bluuebunny/crossref_metadata_2025 huggingface dataset:
Accretion and outflow activity in proto-brown dwarfs
Authors: Riaz B , Bally J
Published: December 2020

We present a near-infrared study of accretion and outflow activity in 6 Class 0/I proto-brown dwarfs (proto-BDs) using VLT/SINFONI spectroscopy and spectro-imaging observations. The spectra show emission in several [Fe II] and H2 lines associated with jet/outflow activity, and in the accretion diagnostics of Pa β and Br γ lines. The peak velocities of the [Fe II] lines (>100 km s−1) are higher than the H2 lines. The Class 0 proto-BDs show strong emission in the H2 lines but the [Fe II] lines are undetected, while the Class I objects show emission in both [Fe II] and H2 lines, suggesting an evolutionary trend in the jets from a molecular to an ionic composition. Extended emission with knots is seen in the [Fe II] and H2 spectro-images for 3 proto-BDs, while the rest show compact morphologies with a peak on-source. The accretion rates for the proto-BDs span the range of (2× 10−6 – 2× 10−8) M⊙ yr−1, while the mass loss rates are in the range of (4× 10−8 – 5× 10−9) M⊙ yr−1. These rates are within the range measured for low-mass protostars and higher than Class II brown dwarfs. We find a similar range in the jet efficiency for proto-BDs as measured in protostars. We have performed a study of the Brackett decrement from the Br 7-19 lines detected in the proto-BDs. The upper Brackett lines of Br 13–19 are only detected in the earlier stage systems. The ratios of the different Brackett lines with respect to the Brγ line intensity are consistent with the ratios expected from Case B recombination.
Value Creation and Moral Comfort Zones
Authors: Rochat Philippe
Published: December 2020

Value creation and agreement with others create the central core of social life. It is the main feature of how we manage to co-exist and somehow tame that selfish beast lying in all of us. We know how to create comfort zones with selected others, which can quickly turn into affective cliques, the exclusive social bubbles where comfort zones are shared. The central questions are, Why and who are those selected to share comfort zones, and who are those accepted within a particular exclusive bubble? Inversely, who are those who are rejected? Those are perennial psychological questions that need to be addressed if we want to understand our morals, in particular, our moral acrobatics. Universally, we strive toward the co-construction of shared comfort zones, what we might refer to as harmonious co-existence with some, possibly the largest possible number of people, yet always by the necessary exclusion of others—those subjectively deemed incapable or not willing to share with the in-group.
Hitler Was a Vegetarian
Authors: Rochat Philippe
Published: December 2020

We all have morals, including Hitler who was contemptuous of meat eaters, a self-proclaimed vegetarian and militant protector of animals. He was also a devoted son, devastated when his mother died. Often tagged “criminal of the century,” Gestapo in chief Heinrich Himmler was responsible for running all Nazi concentration and extermination camps. He was also a die-hard vegetarian, fervently opposed to hunting. Such facts are hard to fathom. They show that the central moral philosophy and psychology question is not whether some have morals and others don’t. The real questions are, What kind of morals, what are they made of, where do they come from, and, more important for this book, what holds them together in spite of blatant inconsistencies?
No Pure Monsters
Authors: Rochat Philippe
Published: December 2020

We have to come to terms with the fact that terrorists and serial killers like Ted Bundy and Ariel Castro love their parents and children. They worship their God and, in most instances, show extreme devotion to others that can lead to horrendous self-sacrifices like suicide bombings. As much as they kill, they also reciprocate affections and dedication from family members, neighbors, or close ideological allies. Pure monsters do not exist, and this is difficult, if not impossible, for us to either fathom or digest. In fact, despite our desire to hold the world in black and white, there are no pure monsters.
Women’s Duty
Authors: Margolin Leslie
Published: December 2020

“Women’s Duty” mirrors the previous chapter on men’s free will by showing how intercourse has been treated as a husband’s right and a woman’s obligation. This chapter uses case studies to reflect on how sex therapists may accept as normal and natural heterosexual women’s obligation to adapt to men’s sexual needs. The chapter also highlights how women’s resistance to sex with men is often seen in sex therapy’s professional literature as an obstacle to achieving family goals and how overcoming that resistance—taking on the burden of unwanted intercourse—is treated as a responsible way of “saving the marriage’ and “protecting the family.”
Epilogue
Authors: Frankel Francine R.
Published: December 2020

Strategic realignments in Asia after the 1962 India-China war are still playing out. China’s attempt to bottle up India in the subcontinent resulted in an “all-weather” China-Pakistan friendship, including transfer of blueprints for a nuclear bomb. The 1973 India-Pakistan war and the creation of Bangladesh changed the political map of the subcontinent. China’s rapid economic growth and military modernization now challenges US primacy in Asia, its long-sought goal since the Korean War. An Indian-US strategic partnership remains under discussion.
The New Landscape of Tenure
Authors: Redstone Ilana
Published: December 2020

The tenure decision is intentionally constructed around the very idea of career vulnerability, since the real possibility of its denial is central to the entire process. The last thing a tenure-track professor wants or needs is to do or say anything that will motivate people to oppose a positive tenure decision. The surest way to avoid this is to steer clear of both research and social media activity that might stir up opposition. Thus, obtaining tenure now requires a more careful effort than in the past to steer clear of politically controversial topics, both in research and in public statements on any topic.
Back to Church
Authors: Coffman Elesha J.
Published: December 2020

It is not possible directly to connect Mead’s return to Manus in 1953 with her return to church in 1955. She was, however, exposed to a particularly vibrant form of Christianity there, one that propelled rather than impeded social change. During the past decade, she had grown frustrated with American churches that she saw as divisive, harboring racism, anti-Semitism, and anti-scientific attitudes, but in Manus she saw the power of institutional religion in a new way. Maybe American Christianity could be a vehicle for her moral vision. Her perspective on Christian missions also shifted considerably. Not long after her trip, she renewed her church membership, and soon after that she got deeply involved in church work. She would not say that she recovered her faith, because she insisted that she never lost it. Still, something came into focus for her in the mid-1950s that had been blurry for many years, and her still-boundless energies found new, and more explicitly churchly, directions.
Geometry of Black Holes
Authors: Chruściel Piotr T.
Published: December 2020

There exists a large scientific literature on black holes, including many excellent textbooks of various levels of difficulty. However, most of these prefer physical intuition to mathematical rigour. The object of this book is to fill this gap and present a detailed, mathematically oriented, extended introduction to the subject. The first part of the book starts with a presentation, in Chapter 1, of some basic facts about Lorentzian manifolds. Chapter 2 develops those elements of Lorentzian causality theory which are key to the understanding of black-hole spacetimes. We present some applications of the causality theory in Chapter 3, as relevant for the study of black holes. Chapter 4, which opens the second part of the book, constitutes an introduction to the theory of black holes, including a review of experimental evidence, a presentation of the basic notions, and a study of the flagship black holes: the Schwarzschild, Reissner–Nordström, Kerr, and Majumdar–Papapetrou solutions of the Einstein, or Einstein–Maxwell, equations. Chapter 5 presents some further important solutions: the Kerr–Newman–(anti-)de Sitter black holes, the Emperan–Reall black rings, the Kaluza–Klein solutions of Rasheed, and the Birmingham family of metrics. Chapters 6 and 7 present the construction of conformal and projective diagrams, which play a key role in understanding the global structure of spacetimes obtained by piecing together metrics which, initially, are expressed in local coordinates. Chapter 8 presents an overview of known dynamical black-hole solutions of the vacuum Einstein equations.
A House for Mr Biswas and the Theory of the West Indian Novel
Authors: Ghosh William
Published: December 2020

This chapter is about the novel form in the West Indies in the 1960s. The novel, in this period, was a key site in which debates about decolonization, originality, and cultural sovereignty took place. Naipaul’s A House for Mr Biswas was central to this debate. It responds to a history of West Indian novels and novel theory, and became an influential text in novels, criticism, and social theory in the region. Work by George Lamming, Kamau Brathwaite, and Sylvia Wynter is discussed in detail. By tracing the changing reception of A House for Mr Biswas in the Caribbean through the 1960s, we can also trace changing ideas and priorities in Caribbean social thought.
The Enigma of Heteronymy
Authors: Ganeri Jonardon
Published: December 2020

The two poles around which Pessoa’s entire philosophy of self revolves are commitments to two extremely enigmatic propositions: [simulation] I am a subject other than the subject I am; and [depersonalization] I am merely a forum for the subject I am. What I am calling the ‘enigma of heteronymy’ is the challenge to provide an analysis of the functions of the first person, that is to say, the use or uses of the pronoun ‘I’ and so of the phenomenology of self-consciousness, according to which this pair of propositions is not trivially false but, on the contrary, interestingly and importantly true. I set aside a solution to the enigma which some interpreters of Pessoa have found tempting. The enticing solution is to deny that Pessoa is rational. To put it another way: has Pessoa made a fundamental discovery about the nature of subjectivity, or is he in the grip of a psychosis? It is clear though, first of all, that the depersonalization Pessoa is talking about does not satisfy the diagnostic criteria of the eponymous mental disorder. Contemporary philosophers of psychiatry agree that a characteristic of a genuine mental disorder is that it is something over which the sufferer has little or no control. Pessoa refers to Henri-Frédéric Amiel several times, and his experiences too are ‘philosophical experiences’, under the direction of his guided imagination.
The Multiplicity of I
Authors: Ganeri Jonardon
Published: December 2020

If in heteronymic simulation I am a subject other than the subject I am, there are evidently as many other I’s as there are possible acts of simulation. Pessoa, inhabiting countless lives, says that by creating in imagination a multiplicity of virtual subjects, each of which is him, he has ‘ubiquitized’ himself. So he affirms a thesis I will call ‘Subject Plurality’: I am many subjects other than the subject I am. We need, though, to distinguish two versions of this thesis, for it can be read as making either a diachronic claim or a synchronic one. Interpreters of Pessoa have been drawn to present the Pessoan self as a sort of parliament or confederation of souls. Despite Pessoa’s appeal, once, to the metaphor of a colony—and there only in connection with the phenomenal unity of consciousness rather than with reference to the multiplicity of heteronyms—the ‘confederation’ theory is not Pessoa’s. It is a Proustian, not a Pessoan, picture of multiplicity. An appreciation of this distinction is crucial to seeing why Pessoa’s multiplicity of I is not reducible to another mental illness, multiple personality disorder. The distinction between successive and simultaneous subject plurality has found a surprising application: understanding Afrofuturism’s experimentation with multiple sonic selves.
Origins of ISDS Treaties
Authors: Van Harten Gus
Published: December 2020

In this chapter, it is explained how investor–state dispute settlement (ISDS) treaties originate in the efforts of former colonial powers and international organizations, especially the World Bank, to constrain newly independent countries. The treaties grew slowly in the 1970s and 1980s and then very rapidly in the 1990s, setting the stage for today’s litigation boom. A new legal industry began to grow too, pursuing an opportunity, which arbitrators helped to create, to feed on the carcass of the pre-ISDS sovereign. In addition, institutions like the World Bank’s International Centre for Settlement of Investment Disputes, the Permanent Court of Arbitration, and the Stockholm Chamber of Commerce sought to attract the claims that brought business to the house.
Computation and Information Processing
Authors: Piccinini Gualtiero
Published: December 2020

This chapter presents a mechanistic account of physical computation and elucidates the relation between computation and information processing. Physical computation is the processing of medium-independent vehicles by a functional mechanism in accordance with a rule. Physical computation may be digital, analog, or of other kinds. Individuating computational vehicles and the functions a system computes requires considering the interaction between a system and its immediate environment; in this sense, computational individuation is externalistic. Information processing is the processing, by a functional mechanism, of vehicles that carry information. In general, computation can occur without information processing and information processing can occur without computation. Nevertheless, typical computing systems process information, and many information processors are computing systems.
Literature and Moral Philosophy
Authors: Christensen Anne-Marie Søndergaard
Published: December 2020

The chapter contributes to the development of a pluralistic conception of moral philosophy consisting of a diversity of descriptive activities by exploring one example of how to combine an understanding of the particulars of moral life with the more general and abstract insights traditionally developed in moral philosophy, namely via moral philosophy’s engagement with literature. The chapter is motivated by the argument that the irreducible role of the particular in moral life raises a demand for moral philosophy to interact with other disciplines which may serve as sources of knowledge about the particularities of moral life. It is argued that engagement with literature offers us knowledge by acquaintance and possibilities of moral cultivation, and that literature can be a suitable partner for moral philosophy in three activities that differ from the development of moral theories: namely in the exploration, the critique, and the development of moral life. The last type of activity, where literature is a partner for moral philosophy in initiating forms of moral change, is given special attention, and it is shown that this is an integrated part of moral philosophy, even if it is currently underexplored.
Descriptive Moral Philosophy
Authors: Christensen Anne-Marie Søndergaard
Published: December 2020

The final chapter develops the conception of a descriptive, pluralistic, and elucidatory moral philosophy established throughout the book and investigates the relationship between moral philosophy and moral life. It expands on two central suggestions of this work, namely that moral philosophy is fundamentally descriptive, and that the moral cannot be delineated, but is a pervasive presence in moral life. This leads to a discussion of how we are to understand the practicality of moral philosophy, and how it can be said to be aiding moral life, namely by advancing moral orientation, by making recommendations for moral attention, and by inviting us to develop and engage with new forms of moral thought, even forms of moral change. A central discussion concerns the role of the moral philosopher, and it is argued that philosophical work is an activity that itself involves a two-sided responsibility, an inward responsibility to continuously work on one’s wants and expectations and an outward responsibility to continuously stay open and attentive towards the investigated phenomenon. The last section recapitulates and evaluates the work done in the book.
Artificial Intelligence-Assisted Cytology for Detection of Cervical Intraepithelial Neoplasia or Invasive Cancer: A Multicenter, Clinical-Based, Observational Study
Authors: Bao Heling , Bi Hui , Zhang Xiaosong , Zhao Yun , Dong Yan , Luo Xiping , Zhou Deping , You Zhixue , Wu Yinglan , Liu Zhaoyang , Zhang Yuping , Liu Juan , Fang Liwen , Wang Linhong
Published: December 2020

(Abstracted from Gynecol Oncol 2020;159:171–178)

Despite the advances of cytology-based screening for cervical cancer, its efficacy as a primary screening method in many developing countries is limited by low sensitivity for cervical intraepithelial neoplasia (CIN) or invasive cancer. Because of this, human papillomavirus (HPV) screening is often introduced for primary screening.
Association of Menopausal Hormone Therapy With Breast Cancer Incidence and Mortality During Long-term Follow-up of the Women's Health Initiative Randomized Clinical Trials
Authors: Chlebowski Rowan T. , Anderson Garnet L. , Aragaki Aaron K. , Manson JoAnn E. , Stefanick Marcia L. , Pan Kathy , Barrington Wendy , Kuller Lewis H. , Simon Michael S. , Lane Dorothy , Johnson Karen C. , Rohan Thomas E. , Gass Margery L. S. , Cauley Jane A. , Paskett Electra D. , Sattari Maryam , Prentice Ross L.
Published: December 2020

(Abstracted from JAMA 2020;324:369–380)

Hormone therapy (HT) for menopausal symptoms and its risk-to-benefit ratio have been a controversial topic within the scientific community for several decades. The complicated benefits and potential adverse events associated with menopausal HT were first reported in 2002 by the Women's Health Initiative (WHI).
Therapeutic effects of brain-computer interface-controlled functional electrical stimulation training on balance and gait performance for stroke
Authors: Chung Eunjung , Lee Byoung-Hee , Hwang Sujin
Published: December 2020

Background:

Brain-computer interface-controlled functional electrical stimulation (BCI-FES) approaches as new feedback training is increasingly being investigated for its usefulness in improving the health of adults or partially impaired upper extremity function in individuals with stroke.

Objective:

To evaluate the effects of BCI-FES on postural control and gait performance in individuals with chronic hemiparetic stroke.

Methods:

A total of 25 individuals with chronic hemiparetic stroke (13 individuals received BCI-FES and 12 individuals received functional electrical stimulation [FES]). The BCI-FES group received BCI-FES on the tibialis anterior muscle on the more-affected side for 30 minutes per session, 3 times per week for 5 weeks. The FES group received FES using the same methodology for the same periods. This study used the Mann-Whitney test to compare the two groups before and after training.

Results:

After training, gait velocity (mean value, 29.0 to 42.0 cm/s) (P = .002) and cadence (mean value, 65.2 to 78.9 steps/min) (P = .020) were significantly improved after BCI-FES training compared to those (mean value, 23.6 to 27.7 cm/s, and mean value, 59.4 to 65.5 steps/min, respectively) after FES approach. In the less-affected side, step length was significantly increased after BCI-FES (mean value, from 28.0 cm to 34.7 cm) more than that on FES approach (mean value, from 23.4 to 25.4 cm) (P = .031).

Conclusion:

The results of the BCI-FES training shows potential advantages on walking abilities in individuals with chronic hemiparetic stroke.
Guizhi Fuling wan for chronic pelvic inflammatory disease protocol
Authors: Wang Chunrong , Chen Jingyun , Xiao Yanling , Shen Qilin
Published: December 2020

Background:

Chronic pelvic inflammatory disease (CPID) is one of common diseases of department of gynaecology, point to female inside genital and circumferential organization to suffer from infection of all sorts of pathogenic bacteria and cause chronic inflammation sex disease, also cause one of main factors of infertile of female of childbearing age period. Due to its insidious onset, it is not easy to find out in the early stage. Therefore, it is difficult to obtain satisfactory curative effect by taking routine treatment with antibiotics. In recent years, TCM has made great strides in the treatment of chronic pelvic inflammation, a number of clinical studies have shown that Guizhi Fuling wan combined with antibiotics can significantly improve the clinical symptoms and enhance the therapeutic effect. Therefore, we intend to conduct a system review and meta-analysis to further clarify the effectiveness and safety of GZFLW for CPID.

Methods:

We will search each database from the built-in until September2020.The English literature mainly searches Cochrane Library, PubMed, EMBASE, and Web of Science, while the Chinese literature comes from CNKI, CBM, VIP, and Wangfang database. Simultaneously we will retrieval clinical registration tests and grey literatures. This study only screens the clinical randomized controlled trials (RCTs) about GZFLW for CPID to assess its efficacy and safety. The 2 researchers worked independently on literature selection, data extraction, and quality assessment. The dichotomous data is represented by relative risk (RR), and the continuous is expressed by mean difference (MD) or standard mean difference (SMD), eventually the data is synthesized using a fixed effect model (FEM) or a random effect model (REM) depending on whether or not heterogeneity exists. The clinical efficacy, pelvic effusion and mass were evaluated as the main outcomes. The serum interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor (TNF)-α, erythrocyte sedimentation rate (ESR), erythrocyte specific volume was secondary outcomes. Finally, meta-analysis was conducted by RevMan software version 5.3.

Results:

This study will provide high-quality evidence for treatment of CPID with GZFLW in terms of effectiveness and safety.

Conclusion:

This systematic review aims to provide new options for GZFLW treatment of CPID in terms of its efficacy and safety.

Ethics and dissemination:

This study does not require ethical approval. We will disseminate our findings by publishing results in a peer-reviewed journal.

OSF registration number:

DOI 10.17605 / OSF.IO / R9NVT.
Perceived neighborhood safety and exercise behavior among community dwellers in Gauteng, South Africa
Authors: He Zhifei , Ghose Bishwajit , Yaya Sanni , Cheng Zhaohui , Zhou Yan
Published: December 2020

Maintaining a physically active life is an important determinant of overall health and psychosocial wellbeing among adults. Physical exercise behavior can be influenced by various social and environmental circumstances including neighborhood safety. Using data from South Africa Quality of life Survey 2015/16, this study aimed to assess the hypothesis that lack of perceived neighborhood safety (PNS) can reduce the likelihood of engaging in physical exercise (PE). The participants were 30,002 men and women aged 18 years and above. The association between self-reported PE behavior and neighborhood safety were assessed by multivariable regression method while adjusting for potentially confounding factors. Less than a quarter (23.41%) of the participants reported taking exercise on daily basis whereas 27.90% reported never taking any. Respectively 6.0% and 38.1% of the participants reported feeling very unsafe walking in the neighborhood during day and night. In regression analysis, both the pooled and stratified models indicated that lack of PNS was inversely associated with regular PE. Lack of PNS (bit unsafe) during day was associated with lower odds of PE both among men (OR = 0.776, P < .001) and women (OR = 0.874, P < .001). The negative association between lack of PNS and PE during day was significant among those living with disability (OR = 0.758, P < .001). Further analysis showed that the negative association between lack of PNS with regular PE during day was significant in Johannesburg (OR = 0.800, P < .001), Tshwane (OR = 0.735, P < .001) and Emfuleni (OR = 0.619, P < .001) only, while that during night was significant in Johannesburg (OR = 0.737, P < .001), Ekurhuleni (OR = 0.673, P < .001), Emfuleni (OR = 0.418, P < .001), Lesedi (OR = 0.385, P < .001), Mogale City (OR = 0.693, P < .001), and Randfontein (OR = 0.565, P < .001). Overall, the findings highlight a significantly inverse association between lack of PNS and PE behavior. In light of the current findings, it is recommended that PE promotion programs pay special attention on population living in the neighborhoods fraught with crime concerns.
The recent effects of small dose of folic acid on lipoprotein-associated phospholipase A2 and systolic blood pressure variability in coronary heart disease patients with hyperhomocysteinemia
Authors: Liu Xiangyang , Tang Liangqiu , Fan Wenmao , Li Aihua , Pang Jungang , Feng Yingjun
Published: December 2020

To Investigate the recent effects of small dose of folic acid on lipoprotein-associated phospholipase A2 (LP-PLA2) and systolic blood pressure variability in coronary heart disease (CHD) patients with hyperhomocysteinemia.

In this prospective cohort study, a total of 167 CHD patients with hyperhomocysteinemia were consecutively enrolled, and they were divided into Group A (without folic acid intervention, n = 99), Group B (with 0.4 mg of folic acid intervention, n = 34), Group C (0.8 mg of folic acid intervention, n = 34). General information, fasting blood glucose, and blood lipid, folic acid, homocysteine, Lp-PLA2, and blood pressure variability were compared among 3 groups. The above indicators were reviewed after 3 months of treatment.

There were no statistically significant differences of age, gender, blood pressure, incidence of type 2 diabetes mellitus, fasting blood glucose, folic acid, homocysteine, Lp-PLA2, total cholesterol, 3 acyl glycerin, apolipoprotein B, lipoprotein (a), high density lipoprotein cholesterol, and low density lipoprotein cholesterol were found among 3 groups (P > .05); however, after being treated for 3 months, there was statistically significant difference in folic acid among 3 groups (P < .05), there was statistically significant difference in apolipoprotein A between Group A and Group B (t = 0.505, P = .039), and also between Group A and Group C (t = 0.052, P = .017). There were statistically significant differences in Lp-PLA2 (t = 24.320, P = .016) and systolic blood pressure variability (t = 0.154, P = .018) between Group A and Group C.

For CHD patients with hyperhomocysteinemia, the higher dose (0.8 mg) of folic acid supplement was beneficial for increasing the apolipoprotein A, reducing the Lp-PLA2, and improving the systolic blood pressure variation, which might help to improve the prognosis in these patients.
Multidisciplinary diagnosis and treatment of recurrent follicular dendritic cell sarcoma in abdomen
Authors: Qu Chang , Tian Xiaodong , Ma Yongsu , Xie Xuehai , Wang Mingyue , Dong Yujun , Zhang Jixin , Liu Ping , Yang Yinmo
Published: December 2020

Rationale:

Follicular dendritic cell sarcoma (FDCS) is a rare malignant tumor derived from follicular dendritic cells, and is often associated with Castleman disease. Here we present a rare case of paraneoplastic pemphigus (PNP) with FDCS which required multidisciplinary approach for the diagnosis and treatment.

Patient concerns:

A 28-year-old Chinese female had FDCS recurrence, and primary clinical manifestation was PNP.

Diagnoses:

PNP with FDCS.

Interventions:

The patient received gamma globulin infusion, took anlotinib, and underwent plasma exchange therapy.

Outcomes:

The skin lesions recovered and there was no evidence of tumor recurrence.

Lessons:

The diagnosis and management of PNP with FDCS require close cooperation among surgeons, dermatologists, hematologists, otolaryngologists, oncologists, radiologists, pathologists, and respiratory doctors. The interesting clinical manifestations of this patient provide a multifaceted approach to the investigation of the interactions among FDCS, Castleman disease, and PNP.
Complete response of radioresistant brain metastases from non-small cell lung cancer with temozolomide
Authors: Yang Yi , Pu Yu , Dai Nan , Wang Dong , Xu Mingfang
Published: December 2020

Rationale:

Non-small cell lung cancer (NSCLC) patients with brain metastases (BMs) have been found as subjects of poor prognosis. Whole-brain radiotherapy (WBRT), surgery, and stereotactic radiosurgery, epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), or some combinations are the most commonly employed strategies for the treatment of treatments BMs. However, some patients are resistant to all these treatments.

Patient Concerns:

We present an NSCLC patient with progression of BMs after treatment with WBRT and EGFR-TKIs. The patient was diagnosed with multiple metastases on July 9, 2014, and treated with docetaxel plus cisplatin chemotherapy followed with gefitinib as the maintenance therapy. The patient showed recurrence of BMs after 8-months of chemotherapy. WBRT with 30 Gy was administrated in 10 fractions. Tumor progression of the brain was diagnosed with an magnetic resonance imaging scan after 2-months of WBRT.

Diagnoses:

The patient was diagnosed as pulmonary adenocarcinoma with diffuse metastases in both lungs and multiple metastases in bone and brain. Progression of BMs was confirmed through magnetic resonance imaging.

Interventions:

This patient was administered temozolomide (150 mg/m2/d for 5 days every 28-day cycle). As a whole, 6 cycles were performed after the progression of BMs from August 2015.

Outcomes:

The patient got complete brain remission and lived without discomfort. The intracranial lesion did not progress until the progression of the lung lesion and led to death on February 20, 2019. The intracranial progression-free survival was 42 months, whereas the overall survival was 55 months.

Lessons:

For patients with NSCLC and BMs, temozolomide can be used as a treatment option, especially in patients with EGFR-TKIs resistance or without driver mutations.
Rheumatoid arthritis patients with peripheral blood cell reduction should be evaluated for latent Felty syndrome
Authors: Wu Peng , Sun Weifeng , Li Jing
Published: December 2020

Rationale:

Felty syndrome is a rare and life-threatening type of rheumatoid arthritis (RA).

Patient concerns:

A patient with RA had skin rash and subcutaneous hemorrhage, with a significant decrease in blood hemoglobin (Hb), white blood cell count (WBC), and blood platelet count (BPC).

Diagnoses:

The patient had a history of RA, splenomegaly, decreased Hb, WBC, BPC, and normal immunological indexes, combined with a series of bone marrow related tests and genetic tests.

Interventions:

She was given high-doses of glucocorticoids intravenously, followed by oral prednisone and cyclosporine maintenance therapy.

Outcomes:

Her symptoms were resolved within 2 weeks after the start of immunosuppression. After 2 weeks of discharge, the Hb, WBC, BPC basically returned to normal, and prednisone gradually decreased.

Lessons:

Felty syndrome is a rare complication of RA. Reductions in Hb, WBC, BPC, and subcutaneous hemorrhage should be considered strongly as the possibility of Felty syndrome. Multi-disciplinary diagnosis and related tests of bone marrow and genes are helpful for diagnosis and correct treatment.
Clinical characteristics of systemic lupus erythematosus with chylothorax and/or chylous ascites
Authors: Zhang Guo-Hua , Zhang Ling-Ling , Wang Yu-Hua , Shen Wen-Bin
Published: December 2020

This analysis of clinical data from systemic lupus erythematosus (SLE) patients with chylothorax and/or chylous ascites was conducted to guide further clinical work.

From June 2008 to June 2019, 15 SLE patients (14 females and 1 male) with chylothorax and/or chylous ascites were hospitalized at the Beijing Shijitan Hospital. Sixty SLE patients without chylothorax and chylous ascites were randomly selected as controls. Patients’, clinical data was investigated.

The mean age of onset of chylothorax and/or chylous ascites in patients with SLE was 35.7 ± 3.7 years (range, 15–69 years). The mean disease duration of chylothorax and/or chylous ascites in patients with SLE was 13.7 ± 3.4 months (range, 1–48 months). Patients with chylothorax and/or chylous ascites were always diagnosed at later stages of SLE compared with the controls. Among cases, glomerulonephritis and hematologic system involvement were the most common complications. Anti-Sjogren's syndrome antigen A antibody was positive in 7 cases (46.7%). Among cases, direct lymphangiography was performed in 13 patients, indicating thoracic duct outlet obstruction or a poor backflow at the terminal of the thoracic duct. Subsequently, 13 patients were treated with corticosteroids, combined with immunosuppressants in 11 patients and thoracic duct surgery in 6 patients. Eleven patients were followed up for 0.5 to 7.0 years. One patient died of infection. Eight patients (53.3%) achieved remission.

Chylothorax and/or chylous ascites are rare complications of SLE. An early diagnosis and timely initiation of glucocorticoids, immunosuppressants, and surgery are critical to relieve symptoms and to improve prognosis.
Correlations between the properties of saliva and metabolic syndrome
Authors: Suzuki Daisuke , Yamada Shin-Ichi , Sakurai Akinari , Karasawa Imahito , Kondo Eiji , Sakai Hironori , Tanaka Hirokazu , Shimane Tetsu , Kurita Hiroshi
Published: December 2020

Saliva tests, which are easy to perform and non-invasive, can be used to monitor both oral disease (especially periodontal disease) and physical conditions, including metabolic syndrome (MetS). Therefore, in the present study the associations between saliva test results and MetS were investigated based on medical health check-up data for a large population. In total, 1,888 and 2,296 individuals underwent medical check-ups for MetS and simultaneous saliva tests in 2017 and 2018, respectively. In the saliva tests, the buffer capacity of saliva, salivary pH, the salivary white blood cell count, the number of cariogenic bacteria in saliva, salivary occult blood, protein, and ammonia levels were tested using a commercially available kit. The relationships between the results of the saliva tests and MetS components were examined in cross-sectional and longitudinal multivariate analyses. Significant relationships were detected between salivary protein levels and serum HbA1c levels or blood pressure levels and between the buffer capacity of saliva and serum triglyceride levels. In addition, salivary pH was increased irreversibly by impaired renal function. This study suggested that saliva tests conducted during health check-ups of large populations might be a useful screening tool for periodontal disease and MetS/MetS components.
Acupuncture and related therapies for treating stable angina pectoris
Authors: Sun Haiju , Li Xiaoyu , Lou Jiali , Zhang Yajun , Jiang Yongliang , Fang Jianqiao
Published: December 2020

Background:

Stable angina pectoris (SAP) is a global health challenge. Multiple previous systematic reviews (SRs) have been conducted to assess the effectiveness of acupuncture and related therapies on SAP. We will carry out a comprehensive overview to map, synthesize, and assess the all the available evidence of acupuncture and related therapies on SAP.

Methods:

We will search 7 databases, including China National Knowledge Infrastructure (CNKI) and Chinese Biomedical Literature Database (CBM), WanFang Database, the Cochrane Library, PubMed, EMbase, MEDLINE. SRs and meta-analyses (MAs) of acupuncture and related therapies on SAP will be screened for eligibility. Systematic reviews, qualification evaluation, data extraction, methodological quality, and evidence quality evaluation will be conducted in pairs. The outcomes of interest include: frequency of angina attack, changes in nitroglycerin use, intensity of anginal pain, depression assessment, changes of the electrocardiogramme (ECG), anxiety assessment, results of the Six-Minute Walk Test (6-MWT), overall effectiveness, the Seattle Angina Questionnaire (SAQ), and adverse events. Where appropriate, the evidence will be synthesized based on the outcomes and patient subgroups.

Results:

This overview will be published in a peer-reviewed journal.

Conclusion:

This overview is expected to provide a reliable and valuable evidence of acupuncture for treating SAP.

Ethics and communication:

Given that this is an overview of published research, patient consent and ethical approval are not needed. The findings of this study will be disseminated through conference presentations and publication in peer-reviewed journals.

PROSPERO registration number:

CRD42020164466.
Anesthesia and airway managements for emergency removal of esophageal foreign body in a trisomy 21 patient with mental retardation and predicted difficult airway
Authors: Wei Wei , Qiu Huan-Rong , Wang Hai-Xia , Xue Fu-Shan
Published: December 2020

Introduction:

The typical manifestations of patients with a trisomy 21 syndrome are mental retardation and anatomical deformities of face and neck. In the available literature, all case reports regarding anesthetic management of mentally retarded patients have focused on elective surgeries. There is no report regarding anesthetic management of mentally retarded patients undergoing emergency surgery.

Patient concerns:

A 47-year-old woman with a mental retardation grade 2 by trisomy 21 syndrome suffered from an esophageal foreign body for 3 days and needed emergency removal of esophageal foreign body. The patient had a poor cooperation and obvious anatomical abnormalities of head and neck.

Diagnoses:

Difficult anesthesia and airway managements for emergency removal of esophageal foreign bodies in a trisomy 21patients with mental retardation and predicted difficult airways.

Interventions:

Combined use of an intubating supraglottic airway and the flexible bronchoscope-guided intubation after intravenous anesthesia induction.

Outcomes:

Effective airway was safely established and an esophageal foreign body was successfully removed by rigid esophagoscopy under anesthesia. The patient recovered smoothly without any complication.

Lessons subsections as per style:

When general anesthesia and emergency airway management are required in the patients with mental retardation and predicted difficult airways, a combination of the supraglottic airway and the flexible bronchoscope maybe a safe and useful choice for airway control.
The effect of acupuncture on emotional disorders in patients with insomnia
Authors: Huang Bi-Qing , Xu Gu-Xing , Luo Ling
Published: December 2020

Background:

Insomnia with high incidence is usually accompanied by many other diseases, especially mental disorders with the under-diagnosis and under-treatment. Some studies demonstrated that acupuncture may be effective for emotional disorders accompanied by insomnia. The systematic review protocol is designed to guiding analysis the effectiveness and safety of acupuncture for emotional disorders in patients with insomnia.

Methods:

Seven databases, Cochrane central register of controlled trials, Medline, Embase, China National Knowledge Infrastructure, Chinese Biomedical Literature database, VIP database and Wanfang database, will be searched from initial to December 2020. Randomized controlled trials (RCTs) of acupuncture for insomnia with emotional disorders (depression and anxiety) outcomes, which were reported in Chinese or English, will be included. The primary outcome is the change of degree of anxiety and depression. Study selection, data extraction and assessment of the risk of bias will be performed independently by 2 or more reviewers. Available data will be synthesized and statistically analyzed in RevMan V.5.3. The model of fixed effects will be used for the pooled data when the heterogeneity tests show little or no statistical heterogeneity (I2 < 50%). The random-effects model will be taken with heterogeneous data (50% ≤ I2 < 75%).

Results:

The effect of acupuncture on emotional disorders in patients with insomnia will be assessed on Hamilton anxiety Scale, Hamilton anxiety Scale, Pittsburgh Sleep Quality Index, Insomnia Severity Index, Self-rating Anxiety Scale, Self-rating Depressive Scale and the number of participants secede and the number of patients reported adverse events.

Conclusion:

the emotional disorders interaction with insomnia and the increase of risk on disease evolving and insomnia-related burden, it is so momentous to know that the role of insomnia treatment on comorbidities. We should concern about the management of emotional disorders when treat insomnia, and acupuncture treatment anxiety and depression caused by insomnia may be effective.

Ethics and dissemination:

Ethics approval is not be needed because the data will not contain individual patient data, and there are no concerns about privacy. The results of this meta-analysis will be disseminated through publication in a peer-reviewed academic journal or relevant conference.

INPLASY registration number:

INPLASY2020100115.
Corticosteroids vs autologous blood injection for lateral epicondylitis
Authors: Zhou Chaodong , Wang Lu
Published: December 2020

Background:

There is limited evidence to assess the evaluation of the safety and effectiveness of autologous blood injections in the treatment of lateral epicondylitis patients. For this study, the aim was to compare the efficiency of corticosteroid and autologous blood injections for the treatment of lateral epicondylitis in a retrospective cohort trial in our single center.

Methods:

After being approved by the institutional review committee of Chongqing General Hospital (IRB# 2018.417.C, November 9, 2018), we performed a single-center, retrospective study between November 2018 and January 2020. All participants provided written informed consent. The criteria for inclusion in our experiment are as follows: over 18 years old; with the history of at least 6 months of lateral epicondylitis; and the palpation of lateral epicondyle tenderness; visual analog scale (≥4). In the group A, the patient were injected the autologous blood. In group B, the patients were immersed with 0.5% of bupivacaine (1 ml) and local corticosteroids (2 ml) at lateral epicondyle. The outcomes were composed of a visual analog scores of subjective pain severity over the past 24 hours as the primary result; and limb function in various tasks of daily activity measured with disabilities of the arm, shoulder, and hand quick questionnaire scores, the maximum grip strength and the modified scores of Nirschl, as secondary results. All the results were assessed before the injection and at 4 weeks and 8 weeks after the injection. For all examination, when the P value was less than .05, it would be defined to be a statistically significant difference.

Results:

The results of this study would provide new information about the influence of autologous blood injections in treating the lateral epicondylitis.

Trial registration:

This study protocol was registered in Research Registry (researchregistry6263).
Novel coronavirus pneumonia (COVID-19) combined with Chinese and Western medicine based on ”Internal and External Relieving -Truncated Torsion” strategy
Authors: Wu Xinxin , Lu Wei , Guo Quan , Cao Min , Zhang Wen , Liu Changya , Qu Yao , Peng Wei , Che Jinhua , Fang Bangjiang , Zhou Shuang
Published: December 2020

Introduction:

The outbreak of novel coronavirus disease 2019 (COVID-19) has caused a global pandemic since December 2020. It has not only associated with physiological disorder but also with psychological distress and symptoms of mental illness. Whether the vaccines and antivirals can provide protects remains unknown. Traditional Chinese medicine (TCM) is recommended as an alternative and significant way of preventing and treating COVID-19 in China. However, few studies have assessed the benefits of this treatment and mental health after they recover. Our study is designed to investigate effects and safety when using TCM on the course of this disease and the impact of COVID-19 on pandemic-related anxiety.

Method:

For this prospective cohort study, we will enroll 300 COVID-19 patients aged 18 to 80 years at 4 centers. We divide them into 2 groups, according to whether they use Baidu Jieduan Granule at a ratio of 1:1. We will compare treatments combined Baidu Jieduan Granule with conventional Western medicine (experimental group) vs treatment of conventional Western medicine only (control group). The basic information of patients including demographic, general condition, primary diseases, and complications will be assessed. Related examines will be conducted at 1, 3, 5, 7, and 14 days. The primary outcomes are clinical outcome. A follow-up time of 1 year (to June 30, 2021) allow us to evaluate the psychiatric disorder after recovery. We will monitor adverse events throughout the trial.

Discussion:

It will be the first prospective cohort study which uses Baidu Jieduan Granule, based on the innovation traditional Chinese medicine strategy of “ Internal and External Relieving -Truncated Torsion ” to treat the common type of COVID-19. The result of this study may provide evidence-based recommendations of TCM for treatment and psychological distress or symptoms of mental illness of the common type of COVID-19.
Telehealth in type 1 diabetes
Authors: Kompala Tejaswi , Neinstein Aaron B.
Published: December 2020

Purpose of review

The role of telehealth in the care of people with type 1 diabetes (T1D) has expanded dramatically during the coronavirus pandemic, and is expected to remain a major care delivery modality going forward. This review explores the landscape of recent evidence for telehealth in T1D care.

Recent findings

Telemedicine for routine T1D care has shown equivalence to standard in-person care, with respect to glycemic control, while also increasing access, convenience, and satisfaction. Telehealth use promotes increased engagement of adolescents with T1D. Telehealth platforms have successfully been used in the care of microvascular complications and to support mental health related to diabetes. Machine learning and advanced decision support will increasingly be used to augment T1D care, as recent evidence suggests increasing capabilities to improve glycemic control. A spectrum of digital connected care services are emerging to support people with diabetes with daily management of diabetes. Finally, policy and systems are required that promote data interoperability, telemedicine provision, and reimbursement to support the ongoing growth of telehealth in T1D.

A developing field of evidence supports use of telehealth in T1D. As this care modality scales, it has the potential to increase access to high-quality diabetes care for many people with T1D.