bluuebunny/crossref_metadata_2025 huggingface dataset:
Burglaries and entry controls in gated communities
Authors: Wang Zengli , Liu Lin , Haberman Cory , Lan Minxuan , Yang Bo , Zhou Hanlin
Published: January 2021

This article examines whether different levels of entry controls impact burglary rates in gated communities. It differs from the previous studies that only distinguish gated communities from non-gated communities but ignore important variation in different levels of entry controls. A sample of 698 gated communities in a large Chinese city are selected for this study. A negative binomial regression model estimates the relationships between entry control levels and burglary rates in gated communities. The test of these relationships accounts for the control of other important explanatory variables, including management fee, building height, building age, housing price, house for sale, rental house and floating population. Results indicate that higher entry control levels are associated with significantly lower burglary rates in gated communities. This is the first study that reveals a quantitative relationship between burglary and entry control level in gated communities at the city-wide scale.
Normocalcemic and Normohormonal Primary Hyperparathyroidism: Laboratory Values and End‐Organ Effects
Authors: Hollowoa Blake R. , Spencer Horace J. , Stack Brendan C.
Published: January 2021

Objective

Variants of primary hyperparathyroidism (pHPT), described as normocalcemic (NC) and normohormonal (NH), can confuse the diagnosis of classic pHPT.

Data Sources

A MEDLINE search was performed for variants of pHPT using the PubMed database (last queried October 2019).

Review Methods

The search was restricted to articles published after 1960 that were specific to humans. Studies were included in our analysis if laboratory values and incidence of end‐organ involvement were reported for NCpHPT and NHpHPT variants. The search returned 189 articles; 27 additional studies were identified and included for a total of 216. Non‐English‐language studies were excluded. Abstracts were screened, full‐text articles were then assessed, and 82 articles were excluded. Data were pooled using a random‐effects model in studies that compared NC or NH pHPT to classic pHPT. Comparative laboratory values are presented.

Conclusion

This analysis compares NCpHPT and NHpHPT to classic pHPT. Nephrolithiasis was 21.7% (NCpHPT), 15.9% (classic pHPT), and 25.4% (NHpHPT). Decreased bone mineral density was 49.7% (NCpHPT), 39.7% (classic pHPT), and 40.3% (NHpHPT). Fractures in the NCpHPT group were not significantly different from the classic pHPT. Hypertension in the NCpHPT group was significantly less than classic pHPT (odds ratio, 0.59; 95% CI, 0.40‐0.88).

Implications for Clinical Practice

This information may serve to inform clinicians of the laboratory subtleties of these variants that are being seen with greater frequency in contemporary practice.
Determining the Odds of Difficult Airway Resolution Among Pediatric Patients: A Case Series
Authors: Kiss Edgar Erold , Olomu Patrick , Johnson Romaine F.
Published: January 2021

Objective

We sought to determine the patient factors that contribute to the improvement and resolution of difficult airways in pediatric patients.

Study Design

The hospital’s Multidisciplinary Airway Registry Committee was created in November 2006 to develop a process for recognition and management of children with difficult airways. A database of these patients is actively maintained, allowing for statistical data analysis.

Setting

The tertiary care hospital system consists of 2 campuses serving the indigent pediatric population of the greater Dallas metropolitan area and performs an average of 40,000 anesthetic encounters per year.

Methods

We examined the data from a difficult airway database from a major tertiary care pediatric hospital to determine patient factors that led to airway improvement over time. Patients enrolled in the registry from November 2006 to October 2019 due to difficulties with intubation or mask ventilation were studied through statistical analysis.

Results

A total of 579 patients were identified. The Kaplan‐Meier estimate of the 5‐year deactivation rate was 14%. The most common reason for deactivation in our cohort was resolution of the difficult airway as defined by direct laryngoscopy Cormack and Lehane grade I or IIa/IIb, easy mask ventilation or laryngeal mask placement, or resolution of subglottic stenosis.

Conclusion

Advancing age and male sex at the time of enrollment were the most important predictors of an airway remaining difficult.
Assessing the Appropriateness of the EQ-5D for Duchenne Muscular Dystrophy: A Patient-Centered Study
Authors: Crossnohere Norah L. , Fischer Ryan , Lloyd Andrew , Prosser Lisa A. , Bridges John F. P.
Published: January 2021

Background

Duchenne muscular dystrophy is a rare degenerative neuromuscular disorder with pediatric onset. Recent approvals in Duchenne have placed attention on the economic evaluation in pricing and reimbursement decisions across a range of rare conditions. We sought to assess the appropriateness of the EQ-5D, a common measure of generic health state utility, for use among patients and caregivers affected by Duchenne.

Methods

An international, cross-sectional sample of adults with Duchenne and caregivers reported patient health status using self- or proxy-reported EQ-5D-3L. Appropriateness was assessed across 6 domains of concern raised by stakeholders in Duchenne. These concerns were that the EQ-5D/EQ-VAS would not capture meaningful differences in health status, correlate with disease-specific measures, reflect real health status, exhibit face validity, be accurately interpreted, and be low burden. We evaluated these concerns by comparing EQ-5D index score and EQ-VAS scores to other condition-specific functional measures and open- and closed-ended questions.

Results

In total, 263 participants (74% response) completed the survey, 24% of whom were adult patients. Most participants lived in the United States or United Kingdom (58%). Patient age ranged from 1 to 48 y. EQ-5D index was higher in ambulatory than nonambulatory patients (0.60 v. 0.30, P < 0.001) and was negatively correlated with upper limb impairment ( r = 0.61, P < 0.001). Three-quarters of respondents agreed that EQ-5D measured real health status (74%). Most respondents interpreted EQ-VAS anchors of best and worst imaginable health as full health (61%) and death/near death (58%). Respondents indicated the EQ-5D was easy to understand (86%) and answer (71%).

Conclusions

Contrary to anecdotal concerns, we found support for the appropriateness of EQ-5D to assess health status in Duchenne. While other measures may be more sensitive to specific outcomes in Duchenne, there may be some value in results using the EQ-5D measure.
Is Easier Better Than Harder? An Experiment on Choice Experiments for Benefit-Risk Tradeoff Preferences
Authors: Yang Jui-Chen , Reed Shelby D. , Hass Steve , Skeen Mark B. , Johnson F. Reed
Published: January 2021

Objectives

To test the convergent validity of simple and more complex study designs in a discrete-choice experiment (DCE) of multiple sclerosis (MS) treatment preferences.

Methods

Five hundred US adults with MS completed an online DCE survey. Respondents answered 8 choice questions with pairs of constructed MS treatment profiles defined by delays in problems with walking, delays in problems with cognition, thyroid disorders, and 10-y risks of kidney failure and serious brain infection (i.e., progressive multifocal leukoencephalopathy [PML]). Four hundred respondents completed choice questions using 4 levels for all attributes, except thyroid disorders with 3 levels. One hundred respondents completed choice questions using only the 2 extreme attribute levels of the 4-level version. Random-parameters logit models were used to estimate choice-model parameters.

Results

Respondents viewing the 4-level and 2-level versions agreed on the relative importance of the 3 most important attributes: cognition, walking, and PML. Respondents viewing the 4-level version indicated much stronger disutility for a 0% to 0.5% increase in kidney-failure risk than those viewing the 2-level version where the risk for kidney failure increased from 0% to 3%. Otherwise, utilities for other 4-level attributes were approximately linear but with significantly steeper slopes (except for cognition) than the 2-level estimates, indicating that attributes were perceived as more important as the number of levels increased.

Conclusions

Although the relative importance of some attributes was similar, the 2-level and 4-level versions generally failed to demonstrate convergent validity. If the study goal is attribute rankings, a 2-level version could be adequate. If goals include quantifying tradeoffs among attribute levels, more complex designs can help respondents discriminate among attribute levels. Reductions in measurement error using fewer attribute levels appear to have come at the expense of less discriminating evaluations.
Crossmodal Nonspatial Repetition Inhibition Due to Modality Shift
Authors: Zhang Ming , Wu Xiaogang , Wang Aijun
Published: January 2021

Previous studies have found that processing of a second stimulus is slower when the modality of the first stimulus differs, which is termed the modality shift effect. Moreover, people tend to respond more slowly to the second stimulus when the two stimuli are similar in the semantic dimension, which is termed the nonspatial repetition inhibition effect. This study aimed to explore the modality shift effect on nonspatial repetition inhibition and whether such modulation was influenced by different temporal intervals. A cue–target paradigm was adopted in which modality priming and identity priming were manipulated at three interstimuli intervals. The results showed that the response times under the modality shift condition were slower than those under the modality repeat condition. In trials with modality shift, responses to congruent cues and targets were slower than to incongruent cue–target combinations, indicating crossmodal nonspatial repetition inhibition. The crossmodal nonspatial repetition inhibition effect decreased with increasing interstimuli interval. These results provide evidence that the additional intervening event proposed in previous studies is not necessary for the occurrence of crossmodal nonspatial repetition inhibition.
Neoliberalism and public library policy in Ireland, 1998–2011: From the first government policy document to the first general election after the Great Recession
Authors: Garvey Maureen
Published: January 2021

This article discusses the influence of neoliberal ideology on public libraries in Ireland, from the first government policy document published in 1998 to the first election after the recession in 2011. The context of the rise in importance of the idea of information and the parallel acceptance of the principles of the free market for providing public services are examined. The Irish government policy documents from the period are analyzed. A critical awareness of these changes is needed in the library and information science field to recognize and oppose policies that are detrimental to the public provision of a library service.
“Doing Hope”: Ecofeminist Spirituality Provides Emotional Sustenance to Confront the Climate Crisis
Authors: Bell Finn McLafferty , Dennis Mary Kate , Brar Glory
Published: January 2021

Environmental crises caused by our changing global environment evoke intense and difficult emotions, particularly the paralysis that often results from despair. Understanding how people who are deeply engaged in environmental activism deal with their emotions can help in emotionally equipping people to address the climate crisis. Ecofeminist spirituality directly addresses these issues through an environmental stewardship that offers hope and healing for the world. This study includes 14 interviews with workers at an ecojustice center founded by an order of Catholic sisters in the United States. We used thematic analysis to identify three main themes that collectively describe the participants’ perspectives on (a) experiences of difficult feelings, (b) strategies for coping with those feelings, and (c) perspectives on cultivating hope. Participants shared how they were able to cope with difficult emotions and cultivate hope that the work they are doing matters, which was essential to sustaining their ecojustice work. As social workers respond to the changing environment, understanding how to sustain environmental work at the macro-level is essential to addressing largescale problems while also attending to difficult emotions at the microlevel. Further implications for social work practice include the importance of intergenerational organizing, living in “right relationship,” incorporating spirituality, and reinhabiting the profession.
Willingness to Pay for Police Reform
Authors: Powell Zachary A. , Worrall John L.
Published: January 2021

Consent decrees, authorized by Section 14141 of the 1994 Violent Crime Control Act, represent one of the most powerful governmental tools used to encourage—and possibly force—police reform. The consent decree process, however, carries a significant fiscal burden; in some cases, the cost of police reform inhibits agencies’ cooperation with the decrees. One possible solution to this problem calls for the creation of a public-supported police reform fund, whose monies are reserved strictly for consent decrees. Guided by focal concerns theory, this study reports on a factorial survey experiment used to assess variation across individuals’ willingness to pay for police reform. Results indicate that the seriousness of a police reform issue and the agency’s ability to pay for reform act as significant drivers of endorsement of a police reform fund.
Hyperhomocysteinemia and Dementia Associated With Severe Cortical Atrophy, but No Amyloid Burden
Authors: Reffo Alessandro , Gabelli Carlo
Published: January 2021

We report a case of a 77 years old patient who was admitted to our memory clinic because of progressive gait impairment and amnestic cognitive decline associated with extrapyramidal symptoms and behavioral changes. The clinical picture was consistent with a possible diagnosis of Alzheimer’s Disease associated with parkinsonian symptoms or with a Parkinson Plus syndrome. After a complete investigation, she was found to have a high plasma level of homocysteine due to homozygous methylene-tetrahydrofolate reductase (MTHFR) gene C665 T polymorphism, cognitive and motor impairment were associated with a severe cortical atrophy and mild subcortical vascular disease. PET neuroimaging excluded a significant amyloid load. Clinically, she showed improvement of the movement disorder and functional status after folate integration plus levodopa and memantine administration. We concluded for a primary degenerative dementia with movement impairment associated with persistent hyperhomocysteinemia. We hypothesized that neurodegeneration is driven by mechanisms linked to homocysteine metabolism possibly associated with tauopathy.
Psychosis Management in Lewy Body Dementia: A Comprehensive Clinical Approach
Authors: Badwal Karun , Kiliaki Shangwe A. , Dugani Sagar B. , Pagali Sandeep R.
Published: January 2021

Lewy body dementia (LBD) is asynucleinopathy that results in clinical manifestation of motor and neuropsychiatric symptoms. The disease burden associated with psychosis in LBD patients is significantly higher compared to other types of dementia or even to LBD without psychosis. Effective care management processes should include consideration of de-prescribing any offending agents including anticholinergics and dopaminergic agents, followed by nonpharmacological and low risk pharmacological approach. If addition of pharmacological agents is required, consideration should be given to acetylcholinesterase inhibitors, pimavanserin and atypical antipsychotics such as quetiapine or clozapine. Side effects of these medications should be considered prior to selection and initiation of a medication regimen. Goals of care and functional assessment are a crucial part of the optimized care plan, given overall guarded prognosis, in the context of numerous complications observed in this population. Palliative care consultation could facilitate symptom control and timely enrollment into hospice if consistent with patient’s goals.
Don’t hatch the messenger? On the desirability of restricting the political activity of bureaucrats
Authors: Forand Jean Guillaume , Ujhelyi Gergely
Published: January 2021

Many countries place restrictions on the political rights of government workers. This includes limitations on political activities such as taking an active part in political campaigns. Are such restrictions desirable? We present a formal welfare analysis of this question. Bureaucrats’ political activities affect voter perceptions of the government and this can have informational benefits. However, they can also induce policy mistakes and are susceptible to ‘noise’ from some bureaucrats’ innate desire for political expression. When politicians have limited control over bureaucrats and successfully coordinate with voters, bureaucrats’ political activities can be desirable. In most cases, however, banning political activities is optimal.
Effects of pores on nonlinear vibration and post buckling behavior of functionally graded material pipes conveying fluid
Authors: Li Nan , Zhang Hongyan , Bai Changqing
Published: January 2021

Functionally graded material (FGM) has an important application prospect in aircraft engineering, especially in smart aircraft. The dynamic behavior of FGM has been widely investigated so far but more work is needed for the porous FGM pipes conveying fluid. In this paper, a sensible pore distribution function related with the volume fraction of metal and ceramic is proposed for the dynamic modeling of porous FGM pipes conveying fluid. The maximum porosity and its corresponding position are taken into account in the present mechanical model. The material properties of the porous pipes are temperature dependent and can be affected by pore distribution. The governing equation of the porous FGM pipe is derived and then the exact solution of post buckling is obtained. The nonlinear primary resonance is determined by the multiple scale method. It is shown that the effect of the pore distribution is very significant on the post buckling behavior and nonlinear primary resonance of the porous FGM pipes. The current work is very helpful in understanding the influence of pore distribution on static and dynamic behavior of pores FGM structures in engineering practice.
Investigation on clinching assembly process of automobile wheel hub bearings
Authors: Li Wei , Chen Qidi , Yang Yunsong , Xiao Yunya , Li Maojun
Published: January 2021

In this study, a precise and high-efficient clinching assembly strategy was proposed to improve the automobile wheel hub bearing’s reliability of service quality consistency. The structure of the wheel hub bearing was first improved to enable the requirement of axial working clearance. During assembly, the accuracy of each bearing was monitored online via micro-laser sensor to achieve precise and consistent axial working clearance. The effect of processing parameters were analyzed via simulation analysis. According to simulation results, it only cost 2.35 s to complete assembly process and the optimal clamping force of 38.8 kN was generated. The prototype bearings were manufactured and exhibited a reliable service life of more than 250,000 km, which verified the reasonability of the proposed clinching assembly strategy. Additionally, the assembly mechanism was further analyzed. The ferrite in the clinched hub shaft end was gradually lengthened and the cementite aggregation was improved.
Classifying interval cancers as false negatives or newly occurring in fecal immunochemical testing
Authors: Hsu Wen-Feng , Hsu Chen-Yang , Yen Amy Ming-Fang , Chen Sam Li-Sheng , Chiu Sherry Yueh-Hsia , Fann Jean Ching-Yuan , Lee Yi-Chia , Chiu Han-Mo , Chen Hsiu-Hsi
Published: January 2021

Objective

To classify interval colorectal cancers as false negatives or newly occurring cases in a biennial Fecal immunochemical test (FIT) screening program and by various interscreening intervals.

Setting

Data from the Taiwanese biennial colorectal cancer screening program involving FIT from 2004 to 2014 were used to estimate the incidence rate of asymptomatic colorectal cancer and the rate of its subsequent progression to clinical mode.

Methods

The sensitivity of detecting asymptomatic colorectal cancers excluding newly developed colorectal cancers was compared to the conventional estimate of sensitivity, the complementary FIT interval cancer rate as a percentage of the expected incidence rate ((1-I/E)%). The relative contribution of newly developed or false-negative cases to FIT interval colorectal cancers was estimated by age and interscreening intervals.

Results

The Taiwanese biennial fecal immunochemical test screening program had a conventional sensitivity estimate of 70.2%. After newly developed colorectal cancers were separated from FIT interval cancers, the ability to detect asymptomatic colorectal cancers increased to 75.5%. FIT interval colorectal cancers from the biennial program mainly resulted from newly developed colorectal cancers (68.8%). The corresponding figures decreased to 61.1% for the annual program but increased to 74.7% for the triennial program. The preponderance of newly developed colorectal cancers among FIT interval cancers was more prominent in screenees aged 50–59  than in those aged 60–69.

Conclusions

Newly developed colorectal cancers showed a predominance among the FIT interval colorectal cancers in particular in the younger population screened. It is desirable to identify high-risk individuals to offer them a short interscreening interval or advanced detection methods to reduce their odds of developing interval cancer.
Burying the Dead: Predicting the Purchase Intentions for Funeral Products Using the Theory of Reasoned Action
Authors: Monkge Tshegofatso Alice , Makgosa Rina
Published: January 2021

The study departs from the norm by investigating how attitudes and subjective norms conceptualized through the aggregated and disaggregated approaches predict intentions to purchase funeral products, as well as how the effects differ between groups based on past purchase behaviour. A structured questionnaire was self-administered to a purposeful sample of 500 Christians in Gaborone, Botswana, of which 457 (i.e., 91%) were useful responses. The findings of the aggregated approach show that both attitudes and subjective norms significantly and positively affect purchase intentions of funeral products. The effects are more evident for those who have purchased funeral products before, while the purchase intentions of those who have not purchased funeral products are influenced by subjective norms only. However, the findings based on the disaggregated approach reflect that motivation to comply is the most dominant, significant and positive predictor of intentions to purchase funeral products. Further results indicate that the intentions of those who have purchased funeral products before were significantly and positively influenced by evaluations, normative beliefs and motivation to comply, while the intentions of non-purchasers were only influenced significantly and positively by their motivation to comply. Thus, motivation to comply serves as a significant and positive predictor of intentions regardless of past purchase behaviour. The results imply that various components of attitudes and subjective norms affect intentions differently, and variations do exist in the effects according to the groups’ past purchase behaviour. This study adopts a consumer behaviour perspective in offering insight into Christian burial rituals. By applying the Theory of Reasoned Action, the link between intentions and its predictors is investigated, which extends the literature about the purchase of funeral products beyond the study of spending behaviour. Its concentration on Christians in Botswana also provides a good starting point for highlighting the role of religiosity on the purchase of funeral products, while embracing an understudied society.
Linkages Between Trade Facilitation and Governance: Relevance for Post-COVID-19 Trade Strategy
Authors: Kumari Mamta , Bharti Nalin
Published: January 2021

The devastating effect of COVID-19 on the economy, health and the financial system is well known now. The pandemic has distorted trade as well. In such a situation, trade facilitation (TF) has emerged as an effective tool to mitigate the devastating effect of COVID-19 on trade. Several countries have initiated policy responses to take necessary steps towards TF measures. However, a relevant question arises: Are all these countries prepared for the effective and efficient implementation of the TF measures? This study attempts to answer this question by identifying the major institutional determinants of TF measures (mainly included in the World Trade Organization [WTO] Trade Facilitation Agreement) based on existing theories, such as the ‘theory of institutions’ and the ‘political economy of trade policy’ approach. It utilizes data of many countries for the years 2012, 2015, 2017 and 2019. The findings of this study suggest that the quality of governance has a significant positive impact on all TF measures. Moreover, the study finds that developing and small-sized countries are more responsive to the impact of an institutional factor on their TF performance than developed and large-sized countries. Therefore, it proposes measures to improve TF performance, which is crucial to minimize further disruptions in trade caused by COVID-19.
Chaplaincy Care in the MICU: Examining the Association Between Spiritual Care and End-of-Life Outcomes
Authors: Labuschagne Dirk , Torke Alexia , Grossoehme Daniel , Rimer Katie , Rucker Martha , Schenk Kristen , Slaven James E , Fitchett George
Published: January 2021

Background:

Seriously ill patients admitted to the Intensive Care Unit (ICU) experience severe spiritual and existential distress. Patients’ surrogate decision makers face the burden of making complex decisions about their loved ones’ care. Experienced chaplains may play a role in assisting with decision-making, possibly by aligning patients’ values and wishes with treatment plans and avoiding non-beneficial aggressive measures.

Objectives:

To identify associations between chaplaincy care and length of stay (LOS) in the medical ICU (MICU).

Methods:

This was a retrospective observational study of usual spiritual care in the adult MICUs of 4 medical centers in the United States over a 3-month period. Inclusion criteria were death in the MICU or discharge to palliative care or hospice. Measures included medical, treatment, and spiritual care information. Through bivariate and multivariable analyses associations between spiritual care and LOS were examined.

Results:

In multivariable analysis of the 254 patients, receiving spiritual care was associated with an increased likelihood of being in a higher LOS tertile (adjusted odds ratio = 2.94, p < .001). In post hoc bivariate analysis, cases receiving spiritual care within the first 48 hours of MICU admission revealed a trend toward lower LOS (p = .181).

Conclusion:

Spiritual care in the MICU was associated with longer LOS. Early intervention by chaplains who are well-integrated in the ICU may assist patients and their loved ones in coming to terms with grave illness and making difficult treatment decisions. Further well-designed studies of spiritual care interventions that may affect outcomes are needed.
What Do Adults With HIV Want? End-of-Life Care Goals, Values and Beliefs by Gender, Race, Sexual Orientation
Authors: Grill Katherine B. , Wang Jichuan , Scott Rachel K. , Benator Debra , D’Angelo Lawrence J. , Lyon Maureen E. ,   for the Palliative Care Consortium
Published: January 2021

Objective:

We examined factors influencing end-of-life care preferences among persons living with HIV (PLWH).

Methods:

223 PLWH were enrolled from 5 hospital-based clinics in Washington, DC. They completed an end-of-life care survey at baseline of the FACE™-HIV Advance Care Planning clinical trial.

Findings:

The average age of patients was 51 years. 56% were male, 66% heterosexual, and 86% African American. Two distinct groups of patients were identified with respect to end-of-life care preferences: (1) a Relational class (75%) who prioritized family and friends, comfort from church services, and comfort from persons at the end-of-life; and (2) a Transactional/Self-Determination class (25%) who prioritized honest answers from their doctors, and advance care plans over relationships. African Americans had 3x the odds of being in the Relational class versus the Transactional/Self-determination class, Odds ratio = 3.30 (95% CI, 1.09, 10.03), p = 0.035. Males were significantly less likely to be in the relational latent class, Odds ratio = 0.38 (CI, 0.15, 0.98), p = 0.045. Compared to non-African-Americans, African-American PLWH rated the following as important: only taking pain medicines when pain is severe, p = 0.0113; saving larger doses for worse pain, p = 0.0067; and dying in the hospital, p = 0.0285. PLWH who were sexual minorities were more afraid of dying alone, p = 0.0397, and less likely to only take pain medicines when pain is severe, p = 0.0091.

Conclusion:

Integrating culturally-sensitive palliative care services as a component of the HIV care continuum may improve health equity and person-centered care.
Histopathological Subtypes and PD-L1 Expression in Primary Urethral Adenocarcinoma: A Series of 5 Cases
Authors: Padilla-Ansala Carlos , García-Fernández Eugenia , González-Peramato Pilar
Published: January 2021

Background and Objectives

Urethral adenocarcinoma is a rare disease with poor prognosis that can display multiple histologic patterns and has an unclear histogenesis. Radical surgery with extensive periurethral resection is the preferred therapeutic approach. Both chemotherapy and radiotherapy have been used as complementary treatment options. Due to the tendency of these tumors to recur, treatment-associated complications, and the limited choice of therapeutic options, patient management can be difficult. Given the lack of literature regarding immunotherapy in urethral adenocarcinoma, our objective was to explore the expression of programmed death receptor-ligand 1 (PD-L1) throughout the different histological subtypes of primary urethral adenocarcinoma.

Methods

We reviewed all primary urethral adenocarcinomas diagnosed at our hospital between 1965 and 2019, performed immunohistochemical assays on the tissue blocks, classified them according to their histology and origin, and performed PD-L1 (22C3) immunohistochemistry assays in all cases.

Results

We found a total of 5 cases of primary urethral adenocarcinoma. All of the patients were women. One of the cases was a cribriform adenocarcinoma, 2 were columnar-mucinous adenocarcinomas, and 2 were clear cell adenocarcinomas. One of the clear cell adenocarcinomas strongly expressed PD-L1. In addition, a profuse inflammatory infiltration constituted by CD3-positive and CD8-positive T lymphocytes within tumor cells was observed in this case. None of the other cases showed PD-L1 expression.

Conclusions

In conclusion, some urethral adenocarcinomas may strongly express PD-L1 and thus could potentially allow the use of immunotherapy in selected cases of advanced or recurrent adenocarcinoma.
Do Left-wing Governments Decrease Wage Inequality among Civil Servants? Empirical Evidence from the German States
Authors: Kauder Björn , Krause Manuela , Potrafke Niklas
Published: January 2021

We investigate whether left-wing governments decrease wage inequality among civil servants. The data are based on the salaries of civil servants in the German states. Since a reform in 2006, German state governments are allowed to design salaries of civil servants. We employ encompassing data for pay levels and professions including judges, professors, policemen, and administrators and distinguish between levels of operating experiences. We use six wage inequality measures comparing salaries across pay levels and operating experiences. The results do not suggest that left-wing governments were more active in decreasing wage inequality among civil servants than the center or right-wing governments. Cabinet members are civil servants themselves and decide on their own salaries: government ideology is also not shown to predict the salaries of cabinet members. Because left-wing governments are perceived as taking action against income and wage inequality, future research should employ data from other federal states such as the United States to examine how government ideology influences the salaries of civil servants.
Letter to the Editor: Microbiota in the Respiratory System—A Possible Explanation to Age and Sex Variability in Susceptibility to SARS-CoV-2
Authors: Shah Vishal
Published: January 2021

The Human respiratory tract is colonized by a variety of microbes and the microbiota change as we age. In this perspective, literature support is presented for the hypothesis that the respiratory system microbiota could explain the differential age and sex breakdown amongst COVID-19 patients. The number of patients in the older and elderly adult group is higher than the other age groups. The perspective presents the possibility that certain genera of bacteria present in the respiratory system microbiota in children and young adults could be directly or through eliciting an immune response from the host, prevent full-fledged infection of SARS-CoV-2. The possibility also exists that the microbiota in older adults and the elderly population have bacteria that make it easier for the virus to cause infection. I call upon the scientific community to investigate the link between human microbiota and SARS-CoV-2 susceptibility to further understand the viral pathogenesis.
Modeling temperature rise in multi-track reciprocating frictional sliding
Authors: Blanchet Thierry A
Published: January 2021

As in various manufacturing processes, in sliding tests with scanning motions to extend the sliding distance over fresh countersurface, temperature rise during any pass is bolstered by heating during prior passes over neighboring tracks, providing a “heat accumulation effect” with persisting temperature rises contributing to an overall temperature rise of the current pass. Conduction modeling is developed for surface temperature rise as a function of numerous inputs: power and size of heat source; speed and stroke length, and track increment of scanning motion; and countersurface thermal properties. Analysis focused on mid-stroke location for passes of a square uniform heat flux sufficiently far into the rectangular patch being scanned from the first pass at its edge that steady heat accumulation effect response is adopted, focusing on maximum temperature rise experienced across the pass' track. The model is non-dimensionalized to broaden the applicability of the output of its runs. Focusing on practical “high” scanning speeds, represented non-dimensionally by Peclet number (in excess of 40), applicability is further broadened by multiplying non-dimensional maximum temperature rise by the square root of Peclet number as model output. Additionally, investigating model runs at various non-dimensional speed (Peclet number) and reciprocation period values, it appears these do not act as independent inputs, but instead with their product (non-dimensional stroke length) as a single independent input. Modified maximum temperature rise output appears to be a function of only two inputs, increasing with decreasing non-dimensional values of stroke length and scanning increment, with outputs of models runs summarized compactly in a simple chart.
Virtual monitoring for stable chronic hepatitis B patients does not reduce adherence to medications: A randomised controlled study
Authors: Kumar Rajneesh , Yee Mei-Ling , Goh George BB , Chia Pei-Yuh , Lee Hwei-Ling , Xin X , Teo Pek SE , Ekstrom Victoria SM , Tan Jin YT , Cheah Mark CC , Wang Yu T , Chang Jason PE , Tan Chee-Keat , Tan Hiang Keat , Krishnamoorthy Thinesh L , Chow Wan-Cheng
Published: January 2021

Introduction

Chronic hepatitis B (CHB) remains common in endemic regions, causing significant healthcare burden. Patients with CHB may need to be adherent to nucleoside analogue (NA) for a long period of time to prevent complications. This study aims to investigate the safety, efficacy and patient experience of a virtual monitoring clinic (VMC) in monitoring stable patients taking NA for CHB.

Methods

Patients on NA and regular follow-up were randomised to either VMC alternating with doctors’ clinic visit or to a control group in which they continued standard follow-up by doctors. Therapy adherence was measured by medication possession ratio (MPR) for NA therapy, incidence of virological breakthrough and hepatocellular carcinoma (HCC) development at two years of follow-up. Patient acceptance was measured on a Likert scale of 1–10.

Results

A total 192 patients completed follow-up: 94 and 98 patients in the VMC and control groups, respectively. Mean age was 60.6 ± 10.8 years, with 95.3% Chinese ethnicity and 64.1% males. Age, gender, race, educational, employment and financial status were similar in both groups. Upon study completion, the majority of patients – 76 (80.9%) in VMC group and 74 (75.5%) in control group – had MPR ≥0.8; 88.8% were satisfied and rated VMC better than a traditional follow-up clinic with doctors only. More than 85% of patients rated ≥8/10 on the Likert scale for VMC, and preferred VMC over traditional clinic visits. Clinical outcomes observed were HCC development in one (1.1%) in the VMC group and four (4.1%) in the control group ( p = 0.369). Two (2.1%) and one (1.0%) virological breakthroughs were observed in the VMC and control groups, respectively ( p = 0.615). No incidence of HCC or abnormal blood tests were missed in the VMC arm.

Discussion

VMC is a viable and safe clinical model for monitoring stable CHB patients on NA therapy without compromising patients’ adherence to medications and is preferred by patients.
Intelligent crack detection based on attention mechanism in convolution neural network
Authors: Cui Xiaoning , Wang Qicai , Dai Jinpeng , Xue Yanjin , Duan Yun
Published: January 2021

The intelligent detection of distress in concrete is a research hotspot in structural health monitoring. In this study, Att-Unet, an improved attention-mechanism fully convolutional neural network model, was proposed to realize end-to-end pixel-level crack segmentation. Att-Unet consists of three parts: encoding module, decoding module, and AG (Attention Gate) module. The benefits associated with this module can effectively extract multi-scale features of cracks, focus on critical areas, and reconstruct semantics, to significantly improve the crack segmentation capability of the Att-Unet model. On the same data set, the mainstream semantic segmentation models (FCN and Unet) were trained simultaneously. Upon comparing and analyzing the calculated results of Att-Unet model with those of FCN and Unet, the results are as follows: for crack images under different conditions, Att-Unet achieved better results in accuracy, precision and F1-scores. Besides, Att-Unet showed higher feature extraction accuracy and better generalization ability in the crack segmentation task.
Social inequality in parent–infant relations: Epidemiological study of community nurse records
Authors: Holstein Bjørn E. , Pant Sofie Weber , Ammitzbøll Janni , Pedersen Trine Pagh
Published: January 2021

Background: Some studies suggest that favourable socioeconomic circumstances are associated with better parent–child relations but the documentation of such an association is limited and inconsistent. Few studies focused on infancy, few studies relied on objective measurement of parent–infant relations, and few studies included more than one measurement of parent–infant relations in the first year of life. Aims: To report the prevalence of objectively measured problems in parent–infant relations during the first year of life and to examine the association between socioeconomic circumstances and parent–infant relations in an unselected community sample of infants. Methods: Cross-sectional study of a community sample of children from birth to 10 months in 15 municipalities in Denmark, n = 11,765. The exposure variables were population register data about socioeconomic circumstances: (a) parents’ education, (b) family composition, (c) parents’ origin, and (d) parents’ occupational status. The outcome variable was the health visitor’s concerns about the parent–infant relation assessed at four home visits from birth to 10 months after delivery. Results: The proportion of children with concerns about the parent–infant relation was 10.5%, 7.8% at one home visit and 2.8% at two or more home visits. Logistic regression analyses showed that all four indicators of socioeconomic circumstances were associated with concerns about the parent–infant relation in the first year of life. Conclusions: The risk of problematic parent–infant relations were significantly elevated among, children of immigrant parents, and children of parents with shorter education and not in education or work.
The social worker in community mental health teams: Findings from a national survey
Authors: Abendstern Michele , Wilberforce Mark , Hughes Jane , Arandelovic Andelijia , Batool Saqba , Boland Jennifer , Pitts Rosa , Challis David
Published: January 2021

Social workers have been members of community mental health teams (CMHTs) for many years. However, a combination of factors has resulted in their removal from CMHTs in some areas in recent years. This study presents findings from a 2018 national survey of CMHT team managers (44% response rate), to ascertain the current position of the social worker within CMHTs in England. Analyses focussed on membership, roles and tasks, and change within the previous 12 months. Descriptive statistics were used to analyse the quantitative data and content analysis to interpret free text comments.

Findings

Social workers were found to undertake a variety of generic roles and tasks but were reported to do so proportionally less often than nurses. A large minority were involved in non-traditional social work tasks such as monitoring medication. In one-fifth of teams, managers thought they had too few social workers. Free text comments suggested that managers valued social workers for their social perspective and expressed concern regarding their removal or the curtailment of their role, perceiving this as having a negative effect on overall CMHT service delivery.

Applications

The findings provide evidence of some instability in the position of social workers within CMHTs in relation to both their membership and their involvement in traditional and non-traditional roles and tasks. Free text comments suggest that if a biopsychosocial model of mental health support, now recognised as essential to long-term wellbeing, is to be achieved, a social work presence in CMHTs is required.
Detection and localization of multiple small damages in beam
Authors: Nayyar Ayisha , Baneen Ummul , Naqvi Syed Abbas Zilqurnain , Ahsan Muhammad
Published: January 2021

Localizing small damages often requires sensors be mounted in the proximity of damage to obtain high Signal-to-Noise Ratio in system frequency response to input excitation. The proximity requirement limits the applicability of existing schemes for low-severity damage detection as an estimate of damage location may not be known  a priori. In this work it is shown that spatial locality is not a fundamental impediment; multiple small damages can still be detected with high accuracy provided that the frequency range beyond the first five natural frequencies is utilized in the Frequency response functions (FRF) curvature method. The proposed method presented in this paper applies sensitivity analysis to systematically unearth frequency ranges capable of elevating damage index peak at correct damage locations. It is a baseline-free method that employs a smoothing polynomial to emulate reference curvatures for the undamaged structure. Numerical simulation of steel-beam shows that small multiple damages of severity as low as 5% can be reliably detected by including frequency range covering 5–10th natural frequencies. The efficacy of the scheme is also experimentally validated for the same beam. It is also found that a simple noise filtration scheme such as a Gaussian moving average filter can adequately remove false peaks from the damage index profile.
The value of 18F-FDG-PET-CT in the management of infective native aortic aneurysms
Authors: Hannsberger Daniel , Heinola Ivika , di Summa Pietro Giovanni , Sörelius Karl
Published: January 2021

Objective

The objective of this systematic literature review was to explore the value of positron emission tomography combined with low-dose computed tomography (18F-FDG-PET-CT) in the diagnostics of infective native aortic aneurysm (INAA).

Methods

A systematic literature review was performed using the search terms mycotic- and infected aortic aneurysms in Medline and Sciencedirect databases, published between 1 January 2000 and 1 January 2020. Using the PRISMA statement, articles were scrutinized according to a predefined protocol including: timing of 18F-FDG-PET-CT examination, the maximum standardized uptake value (SUVmax), additional findings on examination, and findings on repeated scanning of 18F-FDG-PET-CT.

Results

Four studies were included in the analysis, comprising a total of 11 patients. Two studies were single case reports, and two were small case series, all were graded to be of low quality with high risk of bias. All patients were examined with a preoperative 18F-FDG-PET-CT, and 10 (91%) had increased 18F-FDG uptakes. The median SUVmax value was 6.53, range 4.46–9.23. The mean duration of antibiotic therapy prior to 18F-FDG-PET-CT was not known. Two patients were examined with repeated 18F-FDG-PET-CT examinations after treatment, where a decrease in SUVmax values could be demonstrated after successful treatment.

Conclusion

The literature on 18F-FDF-PET/CT for diagnosing infective native aortic aneurysms is scarce. However, there might be a role for 18F-FDF-PET/CT in the management of the disease, in particular for patients with clinical suspicion of INAA without convincing findings on CT. SUVmax values ranging from 4.5 to 6.5 could be guiding and suggestive of metabolic activity in agreement of INAA. However, further conclusions on its usefulness, robustness and specific SUVmax values are premature, and a definitive cut-off value is probably not attainable.