bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of trends and causes of death in SLE patients over a 40-years period in a cohort of patients in the United Kingdom
Authors: Lorenzo-Vizcaya Ana , Isenberg David
Published: January 2021

Background

Systemic Lupus Erythematosus (SLE) an autoimmune rheumatic disease with a complex pathogenesis, remains potentially life-threatening. SLE patients have increased morbidity and premature mortality compared to non-SLE patients. The five-year survival rate has improved from <50% in the 1950s to >90% in the 1980s. Lupus patients still have a mortality risk three times that of the general population.

Objectives

To provide a detailed analysis of the causes of death, main characteristics and trends in the management of the deceased SLE patients from the lupus clinic at the University College London Hospital (UCLH); during the past four decades.

Methods

This was a non-interventional, retrospective study based on historical real-world data from paper and electronic records of patients followed up at UCLH. The analysis focused on data collected between 1st January 1978 and 31th December 2018. We collected the: causes of death, duration of disease, key laboratory and clinical parameters and the treatment received. We compared the results from the four decades to ascertain trends in the causes of mortality. All statistical analyses were performed using the Statistical Package for Social Sciences (SPSS), version 22.0. The 95% confidence intervals for the means of data were calculated.

Results

111 SLE patients (15%), died during follow-up. Their median age was 51 years (interquartile range (IQR) = 38–63 years) and the median duration of disease, 15 years (IQR = 8.5–24 years). The main causes of death in the past 40 years were infection (31.7%), cancer (26.7%) and cardiovascular disease (CVD) (21.8%). 93.6% of these patients were immunosupressed. During the 40-year period, there were several therapeutic developments notably the introduction of mycophenolate mofetil (MMF) and rituximab; the latter initially only given to patients when more conventional inmunosupressants had failed, but more recently offered to patients at diagnosis. There was a statistically significant increase in the use of hydroxycloroquine (HCQ), MMF and rituximab. In contrast, the use of Azathioprine (AZA) and steroids, hardly changed over time.

Conclusions

This retrospective review shows how epidemiological factors, causes of death and treatment of SLE patients have changed during the last 40 years in the UCLH cohort.
Cervical screening attendance and cervical cancer risk among women who have sex with women
Authors: Saunders Catherine L , Massou Efthalia , Waller Jo , Meads Catherine , Marlow Laura AV , Usher-Smith Juliet A
Published: January 2021

Objectives

To describe cervical cancer screening participation among women who have sex exclusively with women (WSEW) and women who have sex with women and men (WSWM) compared with women who have sex exclusively with men (WSEM), and women who have never had sex and compare this with bowel (colorectal) and breast screening participation. To explore whether there is evidence of differential stage 3 cervical intraepithelial neoplasia (CIN3) or cervical cancer risk.

Methods

We describe cervical, bowel and breast cancer screening uptake in age groups eligible for the national screening programmes, prevalent CIN3 and cervical cancer at baseline, and incident CIN3 and cervical cancer at five years follow-up, among 218,674 women in UK Biobank, a cohort of healthy volunteers from the UK.

Results

Compared with WSEM, in adjusted analysis [odds ratio (95% confidence interval)], WSEW 0.10 (0.08–0.13), WSWM 0.73 (0.58–0.91), and women who have never had sex 0.02 (0.01–0.02) were less likely to report ever having attended cervical screening. There were no differences when considering bowel cancer screening uptake ( p = 0.61). For breast cancer screening, attendance was lower among WSWM 0.79 (0.68 to 0.91) and women who have never had sex 0.47 (0.29–0.58), compared with WSEM. There were incident and prevalent cases of both CIN3 and cervical cancer among WSEW and WSWM. Compared with WSEM with a single male partner, among WSEW there was a twofold increase in CIN3 1.91 (1.01 to 3.59); among WSWM with only one male partner, this was 2.25 (1.19 to 4.24).

Conclusions

These findings highlight the importance of improving uptake of cervical screening among all women who have sex with women and breast screening among WSWM and women who have never had sex.
Why Does Cancer Screening Persist Despite the Potential to Harm?
Authors: Carter Stacy M.
Published: January 2021

Population screening for early-stage cancer or cancer precursors began in the mid-twentieth century, with the goal of reducing suffering from cancer illness and lengthening average life by preventing cancer deaths. Since the establishment of cancer screening, concerns have emerged that it may be doing considerable harm; despite this, screening practices have remained relatively intractable. This intractability in the face of harm is the central problematic of my analysis. I reinterpret a large study of breast, cervical and prostate cancer screening completed recently by our Australian research group, working across empirical bioethics, public health and social science. I suggest three reasons why cancer screening might persist as it does, and thus reach conclusions about what might be required to make cancer screening systems more responsive to the potential for harm.
V-5 Model of Employee Engagement During COVID-19 and Post Lockdown
Authors: Kumar Puneet
Published: January 2021

COVID-19 has left the globe in a situation of despondency. Physical as well as the human resources (HR) of an organization were adversely affected during the lockdown. The corporate world is observing several corporate crises from the full or partial shutdown of businesses to layoffs, furloughs and resignations. HR managers are struggling to curb this renunciation of employees and grappling with reduced employee engagement. To keep employees highly motivated in this time of mayhem and maelstrom of the pandemic, HR managers need to revisit their employee engagement strategies with a new perspective. This article provides a ready reference list of variables to HR managers to enhance employee engagement level during COVID-19 and post lockdown. This article suggests five major elements of employee engagement, namely—value, voice, variety, virtue and vision. These logical elements of employee engagement are identified after an exhaustive review of the literature. Appropriate variables for each element support author’s perspective. Though neither these elements nor the variables are exhaustive, yet they hold utmost relevance to enhance employee engagement in the time of the global pandemic.
A Novel Design of Ergonomic Ablution Place at Mosques in Arar, Saudi Arabia
Authors: Nazeer Shahrin Azuan bin , Randhawa Mohammad Akram , Alshammari Maher Sayel , Bawadekji Abdulhakim
Published: January 2021

Currently, there are hardly any uniform design specifications for the construction of ablution places at mosques in Saudi Arabia. Designs of ablution places are usually copied from designs of ablution places in other mosques or based on individual perspectives. Based on the researchers’ anecdotal observations, most of these designs are nonergonomic, uncomfortable, and less user-friendly for ablution in either sitting or standing position, especially for the elderly. In such designs, water splashing is common because of inappropriate heights of platforms or seats, insufficient distances between seats and faucets, and improper shapes and depths of water drain. The purpose of the present study is to present the design of a novel ergonomic ablution place to ensure comfortable, safe, and hygienic conditions. The design is particularly related to the size and height of seat, height and distance of faucet from the seat, depth and slope of water drain, and height and width of the platform. The design was implemented at four mosques in Arar, Saudi Arabia. Modifications at ablution places were made according to the proposed design and were appreciated by the local community. The design was communicated to the Directorate of Mosques in Arar and agreed upon for implementation in other mosques.
Infective Endocarditis in a Hospital-at-Home Setting: A Retrospective Analysis in a Peripheral Spanish Hospital
Authors: Garcia-Carretero Rafael , Vazquez-Gomez Oscar , Rodriguez-Maya Belen , Naranjo-Mansilla Gema , Luna-Heredia Esther
Published: January 2021

Infective endocarditis (IE) is a severe condition with high morbidity and mortality, and it requires long-term suppressive antibiotic therapy. Outpatient parenteral antimicrobial therapy (OPAT) has been used for a range of infectious diseases for more than 30 years, and in Spain it is used in hospital-at-home (HaH) settings. Our objectives were to describe and characterize the demographic, clinical, and microbiological features of patients admitted to an HaH setting and to assess the safety and effectiveness of OPAT. We conducted a retrospective study that included patients diagnosed with IE over a period of 8 years (2011-2018). We collected demographic and clinical features, length of hospital stay, antimicrobial treatment, microbiological profiles, and outcomes. We included 26 patients during the observation period. Their mean age was 66.5 years, and 88.5% were male. The mean hospital stay was 10.5 days, and the mean stay in the HaH setting was 31 days. A total of 6 patients required readmission due to deterioration, of whom 3 had severe mitral insufficiency. The 8 patients had symptoms of heart failure, but they were treated at home and did not require readmission. Ultimately, 12 patients recovered and were referred to a surgical unit for valvular repair and replacement on a scheduled basis. OPAT is a useful and effective tool for the management of patients diagnosed with IE in HaH settings.
Cognitive Developmental Trajectories in Adult ADHD Patients and Controls: A Comparative Study
Authors: Hong Ji Sun , Lee Young Sik , Hong Minha , Kim Bongseog , Joung Yoo Sook , Yoo Hanik K , Kim Eui-Jung , Lee Soyoung Irene , Bhang Soo Young , Lee Seung Yup , Bahn Geon Ho , Han Doug Hyun
Published: January 2021

Objective:

There is an updated conceptualization of whole-lifespan attention-deficit hyperactivity disorder (ADHD), promoted by awareness of probable persistence of impairment into adulthood. We investigated cognition trajectories from adolescence to mid-adulthood in ADHD.

Method:

Data of 240 patients with ADHD and 244 healthy controls (HCs) were obtained; clinical symptoms and neuropsychological functions were assessed using the various tests.

Results:

Compared to HCs, patients with ADHD except 35 to 44 age interval showed lower full scale intelligence quotient. They showed decreased verbal comprehensive scores except in the 35 to 44 age interval and working memory scores in all intervals. In the Comprehensive Attention Test, patients with ADHD showed increased working memory error frequencies except in the 15 to 17 age interval and divided attention omission error in all intervals.

Conclusion:

Adults with ADHD showed deficits not in simple attention but in complex attention, including divided attention and working memory.
Parental Barriers in Seeking Mental Health Services for Attention Deficit Hyperactivity Disorder in Children: Systematic Review
Authors: Kappi Amani , Martel Michelle
Published: January 2021

Objective:

Many children at risk for negative outcomes related to untreated attention deficit hyperactivity disorder (ADHD) do not receive necessary mental healthcare. Parents’ mental health-seeking behavior is important in the early identification of ADHD and preventing comorbidities with ADHD. Parents may experience some barriers that may delay or stop parents from seeking mental healthcare for their children.

Method:

This systematic review summarized existing evidence of parents’ barriers to seeking mental healthcare for their children at risk of ADHD.

Results:

This review included 21 studies that address different parental barriers under the three levels of the social-ecological model, including individual, interpersonal, and community levels.

Conclusion:

Raising parents’ awareness of the process of seeking mental healthcare has the potential to help identify children at risk for ADHD earlier. Developing psychoeducational intervention that improves parents’ seeking behavior and reduces barriers toward seeking mental healthcare is needed.
Brain and Placental Pathology in Fetal COL4A1 Related Disease
Authors: Shannon Patrick , Hum Courtney , Parks Tony , Schauer GM , Chitayat David , Chong Karen , Shinar Shiri , Blaser Susan , Moore Gaea , Van Mieghem Tim
Published: January 2021

Introduction

Although fetal brain injury due to COL4A1 gene mutation is well documented, fetal central nervous system (CNS) and placental histopathology lack description. We report CNS and placental pathology in fetal cases with symptomatic COL4A1 mutation.

Methods

We retrieved four autopsy cases of COL4A1 related disease, confirmed by genetic sequencing after fetal brain injury was detected.

Results

One case was a midgestation fetus with residua of ventricular zone hemorrhage and normal placental villi. Three cases were 30-32 week gestation fetuses: two demonstrated CNS small vessel thrombosis, with CNS injury. Both demonstrated high grade placental fetal vascular malperfusion (FVM). One additionally showed villous dysmorphism, the other demonstrated mild villous immaturity. The fetus whose placenta demonstrated high grade FVM was growth restricted. A fourth fetus demonstrated schizencephaly with a CNS arteriopathy with smooth muscle cell degeneration and cerebral infarcts; the placenta demonstrated severe villous dysmorphism and low grade FVM.

Discussion

These cases confirm that small vessel disease is important in producing intracranial pathology in COL4A1mutation. We report an arteriopathy distinct from microvascular thrombosis and demonstrate that placental pathology is common in fetal COL4A1 related disease. This tentatively suggests that placental pathology may contribute to CNS abnormalities by affecting circulatory sufficiency.
The vibroacoustic behaviour of aluminium foam sandwich panels in similitude
Authors: Casaburo Alessandro , Petrone Giuseppe , Meruane Viviana , Franco Francesco , Rosa Sergio De
Published: January 2021

Aluminium Foam Sandwich (AFS) panels are a type of structural configuration in which two aluminium thin layers enclose a core made of foamed aluminium. Both the metallic characteristic of the matrix and the foam porosity lead to a remarkable combination of properties which range from high specific stiffness to thermal and acoustic isolation. However, these characteristics, depending on core properties as foam density, pores morphology, type and size of gas bubbles, are obtained by means of a manufacturing process that is not fully controlled. Thus, in order to reduce the financial and temporal costs of the campaign of experimental tests needed for completely understanding the properties and potentialities of AFS panels, similitude methods can be used so that scaled-down models can be tested in place of the full-scale structure. In this work, the similitude conditions and scaling laws of Alulight® AFS panels with two different boundary conditions (simply supported and free-free) are derived and validated. In particular, two different sets of conditions are derived: the first by expliciting all the geometrical and material properties, the second by combining some parameters into just one with physical meaning, the bending stiffness. The analysis in similitude is addressed towards the prediction of vibroacoustic properties such as natural frequencies, Frequency Response Function (FRF) and radiated acoustic power. Both models in complete and partial similitude are investigated. While the former allow to reconstruct the vibroacoustic characteristics of the prototype, the latter does not. Furthermore, it is proved that it is possible to derive a simplified set of similitude conditions if many parameters are gathered into just one parameter with physical meaning.
Effects of autism acceptance training on explicit and implicit biases toward autism
Authors: Jones Desiree R , DeBrabander Kilee M , Sasson Noah J
Published: January 2021

Non-autistic adults often hold explicit and implicit biases toward autism that contribute to personal and professional challenges for autistic people. Although previous research indicates that non-autistic adults with higher autism knowledge and familiarity express more inclusionary attitudes, it remains unclear whether training programs designed to promote autism acceptance and understanding affect subsequent implicit and explicit biases toward autism. In this study, non-autistic adults ( N = 238) completed an autism acceptance training featuring factual information and engaging first-person narratives, a general mental health training not mentioning autism, or a no-training control, then responded to surveys assessing their autism knowledge, stigma, and impressions of autistic adults, and completed a novel implicit association task about autism. Non-autistic adults in the autism acceptance training condition reported more positive impressions of autistic adults, demonstrated fewer misconceptions and lower stigma about autism, endorsed higher expectations of autistic abilities, and expressed greater social interest in hypothetical and real autistic people. However, training had no effect on implicit biases, with non-autistic adults associating autism-related labels with unpleasant personal attributes regardless of training condition. These findings suggest that the autism acceptance training program in this study, designed to increase autism knowledge and familiarity among non-autistic people, holds promise for reducing explicit but not implicit biases toward autism.

Lay abstract

Autistic adults face prejudice from non-autistic people. They are often judged unfairly and left out of social activities because of their differences. This can make it difficult for autistic people to make friends and find jobs. Some training programs have tried to teach autistic people to act more like non-autistic people to help them gain acceptance. Fewer have focused on teaching non-autistic people how to be more autism friendly. In this study, we used a short training video that teaches people about autism. The video was created with the help of autistic adults and included clips of real autistic people. We found that non-autistic people who watched this video had better knowledge about autism and showed more autism-friendly attitudes than those who watched a video about mental health or those who did not watch any video. They were more open to having a relationship with an autistic person and had more positive beliefs about autism. However, our video did not affect people’s unconscious attitudes about autism. People in our study connected autism with unpleasant traits, even if they had watched the autism training video. This suggests that teaching non-autistic people about autism may promote more autism-friendly attitudes, but some beliefs may be harder to change.
Cross-linguistic differences affect emotion and emotion-laden word processing: Evidence from Polish-English and Romanian-English bilinguals
Authors: Bromberek-Dyzman Katarzyna , Jończyk Rafał , Vasileanu Monica , Niculescu-Gorpin Anabella-Gloria , Bąk Halszka
Published: January 2021

Aims:

We study how emotions are represented in Polish-English and Romanian-English bilinguals, whose respective languages either mostly share emotion lexicon (Romanian-English) or not (Polish-English). We test to what extent such variance in lexical proximity between the two bilingual groups affects their decisions about emotional word content.

Methodology:

In a masked priming paradigm, participants viewed prime-target adjective pairs, and judged whether the target adjective was positive or negative in meaning. Primes and targets either named (emotion word) or evoked (emotion-laden word) emotions, and were either related – that is, belonged to one word type (emotion or emotion-laden) – or unrelated.

Data and analysis:

Behavioural data were analysed using linear mixed-effects models, with within-subject fixed effects of language, word type, valence and relatedness, and their interactions.

Findings/conclusions:

We found processing facilitation of emotion-laden rather than emotion words in both participant groups, irrespective of language of operation. Emotion target adjectives, particularly of negative valence, tended to slow down responses of Polish-English bilinguals in their first language. In the Romanian-English group, emotion target adjectives were recognized with lower accuracy in the second language. This pattern of results suggests that affective responsiveness is modulated by the lexical proximity between the first language and second language.

Originality:

Extending bilingual emotion research, this study tests how emotions are represented in languages that vary in lexical proximity with English: Polish and Romanian. We demonstrate that cross-linguistic differences between the respective languages of a bilingual impact emotional meaning processing in the first and second language.

Significance/implications:

We provide support for the emotion context-of-learning theory, language-specific episodic trace theory and the sense model in bilingualism, showing that cross-linguistic differences between the first and second language modulate emotion and emotion-laden word processing. Our findings also demonstrate that the distinction between the emotion and emotion-laden words is not as universal as previously assumed.
Sisterhood and affective politics: The CaiRollers mobilising change through roller derby in Egypt
Authors: Rodriguez Castro Laura , Pavlidis Adele , Kennelly Millicent , Nichols Erin
Published: January 2021

This article narrates the affects and experiences of the CaiRollers, the first and only roller derby team in Egypt. Through visual affective discourse analysis of their Instagram account and interviews with team members, the article addresses the question: What do physical practices such as roller derby ‘do’ in e/affecting and mobilising change? In conversation with feminisms from the Middle East, our analysis highlights how the team’s ‘sisterhood’ is a site of affective politics that transcends the roller derby track. At the same time, a desire to be tough and to embrace risk permeated the CaiRollers discourses. Yet, while the team has established its legitimacy within the transnational roller derby community, we narrate the obstacles they face in Egypt. In sum, we found that the CaiRollers involvement in roller derby was entangled in mobilising change in political movements, gender politics, transnational mobilities and questions of legitimacy and sport.
Effect of anchorage number and CFRP strips length on behavior of strengthened glulam timber beam for flexural loading
Authors: İşleyen Ümmü Karagöz , Ghoroubi Rahim , Mercimek Ömer , Anıl Özgür , Togay Abdullah , Erdem R Tuğrul
Published: January 2021

Laminated wooden beams are more preferred in the production of wooden structures than solid timber beams because they have a higher load-carrying capacity and allow larger openings to be used in the structure. The widespread use of wooden structures and the increasing size of the structures have revealed the need for strengthened laminated wooden beams and increase their ultimate load capacity. It has become necessary to develop reinforcement details to increase the ultimate load capacity of laminated wooden beams in wooden railroads or highway bridge beams, where the traffic load increases, especially in large wooden structures, in cases where large openings must be passed. Within the horizon of the study, the behavior and performance of three-layer glulam wooden beams strengthened with anchorage and non-anchorage CFRP strips with different bonding length under flexural loading were investigated experimentally. The three-point bending test was applied to glulam timber beam test specimens produced by laminating yellow pine wood material using the polyurethane adhesive. General load-displacement behaviors, ultimate load capacity, initial stiffness, displacement ductility ratios, and energy dissipation capacities were obtained. The increase in the bonding length of the CFRP strips used for strengthening in the glulam timber beam specimens and the use of CFRP fan type anchors at the strip ends increased the ultimate load capacity and initial stiffness values of the wooden beams, as well as the displacement ductility ratios and energy dissipation capacity values.
Overview of recent cases before the Court of Justice of the European Union (September 2020-December 2020)
Authors: Melin Pauline
Published: January 2021

The reporting period (September 2020-December 2020) was a particularly intense time in terms of important judgments on social security with no fewer than four judgments from the Grand Chamber of the Court. This overview reports five cases in total. First, there are three cases on the Posted Workers Directive. The first two are on the dismissal of the annulment procedures regarding the adoption of the new Posted Workers Directive (Directive 2018/957) started by Hungary (C-620/18) and Poland (C-626/18). Then, the FNV case (C-815/18), which is on the application of the Posted Workers Directive (Directive 96/71) to the transnational provision of services in the road transport sector, is discussed. The overview continues onto other subjects, with a follow-up of the Dano and Alimanovic saga in the Job Center Krefeld case (C-181/19), which relates to the access to social assistance for a job-seeker who is the primary carer of a child receiving education in the host Member State. From there, commentary is given on the A v. Veselï bas ministrija case, which deals with the difficult balance between the freedom of religion and the system of prior authorization for planned healthcare. Finally, the Syndicat CFTC case (C-463/19) is reviewed, and it concerns the conditions under which an additional maternity leave can be reserved to female workers without being considered as discriminatory.
Air pollution and health risk assessment in Northeastern China: A case study of Jilin Province
Authors: Bai Li , Li Chunhui , Yu Chuck Wah , He Zijian
Published: January 2021

In recent years, the pollution of the air environment has been increasing, which has seriously endangered human health. The large amount of coal burning and automobile exhaust emissions in winter have caused serious regional pollution, which has greatly increased the prevalence of respiratory disease of people. The purpose of this study is to use Jilin Province as an example to map out the environmental pollution status in Northeastern China, and to provide suggestions for the improvement of the atmospheric environment. Using the annual data of China's atmospheric monitoring, the atmospheric environment in Jilin was comprehensively analysed using ArcGIS, principal component analysis (PCA) and non-carcinogenic risk model calculations. The results showed that the temporal distribution of pollutants was winter > spring > autumn > summer, and the spatial distribution is decreasing from northwest to southeast. The PCA showed that the first principal components were PM2.5 and CO, and the second principal components were PM10 and O3. The main sources of air pollution were coal-fired (62.365%) and automobile emissions (19.153%). The non-carcinogenic risks of pollutants are all within the acceptable range (1 × 10−6), but as age increases, the risk gradually decreases, and the risk value of male is higher than that of female.
Multilingualism: A threat to public education or a resource in public education? – European histories and realities
Authors: Gogolin Ingrid
Published: January 2021

Public education systems in Europe were created in the course of the foundation of the ‘classical’ nation state in the 18th and 19th centuries. Historical analyses show that it was part of their destiny to contribute to the consolidation of the respective states’ national self-design. In the 19th century, the myth developed that a nation state is monolingual not by its creation but ‘by mere nature’, and that monolingualism in the national language is the ‘natural’ result of being born and growing up in a nation state. Many of today’s public education systems are still based on this notion of linguistic ‘normality’ with respect to the composition of their clientele as well as their image of an individual ‘normal’ child(hood). However, the populations of nation states are in fact multilingual. Linguistic diversity increased as a result of migration and factors such as technical means for virtually ‘borderless’ communication. My contribution presents the European traditions of nation building since the late 1700s and asks for the functionality of monolingual habitual practice in education systems today. First results from an empirical study are presented which illustrate individual language abilities of multilingual children and the potential of linguistic diversity as a resource.
Antibody-based delivery of interleukin-9 to neovascular structures: Therapeutic evaluation in cancer and arthritis
Authors: Gouyou Baptiste , Ongaro Tiziano , Cazzamalli Samuele , De Luca Roberto , Kerschenmeyer Anne , Valet Philippe , Villa Alessandra , Neri Dario , Matasci Mattia
Published: January 2021

Interleukin-9 is a cytokine with multiple functions, including the ability to activate group 2 innate lymphoid cells, which has been postulated to be therapeutically active in mouse models of arthritis. Similarly, interleukin-9 has been suggested to play an important role in tumor immunity. Here, we describe the cloning, expression, and characterization of three fusion proteins based on murine interleukin-9 and the F8 antibody, specific to the alternatively spliced EDA domain of fibronectin. EDA is strongly expressed in cancer and in various arthritic conditions, while being undetectable in the majority of healthy organs. Interleukin-9-based fusion proteins with an irrelevant antibody specific to hen egg lysozyme served as negative control in our study. The fusion proteins were characterized by quantitative biodistribution analysis in tumor-bearing mice using radioiodinated protein preparations. The highest tumor uptake and best tumor:organ ratios were observed for a format, in which the interleukin-9 moiety was flanked by two units of the F8 antibody in single-chain Fv format. Biological activity of interleukin-9 was retained when the payload was fused to antibodies. However, the targeted delivery of interleukin-9 to the disease site resulted in a modest anti-tumor activity in three different murine models of cancer (K1735M2, CT26, and F9), while no therapeutic benefit was observed in a collagen induced model of arthritis. Collectively, these results confirm the possibility to deliver interleukin-9 to the site of disease but cast doubts about the alleged therapeutic activity of this cytokine in cancer and arthritis, which has been postulated in previous publications.
Addressing Driver Disengagement and Proper System Use: Human Factors Recommendations for Level 2 Driving Automation Design
Authors: Mueller Alexandra S. , Reagan Ian J. , Cicchino Jessica B.
Published: January 2021

Level 2 driving automation has the potential to reduce crashes; however, there are known risks when using these systems, particularly as they relate to drivers becoming disengaged from driving. This paper provides data-driven recommendations for Level 2 driving automation design using the best currently available methods to encourage driver engagement and communicate where and how a system can safely be used. Our recommendations pertaining to driver engagement concern driver management systems that monitor the driver for signs of disengagement and return the driver to the loop using a multimodal escalation process with attention reminders, countermeasures for sustained noncompliance to the attention reminders, and proactive methods for keeping drivers engaged with respect to driver-system interactions and system functionality considerations. We also provide guidance on how the operational design domain (ODD), driver responsibilities, and system limitations should be communicated and how these systems must be self-limited within the ODD. In addition, we discuss the benefits and limitations of training to emphasize the importance of making these systems intuitive to all users, regardless of training, to ensure proper use. These recommendations should be applied as a whole, because selectively adhering to only some may inadvertently exacerbate the dangers of driver disengagement.
Reopening schools safely in the face of COVID-19: Can cluster randomized trials help?
Authors: Weijer Charles , Hemming Karla , Phillips Hey Spencer , Fernandez Lynch Holly
Published: January 2021

The COVID-19 pandemic has highlighted the challenges of evidence-based health policymaking, as critical precautionary decisions, such as school closures, had to be made urgently on the basis of little evidence. As primary and secondary schools once again close in the face of surging infections, there is an opportunity to rigorously study their reopening. School-aged children appear to be less affected by COVID-19 than adults, yet schools may drive community transmission of the virus. Given the impact of school closures on both education and the economy, schools cannot remain closed indefinitely. But when and how can they be reopened safely? We argue that a cluster randomized trial is a rigorous and ethical way to resolve these uncertainties. We discuss key scientific, ethical, and resource considerations both to inform trial design of school reopenings and to prompt discussion of the merits and feasibility of conducting such a trial.
Adolescents’ and their parents’ experiences of using a closed-loop system to manage type 1 diabetes in everyday life: qualitative study
Authors: Rankin D , Kimbell B , Hovorka R , Lawton J
Published: January 2021

Objectives

Type 1 diabetes can have life-shattering consequences for adolescents and parents. A closed-loop system is a cutting-edge technology which automatically regulates glucose to reduce the burden of diabetes management. We explored adolescents’ and parents’ experiences of using this technology to understand how it affects their biographies and everyday lives.

Methods

In-depth interviews with 18 adolescents newly diagnosed with type 1 diabetes and 21 parents after ≥12 months experience using closed-loop technology. Data were analysed thematically.

Results

Participants reported very few disruptions to their lives when using a closed-loop. Reports of family conflict were minimal as the closed-loop enabled dietary flexibility and glucose levels to be checked effortlessly. Adolescents described doing ‘normal’ activities without worrying about high/low glucose, and parents reported allowing them to do so unsupervised because the closed-loop would regulate their glucose and keep them safe. Some adolescents expressed concerns about the visibility of components and, to avoid stigma, described curtailing activities such as swimming. Participants described how the closed-loop enabled adolescents to be in control of, or create distance from, diabetes.

Discussion

The closed-loop has life-enhancing consequences for both adolescents and parents and helps to reduce the biographical disruption of type 1 diabetes in this age group.
An interpretative phenomenological analysis of the meaning of work to women living with breast cancer
Authors: MacLennan Sara J , Cox Thomas , Murdoch Sarah , Eatough Virginia
Published: January 2021

Objective

Work is an important aspect of everyday life. This remains true for those living with and beyond cancer. Less is known about how the meaning of work may change over the cancer journey, the needs of the individual in response to changes and how healthcare professionals and employing organisations can meet these needs. The aim of this study was to explore the lived experience of work after treatment for breast cancer in a group of professional working women within the UK.

Methods

This article presents an Interpretative Phenomenological Analysis (IPA) of the experiences of 15 professional women diagnosed with breast cancer.

Results

We discuss these women’s journey from (1) rethinking the meaning of work to (2) making decisions about work ability and advice on work to (3) transitioning back in to the workplace and the value of continued engagement with employer.

Discussion

The findings from this study demonstrate the complex interplay between living with cancer, treatment decisions and work. This study highlights two key areas for inclusion in practice: (1) support from Healthcare Professionals and judgements of functional ability and work ability and (2) the role of line managers in managing cancer and work.
Post-stroke cognitive impairment on the Mini-Mental State Examination primarily relates to left middle cerebral artery infarcts
Authors: Weaver Nick A , Kancheva Angelina K , Lim Jae-Sung , Biesbroek J Matthijs , Wajer Irene MC Huenges , Kang Yeonwook , Kim Beom J , Kuijf Hugo J , Lee Byung-Chul , Lee Keon-Joo , Yu Kyung-Ho , Biessels Geert Jan , Bae Hee-Joon
Published: January 2021

Background

Post-stroke cognitive impairment can occur after damage to various brain regions, and cognitive deficits depend on infarct location. The Mini-Mental State Examination (MMSE) is still widely used to assess post-stroke cognition, but it has been criticized for capturing only certain cognitive deficits. Along these lines, it might be hypothesized that cognitive deficits as measured with the MMSE primarily involve certain infarct locations.

Aims

This comprehensive lesion-symptom mapping study aimed to determine which acute infarct locations are associated with post-stroke cognitive impairment on the MMSE.

Methods

We examined associations between impairment on the MMSE (<5th percentile; normative data) and infarct location in 1198 patients (age 67 ± 12 years, 43% female) with acute ischemic stroke using voxel-based lesion-symptom mapping. As a frame of reference, infarct patterns associated with impairments in individual cognitive domains were determined, based on a more detailed neuropsychological assessment.

Results

Impairment on the MMSE was present in 420 patients (35%). Large voxel clusters in the left middle cerebral artery territory and thalamus were significantly (p < 0.01) associated with cognitive impairment on the MMSE, with highest odds ratios (>15) in the thalamus and superior temporal gyrus. In comparison, domain-specific impairments were related to various infarct patterns across both hemispheres including the left medial temporal lobe (verbal memory) and right parietal lobe (visuospatial functioning).

Conclusions

Our findings indicate that post-stroke cognitive impairment on the MMSE primarily relates to infarct locations in the left middle cerebral artery territory. The MMSE is apparently less sensitive to cognitive deficits that specifically relate to other locations.
How do treatment times impact on functional outcome in stroke patients undergoing thrombectomy in Germany? Results from the German Stroke Registry
Authors: Herm Juliane , Schlemm Ludwig , Siebert Eberhard , Bohner Georg , Alegiani Anna C , Petzold Gabor C , Pfeilschifter Waltrud , Tiedt Steffen , Kellert Lars , Endres Mattias , Nolte Christian H
Published: January 2021

Background

Functional outcome post-stroke depends on time to recanalization. Effect of in-hospital delay may differ in patients directly admitted to a comprehensive stroke center and patients transferred via a primary stroke center. We analyzed the current door-to-groin time in Germany and explored its effect on functional outcome in a real-world setting.

Methods

Data were collected in 25 stroke centers in the German Stroke Registry-Endovascular Treatment a prospective, multicenter, observational registry study including stroke patients with large vessel occlusion. Functional outcome was assessed at three months by modified Rankin Scale. Association of door-to-groin time with outcome was calculated using binary logistic regression models.

Results

Out of 4340 patients, 56% were treated primarily in a comprehensive stroke center and 44% in a primary stroke center and then transferred to a comprehensive stroke center (“drip-and-ship” concept). Median onset-to-arrival at comprehensive stroke center time and door-to-groin time were 103 and 79 min in comprehensive stroke center patients and 225 and 44 min in primary stroke center patients. The odds ratio for poor functional outcome per hour of onset-to-arrival-at comprehensive stroke center time was 1.03 (95%CI 1.01–1.05) in comprehensive stroke center patients and 1.06 (95%CI 1.03–1.09) in primary stroke center patients. The odds ratio for poor functional outcome per hour of door-to-groin time was 1.30 (95%CI 1.16–1.46) in comprehensive stroke center patients and 1.04 (95%CI 0.89–1.21) in primary stroke center patients. Longer door-to-groin time in comprehensive stroke center patients was associated with admission on weekends (odds ratio 1.61; 95%CI 1.37–1.97) and during night time (odds ratio 1.52; 95%CI 1.27–1.82) and use of intravenous thrombolysis (odds ratio 1.28; 95%CI 1.08–1.50).

Conclusion

Door-to-groin time was especially relevant for outcome of comprehensive stroke center patients, whereas door-to-groin time was much shorter in primary stroke center patients. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT03356392 . Unique identifier NCT03356392
Analyzing the social context of health information and misinformation during the COVID-19 pandemic: a case of emerging inequities in Lebanon
Authors: Makhoul Jihad , Kabakian-Khasholian Tamar , Chaiban Lea
Published: January 2021

With the far-reaching COVID-19 pandemic starting in December 2019, a surge of misinformation, now coined by the World Health Organization (WHO) as an ‘infodemic’, has also taken the world by storm. False information and variations in interpretations about the pandemic and mitigation interventions/strategies continue to spread at a faster pace than the relevant scientific evidence. The WHO has called for a fight against this infodemic, describing it as the most contagious aspect of the pandemic. In this era of rapid information exchange, public health measures, and state interventions to control the pandemic, a contextual understanding of how information is communicated and shared is important for uncovering possible reasons for action or inaction by the general public. With the Lebanese state scrambling to implement and enforce different measures to control and mitigate the spread of COVID-19, adherence by the general public is not uniform. In this paper, we refer to social science and risk communication theory to discuss how the political, economic and social contexts in the country, and not only the content of the messages that people receive from officials, affect how they interpret and act on information. We highlight how this has played out in Lebanon and identify societal aspects of importance in a low-middle income country fraught with social, economic and political inequalities which continue to undermine the efforts to contain the spread. Implications to inform state response in the context of low-middle income countries are also discussed.
Complications Following Total Ankle Arthroplasty Versus Ankle Arthrodesis for Primary Ankle Osteoarthritis
Authors: Ross Bailey J. , Savage-Elliott Ian , Wu Victor J. , Rodriguez Ramon F.
Published: January 2021

Introduction

There are minimal data comparing complications between ankle arthrodesis (AA) versus total ankle arthroplasty (TAR) for operative management of primary osteoarthritis (OA). This study aimed to compare outcomes following AA versus TAR for primary ankle OA using a large patient database.

Methods

Patients who received AA or TAR for primary ankle OA from 2010 to 2019 were queried from PearlDiver. Rates of common joint complications were compared at 90 days, 1 year, and 2 years postoperatively using multivariable logistic regression.

Results

A total of 1136 (67%) patients received AA and 584 (33%) patients underwent TAR. Patients that received AA exhibited significantly higher rates of at least one common joint complication at 90 days (19.3% vs 12.6%; odds ratio [OR] 1.69), 1 year (25.6% vs 15.0%; OR 2.00), and 2 years (26.9% vs 16.2%; OR 1.91) postoperatively. This included higher rates of adjacent fusion or osteotomy procedures, periprosthetic fractures, and hardware removal at each postoperative follow-up (all P < .05). Rates of prosthetic joint infection were comparable at 2 years postoperatively (4.3% vs 4.2%; OR 0.91).

Conclusion

The AA cohort exhibited higher rates of postoperative joint complications in the short and medium-term, namely, subsequent fusions or osteotomies, periprosthetic fractures, and hardware removal.

Levels of Evidence

Level III
Situation Perception Mediates the Link Between Narcissism and Relationship Satisfaction: Evidence From a Daily Diary Study in Romantic Couples
Authors: Rentzsch Katrin , Wieczorek Larissa L. , Gerlach Tanja M.
Published: January 2021

Research has shown that diverging romantic relationship outcomes of grandiose narcissism can be explained by differential associations of agentic and antagonistic aspects of narcissism. In this study, we wanted to further investigate the underlying mechanisms by examining how narcissists perceive daily situations with their partners. In an online diary, 171 couples reported on 1941 daily situations experienced together. Analyses revealed that agentic narcissism was positively and antagonistic narcissism was negatively related to daily relationship satisfaction. These effects were differentially linked through distinct situation perceptions: Agentic narcissism was positively linked with relationship satisfaction through perceiving daily situations as, for example, containing more romance, sexuality, and love, while antagonistic narcissism was negatively linked with relationship satisfaction through perceiving, for example, more threat, criticism, and accusation. Results are discussed in light of the Narcissistic Admiration and Rivalry Concept and with respect to person–situation transactions in romantic relationships.
Estimating Bar Graph Averages: Overcoming Within-the-Bar Bias
Authors: Kang Hyunmin , Ji Jeayeong , Yun Yeji , Han Kwanghee
Published: January 2021

Although most people are not aware of it, bias can occur when interpreting graphs. Within-the-bar bias describes a misinterpretation of the distribution of data underlying bar graphs that indicate an average or where the average estimation point moves inside the bar when the average of several graphs is estimated. This study proposes and tests two methods based on information processing to reduce within-the-bar bias. The first method facilitates bottom-up processing by changing various graph features, such as presenting confidence intervals, placing boundaries around the graph, and showing cumulative bars with different tones. The second method facilitates top-down processing by instructing participants to estimate the mean based on a dot at the end of each bar. Testing of the first method showed that cumulative bars reduced bias, but the other methods did not. The second method was found to reduce bias. Overall, our results demonstrate that the accurate interpretation of bar graphs can be facilitated through the manipulation of specific graph features and instruction.