to strengthening the patient–practitioner relationship and improving the clinical encounter.
How Does Hypodontia Compare in Nonsyndromic Pierre Robin Sequence Versus Isolated Cleft Palate and Isolated Cleft Lip?
Authors: Dillon Maria , Seshu Madhavi , Flannigan Norah , Dominguez-Gonzalez Susana
Published: May 2021

Objective:

To assess the prevalence and patterns of hypodontia in nonsyndromic Pierre Robin sequence (PRS) and compare it with hypodontia in nonsyndromic isolated cleft palates and isolated cleft lips.

Design:

Retrospective cohort study.

Setting:

Alder Hey Children’s Hospital, United Kingdom.

Patients:

Patients with nonsyndromic PRS (group 1), isolated cleft palate (group 2), and isolated cleft lip (group 3).

Main Outcome Measures:

Hypodontia in the permanent dentition assessed from orthopantomographs.

Results:

A total of 154 patients were included. Group 1 had the highest incidence of hypodontia with 47% having at least one tooth congenitally absent. Groups 2 and 3 had reduced rates of hypodontia with 27% and 19% of the groups missing teeth, respectively; 93% of cases of hypodontia in group 1 involved the absence of at least one second premolar. Of these patients, there was found to be bilateral agenesis of second premolars in 50% of cases.

Conclusions:

Patients with PRS and cleft palates are more likely to have hypodontia than those with isolated cleft palates or unilateral cleft lips. Patients with PRS have more severe hypodontia than those with isolated cleft palates or unilateral cleft lips. Bilateral agenesis of lower second premolars is a commonly seen pattern among patients with PRS. In this large UK study, a similar prevalence and pattern of hypodontia to other nonsyndromic PRS populations worldwide has been demonstrated.
Spatially random modulus and tensile strength: Contribution to variability of strain, damage, and fracture in concrete
Authors: Castillo Daniel , Nguyen Tuan HA , Niiranen Jarkko
Published: May 2021

This paper explores the computational modeling of nonlocal strain, damage, and fracture in concrete, considering the isolated contribution of two random, spatially variable properties related to the fracture process: Young’s modulus (E) and tensile strength (ft). Applying a continuum damage model, heterogeneous specimens of concrete with random and spatially varying E or ft were found to produce substantial differences when contrasted with traditional homogeneous (non-random) specimens. These differences include variable and uncertain strain and damage, wandering of the failure paths, and differing (sometimes lower) peak forces, i.e. increased probabilities of failure in the heterogeneous specimens. It is found that ft variability contributes more (from 1.7 to up to 4 times more, depending on the parameter) to the overall performance variability of the concrete than E variability, which has a comparatively lower contribution. Performance is evaluated using (1) force-displacement response, (2) individual, average, and standard deviation maps of non-local strain and damage, (3) fracture paths and strain and damage values along the fractures. The modeling methodology is illustrated for two specimen geometries: a square plate with a circular hole, and an L-shaped plate. The computational results correlate well with reported experimental data of fracture in concrete specimens.
The Foot and Ankle Outcome Score (FAOS) During Early Recovery After Ankle Fracture
Authors: Larsen Peter , Al-Bayati Mohammed , Elsøe Rasmus
Published: May 2021

Background:

Several patient-reported outcome measures (PROMs) are available for assessing the outcomes following ankle fractures. This study aimed to evaluate validity, reliability, and responsiveness and detect the minimal clinically important difference of the Foot and Ankle Outcome Score (FAOS) in patients with ankle fractures.

Methods:

The study design is a prospective cohort study, including all patients treated both conservatively and surgically following an ankle fracture (AO-43A/B/C). Content validity, test-retest reliability, responsiveness, and minimal clinically important difference were evaluated from 14 days to 3 months following the fracture.

Results:

The study population consisted of 52 females and 24 males. The mean age was 52.0 years (range, 15-75 years). The percentage of patients at 12 weeks reporting the 5 subscales at least somewhat relevant were pain, 77%; symptoms, 75%; activities of daily living (ADL), 64%; sport, 81%; and quality of life (QOL), 88%. High test-retest reliability of the FAOS questionnaire was observed. The interclass coefficients were 0.78, 0.77, 0.71, 0.73, and 0.74 for the pain, symptoms, ADL, sport, and QOL subscales, respectively. Responsiveness was evaluated with high effect size for the symptoms (0.83), ADL (1.19), sport (4.36), and QOL (2.12) subscales. The minimal clinically important difference of the FAOS was 14 (95% CI, 12-17).

Conclusion:

The FAOS during early recovery after ankle fracture has high reliability and validity.

Level of Evidence:

Level II, prospective cohort study
Use of a Locking Plate and Drill Sleeves to Guide Dome-Shaped Supramalleolar Osteotomy: Technique Tip
Authors: Easley Mark E. , Park Young Uk , Park Jae Yong , Kim Hyong Nyun
Published: May 2021

Level of Evidence: Level V, expert opinion.
Changes in the Syndesmotic Reduction After Syndesmotic Suture-Button Fixation for Ankle Malleolar Fractures: 1-Year Longitudinal Evaluations Using Computed Tomography
Authors: Kimura Seiji , Yamaguchi Satoshi , Ono Yoshimasa , Watanabe Shotaro , Akagi Ryuichiro , Sasho Takahisa , Ohtori Seiji
Published: May 2021

Background:

Evaluation over time is important in assessing the reduction of the syndesmosis after suture-button fixation for ankle malleolar fractures. The purposes of this study were to evaluate time-dependent change in the syndesmotic reduction immediately after suture-button fixation for ankle malleolus fractures and 1 year after surgery using computed tomography, and to investigate the reliability of the measurement values to evaluate the reduction of syndesmosis.

Methods:

We assessed 28 patients who underwent suture-button fixation for ankle fractures. Syndesmotic reduction was assessed within 2 weeks of the fracture surgery and 1 year after surgery using axial computer tomographic images. Side-to-side differences in the anterior, central, and posterior tibiofibular distances, anteroposterior fibular translation, fibular rotation, and syndesmosis area were measured.

Results:

The mean anterior tibiofibular distance and anteroposterior fibular translation were 1.8 mm and 1.5 mm, respectively, after syndesmotic fixation. They decreased to 1.2 mm and 0.6 mm, respectively, at 1 year after surgery ( P = .03 and P = .01, respectively). The other measurement values did not change over time. The minimum detectable change in the distance of measurements was 1 mm or less.

Conclusion:

The anterior tibiofibular distance and anteroposterior fibular translation had decreased 1 year after fixation in ankle malleolar fractures with syndesmotic suture button. Even if the fibula is posteriorly malreduced by the time computed tomography is performed immediately after surgery, the fibula may return to a good position 1 year after surgery.

Level of Evidence:

Level IV, case series.
Alzheimer’s Disease: Innovative Therapeutic Approaches Based on Peptides and Nanoparticles
Authors: Mota Isabela F. L. , de Lima Larissa S. , Santana Bruna de M. , Gobbo Giovanna de A. M. , Bicca João V. M. L. , Azevedo Juliana R. M. , Veras Letícia G. , Taveira Rodrigo de A. A. , Pinheiro Gabriela B. , Mortari Márcia R.
Published: May 2021

Alzheimer’s disease (AD) is the main cause of dementia in the world and its etiology is not yet fully understood. The pathology of AD is primarily characterized by intracellular neurofibrillary tangles and extracellular amyloid-β plaques. Unfortunately, few treatment options are available, and most treat symptoms, as is the case of acetylcholinesterase inhibitors (IAChE) and N-methyl-d-aspartate receptor antagonists. For more than 20 years pharmaceutical research has targeted the “amyloid cascade hypothesis,” but this has not produced meaningful results, leading researchers to focus now on other characteristics of the disease and on multitarget approaches. This review aims to evaluate some new treatments that are being developed and studied. Among these are new treatments based on peptides, which have high selectivity and low toxicity; however, these compounds have a short half-life and encounter challenges when crossing the blood-brain barrier. The present review discusses up-and-coming peptides tested as treatments and explores some nanotechnological strategies to overcome the downsides. These compounds are promising, as they not only act on the symptoms but also aim to prevent progressive neuronal loss.
Online parameter estimation and adaptive control with limited information in structures
Authors: Amini Fereidoun , Aghabarari Elham
Published: May 2021

An online parameter estimation is important along with the adaptive control, that is, a time-dependent plant. This study uses both online identification and the simple adaptive control algorithm with velocity feedback. The recursive least squares method was used to identify the stiffness and damping parameters of the structure’s stories. Identification was carried out online without initial estimation and only by measuring the structural responses. The limited information regarding sensor measurements, parameter convergence, and the effects of the covariance matrix is examined. The integration of the applied online identification, the appropriate reference model selection in simple adaptive control, and adopting the proportional integral filter was used to limit the structural control response error. Some numerical examples are simulated to verify the ability of the proposed approach. Despite the limited information, the results show that the simultaneous use of online identification with the recursive least squares method and simple adaptive control algorithm improved the overall structural performance.
The cost-effectiveness of atezolizumab in first-line for metastatic triple negative breast cancer is heavily linked to PD-L1 level
Authors: Giuliani Jacopo , Mantoan Beatrice , Bonetti Andrea
Published: May 2021

The present analysis was conducted to assess the pharmacological costs of atezolizumab as first-line treatment in triple negative metastatic breast cancer (mBC). Pivotal phase III randomized controlled trial (RCT) was considered. Nine hundred and two patients were included. Differences in costs between the 2 arms (atezolizumab plus nabpaclitaxel versus placebo plus nab-paclitaxel) was 17 398 €, with a cost of 7564 €per month of OS-gain in the overall population and 2485 €per month of OS-gain in PD-L1-positive (≥1) population. Combining pharmacological costs of drugs with the measure of efficacy represented by the OS, atezolizumab could be considered cost-effective in first-line treatment for triple-negative mBC only in PD-L1-positive population, but a reduction of costs is mandatory.
Measurement Invariance and Comparison of Mean Scores by Age Cohort of Two Versions of the Male Role Norms Inventory
Authors: Levant Ronald F. , Martin-Fernandez Javier , McDermott Ryon C. , Thompson Edward H.
Published: May 2021

This study was designed to inquire into the effects of aging versus age cohort by examining how men and women representing four age cohorts across the life span endorse masculinity ideology. Ascertaining whether different groups (such as age cohorts) understand a scale in the same way by assessing measurement invariance is a fundamental but oft-ignored prerequisite to comparing their scores on the scale. The Male Role Norms Inventory-Short Form (MRNI-SF) is a multidimensional measure used to assess beliefs in specific norms of masculinity, as well as general beliefs in traditional masculinity ideology (TMI). A five-item unidimensional MRNI -Very Brief (MRNI-VB) has also been developed measuring TMI only. This study administered the MRNI-SF (which includes the five items for the MRNI-VB) to 1,352 men and women in four age cohorts: young, established, middle-aged, and older. Multi-group confirmatory factor analyses found support for partial strong invariance for the MRNI-SF across age cohorts. Support for partial strict invariance was found for the MRNI-VB across age cohorts. For both scales, the effect sizes of non-invariant parameters were small in magnitude, thus non-invariance may have little practical significance. These results suggest that the MRNI-SF and the MRNI-VB measure similar masculinity ideology constructs across men and women in four age cohorts. Mean scores on each instrument were therefore compared across age cohorts with confidence, finding that the age cohorts commonly did not endorse “traditional” masculinity ideology, but differed in the level of disagreement with the tenets of TMI in six out of nine comparisons. In five of those six, older adults hewed more strongly to TMI than younger adults, suggesting that age cohort was more determinative of masculinity beliefs than age.
Retroperitoneal fibrosis as a postoperative complication following renal transplantation in cats
Authors: Byer Brittney J , Hardie Robert J , McAnulty Jonathan F
Published: May 2021

Objectives

The aim of this report was to describe the clinical signs, diagnostic imaging findings, surgical management, histopathological findings, outcome and possible risk factors for cats that developed retroperitoneal fibrosis (RPF) following renal transplantation.

Methods

Medical records of cats that underwent renal transplantation and developed clinically significant RPF between 1995 and 2019 were reviewed.

Results

Eighty-one cats underwent 83 renal transplantations. Of these 81 cats, six developed clinically significant RPF. For all six cats, renal transplantation was performed using cold organ preservation solution and ureteral papilla implantation. Immunosuppression protocol included ciclosporin and prednisolone. All cats had at least one subtherapeutic trough ciclosporin level (<250 ng/ml) in the postoperative period. Cats presented with moderate-to-severe azotemia 39–210 days following renal transplantation. Abdominal ultrasonography and contrast pyelography revealed various degrees of hydroureter and hydronephrosis of the transplanted kidney. Surgical examination revealed a layer of dense fibrous tissue surrounding the transplanted kidney, ureter and bladder resulting in ureteral obstruction. Ureteral obstruction was managed by reimplantation of the proximal ureter or renal pelvis to the bladder. Histopathologic examination of the fibrous tissue and affected portion of the distal ureter revealed fibrous connective tissue with lymphoplasmacytic infiltration and perivascular inflammation suggestive of an autoimmune type reaction. Of the six cats, two died within 5 days after revision surgery, two developed signs consistent with recurrent partial ureteral obstruction (40 and 41 days after revision), one was euthanized 6 years later for an unrelated disease and one was lost to follow-up.

Conclusions and relevance

The incidence of RPF in this population of cats was relatively low (7%), but still represents a significant cause of morbidity and mortality. The cause of RPF remains unknown, although investigation into suboptimal immunosuppression as a potential cause for local rejection reaction is warranted.