bluuebunny/crossref_metadata_2025 huggingface dataset:
First-in-Human Assessment of cRGD-ZW800-1, a Zwitterionic, Integrin-Targeted, Near-Infrared Fluorescent Peptide in Colon Carcinoma
Authors: de Valk Kim S. , Deken Marion M. , Handgraaf Henricus J.M. , Bhairosingh Shadhvi S. , Bijlstra Okker D. , van Esdonk Michiel J. , Terwisscha van Scheltinga Anton G.T. , Valentijn A. Rob P.M. , March Taryn L. , Vuijk Jaap , Peeters Koen C.M.J. , Holman Fabian A. , Hilling Denise E. , Mieog J. Sven D. , Frangioni John V. , Burggraaf Jacobus , Vahrmeijer Alexander L.
Published: April 2020

Purpose:

Incomplete oncologic resections and damage to vital structures during colorectal cancer surgery increases morbidity and mortality. Moreover, neoadjuvant chemoradiotherapy has become the standard treatment modality for locally advanced rectal cancer, where subsequent downstaging can make identification of the primary tumor more challenging during surgery. Near-infrared (NIR) fluorescence imaging can aid surgeons by providing real-time visualization of tumors and vital structures during surgery.

Experimental Design:

We present the first-in-human clinical experience of a novel NIR fluorescent peptide, cRGD-ZW800-1, for the detection of colon cancer. cRGD-ZW800-1 was engineered to have an overall zwitterionic chemical structure and neutral charge to lower nonspecific uptake and thus background fluorescent signal. We performed a phase I study in 11 healthy volunteer as well as a phase II feasibility study in 12 patients undergoing an elective colon resection, assessing 0.005, 0.015, and 0.05 mg/kg cRGD-ZW800-1 for the intraoperative visualization of colon cancer.

Results:

cRGD-ZW800-1 appears safe, and exhibited rapid elimination into urine after a single low intravenous dose. Minimal invasive intraoperative visualization of colon cancer through full-thickness bowel wall was possible after an intravenous bolus injection of 0.05 mg/kg at least 2 hours prior to surgery. Longer intervals between injection and imaging improved the tumor-to-background ratio.

Conclusions:

cRGD-ZW800-1 enabled fluorescence imaging of colon cancer in both open and minimal invasive surgeries. Further development of cRGD-ZW800-1 for widespread use in cancer surgery may be warranted given the ubiquitous overexpression of various integrins on different types of tumors and their vasculature.
Profiling of the Risk Factors and Designing of a Model to Identify Ischemic Stroke in Patients with Non-Hodgkin Lymphoma: A Multicenter Retrospective Study
Authors: Wei Yunfei , Yang Qingqing , Qin Qixiong , Chen Ya , Quan Xuemei , Wei Jing , Zhou Liyuan , Wang Dacheng , Li Haihong , Li Guohui , Li Shengyu , Liang Zhijian
Published: April 2020

Background: The occurrence of ischemic stroke in patients with non-Hodgkin lymphoma (NHL) is not well understood. This study aimed to determine independent risk factors to identity ischemic stroke in non-Hodgkin lymphoma-associated ischemic stroke (NHLAIS) patients. Methods: This retrospective study was conducted on NHLAIS patients and age- and gender-matched NHL patients. We collected clinical data of patients in both groups and used multiple logistic regression analysis to identify independent risk factors for NHLAIS. A receiver operating characteristic (ROC) analysis was used to establish an identification model based on potential risk factors of NHLAIS. Results: Sixty-three NHLAIS patients and 63 NHL patients were enrolled. Stage III/IV (58/63, 92.1%) and multiple arterial infarcts (44/63, 69.8%) were common among NHLAIS patients. Notably, NHLAIS patients had higher levels of serum fibrinogen (FIB), D-dimer, and ferritin (SF) and prolonged thromboplastin time and prothrombin time (PT) compared with NHL patients (all p < 0.05). Elevated FIB, D-dimer, and SF and prolonged PT were independent risk factors for NHLAIS. The area under the ROC curve of the identification model of NHLAIS patients was largest compared to that of other risk factors (0.838, 95% confidence interval: 0.759–0.899) (p < 0.05). Conclusion: This study reveals that elevated serum FIB, D-dimer, and SF and prolonged PT are potential independent risk factors of NHLAIS. The identification model established in this study may help monitor NHL patients who are at high risk of developing NHLAIS.
Macrophages and Fibroblasts Differentially Contribute to Tattoo Stability
Authors: Strandt Helen , Voluzan Odessa , Niedermair Tanja , Ritter Uwe , Thalhamer Josef , Malissen Bernard , Stoecklinger Angelika , Henri Sandrine
Published: April 2020

Background: Little information is available about the complexity and function of skin cells contributing to the high stability of tattoos. It has been shown that dermal macrophages play an important role in the storage and maintenance of pigment particles. By contrast, the impact of dermal fibroblasts, forming the connective tissue of the skin, on the stability of the tattoo is not known. Method: In this study, we compared the cell number and the particle load in dermal macrophages versus dermal fibroblasts, isolated from tail skin of tattooed mice. Results: Microscopic analysis revealed that both cell populations contained the tattoo particles, although in largely different amounts. A small number of macrophages with high side scatter intensity contained a large quantity of pigment particles, whereas a high number of dermal fibroblasts harbored only a few pigment particles. Using the CD64dtr mouse model that allows for selective, diphtheria toxin-mediated depletion of macrophages, we have previously shown that macrophages hold the tattoo in place by capture-release and recapture cycles. In the tattooed skin of macrophage-depleted mice, the content of pigment particles in fibroblasts did not change; however, the total number of fibroblasts carrying particles increased. Conclusion: The present study demonstrates that dermal macrophages and fibroblasts contribute in different ways to the tattoo stability and further improves our knowledge on tattoo persistence.
A Rare Cause of Adrenal Insufficiency – Isolated ACTH Deficiency Due to TBX19 Mutation: Long-Term Follow-Up of Two Cases and Review of the Literature
Authors: Kardelen Al Aslı Derya , Poyrazoğlu Şükran , Aslanger Ayça , Yeşil Gözde , Ceylaner Serdar , Baş Firdevs , Darendeliler Feyza
Published: April 2020

Introduction: Isolated adrenocorticotropic hormone (ACTH) deficiency (IAD) is a rare cause of adrenal insufficiency and T-box pituitary restricted transcription factor (TBX19) mutations are responsible for two-thirds of the neonatal onset form of the disease. IAD presents with hypoglycemia and prolonged jaundice in the neonatal period. TBX19 is important for both pro-opiomelanocortin (POMC) gene transcription and differentiation of POMC-expressing cells. We describe 2 patients, 1 with a reported and 1 with a novel TBX19 mutation, and present information about the long-term follow-up of these patients. Case Presentation: Both patients had critical illnesses, recurrent hypoglycemia, convulsions, and neonatal hyperbilirubinemia. They also had low cortisol and ACTH levels, while other pituitary hormones were within the normal range. Pituitary imaging was normal. After hydrocortisone treatment, there was resolution of the hypoglycemia and the convulsions were controlled. Genetic studies of the patients revealed both had inherited a homozygous mutation of the TBX19 gene. The first patient had an alteration of NM_005149.3:c.856C>T (p.R286*) and the second patient had a novel NM_005149.3:c.584C>T (p.T195I) mutation, analyzed by next-generation sequencing. The noteworthy findings of the patients at follow-up were: short stature, microcephaly, and decreased pubic hair in the first, and dysmorphic features, Chiari type 1 malformation, tall stature, and low bone mineral density (BMD) in the second. Conclusion: Congenital IAD can be life-threatening if it is not recognized and treated early. TBX19 mutations should be considered in the differential diagnosis of IAD. Further cases or functional analyses are needed for genotype-phenotype correlations. Low BMD, dysmorphic features, Chiari type 1 malformation, and sparse pubic hair are some of the important features in these patients.
Effect of Unilateral Left Nostril Breathing (Chandra Anga Pranayama) on Cognitive Function in Healthy Yoga-Naïve Individuals: A Randomized, Controlled, Pilot Study
Authors: Santhanam Kumar Sai Suvethasri , Kamath Ashwin , Poojary Surekha
Published: April 2020

Introduction: Breathing modulates cortical neuronal activity. Various breathing exercises are purported to have specific effects on emotional and cognitive functions. Objective: To determine the effect of unilateral left nostril breathing (ULNB) on nonlateralized, overall cognitive functions using computerized psychometric tests. Methods: A randomized, controlled, pilot study was conducted among 20 healthy yoga-naïve medical students. ULNB was performed for 15 min by the test group (n = 10) and breath awareness by the control group (n = 10). Attention and processing speed, memory, and executive function were assessed using the Letter-Digit Substitution Test, Sternberg Memory Task, and Victoria Stroop Test, respectively. Baseline, pre- and postintervention scores were recorded. Results: There was no significant difference between the groups in baseline scores. In the Sternberg Memory Task, a statistically significant decrease in response time was seen in the test (t(9) = 3.855, p = 0.004) as well as the control group (t(9) = 3.120, p = 0.012); there was no significant difference between the groups. No significant effect of UNLB was seen in the Letter-Digit Substitution Test and Stroop Test. Conclusions: Our study showed no difference in the effects of 15-min practice of ULNB and breath awareness on cognitive functions; both improved memory but not attention or executive function.
Fulminant Emphysematous Pyelonephritis by Candida glabrata in a Kidney Allograft
Authors: Cases-Corona Clara , Shabaka Amir , Gonzalez-Lopez Andrea , Martin-Segarra Oriol , Moreno de la Higuera Maria Angeles , Lucena Rafael , Fernandez-Juarez Gema
Published: April 2020

Emphysematous pyelonephritis (EPN) is a rare and serious necrotizing infection that is potentially life-threatening. It has been seldom reported in kidney grafts and is usually caused by Gram-negative bacteria, with some case reports caused by anaerobic bacteria, and has been closely associated with poorly controlled diabetes mellitus (DM) and urinary tract structural abnormalities. There are no reports of EPN of fungal etiology in kidney grafts. We present a case of a 53-year-old kidney transplant recipient with a history of DM, active vesicoureteral reflux, and recurrent urinary tract infections who developed EPN in the kidney allograft caused by Candida glabrata, 3 weeks after starting treatment with empagliflozin, with an aggressive course that required urgent transplant nephrectomy.
Performing Bronchoscopy in Times of the COVID-19 Pandemic: Practice Statement from an International Expert Panel
Authors: Luo Fengming , Darwiche Kaid , Singh Suveer , Torrego Alfonso , Steinfort Daniel P. , Gasparini Stefano , Liu Dan , Zhang Wei , Fernandez-Bussy Sebastian , Herth Felix J.F. , Shah Pallav L.
Published: April 2020

These recommendations for physicians who perform bronchoscopy will help to protect those patients (un)-affected by the current COVID-19 pandemic, minimize the risk of transmission, and maintain clinical care for all patients.
Climate and weather impacts on agriculture: the case of Brazil
Authors: Pereda Paula Carvalho , Alves Denisard
Published: April 2020

The world’s population will rise exponentially in the coming decades, increasing the demand for food and challenging the agricultural sector to ensure food security. Due to the importance of climate conditions for agriculture, this article analyzed two different hypotheses regarding climate impacts on agricultural markets in Brazil. First, farmers only observe the average climate conditions of their region when deciding the type and amount of crop or animal to grow or raise. Second, weather diversions from normal climate conditions cause farmers to deviate from optimal profits. Neither hypothesis was rejected by the data. The 2006 estimated loss from rainfall anomalies was 12.8 billion dollars (in 2014 values).
Influence of time and storage temperature on raw milk deteriorating microbiota
Authors: Schmiedt Jhennifer Arruda , Tadielo Leonardo Ereno , Bellé Thiago Henrique , Rodrigues Carolina Dias , Montanhini Maike Tais Maziero , Barcellos Vinicius Cunha , Bersot Luciano Dos Santos
Published: April 2020

The quality of raw milk depends on initial microbial contamination and conditions of storage until industry processing. Considering the influence of time and storage temperature on raw milk microbiota, the objective of this work was to quantify and monitor the multiplication of these groups under different conditions. For this purpose, 41 samples of raw milk were collected immediately after milking, stored in the following storage conditions: 25 °C/2 h; 35 °C/2 h; 7 °C/24 h; 7 °C/48 h and 7 °C/60 h and analyses of aerobic mesophilic, psychrotrophic and proteolytic psychrotrophic microorganisms. The milk samples analyzed in the study had an initial mean count of mesophilic aerobes of 5.38 Log CFU/mL at Time Zero. The milk stored at 25 °C/2 h and 35 °C/2 h kept the mesophilic aerobic counts within the limits established by the legislation (5.48 Log CFU/mL), with an increase in counts of psychrotrophic and proteolytic microorganisms. When stored at 7 °C/24 h and 7 °C/48 h, the count of mesophiles exceeded the established parameters. A significant increase in the count of proteolytic psychrotrophs and psychrotrophs was also observed during storage at 7 °C from 24 h. The results of this study indicate that the temperature of 7 °C is not suitable for the milk conservation, since it was not able to control the microbial multiplication. Thus, the results contribute to the change in milk storage temperature proposed by the new Brazilian legislation.
Wet citrus pulp in finishing diets for feedlot lambs:
Authors: Mello Raquel Rodrigues Costa , Moreira Elizângela Mirian , Polizel Daniel Montanher , Ferraz Júnior Marcos Vinícius Castro , Biava Janaina Socolovski , Ferreira Evandro Maia , Pires Alexandre Vaz
Published: April 2020

Pectin industry generates a citrus pulp residue compounded by peduncle, endocarp, juice vesicles, columella, seeds and tiny fractions of epicarp and mesocarp of citrus fruits, denominated Wet Citrus Pulp (WCP), which has not yet been tested as food for lamb’s nutrition. Thus, this study aimed to determine the effect of partial replacement of ground corn by WCP in high-concentrate diets on the performance and hepatic enzyme concentration of feedlot lambs. Forty-two male lambs (15 Santa Inês and 27 ½ Dorper × Santa Inês), with 24.7 ± 1.5 kg of BW and 60 ± 5 d of age was assigned to a randomized complete block design. Within blocks (n = 14), lambs were randomly assigned to 1 of 3 treatments: 0WCP (control) – diet containing 75.5% ground corn without WCP; 20WCP – diet containing 20% WCP in replacement of ground corn, and 40WCP – diet containing 40% WCP in replacement of ground corn. The experiment lasted 70 days, which was split in 3 experimental periods (14 days of diets’ adaptation and 2 sub-periods of 28 days each). Statistical analyses were performed using the MIXED procedure of the SAS. Orthogonal polynomials for diet response were determined by linear and quadratic effects. There was a quadratic effect for DM, CP, ash, ether extract and NFC intake The highest DM and CP intake was observed for lambs fed 20WCP, however, the control diet increased the ash, ether extract and NFC intake. The increased levels of WCP decreased the ADG and feed efficiency (FE) during the adaptation period, however, did not affect the ADG and FE on periods 1 and 2. Consequently, the increased levels of WCP inclusion decreased linearly the BW. There was no effect of WCP inclusion in diets on Gamma-Glutamyl Transferase (GGT) concentration. However, there was a linear increase for Aspartate Aminotransferase (AST) concentration during the adaptation period, but without difference in other periods. In conclusion, adding up to 40% of WCP in finishing diets for feedlot lambs decrease performance during adaptation period, compromising the final body weight, but without damages effects on liver enzymes.
Evidence of in utero infection by Mycobacterium avium subsp. paratuberculosis using Multiple-Locus Variable-number tandem-repeat Analysis:
Authors: Vasini Rosell Brenda , Lagleyze Bernardo , Morsella Claudia , Mendez Laura , Bresky Florencia , Gioffré Andrea , Paolicchi Fernando
Published: April 2020

A pregnant heifer with an advanced clinical stage of paratuberculosis was reported in a herd in Argentina. Thus, the animal was euthanized and samples of organs of the cow and its fetus was taken and cultured for bacteriology in specific medium. Tissues were analyzed by histopathology (hematoxylin-eosin and Ziehl-Neelsen staining). Histopathological analysis of the cow’s samples revealed the presence of lesions consistent with paratuberculosis, and Ziehl-Neelsen staining revealed the presence of acid-fast bacilli, whereas the fetal tissues showed absence of lesions but the presence of acid-fast bacilli by Ziehl-Neelsen staining. After growing in specific medium, colonies in tissues from both cow and fetus were positive for IS900-PCR, confirming the presence of Mycobacterium avium subsp. paratuberculosis (MAP). Finally, the isolates were typed by Multiple-Locus Variable-number tandem-repeat Analysis (MLVA), which confirmedthe epidemiological link between them. This study is the first in Argentina to report the detection of MAP that shares an identical MLVA type in a pregnant cow and its fetus. The results of this study are consistent with previous reports and highlight the intra-uterine transmission of MAP as an important source of infection within herds.
Suicidal ideation and associated factors among high school adolescents
Authors: Sousa Cyntia Meneses de Sá , Mascarenhas Márcio Dênis Medeiros , Gomes Keila Rejane Oliveira , Rodrigues Malvina Thaís Pacheco , Miranda Cássio Eduardo Soares , Frota Karoline de Macêdo Gonçalves
Published: April 2020

OBJECTIVE: To analyze the prevalence of suicidal ideation and its associated factors in school adolescents. METHODS: Cross-sectional school-based study with 674 students from public and private schools in Teresina, Piauí, in 2016. Bivariate analysis was performed with the chi-square test and multiple analysis by the Poisson regression model to estimate prevalence ratios (PR) and 95% confidence intervals (95%CI). RESULTS: The study participants were mostly female (56.7%), black (77.4%), who lived with their parents (85%), whose mothers had schooling greater than or equal to 8 years of schooling (68.8%), with family income greater than a minimum wage (58.3%), practitioners of some religion (86.8%) and coming from public school (64.7%). The prevalence of suicidal ideation was 7.9%. Higher frequency of suicidal ideation was reported among female students (10.2%). Suicidal ideation was statistically associated with students who reported not living with their parents (adjusted PR = 2.27; 95%CI 1.26–4.10; p < 0.05) and those who reported having suffered sexual violence by other students, teachers or school staff (adjusted PR = 3.40; 95%CI 1.80–6.44; p < 0.05), among which the prevalence of suicidal ideation was more than three times that observed among those who did not mention this type of violence. CONCLUSION: The prevalence of suicidal ideation in school adolescents was associated with female students, who did not live with parents and have been victim of sexual violence at school. We recommend advising the school community and health professionals to identify signs of suicidal behavior, especially in those with suspicion or proof of the occurrence of sexual violence at school.
Consequences of Chronic Non-Cancer Pain in adulthood. Scoping Review
Authors: Cáceres-Matos Rocío , Gil-García Eugenia , Barrientos-Trigo Sergio , Porcel-Gálvez Ana María , Cabrera-León Andrés
Published: April 2020

OBJECTIVE: To examine and map the consequences of chronic pain in adulthood. METHOD: Documents addressing the impact of chronic pain on the psychological and social spheres of people suffering from chronic pain, published in Spanish and English between 2013 and 2018, were included. Those who addressed pharmacological treatments, chronic pain resulting from surgical interventions or who did not have access to the full text were excluded. Finally, 28 documents from the 485 reviewed were included. RESULTS: Studies show that pain is related to high rates of limitation in daily activities, sleep disorders and anxiety-depression spectrum disorders. People in pain have more problems to get the workday done and to maintain social relationships. Chronic pain is also associated with worse family functioning. CONCLUSIONS: This review shows that limitations in the ability to perform activities of daily living, sleep, psychological health, social and work resources and family functioning are lines of interest in published articles. However, knowledge gaps are detected in areas such as the influence of having suffered pain in childhood or adolescence, the consequences of non-fulfillment of working hours and gender inequalities.
Community-Based Rehabilitation (CBR) in primary care centers in Chile
Authors: Besoain-Saldaña Álvaro , Sanhueza Jame Rebolledo , Hizaut Mónica Manríquez , Rojas Valentina Cortínez , Ortega Gabriela Huepe , Aliaga-Castillo Verónica
Published: April 2020

OBJECTIVE: To describe the implementation status of the Community-Based Rehabilitation in Chile. METHODS: Quantitative, transversal and descriptive study. The scope was constituted by the 66 community-based rehabilitation centers in the Chilean Metropolitan Region that implemented Community-Based Rehabilitation until December 2016. The sampling was based on a census method, so all the community centers were contacted. A self-administered questionnaire designed based on the Community-Based Rehabilitation matrix defined by the World Health Organization was applied. The questionnaire was answered on-line by the coordinators of the strategy in their respective centers. The data analysis was performed using descriptive statistics. RESULTS: A heterogeneous level of implementation of Community-Based Rehabilitation was identified, specifically in terms of the components of the matrix described by the World Health Organization. The most implemented component was Health; the Social, Livelihood and Empowerment components were moderately implemented; and the Education component was the least implemented. CONCLUSION: The implementation of Community-Based Rehabilitation is mainly based on the Health component. The level implementation of the other components of the matrix needs to be increased, as well as interdisciplinary and intersectoral strategies to achieve greater social inclusion of people with disabilities.
On the Vorticity Balance over Steep Slopes: Kuroshio Intrusions Northeast of Taiwan
Authors: Liu Xiaohui , Wang Dong-Ping , Su Jilan , Chen Dake , Lian Tao , Dong Changming , Liu Tongya
Published: April 2020

The circulation of the Kuroshio northeast of Taiwan is characterized by a large anticyclonic loop of surface intrusion and strong upwelling at the shelfbreak. To study the mechanisms of Kuroshio intrusions, the vorticity balance is examined using a high-resolution nested numerical model. In the 2D depth-averaged vorticity equation, the advection of geostrophic potential vorticity (APV) term and the joint effect of baroclinicity and relief (JEBAR) term are dominant. On the other hand, in the 2D depth-integrated vorticity equation, the main balance is between nonlinear advection and bottom pressure torque. It is shown that JEBAR and APV tend to compensate, and their difference is comparable to bottom pressure torque. Perhaps most significantly, a general framework is provided for examination of vorticity balance over steep slopes through a full 3D depth-dependent vorticity equation. The 3D analysis reveals a well-defined bottom boundary layer over the shelfbreak, about 40 m deep and capped by the vertical velocity maximum. In the upper frictionless layer from the surface to about 100 m, the primary balance is between nonlinear advection and horizontal divergence. In the lower frictional layer, viscous stress is balanced by nonlinear advection and horizontal divergence. The bottom pressure torque, which corresponds to the depth-integrated viscous effect, is a proxy for viscous stress divergence at the bottom. The importance of nonlinear advection is further demonstrated in a sensitivity experiment by removing advective terms from momentum equations. Without nonlinear advection, the bottom pressure torque becomes trivial, the boundary layer vanishes, and the on-shelf intrusion is considerably weakened.
Towards accounting harmonization in Europe: a multinational survey among budget experts
Authors: Frintrup Markus , Schmidthuber Lisa , Hilgers Dennis
Published: April 2020

Severe fiscal problems, the insufficient comparability of financial information and increasing demands for better accountability require national governments and international organizations to change their current accounting regimes and to move towards a system of standardized accounting practices. As the International Public Sector Accounting Standards have insufficiently moved Europe towards accounting harmonization in recent years, the European Commission currently aims to suggest the adoption of European Public Sector Accounting Standards. Based on a multinational survey among budget experts, the current article investigates budget experts’ perceptions towards adopting the European Public Sector Accounting Standards. The findings compare attitudes towards new accounting practices and European Public Sector Accounting Standards reform expectations on a comparative basis, and relate them to the current national accounting system and contextual factors. Empirical results indicate great variation in terms of European Public Sector Accounting Standards reform expectations across countries. The study concludes with discussing the implications of the findings for international accounting research, accounting harmonization and the development of a European accounting system.

Points for practitioners

In this early stage of European Public Sector Accounting Standards development, understanding the factors associated with a country’s decision to adopt them could be helpful for practitioners and professionals. The current study identifies information technology costs as a potential barrier to implementing the European Public Sector Accounting Standards. Politicians and standard setters might take this into account while developing the European Public Sector Accounting Standards. Furthermore, this article reveals that encouraging the voluntary introduction of accrual accounting in the first stage of European Public Sector Accounting Standards development might be the appropriate approach of the European Commission.
International support networks and the calculus of uprising
Authors: Jackson Jaime A , San-Akca Belgin , Maoz Zeev
Published: April 2020

How does the anticipation of external support for both opposition groups and governments affect the likelihood and form (violent vs. nonviolent) of uprising within states? We develop a novel approach to address these issues, building on a network perspective. Our model suggests that both opposition groups and governments’ strategies are affected by an anticipation of the degree and nature of expected support by external parties (states and non-state actors). Using a set of indicators – including cultural affinity, strategic factors, and normative values – we develop a unique measure of anticipated support based on the potential support networks of target states and their opposition in order to evaluate our hypotheses. We argue that the anticipated balance of support for opposition and governments affects: (a) the likelihood of uprising and (b) the principal – violent or nonviolent – strategy used by the opposition group. We analyze data on violent and nonviolent civil conflicts over the period 1946–2010. We find that when the balance of anticipated support favors the opposition over their target government, the onset of an uprising is more likely. Specifically, the type of anticipated support has implications for whether a violent or nonviolent uprising occurs. These findings provide new insights into the role external support can play even before conflict occurs.
The Dark Side of Politics: Participation and the Dark Triad
Authors: Chen Philip , Pruysers Scott , Blais Julie
Published: April 2020

Personality traits are one piece in the larger puzzle of political participation, but most studies focus on the Five-Factor Model of personality. We argue that the normative implications of the influence of personality on politics are increased when the personality traits being studied correlate with negative social behaviors. We investigate the role of the Dark Triad on political participation as mediated through political beliefs such as interest and knowledge. We find that Psychopathy and Narcissism are positively associated with political interest, but Narcissism is also negatively associated with political knowledge. In addition, both Psychopathy and Narcissism exert a direct, positive influence on participation. Our results imply that individuals exhibiting higher levels of Narcissism are not only less knowledgeable but also more interested in politics and more likely to participate when given the opportunity.
Reflux Disease and Laryngeal Neoplasia in Nonsmokers and Nondrinkers
Authors: Parsel Sean M. , Iarocci Andrew L. , Gastañaduy Mariella , Winters Ryan D. , Marino Jeffrey P. , McCoul Edward D.
Published: April 2020

Gastroesophageal reflux disease (GERD) has been hypothesized as a risk factor for development of laryngeal cancer. A case‐control study was performed to assess the association of laryngeal neoplasia with GERD. Cases consisted of patients with a history of laryngeal cancer or carcinoma in situ. Controls were patients without neoplasia who matched cases 2:1 on age, sex, race, and smoking history. Univariate and multivariate analyses were performed to assess risk of laryngeal neoplasia and GERD. In total, 2094 patients were included. Cases had higher rates of GERD. Univariate analysis demonstrated a positive association between GERD and laryngeal neoplasia (odds ratio, 1.33; 95% CI, 1.07‐1.64). Multivariate analysis controlling for alcohol use history also demonstrated a positive association between GERD and laryngeal neoplasia (adjusted odds ratio, 1.29; 95% CI, 1.04‐1.59). These results suggest increased odds of laryngeal carcinoma and carcinoma in situ in patients with GERD when controlling for smoking and drinking history.
Evidence‐Based Guidelines for Management of Head and Neck Mucosal Malignancies during the COVID‐19 Pandemic
Authors: Crosby Dana L. , Sharma Arun
Published: April 2020

Objective

Due to the current coronavirus disease 2019 (COVID‐19) pandemic, otolaryngologists face novel challenges when treating patients with head and neck cancer. The purpose of this review is to evaluate the current evidence surrounding the treatment of these patients during this pandemic and to provide evidence‐based recommendations with attention to increased risk in this setting.

Data Sources

A review of the literature was performed with PubMed. Because recently published articles on this topic may not yet be indexed into PubMed, otolaryngology journals were hand searched for relevant articles. Guidelines from national organizations were reviewed to identify additional relevant sources of information.

Review Methods

Two groups of search terms were created: one with terms related to COVID‐19 and another with terms related to head and neck cancer and its management. Searches were performed of all terms in each group as well as combinations of terms between groups. Searches and subsequent exclusion of articles were performed in accordance with the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta‐analyses). Additional articles were identified after relevant journals and guidelines from national organizations were reviewed.

Conclusions

Patients with head and neck mucosal malignancy require continued treatment despite the current pandemic state. Care must be taken at all stages of treatment to minimize the risk to patients and health care workers while maintaining focus on minimizing use of limited resources.

Implications for Practice

Patient care plans should be guided by best available evidence to optimize outcomes while maintaining a safe environment in the setting of this pandemic.
Design and development of a novel expanding flexible rod device (FRD) for stability in the lumbar spine: A finite-element study
Authors: Rana Masud , Roy Sandipan , Biswas Palash , Biswas Shishir Kumar , Biswas Jayanta Kumar
Published: April 2020

The aim of this study is to design a novel expanding flexible rod device, for pedicle screw fixation to provide dynamic stability, based on strength and flexibility. Three-dimensional finite-element models of lumbar spine (L1-S) with flexible rod device on L3-L4-L5 levels are developed. The implant material is taken to be Ti-6Al-4V. The models are simulated under different boundary conditions, and the results are compared with intact model. In natural model, total range of motion under 10 Nm moment were found 66.7°, 24.3° and 13.59°, respectively during flexion–extension, lateral bending and axial rotation. The von Mises stress at intact bone was 4 ± 2 MPa and at bone, adjacent to the screw in the implanted bone, was 6 ± 3 MPa. The von Mises stress of disc of intact bone varied from 0.36 to 2.13 MPa while that of the disc between the fixed vertebra of the fixation model reduced by approximately 10% for flexion and 25% for extension compared to intact model. The von Mises stresses of pedicle screw were 120, 135, 110 and 90 MPa during flexion, extension, lateral bending, and axial rotation, respectively. All the stress values were within the safe limit of the material. Using the flexible rod device, flexibility was significantly increased in flexion/extension but not in axial rotation and lateral bending. The results suggest that dynamic stabilization system with respect to fusion is more effective for homogenizing the range of motion of the spine.
Decomposing Rural Income into Sectors to Identify Their Likely Contributions to Rural Poverty Reduction in Bangladesh
Authors: Uddin Mohammed Helal , Islam Nurul
Published: April 2020

The article estimates the contribution of total income from each sector to the overall rural income. It tests if the poor, who are concentrated in the lower-income quintiles, gain most from farm or non-farm sources of income growth. Also, within the farm or non-farm income, what are the relative contributions of its different sources. The dominance of agriculture is still there for the lowest quintile of rural households, farming still being the dominant sub-category. Over 1991–2010, a 13 per cent decrease in per capita real income from agricultural wages for all rural households and a 41 per cent decrease in that for Quintile 1 rural households contradict the earlier finding that increases in real wages were one of the main contributors to poverty reduction. Quintile-wise decomposition suggests that a substantial income enhancement was realised at upper quintiles of rural households. It also appears from the quintile-wise decomposition that the efficiency enhancement was realised more at upper quintiles leaving a relatively smaller effect on poverty reduction.
How Can Law and Policy Advance Quality in Genomic Analysis and Interpretation for Clinical Care?
Authors: Evans Barbara J. , Javitt Gail , Hall Ralph , Robertson Megan , Ossorio Pilar , Wolf Susan M. , Morgan Thomas , Clayton Ellen Wright ,   for the LawSeq Quality Task Force
Published: April 2020

Delivering high quality genomics-informed care to patients requires accurate test results whose clinical implications are understood. While other actors, including state agencies, professional organizations, and clinicians, are involved, this article focuses on the extent to which the federal agencies that play the most prominent roles — the Centers for Medicare and Medicaid Services enforcing CLIA and the FDA — effectively ensure that these elements are met and concludes by suggesting possible ways to improve their oversight of genomic testing.
Key Expert Stakeholder Perceptions of the Law of Genomics: Identified Problems and Potential Solutions
Authors: Cheung Fook Yee , Clatch Lauren , Wolf Susan M. , Clayton Ellen Wright , Lawrenz Frances
Published: April 2020

The law applicable to genomics in the United States is currently in transition and under debate. The rapid evolution of the science, burgeoning clinical research, and growing clinical application pose serious challenges for federal and state law. Although there has been some empirical work in this area, this is the first paper to survey and interview key scientific and legal stakeholders in the field of genomics to help ground identification of the most important legal problems that must be solved to successfully integrate genomics into clinical care. The respondents in this study identified a wide range of interconnected issues, focusing specifically on the need for clear guidelines about how to use these data, fear of liability for those who use these data, and the need to protect patients from use of this information particularly by insurers, while endorsing data sharing. Developing legal strategies to support appropriate use of genomics now and in the future clearly will require making trade-offs, taking into account the full complexity of this legal ecosystem.
Australian Aboriginal and Torres Strait Islander Collections of Genetic Heritage: The Legal, Ethical and Practical Considerations of a Dynamic Consent Approach to Decision Making
Authors: Prictor Megan , Huebner Sharon , Teare Harriet J.A. , Burchill Luke , Kaye Jane
Published: April 2020

Dynamic Consent (DC) is both a model and a specific web-based tool that enables clear, granular communication and recording of participant consent choices over time. The DC model enables individuals to know and to decide how personal research information is being used and provides a way in which to exercise legal rights provided in privacy and data protection law. The DC tool is flexible and responsive, enabling legal and ethical requirements in research data sharing to be met and for online health information to be maintained. DC has been used in rare diseases and genomics, to enable people to control and express their preferences regarding their own data. However, DC has never been explored in relationship to historical collections of bioscientific and genetic heritage or to contexts involving Aboriginal and Torres Strait Islander people (First Peoples of Australia).

In response to the growing interest by First Peoples throughout Australia in genetic and genomic research, and the increasing number of invitations from researchers to participate in community health and wellbeing projects, this article examines the legal and ethical attributes and challenges of DC in these contexts. It also explores opportunities for including First Peoples' cultural perspectives, governance, and leadership as a method for defining (or redefining) DC on cultural terms that engage best practice research and data analysis as well as respect for meaningful and longitudinal individual and family participation.
There Oughta Be a Law: When Does(n’t) the U.S. Common Rule Apply?
Authors: Meyer Michelle N.
Published: April 2020

Using mobile health (mHealth) research as an extended example, this article provides an overview of when the Common Rule “applies” to a variety of activities, what might be meant when one says that the Common Rule does or does not “apply,” the extent to which these different meanings of “apply” matter, and, when the Common Rule does apply (however that term is defined), how it applies.
Assessing the Thin Regulation of Consumer-Facing Health Technologies
Authors: Terry Nicolas P.
Published: April 2020

This article addresses the data protection and product safety regulatory models currently applied to consumer-facing health technologies. It explains how the design and structures of existing data protection and safety regulation in the U.S. have resulted in exceptionally thin protection for the users of consumer-facing devices and products that rely on or that facilitate consumer collection or aggregation of health and wellness data. It also examines some appealing legislative alternatives to the current thin model used in the U.S. and suggests a framework for prioritizing ameliorative regulation. To better understand existing regulatory models, their deficiencies, and how they should be reformed, the article employs an analytical model describing these regulatory systems across two axes. The vertical axis describes the quantity or depth of regulation, such as, for example, the strictness of the rules imposed by the regulatory model. The horizontal axis describes the reach of the regulation, the behaviors, products, or industries to which the regulation applies.
The Federal Trade Commission and Consumer Protections for Mobile Health Apps
Authors: Wagner Jennifer K.
Published: April 2020

The Federal Trade Commission (FTC) has an important role to play in the governmental oversight of mobile health apps, ensuring consumer protections from unfair and deceptive trade practices and curtailing anti-competitive methods. The FTC’s consumer protection structure and authority is outlined before reviewing the recent FTC enforcement activities taken on behalf of consumers and against developers of mhealth apps. The article concludes with identification of some challenges for the FTC and modest recommendations for strengthening the consumer protections it provides.
Do Groups Have Moral Standing in Unregulated mHealth Research?
Authors: Yu Joon-Ho , Juengst Eric
Published: April 2020

Biomedical research using data from participants’ mobile devices borrows heavily from the ethos of the “citizen science” movement, by delegating data collection and transmission to its volunteer subjects. This engagement gives volunteers the opportunity to feel like partners in the research and retain a reassuring sense of control over their participation. These virtues, in turn, give both grass-roots citizen science initiatives and institutionally sponsored mHealth studies appealing features to flag in recruiting participants from the public. But while grass-roots citizen science projects are often community-based, mHealth research ultimately depends on the individuals who own and use mobile devices. This inflects the ethos of mHealth research towards a celebration of individual autonomy and empowerment, at the expense of its implications for the communities or groups to which its individual participants belong. But the prospects of group harms — and benefits — from mHealth research are as vivid as they are in other forms of data-intensive “precision health” research, and will be important to consider in the design of any studies using this approach.
Electronic Informed Consent in Mobile Applications Research
Authors: Wilbanks John T.
Published: April 2020

The article covers electronic informed consent (eIC) from different dimensions so that practitioners might understand the history, regulation, and current status of eIC. It covers the transition of informed consent to electronic screens and the implications of that transition in terms of design, costs, and data analysis. The article explores the limits of regulation mandating eIC for mobile application research, and addresses some of the broader social context around eIC.
Privacy and Security Issues with Mobile Health Research Applications
Authors: Tovino Stacey A.
Published: April 2020

This article examines the privacy and security issues associated with mobile application-mediated health research, concentrating in particular on research conducted or participated in by independent scientists, citizen scientists, and patient researchers. Building on other articles in this issue that examine state research laws and state data protection laws as possible sources of privacy and security protections for mobile research participants, this article focuses on the lack of application of federal standards to mobile application-mediated health research. As discussed in more detail below, the voluminous and diverse data collected by some independent scientists who use mobile applications to conduct health research may be at risk for unregulated privacy and security breaches, leading to dignitary, psychological, and economic harms for which participants have few legally enforceable rights or remedies under current federal law. Federal lawmakers may wish to consider enacting new legislation that would require otherwise unregulated health data holders to implement reasonable data privacy, security, and breach notification measures.
International mHealth Research: Old Tools and New Challenges
Authors: Lang Michael , Knoppers Bartha Maria , Zawati Ma’n H.
Published: April 2020

In this paper, we outline the policy implications of mobile health research conducted at the international level. We describe the manner in which such research may have an international dimension and argue that it is not likely to be excluded from conventionally applicable international regulatory tools. We suggest that closer policy attention is needed for this rapidly proliferating approach to health research.
The Mania Pathway Protocol: An Application of Evidence-Based Interventions for the Treatment of Acute Mania on an Inpatient Psychiatric Unit
Authors: Adri Avishay A.
Published: April 2020

Introduction:

Acute manic episodes are a psychiatric emergency related to violence and poor patient outcomes. Combination psychotropic therapy utilizing a mood stabilizer and an atypical antipsychotic has been shown to be more efficacious for treating acute mania compared to monotherapy with either mood stabilizers or antipsychotics alone. This quality improvement project implemented evidence-based interventions for treating acute mania. The mania pathway protocol was created as a comprehensive clinical guide for guiding mania treatment. The protocol was implemented on an inpatient psychiatric unit for patients with mania diagnoses including manic/mixed episodes of bipolar disorder or schizoaffective disorder.

Aims:

(1) to improve the treatment of mania by using evidence-based interventions for rapid mood stabilization and (2) to educate psychiatric providers on up-to-date interventions for treating acute manic states.

Method:

Psychiatric providers were evaluated for knowledge enhancement through a pre-/post–educational session quiz. A retrospective chart review was used for data collection for patients treated with the mania pathway protocol. The retrospective chart review spanned 8 weeks post project implementation. Young Mania Rating Scale (YMRS) scores were analyzed to measure the effect on mania severity.

Results:

The percentage decrease in mean Young Mania Rating Scale scores from admission to the fifth day of hospitalization was 61%. All psychiatric providers proved knowledge attainment by scoring 100% on the postintervention quiz.

Conclusions:

Rapid mood stabilization may be achieved by using a combination therapy–based mania protocol. Educational sessions can enhance psychiatric provider knowledge with regard to evidence-based treatments for mania.