bluuebunny/crossref_metadata_2025 huggingface dataset:
Activists in the dark: Social media algorithms and collective action in two social movement organizations
Authors: Etter Michael , Albu Oana Brindusa
Published: September 2020

It is widely established that social media afford social movement (SM) organizations new ways of organizing. Critical studies point out, however, that social media use may also trigger negative repercussions due to the commercial interests that are designed into these technologies. Yet empirical evidence about these matters is scarce. In this article, we investigate how social media algorithms influence activists’ actualization of collective affordances. Empirically, we build on an ethnographic study of two SM organizations based in Tunisia. The contributions of this paper are twofold. Firstly, we provide a theoretical framework that specifies how algorithms condition the actualization of three collective affordances (interlinking, assembling, augmenting). Specifically, we show how these affordances are supported by algorithmic facilitation, that is, operations pertaining to the sorting of interactions and actors, the filtering of information, and the ranking and aggregation of content. Secondly, we extend the understanding of how social media platforms’ profit-orientation undermines collective action. Namely, we identify how algorithms introduce constraints for organizing processes, manifested as algorithmic distortion, that is, information overload, opacity, and disinformation. We conclude by discussing the detrimental implications of social media algorithms for organizing and civic engagement, as activists are often unaware of the interests of social media-owning corporations.
Comparing older people’s drinking habits in four Nordic countries: Summary of the thematic issue
Authors: Tigerstedt Christoffer , Agahi Neda , K Bye Elin , Ekholm Ola , Härkönen Janne , Jensen Heidi Rosendahl , Lau Cathrine Juel , Makela Pia , Moan Inger Synnøve , Parikka Suvi , Raninen Jonas , Vilkko Anni , Bloomfield Kim
Published: September 2020

Aim:

The present article summarises status and trends in the 21st century in older people’s (60–79 years) drinking behaviour in Denmark, Finland, Norway and Sweden and concludes this thematic issue. Each country provided a detailed report analysing four indicators of alcohol use: the prevalence of alcohol consumers, the prevalence of frequent use, typical amounts of use, and the prevalence of heavy episodic drinking (HED). The specific aim of this article is to compare the results of the country reports.

Findings:

Older people’s drinking became more common first in Denmark in the 1970s and then in the other countries by the 1980s. Since 2000 the picture is mixed. Denmark showed decreases in drinking frequency, typically consumed amounts and HED, while in Sweden upward trends were dominant regarding prevalence of consumers and frequency of drinking as well as HED. Finland and Norway displayed both stable indicators except for drinking frequency and proportion of women consumers where trends increased. In all four countries, the gender gap diminished with regard to prevalence and frequency of drinking, but remained stable in regard to consuming large amounts. In Norway the share of alcohol consumers among women aged 60–69 years exceeded the share among men. During the late 2010s, Denmark had the highest prevalence of alcohol consumers as well as the highest proportion drinking at a higher frequency. Next in ranking was Finland, followed by Sweden and Norway. This overall rank ordering was observed for both men and women.

Conclusion:

As the populations aged 60 years and older in the Nordic countries continue to grow, explanations for the drivers and consequences of changes in older people’s drinking will become an increasingly relevant topic for future research. Importantly, people aged 80 years and older should also be included as an integral part of that research.
The Finnish Drinking Habits Survey: Implications for alcohol policy and prevention
Authors: Warpenius Katariina , Mäkelä Pia
Published: September 2020

Aims/materials:

This reflection piece reviews some of the key results and conclusions from the book Näin Suomi juo ( This is how Finns drink, 2018), based on the Finnish Drinking Habits Survey. Our aim was to go through the results taking the perspective of prevention workers and policymakers: how could they benefit from the scientific findings when tackling alcohol-related harm?

Results/reflections:

The reflections displayed in this article provide some useful arguments and justifications for population-level alcohol policy in the controversial alcohol policy debate. Harms do not only arise among the heaviest drinkers, and efficient methods to prevent harm may be found among the prevention efforts that apply to populations rather than only to the heaviest drinkers. The article also illustrates how the results from a population survey can be used in order to identify specific challenges and solutions for alcohol prevention in a given population. The results help in identifying the population groups and situations with an elevated risk of alcohol-related harm and in characterising the drinking patterns and social situations in which drinking takes place in these vulnerable parts of the population.

Conclusions:

The review illustrates that a many-sided understanding of alcohol consumption and the related harm, based on survey results, is more far-reaching in terms of prevention and policy than a knowledge base built solely on register data on the development of alcohol consumption and harm. For example, the respondents’ drinking patterns are linked not only to their attitudes and risk perceptions but also to what people consider to be appropriate means to reduce alcohol use and the related harm in terms of alcohol policy, informal social control and people’s life management.
Drinking patterns among Finns aged 60 years and over from the 1990s onwards
Authors: Tigerstedt Christoffer , Härkönen Janne , Mäkelä Pia , Parikka Suvi , Vilkko Anni
Published: September 2020

Aim:

To analyse prevalence and trends in older people’s (60+) alcohol use in Finland in 1993–2018.

Data and method:

Data on people aged 65+ were obtained from the Health Behaviour and Health among the Finnish Elderly study (HBHFE) for the years 1993–2011 and from its successor the National FinSote Survey for the years 2013–2018. Data for 60–64-year-olds and for the reference group (20–59-year-olds) were obtained from the Health Behaviour and Health among the Finnish Adult Population (HBHFA) study for the years 1993–2011 and from the FinSote study for the years 2013–2018. Four measures were chosen to describe prevalence and trends in drinking patterns in five-year age groups among men and women aged 60+: prevalence of current drinking, prevalence of frequent drinking, typical amounts of drinking and prevalence of heavy episodic drinking (HED).

Results:

Regarding prevalence of current drinking and frequent drinking, older women have been catching up with men, but older men still consume larger amounts of alcohol per occasion. The long-lasting increase in the prevalence of current drinkers continued in most older female age groups into the 2010s, settled in most older male and some female age groups, and shifted downwards in the oldest male age groups. In most older male and female age groups, the increasing trend in frequent drinking continued to the present. Data on typical amounts consumed and HED were only available for 2013–2018. In that period those measures remained rather stable.

Conclusion:

More detailed research on drinking patterns among people aged 60+ years is needed for two reasons: older people’s drinking is a new cultural phenomenon and alcohol-related social and health harms are increasing in older age groups.
Bifurcation study on fractional non-smooth oscillator containing clearance constraints
Authors: Wang Jun , Shen Yongjun , Yang Shaopu , Zhang Jianchao
Published: September 2020

Bifurcation characteristics of a fractional non-smooth oscillator containing clearance constraints under sinusoidal excitation are investigated. First, the bifurcation response equation of the fractional non-smooth system is obtained via the K–B method. Second, the stability of the bifurcation response equation is analyzed, and parametric conditions for stability are acquired. The bifurcation characteristics of the fractional non-smooth system are then studied using singularity theory, and the transition set and bifurcation diagram under six different constrained parameters are acquired. Finally, the analysis of the influence of fractional terms on the dynamic characteristics of the system is emphasized through numerical simulation. Local bifurcation diagrams of the system under different fractional coefficients and orders verify that the system will present various motions, such as periodic motion, multiple periodic motion, and chaos, with the change in fractional coefficient and order. This manifestation indicates that fractional parameters have a direct effect on the motion form of this non-smooth system. Thus, these results provide a theoretical reference for investigating and repressing oscillation problems of similar systems.
Hetero-sexting as mediated intimacy work: ‘Putting something on the line’
Authors: Amundsen Rikke
Published: September 2020

This article is concerned with women’s digitally mediated practices of creating and sending private sexual images to men, here referred to as ‘hetero-sexting’. Drawing on material from individual interviews with adult British women about their experiences of hetero-sexting, the article develops an understanding of women’s hetero-sexting practices as a form of female-conducted ‘mediated intimacy work’, constituted by a constant negotiation of female risk taking and male trustworthiness. In doing so, it shows how the women relied on and made active use of the sexting-related risk of digital image abuse as a means to establish and enhance trust and, as such, stress the significance of their hetero-sexting activities as performances of intimacy. Sexting-induced vulnerability was therefore both drawn on and dismissed within the very same accounts of hetero-sexting, as it was applied as a means to perform a new form of normative femininity, namely that of the agentic intimacy worker.
Religious perceptions of crime and implications for punitiveness
Authors: Seto Christopher H , Said Iman
Published: September 2020

This study tests the role of crime perceptions in mediating the relationship between religiosity and punitive attitudes about criminal justice. Specifically, we estimate the effects of (a) religious affiliation and (b) fundamentalism on punitiveness and assess mediation by dispositional attribution of crime, perceived rising crime rates, perceived immigrant crime, and fear of violent victimization. Data are from the 2014 wave of the Chapman Survey on American Fears, a nationally representative sample of adults in the United States (N = 1,573). We estimated religious effects on punitiveness using ordinary least squares regression and assessed mediation by crime perceptions with the Karlson-Holm-Breen (KHB) method. Punitiveness was positively associated with Mainline Protestant affiliation (vs. non-religious), Catholic affiliation (vs. non-religious), and fundamentalism (fundamentalism also largely accounted for heightened punitiveness among Evangelical Protestants). Perceptions of crime accounted for about 60% of the effects of religious affiliation on punitiveness and nearly 100% of the effect of fundamentalism. Perceptions of crime as caused by evil or moral failure, belief in rising crime rates, and perceptions of immigrant crime were important to explaining religious effects on punitiveness, while fear of violence was relatively unimportant. These findings illuminate the perceptual mechanisms underlying religious effects on criminal justice attitudes.
Promoting bilingualism and children’s co-participation in Singapore language classrooms: Preschool teacher strategies and children’s responses in Show-and-Tell
Authors: Ng Siew Chin , Vijayakumar Poorani , Yussof Nurul Taqiah , O’Brien Beth Ann
Published: September 2020

Show-and-Tell is one of many activities recommended for encouraging children’s oral language production in classrooms across the world, but there is little research on the topic. From existing studies, teacher facilitation is posited as key to shaping children’s oral language production. This paper explores teacher strategies for facilitating children’s oral language production during Show-and-Tell, in the case studies of four Singapore preschool language teachers (English, Chinese, Malay and Tamil) sampled from a larger nationwide longitudinal study, with 47 children observed across the four classrooms. Using a coding scheme with high reliability ( d = 0.80), a total of 1192 teacher utterances and 539 children’s utterances were coded to capture teacher strategies and types of children’s responses across the classrooms. Findings showed that the English teacher employed language modelling most frequently, while all other teachers most frequently facilitated through questioning. The potential of Show-and-Tell in encouraging children’s language output is observed in how self-initiated talk is among the most frequent form of child participation, especially in the English-language classroom, which was expected given the context of English-dominance among bilingual Singapore children. In response to teacher facilitation, children were more likely to respond with verbal responses and gestures, as compared to not responding. It was, however, noted that a lack of wait-time provided by teachers hampered children’s opportunities to express themselves during the activity. Our findings have implications on the need for different types of teacher strategies required to ensure the effectiveness of Show-and-Tell for promoting children’s oral language production.
Investigating the Assessment Procedures for Children With Complex Communication Needs
Authors: Theodorou Elena , Pampoulou Eliada
Published: September 2020

Successful intervention outcomes and comprehensive assessment is important for people who rely on augmentative and alternative communication (AAC). However, the literature surrounding AAC assessment remains sparse. The purposes of this project were to describe the AAC assessment process followed by speech-language pathologists (SLPs) and to suggest areas for a comprehensive assessment. The research questions were (1) to identify the training received and (2) to explore the key elements of the assessment process. A questionnaire was developed based on the Participation Model and completed by 89 SLPs. The findings show that SLPs base their AAC assessment on clinical decisions, taking into consideration a number of elements, such as language, communication, and social skills. However, the process uncovered through this research cannot be characterized as either comprehensive or systematic. The findings indicate that further training on AAC assessment is warranted, thus ensuring high quality of services for people with complex communication needs.
Expanding Constituency Support Through Shared Local Roots in U.S. House Primaries
Authors: Hunt Charles
Published: September 2020

This paper addresses the enduring connection of localism and place-based roots shared between many elected leaders and their constituents, which previous work has either ignored or improperly specified. I argue that representatives of the U.S. House with these roots—meaning authentic, lived experience in their districts prior to their officeholding—sustain more supportive constituencies in primary election stage. Using an original 7-point index of local biographical characteristics of incumbents seeking renomination from 2002 to 2018, I find that deeply-rooted incumbents are less than half as likely to receive a primary challenge, and on average perform more than 5 percentage points better in their primary elections when they are challenged. These gains take place even after taking district partisanship, national political conditions, incumbent ideology, and other primary factors into account, and should induce scholars to reconsider the importance of local representation even amidst a nationalizing political culture.
Reoperations for Epilepsy: How Many Times Should We Bat?
Authors: Faught Edward
Published: September 2020

[Box: see text]
Is Mesenteric Ischemia In COVID-19 Patients A Surprise?
Authors: Vartanoglu Aktokmakyan Talar , Tokocin Merve , Meric Serhat , Celebi Fatih
Published: September 2020

Aim. The disease caused by the 2019 novel coronavirus is known predominantly for its respiratory outcomes; a subset of critically ill patients demonstrates clinically remarkable hypercoagulability in which thrombotic events range from acute pulmonary embolism in patients with COVID-19 pneumonia to extremity ischemia. Our observational study aimed to describe the incidence and characteristics, as well as clinical outcomes, of patients presenting and treated for mesenteric ischemia during the COVID-19 pandemic. Material and Methods. Between March 13 and May 13, 2020, 60 patients operated for emergency reasons were analyzed, and it was noticed that 5 of the 6 COVID-positive patients were operated due to mesenteric ischemia. Results. Five of sixty patients (83.3%) applied to our emergency clinic with COVID-19 positive and acute abdomen. Two of them (40%) did not have any comorbidities. All of them (%100) were male. There were no complications and only 1 death (20%). Mean leukocyte, neutrophil, and platelet levels were within the normal range, while the lymphocyte level was near the lower limit. C-Reactive Protein was above the limit in all patients. The mean levels of International Normalized Ratio, Platelet, and Activated Partial Thromboplastin Time were above the limits. While D-dimer levels were close to the upper limit; fibrinogen levels were above the normal limit for each patient. Conclusion. The presence of hypercoagulation status in critical COVID-19 patients should be observed closely, and anticoagulation therapy can be considered in selected patients. More clinical data are needed to examine the role of anticoagulation in COVID-19 treatment.
The Diagnostic Accuracy of Testicular Torsion by Doctors on Duty Using Sonographic Evaluation with Color Doppler
Authors: Nakayama Akinori , Ide Hisamitsu , Osaka Akiyoshi , Inoue Yasuyuki , Shimomura Yukihito , Iwahata Toshiyuki , Kobori Yoshitomo , Saito Kazutaka , Soh Shigehiro , Okada Hiroshi
Published: September 2020

As testicular torsion is a medical emergency, it requires quick diagnosis and treatment. Color Doppler ultrasound (CDUS) is useful for the diagnosis of testicular torsion. An accurate diagnosis can be difficult when CDUS indicates the preservation of blood flow in the testis. We examined the accuracy of testicular torsion diagnosis in patients with acute scrotum made by doctors on duty using CDUS. The subjects included 26 patients who visited our department between January 2016 and June 2018 presenting with acute scrotal pain. Patients were placed into one of three groups based on testicular blood flow evaluated by CDUS. The first group had no testicular blood flow, the second had diminished blood flow, and the last group had normal or increased blood flow. Patients were also diagnosed through scrotal exploration. Finally, patients were further divided into two groups identified by CDUS frequency utilized during diagnosis (12 MHz groups and ≤8 MHz groups), and the diagnostic accuracy of the two groups was compared. Characterizing torsion by either the absence of or diminished, testicular blood flow in the CDUS evaluation, the sensitivity and specificity of the CDUS performed by doctors on duty accounted for 69.2% and 53.8%, respectively. No improvement in diagnostic accuracy was evident despite the usage of a 12-MHz ultrasonic transducer. In this study, the sensitivity of CDUS performed by doctors on duty was about 70%, suggesting that scrotal exploration should be performed promptly even if testicular blood flow is observed and testicular torsion is suspected from medical history and body findings.
Reliability and accuracy assessment of morphometric measurements obtained with software for three-dimensional reconstruction of brain aneurysms relative to cerebral angiography measures
Authors: Munarriz Pablo M , Bárcena Eduardo , Alén Jose F , Castaño-Leon Ana M , Paredes Igor , Moreno-Gómez Luis Miguel , García-Pérez Daniel , Jiménez-Roldán Luis , Gómez Pedro A , Lagares Alfonso
Published: September 2020

Objective

To analyze the reliability and accuracy of morphological measurements of software employed to three-dimensionally reconstruct aneurysms and vessels (VMTKlab, version 1.6.1,) with computed tomography angiography (CTA) as the source of images. Agreement with measurements from three-dimensional digital subtraction angiography (3 D-DSA) was evaluated.

Methods

We evaluated 40 patients presenting with aneurysmal subarachnoid hemorrhage (aSAH). We analyzed four main variables of the aneurysm morphology: absolute height (size), neck (maximum neck width), perpendicular height, and maximum width. The CTA images were uploaded to the software and then segmented to reconstruct the aneurysm. This new method was compared to the current gold standard—3D reconstruction of pretreatment cerebral angiography. We used intraclass correlation coefficient (ICC) and Bland-Altman plot analyses to evaluate the agreement between these methods.

Results

The ICCs obtained for absolute height, neck, perpendicular height, and maximum width were 0.85, 0.57, 0.85, and 0.89, respectively. This implied good agreement except for the neck of the aneurysm (moderate agreement). Bland-Altman plots are presented for the four indexes. The average of the differences was not significant in terms of absolute height, perpendicular height, and maximum width indicating good agreement. However, it was significant for the neck of the aneurysm.

Conclusions

We report good agreement between the values generated using VMTKlab and cerebral angiography for three of the four main variables. Discrepancies in neck diameter are not surprising and its underestimation with a traditional delineation from cerebral angiography has been reported before.
Effect of internal leakage on torque converter characteristics
Authors: Pan Xiong , Xinyuan Chen , Hongjun Sun , Jiping Zhong , Chenping Zhen
Published: September 2020

To understand the effect of internal leakage on the torque field and characteristics of a torque converter (TC), a transient analysis was performed on the internal flow of a TC and the pressure pulsation characteristics of monitoring points in the convection channel. It was found that dividing the leakage area of the TC into a separate watershed improved simulation accuracy by 4%. When there was a leakage area, there were distinct collision, mixing, and assimilation stages between the leakage flow and the main flow. These phenomena caused energy loss that was highest at low speed ratios. However, the leakage flow always accounted for 12% of the main flow regardless of the speed ratio. At the same time, the leakage flow had a larger influence on pressure pulsation inside the TC and especially the low frequency band was more substantial. This shows that the leakage area has a large influence on the TC performance, energy loss, and flow state. Analysis of the leakage area showed that reducing the leakage area helps to improve powertrain performance and fuel economy.
Moved by fire: Green criminology in flux
Authors: Lundberg Kajsa
Published: September 2020

The destructive bushfires in Australia 2019–2020 resonate with similar trends around the world as bushfire seasons are becoming longer and more pervasive. Yet, criminological analyses of bushfires are limited and tend to focus on the individual criminal subject and the act of arson, the crime of intentional fire starting. Encouragingly, green criminology, the criminological perspective dealing with environmental crimes and harms, is expanding the categories of offenders and victims of harm by, for example, highlighting non-human victims and harms perpetrated by the capitalist system. Nonetheless, even this perspective is inadequate to deal with the complex and ultimately mobile events of fire and their far-reaching consequences. This article brings green criminology in flux by drawing from the ‘new mobilities paradigm’, emphasising motion, temporality and the mobility of contemporary life. The new mobilities paradigm, or the ‘mobility turn’, has a lot to offer green criminology as is demonstrated here by way of scrutinising the mobility of fire. A mobile green criminology will help trace fire beyond static categories of offenders and victims and open up for more flexible and mobile categories of environmental harms as constructed, complex and unstable processes. Finally, a mobile analysis allows for a more complex and meaningful reading of criminological space, demonstrated by the relationship between social, aesthetic and cultural values of land, politics, power and fire-related behaviours, such as fire suppression or Aboriginal peoples’ cultural burning practices. It is argued here that in order to understand the complex nature of fire, green criminology must attune to the intersections between fire, space, mobility and meaning.
Improved cuckoo search algorithm and its application to permutation flow shop scheduling problem
Authors: Zhang Lieping , Yu Yanlin , Luo Yingxiong , Zhang Shenglan
Published: September 2020

Aiming at the problem that the standard cuckoo search algorithm relies on Levy flights, which leads to the step-size randomness of the search process, a self-adaptive step cuckoo search algorithm based on dynamic balance factor is proposed in our paper. First, two parameters are introduced in our paper, which were iteration number ratio parameter and adaptability ratio parameter. Then, a dynamic balance factor parameter is introduced to adjust the weight number of iteration number ratio parameter and adaptability ratio parameter. Finally, parameter skewness value calculation method and self-adaptive step strategy were proposed combined with the dynamic balance factor. Six typical test functions are used to test the performance of the proposed algorithm, the standard cuckoo search algorithm and the self-adaptive step cuckoo search algorithm which relies only on the iterative times. The test results show that the proposed algorithm had good convergence speed and accuracy. Meanwhile, taking the permutation flow shop scheduling problem as an example, eight operators of Car benchmark class are used as the test data to compare the performance of three algorithms, the effectiveness and superiority of the algorithm in solving the permutation flow shop scheduling problem are verified.
COVID-19: Adapting to change, general surgery at a district general hospital in the United Kingdom
Authors: Ike Sonia , Ikechi Chijioke , Rait Jaideep , Shah Ankur
Published: September 2020

The Coronavirus pandemic has caused major change across the world and in the National Health Service. In order to cope and help limit contagion, numerous institutions recognised the need to adjust clinical practice quickly yet safely. In this paper, we aim to describe the changes implemented in a general surgery department at a district general hospital in the United Kingdom. Across the surgical specialties, frameworks, protocols and guidelines have been established locally and nationally. The aerosol generating procedures involved in general surgery required us to alter our daily activities. Modifications to patient management were necessary to try and reduce viral spread. Staff wellbeing was heavily promoted in order to help maintain the frontline workforce. A holistic approach was required.
Seeing the Genocide against the Tutsi through someone else’s eyes: Prosthetic memory and Hotel Rwanda
Authors: Hitchcott Nicki
Published: September 2020

Alison Landsberg’s theory of ‘prosthetic memory’ suggests that memories are not ‘owned’, that is they do not depend on lived experience, but rather they can occur as a result of an individual’s engagement with a mediated representation (e.g. a film, a museum, a TV series, a novel). One of the best-known mass cultural responses to the 1994 Genocide against the Tutsi in Rwanda is Terry George’s 2004 feature film, Hotel Rwanda. While the film was a huge commercial success, Rwandan survivor testimonies paint a very different picture of what happened in the real ‘Hotel Rwanda’ (the Hôtel des Mille Collines in the Rwandan capital of Kigali). This article discusses the different versions of the ‘Hotel Rwanda’ story through the lens of prosthetic memory and considers the usefulness of Landsberg’s theory for analysing memory narratives from or about Rwanda. While Landsberg promotes prosthetic memories as ‘in the best cases’ capable of generating empathy and political alliances, I show that, when mass-mediated representations create revisionist false ‘memories’, this can have harmful consequences for survivors of trauma. After focusing on the ethical implications of what Landsberg describes as ‘seeing through someone else’s eyes’, I conclude that prosthetic memory is a concept that should be treated with caution.
Human albumin solutions in intensive care: A review
Authors: Melia David , Post Benjamin
Published: September 2020

Albumin plays a key role in the critically ill patient acting as a prognostic marker and as a therapy in the form of human albumin solutions. However, the use of human albumin solution has varied over time with notable differences between health systems. Whilst its use is widely accepted for some clinical indications, its role has not always been clear in the critically ill and has been found to be harmful in some cohorts. Numerous studies have showed conflicting results and critical care clinicians have not always been guided by robust evidence. Nonetheless, at present the use of human albumin solution appears to be increasing again in the United Kingdom. Below, we discuss the latest evidence base for its use in critically ill patients.
FOLFIRINOX after first-line gemcitabine-based chemotherapy in advanced pancreatic cancer: a retrospective comparison with FOLFOX and FOLFIRI schedules
Authors: Foschini Francesca , Napolitano Fabiana , Servetto Alberto , Marciano Roberta , Mozzillo Eleonora , Carratù Anna Chiara , Santaniello Antonio , De Placido Pietro , Cascetta Priscilla , Butturini Giovanni , Frigerio Isabella , Regi Paolo , Silvestris Nicola , Delcuratolo Sabina , Vasile Enrico , Vivaldi Caterina , Bianco Cataldo , De Placido Sabino , Formisano Luigi , Bianco Roberto
Published: September 2020

Background:

Pancreatic adenocarcinoma is the fourth leading cause of cancer-related death. In cases with metastasis, the combination of 5-fluorouracil, irinotecan, and oxaliplatin (FOLFIRINOX) or gemcitabine-based chemotherapy regimens are considered the standard of care. However, the optimal sequence of these regimens is unclear.

Methods:

This retrospective study initially evaluated 186 patients with locally advanced/metastatic pancreatic cancer at three Italian institutions between February 2013 and October 2019. All patients had progressed after receiving gemcitabine-based first-line chemotherapy and were subsequently offered second-line FOLFIRINOX, FOLFOX-6, or FOLFIRI treatment. This study evaluated progression-free survival (PFS), overall survival from the start of second-line treatment (OS2), overall survival from the start of first-line treatment (OS1), and safety outcomes.

Results:

A total of 77 patients received ⩾4 cycles of second-line chemotherapy and were considered eligible: 15 patients received FOLFIRINOX, 32 patients received FOLFOX-6, and 30 patients received FOLFIRI. The FOLFIRINOX group had median PFS of 26.29 weeks and median OS2 of 47.86 weeks, while the FOLFIRI group had median PFS of 10.57 weeks and median OS2 of 25.00 weeks ( p = 0.038). No significant differences were observed between the FOLFIRINOX and FOLFOX-6 groups in terms of PFS (26.29 weeks versus 23.07 weeks) or OS2 (47.86 weeks versus 42.00 weeks). The most common grade 3–4 toxicities were anemia, neutropenia, and thrombocytopenia, which occurred more frequently in the FOLFIRINOX and FOLFOX-6 groups.

Conclusion:

Relative to the FOLFIRI regimen, the FOLFIRINOX regimen had a favorable toxicity profile and better survival outcomes. No significant differences were observed relative to the FOLFOX-6 regimen.
Outcome of oncological patients admitted with COVID-19: experience of a hospital center in northern Italy
Authors: Cherri Sara , Lemmers Daniel H. L. , Noventa Silvia , Abu Hilal Mohammed , Zaniboni Alberto
Published: September 2020

Background:

Recent literature regarding the outcome of cancer patients infected with COVID-19 are not encouraging. Nevertheless, current evidence on the risk and benefits of continuing oncological treatment of cancer patients during the pandemic remains insufficient. We provide our experience in a center with high access for patients with COVID-19-associated pneumonia in Lombardy, Italy. We conducted a retrospective study using a prospectively maintained database of patients admitted to our hospital between 25 February 2020 and 9 April 2020 with a confirmed diagnosis of COVID-19 pneumonia.

Results:

A total of 53 patients with a history or current oncological disease were included in this study. Sixteen oncological patients (30.2%) died during hospitalization. Multivariable logistic regression analysis found that age (Odds ratio [OR]: 1.17, p = 0.009), diabetes (OR: 15.05, p = 0.028) and active oncological disease (OR 13.60, p = 0.015) were independently associated with in-hospital mortality. The mortality rate of the total number of cancer patients is about twice as high as that of non-oncological patients admitted to our hospital with a diagnosis of COVID-19.

Conclusion:

The presence of active oncological disease is independently related to mortality as well as age and diabetes. The majority of patients who died were frail. Careful evaluation of the risks and benefits of treatment in frail patients is needed, considering that difficult access to intensive care may have affected the mortality rate.
Formulation design and pharmacokinetic evaluation of docosahexaenoic acid containing self-nanoemulsifying drug delivery system for oral administration
Authors: Alhakamy Nabil A , Aldawsari Hibah M , Hosny Khaled M , Ahmad Javed , Akhter Sohail , Kammoun Ahmed K , Alghaith Adel F , Asfour Hani Z , Al-Rabia Mohammed W , Md Shadab
Published: September 2020

Docosahexaenoic acid is a omega-3-fatty acid which together with other long-chain omega-3-fatty acid known to have protective effect against various diseases including hypertension, myocardial infarction, Alzheimer disease, and cancers. Poor bioavailability owning to limited aqueous solubility limits its effective therapeutic delivery. Self-nanoemulsifying drug delivery systems are known to enhance the systemic absorption of poorly bioavailable lipophilic bioactive/therapeutics compounds. The purpose of this work was to investigate the potential of self-nanoemulsifying drug delivery systems produced by spontaneous nanoemulsification to enhance the oral bioavailability of docosahexaenoic acid. Initially, the screening of oil, surfactant, and cosurfactant was carried out by determining the miscibility and emulsifiability of the component with docosahexaenoic acid. Docosahexaenoic acid-containing self-nanoemulsifying drug delivery systems were prepared using Capryol 90, Tween 20, and polyethylene glycol 200 due to their excellent miscibility and emulsifiability with docosahexaenoic acid. Docosahexaenoic acid-containing self-nanoemulsifying drug delivery systems’ droplet size, size distribution, and zeta potential were found to be 111.5 ± 4.2 nm, 0.269 ± 0.05 nm, and −23.53 ± 2.9 mV, respectively. The in vitro drug release and ex vivo absorption studies showed better in vitro release and intestinal absorption as compared to docosahexaenoic acid aqueous dispersion. In vivo studies demonstrated a significant increase ( p < 0.001) in the oral bioavailability of docosahexaenoic acid-containing self-nanoemulsifying drug delivery systems in comparison to a docosahexaenoic acid aqueous dispersion. This indicated the potential of self-nanoemulsifying drug delivery systems as an effective unit dosage form for the oral delivery of docosahexaenoic acid.
Two Faces of Ideology: Double-Edged Functions of Ideology in the Reform Discourse Under Xi Jinping
Authors: Kato Yayoi
Published: September 2020

Many scholars recognise that ideology plays indispensable roles in sustaining the legitimacy of the Chinese Communist Party and enhancing its governing capacity. However, less attention has been given to how party ideology operates in public discourse and whether it truly functions as an effective political tool to facilitate support for party initiatives. This article conceptualises public discourse as a “language game” played by the rules set by the party and examines how party ideology is “operationalised” by multiple actors as political rhetoric for persuasion in contentious reform discourse. Through the analysis of more than 400 periodical articles published in Chinese media outlets, this study examines policy discourse over the mixed-ownership reform of state-owned enterprises from 2014 to 2016 as a case study. The analysis demonstrates that ideology assumes two opposing operational functions in public discourse, consensus-inducing and conflict-inducing, depending on how it is employed by participants in the discourse.
Percutaneous Microdialysis and Pharmacokinetic Study of Tongluo-Qutong Rubber Plaster in Rats by UPLC-MS/MS
Authors: Pi Jiaxin , Zhang Ying , Ma Xutong , Wang Ping , Xiong Wei , Zhang Ludan , Liu Yiting , Qi Dongli , Li Nan , Guo Pan , Liu Zhidong
Published: September 2020

Tongluo-Qutong rubber plaster (TQRP) is a well-known traditional Chinese medicine prescription for the treatment of osteoarthritis and cervical spondylosis. Due to a lack of in vivo permeation data, the active ingredients of TQRP have not been fully elucidated, presenting a huge obstacle to quality evaluation, pharmacokinetic studies, and safety assessment of TQRP for clinical application. In this study, a selective and reproducible ultraperformance liquid chromatography tandem mass spectrometry method was developed and validated for percutaneous microdialysis and pharmacokinetic experiments. In the percutaneous microdialysis study, the mean area under the concentration–time curve (AUC0-24h) of emodin (EMO) and piperine (PIP) were 127.1 and 2603.6 h·ng/mL, respectively. In the pharmacokinetic study, ferulic acid (FA), EMO, and PIP were determined in plasma samples. The mean AUC0-32h values of FA, EMO, and PIP in plasma were 15441.5, 202.0, and 1704.5 h·ng/mL, respectively. The in vivo exposure levels of active ingredients such as FA, EMO, and PIP after dermal administration of TQRP provide insights and data to support identification of its bioactive components and further study of its mechanism of action.
Biomedicalization and Media in Comparative Perspective: Audiences, Frames, and Actors in Norwegian, Spanish, U.K. and U.S. Health News
Authors: Hallin Daniel C. , Figenschou Tine Ustad , Thorbjørnsrud Kjersti
Published: September 2020

This study examines health news in Norwegian, Spanish, British, and U.S. newspapers. It seeks to fill a gap in journalism studies in the examination of health news as a genre, particularly in a comparative context, and with a focus on broader social and political roles and meanings of health news, rather than effects on individual behavior. It is rooted in literatures that seek to understand health journalism in sociological terms, considering the role of health journalism in relation to institutional relationships between biomedicine, the market, and the state. It departs, in particular, from the theory of biomedicalization, which holds that the field of biomedicine, increasingly transformed into a complex, commercialized “techno-service complex,” has deep cultural impact, including the spreading of a conception of an individualized patient-consumer who will actively seek information to control risk and pursue wellness. In this article, we ask whether research on health news centered around this model, mostly carried out in the United States, is generalizable to European countries where the health system is organized primarily according to a public service model. The study considers three aspects of health news content: the implied audience of news stories, distinguishing in particular between those that address readers as patient-consumers and those that address them as citizens; the distinction among biomedical, lifestyle, and social frames for understanding health issues; and the range of actors reflected in health news as sources and as story originators.
“Liberation” as a political horizon amidst the coronavirus pandemic in the United States
Authors: Crane Nicholas Jon , Pearson Zoe
Published: September 2020

Participants in diverging US-based protest waves during the coronavirus pandemic are invoking “liberation” as a political horizon. Especially visible are superficially libertarian protests against government “stay-at-home” orders, on the one hand, and, on the other, racial and economic justice organizing around uneven exposure to the deadly effects of the pandemic. Beginning in May 2020, the latter articulation of liberation was amplified by widespread protest against racist police violence. The coronavirus pandemic is putting into sharp relief the contradictions of “liberation” promoted by individualists and underscoring the urgency of organizing for emancipatory social solidarity.
Current and novel therapies for the prevention of vaso-occlusive crisis in sickle cell disease
Authors: Osunkwo Ifeyinwa , Manwani Deepa , Kanter Julie
Published: September 2020

Individuals with sickle cell disease (SCD) are living further into adulthood in high-resource countries. However, despite increased quantity of life, recurrent, acute painful episodes cause significant morbidity for affected individuals. These SCD-related painful episodes, also referred to as vaso-occlusive crises (VOCs), have multifactorial causes, and they often occur as a result of multicellular aggregation and vascular adherence of red blood cells, neutrophils, and platelets, leading to recurrent and unpredictable occlusion of the microcirculation. In addition to severe pain, long-term complications of vaso-occlusion may include damage to muscle and/or bone, in addition to vital organs such as the liver, spleen, kidneys, and brain. Severe pain associated with VOCs also has a substantial detrimental impact on quality of life for individuals with SCD, and is associated with increased health care utilization, financial hardship, and impairments in education and vocation attainment. Previous treatments have targeted primarily SCD symptom management, or were broad nontargeted therapies, and include oral or parenteral hydration, analgesics (including opioids), nonsteroidal anti-inflammatory agents, and various other types of nonpharmacologic pain management strategies to treat the pain associated with VOC. With increased understanding of the pathophysiology of VOCs, there are several new potential therapies that specifically target the pathologic process of vaso-occlusion. These new therapies may reduce cell adhesion and inflammation, leading to decreased incidence of VOCs and prevention of end-organ damage. In this review, we consider the benefits and limitations of current treatments to reduce the occurrence of VOCs in individuals with SCD and the potential impact of emerging treatments on future disease management.
Higher-order clinical risk factor interaction analysis for overall mortality in maintenance hemodialysis patients
Authors: Yang Cheng-Hong , Moi Sin-Hua , Chuang Li-Yeh , Chen Jin-Bor
Published: September 2020

Background and Aims:

In Taiwan, approximately 90% of patients with end-stage renal disease receive maintenance hemodialysis. Although studies have reported the survival predictability of multiclinical factors, the higher-order interactions among these factors have rarely been discussed. Conventional statistical approaches such as regression analysis are inadequate for detecting higher-order interactions. Therefore, this study integrated receiver operating characteristic, logistic regression, and balancing functions for adjusting the ratio in risk classes and classification errors for imbalanced cases and controls using multifactor-dimensionality reduction (MDR-ER) analyses to examine the impact of interaction effects between multiclinical factors on overall mortality in patients on maintenance hemodialysis.

Meterials and Methods:

In total, 781 patients who received outpatient hemodialysis dialysis three times per week before 1 January 2009 were included; their baseline clinical factor and mortality outcome data were retrospectively collected using an approved data protocol (201800595B0).

Results:

Consistent with conventional statistical approaches, the higher-order interaction model could indicate the impact of potential risk combination unique to patients on maintenance hemodialysis on the survival outcome, as described previously. Moreover, the MDR-based higher-order interaction model facilitated higher-order interaction effect detection among multiclinical factors and could determine more detailed mortality risk characteristics combinations.

Conclusion:

Therefore, higher-order clinical risk interaction analysis is a reasonable strategy for detecting non-traditional risk factor interaction effects on survival outcome unique to patients on maintenance hemodialysis and thus clinically achieving whole-scale patient care.
Rationalisation of long-term high-dose opioids for chronic pain: development of an intervention and conceptual framework
Authors: Bailey John , Nafees Sadia , Jones Lucy , Poole Rob
Published: September 2020

There has been a large increase in the number of prescriptions for opioid drugs in the United Kingdom over the last 20 years or more and the prescribing of opioids in high doses continues to increase. Much opioid prescribing is for chronic non-cancer pain (CNCP) despite serious doubts about the long-term effectiveness of opioids for this indication. Clinical experience is that there are increasing numbers of patients who are on high dosages of opioid drugs over sustained periods which provide limited or no pain relief while having significant negative effects on functioning and quality of life. The aim of this article is to bring readers’ attention to some clinical observations of the CNCP population with high doses and to describe an intervention to reduce these doses. Many of these patients have no clinical features of addiction; we suggest that those who show little or no substance misuse behaviours are best understood as a distinct clinical population who have different treatment needs. In order to understand and treat these patients, a model is required which, rather than seeing the problem as lying solely with the patient, focuses on the interaction between the individual and his or her environment and seeks a change in what the patient does every day, rather than a simple, and largely unattainable, goal of symptom elimination. The clinician authors worked together to develop an intervention based upon approaches taken from both pain management and psychiatric practice. A detailed description of this rapid opioid reduction intervention (RORI) is provided along with some preliminary outcome data.