bluuebunny/crossref_metadata_2025 huggingface dataset:
Antidiarrheal Effect of Sechang‐Zhixie‐San on Acute Diarrhea Mice and Network Pharmacology Deciphering Its Characteristics and Potential Mechanisms
Authors: Li Zhiyong , Li Jianliang , Zhang Fengrong , Zhu Na , Sha Zijun , Li Dan , Tu Ya , Hou Jincai
Published: December 2020

Sechang‐Zhixie‐San (SCZX) is an ancient prescription used for pediatric diarrhea by the Yi people in China, which consists of Rodgersia sambucifolia Hemsley (known as Yantuo and abbreviated as YT) and Bentonite (BN). Now, it is also a Chinese patent medicine used in the clinic to treat infantile diarrhea. Besides evaluating the antidiarrheal effect of SCZX on diarrhea mice induced by Folium Sennae, the purpose of this study is to outline the characteristics of the antidiarrheal effect and reveal the potential mechanisms of SCZX through the analysis of the mechanism and active components of YT via network pharmacology and molecular docking, combined with the research progress of BN obtained from the literature. SCZX (3.12 and 12.48 g/kg) effectively inhibited diarrhea in mice, significantly lowering the loose stool rate (LSR), loose stool level (LSL), and loose stool index (LSI). Using network pharmacology, the “herb‐compound‐target‐pathway‐pharmacological action” network was mapped to indicate the antidiarrheal mechanism of YT. And the docking results revealed that 4 components of YT including quercetin, geranyl‐1‐O‐α‐L‐arabinopyranosyl‐(1 ⟶ 6)‐β‐D‐glucopyranoside, 3α‐O‐(E)‐p‐hydroxy‐cinnamoyl‐olean‐12‐en‐27‐oic acid, and daucosterol showed significant docking activities with STAT3, EGFR, and SLC10A2, involving 11 pathways such as Th17 cell differentiation, Jak‐STAT signaling pathway, ErbB signaling pathway, and HIF‐1 signaling pathway. According to our research results and literature reports, the antidiarrheal could be summarized into five aspects: inhibiting intestinal inflammation, acting as a barrier to the intestinal mucosal, regulating water and ion transport, involving the purification of intestinal microorganisms, and intestinal transmission, which might be dependent on multiple proteins and intervention in multiple pathways.
Survival Outcome and Impact of Chemotherapy in T1 Node-Negative Triple-Negative Breast Cancer: A SEER Database Analysis
Authors: Zhang Jingyi , Wang Wenna , Wang Jiayu , Luo Yang , Chen Shanshan , Ma Fei , Xu Binghe , Fan Ying
Published: December 2020

Objective. Although triple-negative breast cancer (TNBC) has been considered to be an aggressive disease, the outcome of small-tumor (T1abcN0M0) TNBC and the effect of adjuvant chemotherapy on TNBC survival remain controversial. Methods. We identified 4565 T1abcN0M0 TNBC patients in the Surveillance, Epidemiology, and End Results (SEER) database from January 1, 2010, to December 31, 2015. After propensity score matching (PSM), 3214 patients were finally analyzed. Survival rates were compared among T1a, T1b, and T1c patients and between patients with and without adjuvant chemotherapy. Results. We classified 424, 1040, and 3101 cases as T1a, T1b, and T1c TNBC, respectively. A total of 2760 (60.5%) patients received adjuvant chemotherapy, accounting for 25.5%, 56.0%, and 66.8% of T1a, T1b, and T1c patients, respectively. Rates of 5-year breast cancer-specific survival (BCSS) for T1a, T1b, and T1c patients receiving chemotherapy were 97.8%, 94.1%, and 94.5%, respectively, compared with 97.2%, 94.0%, and 89.9% in patients without chemotherapy. Patients receiving adjuvant chemotherapy had higher 5-year BCSS (94.5% vs. 89.9%,

P

 = 0.004) in the T1c subgroup, but no significant difference was detected in T1a or T1b patients due to adjuvant chemotherapy. Conclusion. Small-tumor TNBC showed very good prognosis. Adjuvant chemotherapy improved prognosis in T1c TNBC cases to a greater extent than in T1a and T1b patients. More large-scale clinical trials are needed, and further study should be conducted to determine appropriate adjuvant chemotherapy for T1c TNBC patients.
An Efficient and Reliable Routing Method for Hybrid Mobile Ad Hoc Networks Using Deep Reinforcement Learning
Authors: Alkadhmi Murtadha M. A. , Uçan Osman N. , Ilyas Muhammad
Published: December 2020

With the reliance of humans on mobile smart devices that have wireless communication, modules have significantly increased in recent years. Using these devices to communicate with the survivors during a disaster or its aftermath can significantly increase the chances of locating and saving them. Accordingly, a method is proposed in this study to extend the lifetime of the nodes in a Mobile Ad Hoc Network (MANET) while maintaining communications with the nearest base station (BS). Such a methodology allows the rapid establishment of temporary communications with these survivors, as restoring the complex infrastructure is a time-consuming process. The proposed method achieves the longer lifetime of the network by balancing the load throughout the nodes and avoids exhausting those with limited remaining energy. The proposed method has shown significant improvement in the lifetime of the MANET while maintaining similar Packet Delivery Rate (PDR) and route generation time, compared to existing methods.
Porosity Development Controlled by Deep-Burial Diagenetic Process in Lacustrine Sandstones Deposited in a Back-Arc Basin (Makó Trough, Pannonian Basin, Hungary)
Authors: Laczkó-Dobos Emese , Gier Susanne , Sztanó Orsolya , Milovský Rastislav , Hips Kinga
Published: December 2020

Deeply buried Pannonian (Upper Miocene) siliciclastic deposits show evidence of secondary porosity development via dissolution processes at a late stage of diagenesis. This is demonstrated by detailed petrographic (optical, cathodoluminescence, fluorescence, and scanning electron microscopy) as well as elemental and stable isotope geochemical investigations of lacustrine deposits from the Makó Trough, the deepest depression within the extensional Pannonian back-arc basin. The analyses were carried out on core samples from six wells located in various positions from centre to margins of the trough. The paragenetic sequence of three formations was reconstructed with special emphasis on sandstone beds in a depth interval between ca 2700 and 5500 m. The three formations consist, from bottom to top, of (1) open-water marls of the Endrőd Formation, which is a hydrocarbon source rock with locally derived coarse clastics and (2) a confined and (3) an unconfined turbidite system (respectively, the Szolnok and the Algyő Formation). In the sandstones, detrital grains consist of quartz, feldspar, and mica, as well as sedimentary and metamorphic rock fragments. The quartz content is high in the upper, unconfined turbidite formation (Algyő), whereas feldspars and rock fragments are more widespread in the lower formations (Szolnok and Endrőd). Eogenetic minerals are framboidal pyrite, calcite, and clay minerals. Mesogenetic minerals are ankerite, ferroan calcite, albite, quartz, illite, chlorite, and solid bituminous organic matter. Eogenetic finely crystalline calcite yielded δ13

C

V
−
PDB

values from 1.4 to 0.7‰ and δ18

O

V
−
PDB

values from –6.0 to –7.4‰, respectively. Mesogenetic ferroan calcite yielded δ13

C

V
−
PDB

values from 2.6 to –1.2‰ and δ18

O

V
−
PDB

values from –8.3 to –14.0‰, respectively. In the upper part of the turbidite systems, remnants of the migrated organic matter are preserved along pressure dissolution surfaces. All these features indicate that compaction and mineral precipitations resulted in tightly cemented sandstones prior to hydrocarbon migration. Interconnected, secondary, open porosity is associated with pyrite, kaolinite/dickite, and postdates of the late-stage calcite cement. This indicates that dissolution processes took place in the deep burial realm in an extraformational fluid-dominated diagenetic system. The findings of this study add a unique insight to the previously proposed hydrological model of the Pannonian Basin and describe the complex interactions between the basinal deposits and the basement blocks.
Inter-religious Conflict, Translation, and the Usage of the Early Modern Notion of ‘Religion’ from the Fall of Constantinople to the Westphalian Peace Treaty in 1648
Authors: Reeh Niels
Published: December 2020

The article attempts to show that the modern notion of ‘religion’ is a construction that emerged in the context of inter-religious encounters following the fall of Constantinople and especially in the years around the Reformation. Hereby, the article argues that the modern notion of ‘religion’ emerged earlier than found by most previous studies, and that it was used in the legislation of the new Protestant states as well as in the modern (Westphalian) state-system, both of which it has been a part of ever since. The notion of ‘religion’ is, thus, not a scholarly invention (J.Z. Smith) or tied to colonialism (Timothy Fitzgerald) but rather a product of complex historical processes in which religious conflicts and the attempt to overcome these played a key role.
What Do Seculars Understand as ‘Spiritual’? A Replication of Eisenmann et al.’s Semantics of Spirituality
Authors: Demmrich Sarah , Huber Stefan
Published: December 2020

Eisenmann et al. developed a system consisting of forty-four categories to code the definitions of spirituality in samples from the USA and Germany. We tested this category system in a sample of seculars in Switzerland. All original categories were applicable to the individual understandings of spirituality in our sample. Only two additional categories of marginal relevance were formed. This result confirms the validity of the category system. Furthermore, the German and the Swiss samples both stress an understanding of spirituality as transcending without emphasizing transcendence. This concept should be used to construct spirituality scales for quantitative studies.
Islam in Bosnia Between East and West: The Reception and Development of Traditionalism
Authors: Beglerović Samir , Sedgwick Mark
Published: December 2020

The article looks at the reception and development of Guénonian Traditionalism in Bosnia from the 1970s to the present day. Traditionalism was initially received in Yugoslavia as esotericism, but then its reception became more Islamic, based in Sarajevo’s Islamic Theology Faculty. After the Bosnian War, Islamic Traditionalist works became popular among young Bosnians who wanted to combine Islam with European identities. Some Bosnian ulama taught Traditionalist works to their students, a development unparalleled elsewhere, and wrote their own Traditionalist-influenced works, mostly dealing with interreligious dialogue. The Bosnian reception and development of Traditionalism is unique, and it is argued that this reflects Bosnia’s special position between East and West.
Recombinant Endoglin-Single-Chain Variable Fragment/ Induced Protein 10 Fusion Protein Potently Boosts the Anti-Tumor Efficacy of Adoptively Transferred TRP2-Specific CD8+ CD28+ Cytotoxic T Lymphocytes in Mice
Authors: Li Yangzi , Yang Xiaomei , Lu Xiaoling , Peng Zhengui , Lai Chunhui , Xie Shenxia , Wei Shi , Yao Hua , Ding Ziqiang , Zhao Xinyue , Liu Aiqun , Hou Xiaoqiong , Mo Fengzhen
Published: December 2020

In this research, we studied the therapeutic efficacy of a newly designed fusion protein containing Endoglin single-chain variable fragment and IP10 (Endoglin-scFv/IP10), together with our recently generated TRP2-specific CD8+ CD28+ CTLs (CD8+ CD28+
CTLs) in controlling melanoma growth in mice. The recombinant Endoglin-scFv/IP10 was expressed in E. coli, purified by affinity chromatography, and characterized in vitro for its chemotactic movement and immunoreactivity with endoglin-expressing cells. In vivo, melanoma
xenografts were established in mice (C57BL/6) using B16F10 cells. After that, mice were treated with intravenous injections of vehicle (PBS), Endoglin-scFv/IP10 alone, CD8+ CD28+ CTLs alone, or Endoglin-scFv/IP10+ CD8+ CD28+ CTLs. The
therapeutic efficacy was assessed by monitoring tumor growth, mouse survival and cellular biomarkers. Endoglin-scFv/IP10 fusion protein combined with CD8+ CD28+ CTLs observed a reduction in tumor growth, resulting in improved survival. On the cellular level, the combination
treatment dramatically reduced the number of systemic and tumor associated myeloid-derived suppressor cells or regulatory T cells, increased tumor-responsive interferon-γ-producing lymphocytes and tumor-associated CD8+ CXCR3+ T cells, and inhibited proliferation
and angiogenesis but stimulated apoptosis within melanoma tissue. This study demonstrates the therapeutic potential of Endoglin-scFv/IP10 fusion protein in combination with CD8+ CD28+ CTLs in melanoma treatment.
Octreotide Reduces Pancreatic Islet Apoptosis and Improves Islet Transplantation Efficiency In Vitro and In Vivo
Authors: Yang Biao , Zhou Yiming , Tian Lei , Lu Yunfei
Published: December 2020

The drug octreotide, a somatostatin analog, stimulates the cellular free radical scavenging system and inhibits the release of superoxide anions from monocytes. We hypothesized that octreotide also protects islet β cell function and improves the survival of transplanted
islets by ameliorating the adverse effects of hypoxia and reoxygenation on these cells, thus inhibiting apoptosis. To test this hypothesis, we experimentally induced hypoxia in islet cells in mouse insulinoma Min6 cells. Octreotide treatment mildly but significantly improved cell viability
under normoxic and hypoxic conditions. Secreted vascular endothelial growth factor (VEGF) from the Min6 cells was downregulated after octreotide treatment during hypoxia. By contrast, the expression of hypoxia-inducible factor (HIF)-1α was upregulated after octreotide treatment
under both normoxic and hypoxic conditions. Octreotide treatment also lowered the apoptotic rate of Min6 cells under hypoxic conditions in vitro. In a mouse transplant model, octreotide improved the post-transplantation efficacy and function of islet grafts. Expression of p53 and Bax
in islet grafts was upregulated in the recipients treated with octreotide one day after islet transplantation, and the octreotide-treated group produced significantly less Bax than the control group on days 3 and 7 following transplantation. TUNEL assay further demonstrated a decrease in islet
cell apoptosis in the octreotide group on days 1, 3, 7, and 14 after transplantation compared with that of the control group (P < 0.05). No islet cell proliferation was found in the octreotide and control groups on days 1, 3, and 7 following transplantation. However, by day 14, the
group treated with octreotide demonstrated significantly higher average cell proliferation rates than the controls did (P < 0.05). Thus, octreotide decreased the apoptosis of islets under hypoxic conditions in vitro and enhanced the efficacy of islet transplantation in
vivo. Octreotide has excellent potential for therapeutic applications in islet transplantation and merits further study.
In Vivo Self-Assembly Based Cancer Therapy Strategy
Authors: Chen Jinrong , Zhang Shihao , Wang Yuhan , Xie Ruwen , Liu Lishang , Deng Yan
Published: December 2020

Nanotechnology has been widely applied in tumor imaging, diagnostic and therapy. Beside the prefabricated nanomaterials, constructing nanostructures in living cells through self-assemble provides an alternative strategy to treat cancer. In vivo self-assembly renders the conversion
of compatible small molecules into assembled nanostructures with toxicity, and is expected to outperform the prefabricated nanotechnologies as the small molecules diffuse faster than their assembly form. Attributed to the specific tumor environment such as low pH, high ROS, high enzyme expression
and so on, in vivo self-assembly could differentiate cancer cells from normal ones with high selectivity. The in vivo self-assembly based caner therapy has made considerable progress in the last decade with confirmed advantages such as high capacity, minimal drug resistance,
high accumulation, enhanced retention and so on. This review summarized the in vivo self-assembly of nanostructures induced by the stimuli like pH, ROS, enzyme, metal ion, localized concentration, biominerization and their utilization in cancer therapy.
Return of the Repressed: Revisiting Dissociation and the Psychoanalysis of the Traumatized Mind
Authors: Diamond Michael J.
Published: December 2020

Psychoanalytic treatment is often indicated when trauma and its psyche/soma companion, dissociation, severely disrupt symbolic functioning and associative linking. After Freud’s initial thinking on these matters, repression replaced rather than supplemented dissociation (which occasions segregating units of experience) as the primary defensive response to severe trauma. Because psychoanalysis had “repressed” the salience of dissociation as actively motivated (though passively experienced), an unnecessary schism has occurred between trauma theories and mainstream North American psychoanalysis, and within psychoanalysis itself. To fully restore dissociation’s role in primitive mental states and provide a more integrated approach to technique, it is necessary to comprehend the triadic nature of trauma, which entails economic/drive, structural conflict and deficit, and object-relational factors. For a treatment model that addresses defensive dissociation in the here and now, primary and secondary dissociation must be distinguished, with each differentiated from splitting and repression. Technique requires addressing unconscious, repressed fantasies associated with the “trauma,” object-relational patterns that interfere with linking, and psycho-economic issues that have disrupted ego functioning. A clinical example illustrates both the analyst’s persistence in suffering the dead, eerie space of dissociated trauma and efforts to find language that helps structure the patient’s somatic and enacted expressions (and accompanying dissociative and repressive processes) by which traumatic experiences are registered and conveyed.
“We Can Redefine Ourselves”: Enhancing Black College Men’s Persistence Through Counterspaces
Authors: Brooms Derrick R. , Clark Jelisa S. , Druery Jarrod E.
Published: December 2020

Black college men are constantly repositioned in higher education discourse as problems and in crises. However, there is much to be learned from Black men’s engagement in college and the meanings they make from those experiences. In this qualitative study, we use the engagement experiences of 25 Black men at an historically white campus in the U.S. in order to reveal the value of counterspaces on campus. Our findings suggest that the Sankofa Scholars program created important opportunities for these Black men to get acclimated to college, enhance their awareness and development, and resist deficit framings about them. These findings demonstrate that male success initiatives can serve as a counterspace on campus and can play a critical role in empowering Black men’s persistence in college and strengthening their resilience.
Recovery Home Environment Characteristics Associated With Recovery Capital
Authors: Polcin Douglas L. , Mahoney Elizabeth , Witbrodt Jane , Mericle Amy A.
Published: December 2020

Recovery capital refers to internal and external resources that facilitate recovery from alcohol and drug disorders. Examples include support from friends and family, access to health and other services, stable housing and finances, and internal assets, such as self-esteem and motivation. Recovery capital is receiving increased emphasis as an integral component of addiction services. However, there are a limited number of studies assessing recovery capital in different settings. The current study assessed recovery capital among 363 individuals entering sober living (recovery) houses (SLHs) and showed how recovery capital was associated with individual and social environment characteristics of the houses. Individual characteristics were assessed shortly after residents entered the house ( M = 17 days, SD = 9 days). Approximately 1 month later, individuals were interviewed about their perceptions of the social environment within the household. We hypothesized residents’ perceptions of social model characteristics within the household would be associated with higher recovery capital. Study findings showed individual characteristics associated with recovery capital included motivation, support from friends and family, and 12-step involvement. Perceptions of the social environment assessed by four subscales on the Community Oriented Program Evaluation Scale and a measure of social model characteristics were correlated with recovery capital. Regression analyses controlling for individual characteristics showed modest but consistent associations with recovery capital. Even after relatively short periods of time in SLHs, resident perceptions of the social environment show associations with recovery capital. Additional research is needed to understand causal dynamics of this relationship and associations with outcome.
Overturning the ACA’s Medicaid Expansion Would Likely Decrease Low-Income, Reproductive-Age Women’s Healthcare Spending and Utilization
Authors: Chen Lucy , Frank Richard G. , Huskamp Haiden A.
Published: December 2020

In late 2020, the Supreme Court began hearing a case challenging the Affordable Care Act (ACA), which led to coverage gains for many low-income, reproductive-age women. To explore potential implications of a full ACA repeal for this population, we examined gains experienced after Medicaid expansion, assuming that such gains may be reversed. Using restricted 2013 to 2014 data from the Medical Expenditure Panel Survey for 1190 women ages 18 to 44 with household incomes below 138% of the federal poverty level, we compared the change in healthcare spending and utilization for women living in expansion states to the change in non-expansion states using a difference-in-differences design. We found that if Medicaid expansion were overturned, Medicaid coverage is likely to decrease, as well as Medicaid spending and prescription drug utilization.
Fostering Communities of Inquiry and Connectivism in Online Technical Communication Programs and Courses
Authors: Cleary Yvonne
Published: December 2020

In increasingly online higher education environments, instructors must develop positive and community-oriented learning environments, equivalent to, if different from, face-to-face learning experiences. Connectivism and communities of inquiry are complementary theories that facilitate the design and development of online learning and enable online learners to connect with peers. This article discusses two pedagogical interventions that encourage connectivism and foster communities of inquiry in online technical communication programs: (a) a face-to-face orientation workshop at the beginning of an online program and (b) a peer-review activity in a research methods graduate course. The article explains the development, deployment, and evaluation of the activities.
Peer Perspectives Within the Inclusive Postsecondary Education Movement: A Systematic Review
Authors: Carter Erik W. , McCabe Lauren E.
Published: December 2020

Peers play a central role in supporting college access for students with intellectual and developmental disabilities (IDD). This review examines available research addressing the perspectives of college student peers on the inclusive postsecondary education (IPSE) movement and their involvement in it. Approximately 2,670 peers—most of whom were female and undergraduates—participated in these 37 studies. We review findings addressing the views of peers on the following topics: (a) motivations for volunteering, (b) effectiveness as a peer support, (c) challenges they encountered, (d) impact of involvement on themselves, (e) impact of IPSE on their campus, (f) recommendations for IPSE programs, and (g) attitudes regarding disability. This research collectively highlights the multiple factors that draw peers to become involved, the experiences peers have within their campus’ programs, the myriad ways in which they and their campus may benefit from this movement, and their views regarding inclusion and disability. We offer recommendations for research and practice aimed soliciting the views and involvement of peers within the inclusive postsecondary education movement.
Assessment and Determinants of the Quality of Life in Portuguese Cities
Authors: Barreira Ana Paula , Amado Carla , Santos Sérgio , Andraz Jorge , Guimarães Maria Helena
Published: December 2020

The quality of life (QoL) in cities has increasingly been used as a symbol of urban success. Studies addressing this issue tend to focus, however, on large cities and/or on cities from different countries. By using a set of data from a single country, comprehending cities with different population sizes and densities, observations for 11 performance dimensions, and an approach combining the Data Envelopment Analysis (DEA) technique and multivariate regression modeling, this study analyses the QoL of Portuguese cities and explores some of its determinants. The results of this analysis show that both small and large cities can offer high levels of QoL with “transport and accessibility,” “safety,” “housing,” “education,” and “culture and entertainment” being the dimensions that most contribute to the QoL assessment. While Lisbon and Oporto (the two largest Portuguese cities) are benchmark cities, some of the highly populated cities located in their Metropolitan Areas present the most potential for improvement in terms of QoL. The results also show that cities located in the hinterland tend to present higher QoL scores than those on the coast. Equally, cities with lower population size and density, those that are district capitals and those with higher per capita current public expenditures present higher levels of QoL. These findings suggest, therefore, that the cities’ typology, their population size and density, and their dependence from local governments’ public expenditures can significantly contribute to the differences identified in their QoL performance.
Bullying Victimization among Children with Food Allergies and Parental Mental Health
Authors: Rocheleau Brandy N. , Rocheleau Gregory C.
Published: December 2020

Children with food allergies are bullied at higher rates than the general population. Little research, however, has considered how parents of children with food allergies may be affected by the bullying victimization of their children. This research examines if having a child with food allergies who is bullied relates to parental levels of stress, anxiety, and depression. Data were collected by administering surveys in several online support groups for parents of children with food allergies ( N = 623). Results showed that having a food-allergic child bullied is related to higher levels of stress, anxiety, and depression among parents. Policy implications for health care and school professionals are discussed, with an emphasis on broadening treatment services to include the families of victims of bullying.
Bounded Religious Automation at Work: Communicating Human Authority in Artificial Intelligence Networks
Authors: Cheong Pauline Hope
Published: December 2020

Existential threats to human work and leadership have been expressed over intensifying human-machine communication, and the development of robots and artificial intelligence (AI). Yet popular texts and techno-centric approaches to AI assume a flat ontology in human-machine communication which obscures power relations governing new technologies, necessitating a bounded automation approach integrating socio-economic influences that shape AI diffusion in distinctive occupational settings. This article advances three critical lines of enquiry to interrogate abstract labor displacement propositions by contextualizing human authority and communication in spiritual work. By explicating the dynamic and relational ways in which clerics strategically manage emerging social robotics, discussion of the case of ‘the world’s first robot monk’ illustrates how organizational leaders can influence AI agents to (re)produce values and cultural realities. In the process, priests strengthen normative regulation of power by aligning epistemic knowledge shared about AI and during human-machine communication to extant understandings of collective ideals.
The History of Anti-vivisection Legislation in Turkey and the Role of a New Association
Authors: Kınıkoğlu Oğuzcan
Published: December 2020

A new anti-vivisection association (Deneye Hayır Derneği) was recently established in Turkey with the aim of carrying out advocacy and lobbying activities to end non-human animal use by replacing animal-based experiments with alternative scientific methods. To achieve this end-goal, the Association works hard to create awareness of animal experiments and to protect the rights of animals. Complementary to our lobbying efforts to bring about a ban on animal use, we undertake a wide range of public awareness campaigns and other activities, such as: publishing communication material; organising workshops; participating in outreach events; networking with universities to promote the adoption of alternative methods and best practice learning tools; informing the general public via social media.
Rehabilitation following rotator cuff repair: A multi-centre pilot & feasibility randomised controlled trial (RaCeR)
Authors: Littlewood Chris , Bateman Marcus , Butler-Walley Stephanie , Bathers Sarah , Bromley Kieran , Lewis Martyn , Funk Lennard , Denton Jean , Moffatt Maria , Winstanley Rachel , Mehta Saurabh , Stephens Gareth , Dikomitis Lisa , Foster Nadine E
Published: December 2020

Objective:

To evaluate the feasibility of a multi-centre randomised controlled trial to compare the clinical and cost-effectiveness of early patient-directed rehabilitation versus standard rehabilitation following surgical repair of the rotator cuff of the shoulder.

Design:

Two-arm, multi-centre pilot and feasibility randomised controlled trial.

Setting:

Five National Health Service hospitals in England.

Participants:

Adults ( n = 73) with non-traumatic rotator cuff tears scheduled for repair were recruited and randomly allocated remotely prior to surgery.

Interventions:

Early patient-directed rehabilitation ( n = 37); advised to remove their sling as soon as able and move as symptoms allow. Standard rehabilitation ( n = 36); sling immobilisation for four weeks.

Measures:

(1) Randomisation of 20% or more eligible patients. (2) Difference in time out of sling of 40% or more between groups. (3) Follow-up greater than 70%.

Results:

73/185 (39%) potentially eligible patients were randomised. Twenty participants were withdrawn, 11 due to not receiving rotator cuff repair. The between-group difference in proportions of participants who exceeded the cut-off of 222.6 hours out of the sling was 50% (80% CI = 29%, 72%), with the early patient-directed rehabilitation group reporting greater time out of sling. 52/73 (71%) and 52/53 (98%) participants were followed-up at 12 weeks when withdrawals were included and excluded respectively. Eighteen full-thickness re-tears were reported (early patient-directed rehabilitation = 7, standard rehabilitation = 11). Five serious adverse events were reported.

Conclusion:

A main randomised controlled trial is feasible but would require allocation of participants following surgery to counter the issue of withdrawal due to not receiving surgery.
Anti-CV2/CRMP5 antibody-positive paraneoplastic neurological syndromes with chronic intestinal pseudo-obstruction in a small-cell lung cancer patient: a case report and literature review
Authors: Yan Jinhua , Chen Zhongbo , Liang Yumei , Yang Huijia , Cao Lizhi , Zhou Yuling , Zhao Yang , Zhang Ying
Published: December 2020

Patients with anti-CV2/collapsin response mediator protein (CRMP)5 antibodies present with more frequent chorea, cerebellar ataxia, uveo/retinal symptoms, and Lambert–Eaton myasthenic syndrome or myasthenia gravis. Chronic intestinal pseudo-obstruction (CIPO) is an intestinal motility dysfunction disease dysmotility that is caused by a neuromuscular disease with recurrent or persistent intestinal obstruction in the absence of mechanical obstruction. We report the case of a patient with CRMP5 antibody-positive paraneoplastic neurological syndrome (PNS) that is associated with autonomic dysfunction (presenting most remarkably as CIPO). CIPO is one of the rarest forms of PNS. Some PNS patients who are positive for anti-CV2/CRMP5 antibodies may have fatal complications such as CIPO. To detect if PNS patients are at risk for CIPO, a timely diagnosis and appropriate treatment are required.
How Serious Is Debt Among Probation Clients? A Study Into the Prevalence and Scope of Debt in a Dutch Probation Sample
Authors: van Beek Gercoline , de Vogel Vivienne , van de Mheen Dike
Published: December 2020

Although studies point to a relationship between debt and crime, there is a limited understanding of their reciprocal relationship and possible mediating risk factors. Moreover, knowledge about the prevalence and scope of debt among offenders is lacking. Therefore, the present study analyzed 250 client files including risk assessment data from the Dutch probation service on the prevalence of debt and possibly related risk factors. The results show that debt is highly prevalent and complex, which underlines the importance of acquiring more knowledge about debt as a potential risk factor for relapse during supervision. It was found that problems with regard to childhood and living situation, education and work/daytime activities, and mental and physical health may be possible underlying risk factors in the relationship between debt and crime. These insights can help professionals adequately support clients with regard to debt in order to prevent recidivism.
Unfounded Sexual Assault: Women’s Experiences of Not Being Believed by the Police
Authors: Murphy-Oikonen Jodie , McQueen Karen , Miller Ainsley , Chambers Lori , Hiebert Alexa
Published: December 2020

One in four women will experience sexual assault in their lifetime. Although less than 5% of sexual assaults are reported to law enforcement, one in five cases reported to police are deemed baseless (by police) and therefore coded as “unfounded.” Police officers are in a unique position to act as gatekeepers for justice in sexual assault cases, given their responsibility to investigate sexual assault reports. However, high rates of unfounded sexual assaults reveal that dismissing sexual violence has become common practice amongst the police. Much of the research on unfounded sexual assault is based on police perceptions of the sexual assault, as indicated in police reports. Women’s perspectives about their experiences with police are not represented in research. This qualitative study explored women’s experiences when their sexual assault report was disbelieved by the police. Data collection included open-ended and semi-structured interviews with 23 sexual assault survivors. Interviews covered four areas including the sexual assault, the experience with the police, the experience of not being believed, and the impact on their health and well-being. Interviews were audio-recorded, transcribed, and entered into NVIVO for analysis. Data were analyzed using Colaizzi’s analytic method, resulting in the identification of four themes, including, (a) vulnerability, (b) drug and alcohol use during the assault, (c) police insensitivity, and (d) police process. The women in this study who experienced a sexual assault and reported the assault to police were hopeful that police would help them and justice would be served. Instead, these women were faced with insensitivity, blaming questions, lack of investigation, and lack of follow-up from the police, all of which contributed to not being believed by the institutions designed to protect them. The findings from this research demonstrate that police officers must gain a deeper understanding of trauma and sensitive communication with survivors of sexual assault.
Does COVID-19 as a Long Wave Turning Point Mean the End of Neoliberalism?
Authors: Kılıç Sadık
Published: December 2020

The author claims that the COVID-19 pandemic could cause neoliberalism to break, based on four arguments addressed in four sections. The first section demonstrates that such a break is possible within the long wave theory framework. The second section points out that the neoliberal long wave was created by certain social and political actors from the 1980s onward and has already entered the downswing period since 2008. The third section shows that COVID-19 creates an economic crisis that causes an ideological transformation that further weakens neoliberalism. The fourth section emphasizes that the attitudes of industrial relations actors (and conflicts between them) will affect the shaping of the post-COVID-19 period. As a result, the trade union political action will be crucial in the coming years to revive themselves and create more regulated capital–labor relations.
When Can Negativity Mean Success? Gender Composition, Negative Relationships and Team Performance
Authors: Bradley Bret , Henry Sarah , Blake Benjamin
Published: December 2020

Teams are often plagued by internal discord, such as negative relationships, which can impede successful team performance. While most teams eventually encounter negative relationships, we have limited knowledge on how teams manage this negativity. In this article, we expand scholarship on teams by exploring an inherent team characteristic, gender composition, to assess its role in how teams cope with negative relationships. On the one hand, social role theory suggests that teams comprised of more women will perform better in the presence of negative relationships. On the other hand, theories and evidence on personality and individual differences suggest that teams comprised of more men will perform better in the presence of negative relationships. We studied 151 student project teams, and found that teams of mostly women performed better than teams of mostly men, when negative relationships existed among team members. We discuss the implications of these findings for research and practice.
Comparison of 3 Different Prothrombin Complex Concentrate Regimens for Emergent Warfarin Reversal: PCCWaR Study
Authors: Dietrich Scott K. , Rowe Shaun , Cocchio Craig A. , Harmon Amanda J. , Nerenberg Steven F. , Blankenship Patrick S.
Published: December 2020

Background

The ideal dose and specific prothrombin complex concentrate (PCC) for warfarin reversal is unknown.

Objective

To evaluate the reduction in international normalized ratio (INR) of 3 different PCC dosing regimens: fixed-dose activated 4-factor PCC (aPCC), fixed-dose 4-factor PCC (4PCC), and standard-dose 4PCC.

Methods

This was a multicenter retrospective cohort review. Patients >18 years of age who received PCC for warfarin reversal between January 1, 2017, and December 31, 2017, were screened for inclusion. Patients were excluded if they did not receive the correct PCC dosing regimen, received PCC for nonwarfarin bleeding, had a baseline INR less than 2, or received a massive transfusion protocol. Two institutions utilized aPCC dosed at 500 IU for INR <5 and 1000 IU for INR ≥5. Two institutions utilized fixed-dose 4PCC at 1500 to 2000 units depending on patient factors. Two institutions utilized 4PCC package insert dosing. The primary outcome was achievement of post-PCC target INR ≤1.4. Secondary outcomes included percentage change in INR, lowest 24-hour INR, and mortality.

Results

A total of 154 patients were included (fixed-dose aPCC: n = 29; fixed-dose 4PCC: n = 53; standard-dose 4PCC: n = 72). There was no statistical difference between groups in achieving the primary outcome (58.6% vs 69.8% vs 79.2%, respectively; P = 0.103) or any secondary outcomes.

Conclusion and Relevance:

There was no difference in the ability to achieve a post-PCC INR of ≤1.4 between 3 different PCC regimens for warfarin reversal. Additional research is warranted to determine the ideal dose and PCC agent for warfarin reversal.
Risk of Intracranial Hemorrhage With Concomitant Use of Antidepressants and Nonsteroidal Anti-inflammatory Drugs: A Nested Case-Control Study
Authors: Hou Po-Cheng , Lin Fang-Ju , Lin Shin-Yi , Hwang Tzung-Jeng , Wang Chi-Chuan
Published: December 2020

Background

Whereas previous studies found that concomitant antidepressant and nonsteroidal anti-inflammatory drug (NSAIDs) use may increase the risk of gastrointestinal bleeding, either drug alone increases the risk of intracranial hemorrhage (ICH).

Objective

To assess the risk for ICH in patients on concomitant treatment with antidepressants and NSAIDs.

Methods

This was a nested case-control study using national insurance claims data in Taiwan between 2005 and 2013. Drug exposure was measured and compared during 3 time windows: 1 to 30, 31 to 60, and 61 to 90 days before the index date, which is the date of the ICH event. Both traditional and newer-generation antidepressants were considered in this study.

Results

Patients exposed to both antidepressants and NSAIDs 1 to 30 days before the index date presented a 50% increased odds of developing ICH (OR: 1.53; 95% CI: 1.31-1.80) compared with patients receiving antidepressants alone. Specifically, the concomitant use of nonselective NSAIDs and antidepressants increased these odds compared with antidepressants alone (OR: 1.56; 95% CI: 1.31-1.84), but using a selective cyclooxygenase-2 inhibitor with antidepressant did not alter ICH risk. Regarding antidepressant class, newer-generation antidepressants generally increase the odds of developing ICH by 60% when used concomitantly with NSAIDs.

Conclusion and Relevance

Our results suggested that the concomitant use of antidepressants and NSAIDs was associated with an increased odds of developing ICH. NSAIDs, especially nonselective NSAIDs, and serotonergic antidepressants played an important role in this risk. Given the prevalent use of these 2 classes of drugs, this potential drug interaction deserves more attention.
Impacts of the COVID-19 Pandemic on Home Health and Home Care Agency Managers, Clients, and Aides: A Cross-Sectional Survey, March to June, 2020
Authors: Sama Susan R. , Quinn Margaret M. , Galligan Catherine J. , Karlsson Nicole D. , Gore Rebecca J. , Kriebel David , Prentice Julia C. , Osei-Poku Godwin , Carter Charles N. , Markkanen Pia K. , Lindberg John E.
Published: December 2020

Home health and home care (HH&HC) agencies provide essential medical and supportive services to elders and people with disabilities, enabling them to live at home. Home-based care is an important alternative to facility-based care, especially for infection prevention during the COVID-19 pandemic. The majority of the HH&HC workforce is comprised of aides, who also are vulnerable to COVID-19. There are limited data on the COVID-19 experience of HH&HC agencies, clients and aides. A survey of Massachusetts HH&HC agency managers was conducted June 1 to 30, 2020 to assess the impact of COVID-19 on agencies, clients, and aides early in the pandemic and to identify needs for future pandemic planning. Of the 94 agencies with completed surveys, most (59.6%) provided services to clients with COVID-19 and 3-quarters (73.7%) employed aides who tested positive for COVID-19, were symptomatic, and/or quarantined. Most agencies (98.7%) experienced a decrease in demand for home visits, reflecting clients’ concern about infection, family members assuming care duties, and/or aides being unavailable for work. Simultaneously, managers’ workloads increased to develop more extensive infection prevention policies, procedures and workforce training and sourcing scarce personal protective equipment (PPE). The COVID-19 pandemic imposed substantial new infection prevention responsibilities on HH&HC agencies, clients, and aides. Specific HH&HC needs for future pandemic planning include complete information on the infection status of clients; ready access to affordable PPE and disinfectants; and guidance, tools, and training tailored for the industry. HH&HC should be incorporated more fully into comprehensive healthcare and public health pandemic planning.
Medicalisation, suffering and control at the end of life: The interplay of deep continuous palliative sedation and assisted dying
Authors: Koksvik Gitte Hanssen , Richards Naomi , Gerson Sheri Mila , Materstvedt Lars Johan , Clark David
Published: December 2020

Medicalisation is a pervasive feature of contemporary end of life and dying in Western Europe and North America. In this article, we focus on the relationship between two specific aspects of the medicalisation of dying: deep continuous palliative sedation until death and assisted dying. We draw upon a qualitative interview study with 29 health professionals from three jurisdictions where assisted dying is lawful: Flanders, Belgium; Oregon, USA; and Quebec, Canada. Our findings demonstrate that the relationship between palliative sedation and assisted dying is often perceived as fluid and complex. This is inconsistent with current laws as well as with ethical and clinical guidelines according to which the two are categorically distinct. The article contributes to the literature examining health professionals’ opinions and experiences. Moreover, our findings inform a discussion about emergent themes: suffering, timing, autonomy and control – which appear central in the wider discourse in which both palliative sedation and assisted dying are situated, and which in turn relate to the wider ideas about what constitutes a ‘good death’.
Learning in a time of cholera: Imagining a future for public education
Authors: Wrigley Terry
Published: December 2020

This article considers some theoretical resources for resistance to neoliberalised schooling and develops principles for reimagining the common school. Whilst relevant internationally, it is situated in the particular context of England, as a global epicentre of school reform – a marketised and largely privatised system where the net of surveillance and control is tightly woven from assessment data, inspections and performance pay, and where the curriculum has been systematically divorced from young people’s life experience and concerns. To clarify the meaning of this crisis, the paper draws on some key ideas from the Marxist tradition, particularly class and alienation, situating neoliberal policy within the crises of late capitalism. The paper looks in two directions for resources to help overcome the current impasse. Firstly, it highlights the strengths of more creative and emancipatory pedagogies in earlier decades of English curriculum development, including the value of learners’ experience, vernacular language, dialogic teaching and play. Secondly it examines the northern European paradigm of curriculum construction focused on more holistic human development ( Bildung), focusing particularly on the work of Wolfgang Klafki. The value of this theorisation of curriculum and pedagogy is highlighted through contrasts with the current drive towards a ‘knowledge-based curriculum’.