bluuebunny/crossref_metadata_2025 huggingface dataset:
Identifying patients with chronic pain who respond to acupuncture: results from an individual patient data meta-analysis
Authors: Foster Nadine E , Vertosick Emily A , Lewith George , Linde Klaus , MacPherson Hugh , Sherman Karen J , Witt Claudia M , Vickers Andrew J ,   on behalf of the Acupuncture Trialists Collaboration
Published: June 2020

Background

In a recent individual patient data meta-analysis, acupuncture was found to be superior to sham and non-sham controls in patients with chronic pain. It has been suggested that a subgroup of patients has an exceptional response to acupuncture. We hypothesized the presence of exceptional acupuncture responders would lead to a different distribution of pain scores in acupuncture versus control groups, with the former being skewed to the right.

Methods

This individual patient data meta-analysis included 39 high-quality randomized trials of acupuncture for chronic headache, migraine, osteoarthritis, low back pain, neck pain and shoulder pain published before December 2015 (n = 20,827). In all, 25 involved sham acupuncture controls (n = 7097) and 25 non-acupuncture controls (n = 16,041). We analyzed the distribution of change scores and calculated the difference in the skewness statistic—which assesses asymmetry in the data distribution—between acupuncture and either sham or non-acupuncture control groups. We then entered the difference in skewness along with standard error into a meta-analysis.

Findings

Control groups were more right-skewed than acupuncture groups, although this difference was very small. The difference in skew was 0.124 for non-acupuncture-controlled trials (p = 0.047) and 0.141 for sham-controlled trials (p = 0.029). In a pre-specified sensitivity analysis excluding three trials with outlying results known a priori, the difference in skew between acupuncture and sham was no longer statistically significant (p = 0.2).

Conclusion

We did not find evidence to support the notion that there are exceptional acupuncture responders. The challenge remains to identify features of chronic pain patients that can be used to distinguish those that have a good response to acupuncture treatment.
Career development: Profession or not?
Authors: O’Reilly Val , McMahon Mary , Parker Polly
Published: June 2020

Professions are recognised occupations that require specialised knowledge, training, and skills. Entry into professions is gained through high level qualifications, such as university degrees. The theoretical knowledge base and profession-specific qualifications distinguish professions from other occupations and create a unique identity for them and their members. Professions have defined entry pathways that assist members who practise in the field (practitioners) to construct their professional identity. Governments regulate entry to some professions, such as teaching and psychology. Career development lacks the regulation of other professions and the entry pathway is less defined. This article considers the professional status of career development against a critical reflection on professions, professionalism and professionalisation, and professional identity construction. Potential implications of the differences between career development and other professions related to professional standards and regulation are discussed and questions posed about the construction of a professional identity for the field and its members.
Attitudes and Self-Perception of 10- to 14-Year-Old Students Toward Obese Children
Authors: Ciloglu Hulya , Yilmaz Medine
Published: June 2020

This cross-sectional study was carried out to investigate the self-perception of primary school students aged 10–14 and their attitudes toward obese children ( n = 693). There was a weak, positive, and highly significant correlation between the mean scores for the overall Attitude Toward Obese Children Scale, the Self-Perception Profile for Children Scale, and the Acceptance of Obese Peers subscale ( p = .000). There was a weak, positive, and highly significant correlation between all the subscales except for the Rejection of Obese Peer and Social Acceptance and Athletic Competence subscales ( p < .01). Self-perception in adolescence is effective throughout life in terms of community mental health. Therefore, it is of great importance to carry out education and awareness-raising studies in schools to gain students positive attitudes and behavior toward individuals with different characteristics.
Trifarotene for the Treatment of Facial and Truncal Acne
Authors: Bell Katheryn A. , Brumfiel Caitlin M. , Haidari Wasim , Boger Laura
Published: June 2020

Objective:

This article reviews clinical trials to assess the efficacy, safety, and clinical application of trifarotene 0.005% cream (Aklief).

Data Sources:

A systematic review of the literature was performed using the terms trifarotene OR Aklief OR CD5789 in MEDLINE (PubMed) and EMBASE databases. Articles prior to May 2020 were considered for inclusion. Bibliographies and ClinicalTrials.gov were also searched to identify further studies.

Study Selection and Data Extraction:

Relevant English language and human studies related to pharmacology, clinical trials, and safety were considered.

Data Synthesis:

In the 52-week phase III trial, treatment success rates for facial acne (Investigator Global Assessment [IGA] rating of no or almost no acne) and truncal acne (Physician’s Global Assessment [PGA] rating of no or almost no acne) were 65.1% and 66.9%, respectively. Overall success rates (IGA and PGA success in the same patient) were 57.9%; 52.8% of patients had a Dermatology Quality of Life Index score of 0 or 1, compared with 22.6% at baseline. Trifarotene was well tolerated, with pruritus, irritation, and sunburn as the most common adverse effects.

Relevance to Patient Care and Clinical Practice:

Trifarotene is a newly Food and Drug Administration–labeled fourth-generation topical retinoid that shows particular promise in the treatment of facial and truncal acne vulgaris. It is an effective and safe addition to currently available retinoids.

Conclusion:

Trifarotene is effective and safe for treatment of facial and truncal acne. Future trials should compare its efficacy and tolerability with that of the older, clinically established retinoids. Despite efficacy, cost may be a prohibitive factor.
Prevalence of Abnormal Ultrasound Findings in Asymptomatic Posterior Tibial Tendons
Authors: Mills F. Baker , Williams Kevin , Chu Christopher H. , Bornemann Paul , Jackson J. Benjamin
Published: June 2020

Background:

Posterior tibial tendon dysfunction (PTTD) is a pathological condition that can cause failure of the posterior tibial tendon (PTT). Initially, patients with PTTD are often asymptomatic, making early identification and treatment challenging. Certain ultrasound (US) characteristics have been implicated in the presence of tendinopathy, but their frequency has yet to be assessed in the PTT. The purpose of this study was to identify and report on the frequency of incidental, or potentially early subclinical, tendinopathic US characteristics in asymptomatic PTTs.

Methods:

Following institutional review board approval, 150 participants underwent a bilateral-comprehensive US assessment. The resulting images were reviewed and assessed to identify the presence of abnormalities demonstrated to represent tendinopathy.

Results:

Overall, 266 tendons were assessed and 128 (48.1%) were determined to have at least one tendinopathic trait. Specifically, 51 (19.2%) had circumferential fluid, 69 (25.9%) had noncircumferential fluid, 22 (8.3%) had thickening, 31 (11.7%) had heterogenicity, 19 (7.1%) had hyperemia, and 2 (0.8%) had calcification. Additionally, Caucasian participants were found to be nearly 3 times more likely to have tendinopathic findings when compared with African American participants.

Conclusion:

Sixty-seven percent of participants and 48.1% of PTTs evaluated had at least one tendinopathic feature identified on US. The prevalence rates of these findings, observed in participants, were as follows: noncircumferential fluid, circumferential fluid, heterogenicity, and thickening. Knowing the frequency of these traits may help clinicians to identify subclinical tendinopathy in the PTT before it progresses to PTTD.

Level of Evidence:

Level IV, case series.
A novel ResNet-based model structure and its applications in machine health monitoring
Authors: Duan Jian , Shi Tielin , Zhou Hongdi , Xuan Jianping , Wang Shuhua
Published: June 2020

Machine health monitoring has become increasingly important in modern manufacturers because of its ability to reduce downtime of the machine and cut down the production cost. Enormous signals acquired from machinery are capable of reflecting current working conditions by in-depth analysis with various data-driven methods. Hand-crafted feature extraction and representation from the traditional methods are essential but daunting tasks, and these methods may not be suitable for these massive data. Compared with traditional methods, deep learning ones are able to extract the best feature combination during model training without any artificial intervention, which makes it easier, more efficient, and more effective to monitor machine health, but the training cost and training time hamper its application. The short-time Fourier transform is adopted as the data preprocessing method to cut down the training cost and boost the training procedure. Inspired by the great achievements of ResNet, the new optimized model based on ResNet has been proposed with layer-by-layer dimension reduction of the feature maps. The proposed model is also able to avoid information loss in the conventional pooling layer. All the potential candidate model blocks are introduced and compared, and the best one is selected as the final one. Repeated model block layers are adapted for the best feature combinations, followed by a two-layer full connection layer for the final targets. The proposed method is validated by conducting experiments on bearing fault diagnosis and tool wear prediction dataset. The final results show that the proposed model achieves the best accuracy rate in the classification task and the lowest root mean squared error in the prediction task.
Theory, numeric, and experiment studies on stability of two homodromy vibrators in a vibrating system with double rigid frames
Authors: Zhang Xueliang , Li Zhenmin , Li Ming , Gu Dawei , Wen Bangchun
Published: June 2020

The synchronization and stability of two or more vibrators in vibrating systems with double rigid frames are rarely investigated in previous studies. To make up this drawback, we take a dynamical model with double rigid frames driven by two homodromy vibrators, for example the synchronous and stable states of the corresponding system, as well as the relative motion characteristics between the two rigid frames, are analyzed in detail. First, the mathematical modeling of the system is given; the absolute motion and relative motion differential equations of the system are deduced. After that, the theory conditions of implementing synchronization and those of stability are obtained, by using the average method and Hamilton’s principle, respectively. Based on the theoretical results, some numerical qualitative analyses are provided to reveal the coupling dynamical characteristics of the system, and the corresponding ideal working regions are suggested. Finally, experiments are carried out to further examine the validity of the theoretical and numerical results. The present work can offer a reference to design some new vibrating machines such as the considered model.
Promoting Wellness and Recovery of Young Women Experiencing Gender-Based Violence and Homelessness: The Role of Trauma-Informed Health Promotion Interventions
Authors: Reid Nadine , Kron Amie , Rajakulendran Thanara , Kahan Deborah , Noble Amanda , Stergiopoulos Vicky
Published: June 2020

Little is known regarding the types of interventions most effective in supporting wellness and recovery of victims of gender-based violence, particularly those simultaneously experiencing homelessness. This qualitative study explored the experiences of 18 young women experiencing gender-based violence and homelessness who participated in a community-based, trauma-informed group intervention in Toronto, Canada. Participants completed audio-recorded and transcribed semi-structured interviews, analyzed using thematic content analysis. Participants described valuing the safe, women-only space, shared lived experiences, and tailored psychoeducation and resulting improvements in confidence, coping, health, relationships, and future directedness. Findings suggest community-based, trauma-informed group interventions can facilitate wellness and recovery in this population.
Suprasellar meningioma presenting with glaucomatous type cupping
Authors: Pellegrini Francesco , Marullo Michele , Zappacosta Antonio , Liberali Tatiana , Cuna Alessandra , Lee Andrew G
Published: June 2020

Purpose:

To describe a case of a suprasellar meningioma compressing the chiasm from below and producing a unilateral fascicular (nasal) visual field defect that mimicked glaucomatous cupping.

Case report:

A 78-year-old man presented with painless, progressive, unilateral arcuate visual field defect. He was diagnosed with “normal tension glaucoma” based on an asymmetric cup to disc ratio. Despite treatment with anti-glaucoma drops, the visual field defect progressed. Neurophthalmic evaluation was consistent with a compressive optic neuropathy OD. Brain MRI showed a suprasellar meningioma compressing on the junction of the optic nerve and chiasm from below.

Conclusion:

Although junctional visual field loss (e.g. junctional scotoma and junctional scotoma of Traquair) are well-known presentations of compressive lesions at the optic chiasm, we describe a monocular, ipsilateral compressive superior nasal defect and asymmetric cupping as the presenting sign of a junctional compressive lesion mimicking glaucomatous cupping.
Descent of Bacteria and Eukarya From an Archaeal Root of Life
Authors: Long Xi , Xue Hong , Wong J Tze-Fei
Published: June 2020

The 3 biological domains delineated based on small subunit ribosomal RNAs (SSU rRNAs) are confronted by uncertainties regarding the relationship between Archaea and Bacteria, and the origin of Eukarya. The similarities between the paralogous valyl-tRNA and isoleucyl-tRNA synthetases in 5398 species estimated by BLASTP, which decreased from Archaea to Bacteria and further to Eukarya, were consistent with vertical gene transmission from an archaeal root of life close to Methanopyrus kandleri through a Primitive Archaea Cluster to an Ancestral Bacteria Cluster, and to Eukarya. The predominant similarities of the ribosomal proteins (rProts) of eukaryotes toward archaeal rProts relative to bacterial rProts established that an archaeal parent rather than a bacterial parent underwent genome merger with bacteria to generate eukaryotes with mitochondria. Eukaryogenesis benefited from the predominantly archaeal accelerated gene adoption (AGA) phenotype pertaining to horizontally transferred genes from other prokaryotes and expedited genome evolution via both gene-content mutations and nucleotidyl mutations. Archaeons endowed with substantial AGA activity were accordingly favored as candidate archaeal parents. Based on the top similarity bitscores displayed by their proteomes toward the eukaryotic proteomes of Giardia and Trichomonas, and high AGA activity, the Aciduliprofundum archaea were identified as leading candidates of the archaeal parent. The Asgard archaeons and a number of bacterial species were among the foremost potential contributors of eukaryotic-like proteins to Eukarya.
Investigation of the role of tribolayer formation in improving drilling performance of Ti-6Al-4V using minimum quantity of lubrication
Authors: Bhowmick S , Eskandari B , Khan MZU , Alpas AT
Published: June 2020

Relationships between tribological properties of Ti-6Al-4V and the machining behaviour of the same alloy drilled by a WC-Co cutting tool using minimum quantity lubrication (MQL) were studied. The tribological behaviour of Ti-6Al-4V sliding against WC-Co was evaluated by determining the changes in the coefficient of friction (COF) using cutting fluids employed in MQL and flooded drilling tests. When pin-on-disk tests were carried out under the boundary lubricated condition, the MQL fluid (MQLF) provided a low COF of 0.16 at 25 ℃ and 0.24 at 250 ℃. The observed low COFs were attributed to formation of a tribolayer on the WC-Co counterfaces. A high COF of 0.45 observed at 300 ℃ indicated that the tribolayer was no longer stable. Application of conventional water-based cutting fluid (CF) also resulted in a low COF of 0.26 at 25 ℃ but the COF rose to 0.32 at 100 ℃. During drilling tests, MQLF was supplied at a rate of 80 ml/h using an external MQL system. The average drilling torque was reduced by 35% compared to CF as a result of the formation of tribolayer on the cutting edge of the tool as well as on the drilled hole surfaces, as the cutting temperature remained <250 ℃. According to Raman and X-ray photoelectron spectroscopy (XPS) analyses, the tribolayer on the drilled hole surface was formed as a result of degradation of additives in the MQL. The presence of phosphate- and sulfate-based anti-wear components in the tribolayer proved to be beneficial in preventing metal-metal contacts during drilling and provided a low COF. The low COF between tool-workpiece contact resulted in a low and uniform torque response throughout the drilling cycles and prevention of built-up edge (BUE) formation, leading to an improved surface finish.
Medical students’ perceptions and expectations regarding digital health education and training: A qualitative study
Authors: Edirippulige Sisira , Gong Sophie , Hathurusinghe Malshi , Jhetam Sarah , Kirk Jasmine , Lao Henry , Leikvold Annalise , Ruelcke Jayde , Yau Nim Chi , Zhang Qichen , Armfield Nigel , Senanayake Buddhika , Zhou Xiaoyun , Smith Anthony C , Judd Madelaine-Marie , Coulthard Mark G
Published: June 2020

Introduction

Digital health – the convergence of digital technologies within health and health care to enhance the efficiency of health-care delivery – is fast becoming an integral part of routine medical practice. The integration of digital health into traditional practice brings significant changes. Logic dictates that for medical practitioners to operate in this new digitally enabled environment, they require specific knowledge, skills and competencies relating to digital health. However, very few medical programmes in Australia and globally include digital health within their regular curriculum. This pilot study aimed to explore medical students’ perceptions and expectations of digital health education and training (ET).

Methods

An online survey and focus groups were used to collect information about medical students’ perceptions and expectations relating to digital health and ET relating to this field within the medical programme at the University of Queensland. Sixty-three students took part in the survey, and 17 students were involved in four focus groups.

Results

Most participants had no formal ET in digital health. Most participants ( n = 43; 68%) expressed a willingness to learn about digital health as part of their medical programme.

Discussion

Primarily, knowledge- and practice-related factors have motivated students to learn about digital health. The analysis of focus group data identified two superordinate themes: (a) drivers of digital health ET and (b) expectations relating to digital health ET. Students agreed that digital health is a relevant field for their future practice that should be taught as part of their regular curriculum.
A parametric study of long-span triple-tower suspension bridge
Authors: Lijun Jia , Jinliang Wang , Yang Jiang , Rong Xu
Published: June 2020

A sufficient understanding of the mechanical performance of long-span triple-tower suspension bridge is essential for practical design as such bridge is significantly different from traditional suspension bridges because of the flexible middle tower. Accordingly, a parametric study of a triple-tower suspension bridge with main span of 2000 m is performed in this article. Based on finite-element analysis method, influences of several structural parameters on mechanical performance are investigated, including connection between tower and girder, ratio of beam height to span and beam width to span, which would provide reference and help for parameter selection in preliminary design.
Out of obscurity: The contemporary private investigator in Australia
Authors: King Michael
Published: June 2020

The business of private investigation has grown significantly in the past two decades. No longer can private investigating be considered an obscure form of private policing. Yet, despite the recent growth of interest in private policing, little research has been conducted on the services provided by private investigators. This article presents the results of an analysis of 33 in-depth interviews with Australian private investigators in Queensland, New South Wales and Victoria. The article discusses their contemporary role in the context of providing justice, public policing and future regulatory challenges. The article extends the limited research on the services private investigators provide, including corporate fraud and financial investigations, risk advisory, and cyber and misconduct investigations. It identifies their backgrounds and education, and describes their clients. The study found that, contrary to expectations, to meet these new services, private investigators are now highly qualified academically and professionally. It was found that regulatory gaps have been created in the licensing of contemporary private investigators, and the use of private investigators allows clients to sidestep the justice system.
‘Tightness’, recognition and penal power
Authors: Crewe Ben , Ievins Alice
Published: June 2020

Prison scholarship has tended to focus on the pains and frustrations that result from the use and over-use of penal power. Yet the absence of such power and the subjective benefits of its grip are also worthy of attention. This article begins by drawing on recent literature and research findings to develop the concept of ‘tightness’ beyond its initial formulation. Drawing primarily on data from a study of men convicted of sex offences, it goes on to explain that, in some circumstances, the reach and hold of penal power are not experienced as oppressive and undesirable, and, indeed, may be welcomed. Conversely, institutional inattention and an absence of grip may be experienced as painful. Prisons, then, can be ‘loose’ or ‘lax’ as well as ‘tight’. The article then discusses the different ways in which prisons exercise grip, and, in doing so, recognise or misrecognise the subjectivity of the individual prisoner. It concludes by identifying the connections between this ‘ground-up’ analysis of the relative legitimacy of different forms of penal intervention and recent discussions in penal theory about the proper role of the state in communicating censure and promoting personal repentance and change.
Spiritualizing reason, rationalizing spirit: Muslim public intellectuals in the German far right
Authors: Göpffarth Julian , Özyürek Esra
Published: June 2020

Muslim, ex-Muslim as well as converted Muslim intellectuals are increasingly prominent figures in the West European far-right movement. By analysing their publications and online presence, we observe that concepts utilized by Muslim-background intellectuals popular in the German far right build on two seemingly contradictory tropes of German national identity—rationality and spirituality—and a civilizationism that oscillates between notions of rational liberalism and an illiberalism based on spiritualism. As these intellectuals combine the tropes of German nationhood and European civilisation, the far right builds connections with the growing Muslim demographic in Germany. The movement provides space for a variety of Muslim-background intellectuals: those who embrace a secular-liberal self-description emphasize how rationalism is synonymous with Germanness, while those who embrace a religious self-description critique liberal rationalism as lacking spirit. In so doing, Muslim public intellectuals help the far right to simultaneously spiritualize national reason and rationalize national spirit.
Reconnecting Youth: Beyond Individualized Programs and Risks
Authors: Myers Randy , Goddard Tim , Davidtz Jennifer
Published: June 2020

Presently in the United States, cognitive behavioral approaches are thought to be one of the most effective ways to intervene in the lives of young people in trouble with the law. However, such individualized approaches to youth in trouble with the law, and the risk-based logics that accompany them, say some, often ignore the relationships that young people have with caregivers, as well as the broader social ecological, economic and political contexts within which those relationships develop. Once the individual change work is completed, young people must have productive roles and supportive relationships to return to, especially if we want youth justice practice to translate into justice for youth. Given that meaningful attachments with others serve as the primary context within which individuals learn to regulate emotions and behaviors, youth justice policy and practice ought to seek to repair the capacity to attach and relate –and broader social policy reforms must address the social and economic inequalities that make the adversity and harm that undermine that capacity more likely. In this article, we discuss the limitations of over-relying on skills-based therapies and examine how the neglect of social, material and relational contexts can undermine the meaning and effectiveness of youth justice interventions. Following this, we describe how a youth justice system that attends to relational needs and structural inequalities might better meet the needs of young people.
An accurate triangular spectral element method-based numerical simulation for acoustic problems in complex geometries
Authors: Ye Ximeng , Qin Guoliang , Wang Yazhou
Published: June 2020

An accurate triangular spectral element method (TSEM) is developed to simulate acoustic problems in complex computational domains. With Fekete points and Koornwinder-Dubiner polynomials introduced, triangular elements are used in the present method to substitute quadrilateral elements in traditional spectral element method (SEM). The efficiency of discretizing complex geometry is enhanced while high accuracy of SEM is remained. The weak form of the second-order governing equations derived from the linearized Euler equations (LEEs) are solved, and perfectly matched layer (PML) boundary condition is implemented. Three benchmark problems with analytical solutions are employed to testify the exponential convergence rate, convenient implementation of solid wall boundary condition and capable discretization in complex geometries of the present method respectively. An application on Helmholtz resonator (HR) is presented as well to demonstrate the possibility of using the present method in practical engineering. The numerical resonance frequency of HR reaches an excellent agreement with the theoretical result.
Using Memoirs and Autobiographies To Enhance the Teaching of Abnormal Child Psychology
Authors: Phares Vicky
Published: June 2020

Memoirs and autobiographies can be rich sources of real-world information for students in psychology classes. These resources have been used in adult-oriented abnormal psychology classes, but have yet to be explored for use in courses on abnormal child psychology. This manuscript reviews the use of memoirs and autobiographies in adult-oriented abnormal psychology classes and then explores the use of memoirs and autobiographies in abnormal child psychology classes. In the Appendix, lists of memoirs and autobiographies are provided that instructors can use as a resource in the selection of books for abnormal child psychology classes. Data are analyzed regarding undergraduate students’ opinions about the use of memoirs in an abnormal child psychology class and an investigation of learning outcomes for classes with and without assigned memoirs is provided. Overall, the use of memoirs and autobiographies appears to be a promising way of enhancing the teaching of abnormal child psychology.
Still an ‘invisible crime’? Exploring developments in the awareness and control of human trafficking in Scotland
Authors: Atkinson Colin , Hamilton-Smith Niall
Published: June 2020

In 2010 Korin Lebov published her article ‘Human trafficking in Scotland’, a state-of-the-field piece that reported on the nature and extent of human trafficking and the challenges in tackling this issue. Several important developments have occurred in the period since, including new enforcement measures, the first prosecutions and convictions for human trafficking in Scottish courts, the establishment of a dedicated policing unit within Scotland’s new police service to tackle such crimes, the passage of specific human trafficking legislation through the Scottish Parliament, and, as a direct result of this legislation, the publication of a bespoke strategy by the Scottish Government to take action against human trafficking and support victims. This article draws upon the findings of a qualitative research study exploring the community impact of organized crime in Scotland and, in doing so, refracts advances in both public awareness of human trafficking and the policing response to this issue through the analytical prism of ‘invisible crimes’. Ultimately, it traces the path of human trafficking from a peripheral and largely ‘invisible’ phenomenon to becoming a core issue of concern in Scotland’s policing and community safety landscape.
Prevalence of sexual violence: A comparison of estimates from UK national surveys
Authors: Brunton-Smith Ian , Flatley John , Tarling Roger
Published: June 2020

Accurately measuring the prevalence of sexual violence is difficult. Police-recorded crime figures are known to underestimate the true extent of sexual violence, and so researchers have tended to rely on survey estimates instead. But estimates from surveys are not uniform, with recent estimates from the UK National Survey of Sexual Attitudes and Lifestyles apparently twice as large as official figures from the major crime surveys (the Crime Survey for England and Wales and the Scottish Crime and Justice Survey). In this study we use harmonized data from these three surveys and the UK component of the EU Violence Against Women Survey to explore the features of the surveys that may have contributed to these differences.
Early Advanced Therapy for Diabetic Foot Ulcers in High Amputation Risk Veterans: A Cohort Study
Authors: Doucette Margaret , Payne Kattie M. , Lough Walter , Beck Alison , Wayment Kristi , Huffman John , Bond Laura , Thomas-Vogel Aurora , Langley Susan
Published: June 2020

Veterans with diabetic foot ulcers (DFUs) represent the highest percentage of lower extremity amputations (LEAs) within the Veterans Affairs (VA) population. Many veterans have additional risk factors for amputation. Few studies focus on advanced therapies for this population. This study explores the impact of early application of dehydrated human amniotic membrane allograft (DAMA) with comprehensive care on preventing amputation. This prospective, single-center cohort study (ClinicalTrials.gov Identifier NCT02632929) was conducted through Boise VA Medical Center. Patients with DFUs were objectively stratified for LEA risk. Those with moderate to high amputation risk could participate. Participants received comprehensive care and weekly application of DAMA. Primary endpoint was avoidance of major LEA. Secondary endpoint was wound epithelialization. Monitoring continued 4 months. Between July 2015 and March 2017, 20 patients (mean age 67.2 years) with 24 DFU classified as moderate (12 wounds) to high risk (12 wounds) for amputation were enrolled. Wound volumes ranged from 0.072 cm3 to 56.4 cm3. Risk factors included neuropathy (20 patients), osteomyelitis (16 wounds), exposed tendon/ligament/bone (19 wounds), Charcot (5 patients), and peripheral arterial disease (13 wounds). All subjects avoided amputation within the study period, all 24 wounds achieved re-epithelialization within 4 to 33 weeks; mean healing time 13.2 weeks. Cost for the DAMA tissue ranged from $750 to $38 150. Estimated cost for LEA ranges from $30 000 to $50 000. No treatment-related adverse events during the study period were reported. The results suggest that early and frequent application of DAMA with comprehensive care may help prevent amputation. Additional research will help inform third-party payors and clinicians.
Efficacy of Ethyl Acetate Fraction of Cordyceps militaris for Cancer-Related Fatigue in Blood Biochemical and 1H-Nuclear Magnetic Resonance Metabolomic Analyses
Authors: Oh Junsang , Choi Eunhyun , Kim Jayoung , Kim Heesu , Lee Sangheun , Sung Gi-Ho
Published: June 2020

This study investigated the adjuvant effects for anticancer and antifatigue of the combination of Cordyceps militaris extract with sorafenib. The 5 extracts of C militaris were obtained through hexane, chloroform, ethyl acetate, butanol, and water and were evaluated for anticancer growth activity. Among these extracts, ethyl acetate extract of C militaris showed the best tumor growth inhibitory activity and the adjuvant effects in combination with sorafenib. As a result of biochemical analysis with serum, the combination of ethyl acetate extract of C militaris with sorafenib showed the adjuvant effects both improving hepatic function and relieving cancer-related fatigue. In addition, 1H-nuclear magnetic resonance–based metabolic profiling in liver tissues showed that the change of metabolism by ethyl acetate extract of C militaris with sorafenib was related with serum fatigue biomarkers. Therefore, the combination strategy such as ethyl acetate extraction of C militaris with sorafenib constitutes a promising therapeutic strategy in hepatocellular carcinoma, via the inhibition of cancer growth, the enhancement of liver function, as well as the alleviation of cancer-related fatigue.
The future of Stalinist art: Muñoz’s queer theory and the decontextualization of history
Authors: Popa Bogdan
Published: June 2020

In this article, I reinterpret the Romanian film The Valley Resounds ( Răsună valea, Călinescu 1949) to challenge reductive explanations of Stalinist art as totalitarian and suggest a novel use of socialist artworks in the era of digital capitalism. In advancing a practice of decontextualization, I claim that Marxist films need to be reinscribed in new art contexts so that they could generate utopian desires about sexuality and radical politics. Given that socialist realist productions function not unlike José Esteban Muñoz’s queer practices of dis-identification, I argue that Stalinist films offer an archive that calls for the abolition of capitalist sex roles.
The ratio processing system and its role in fraction understanding: Evidence from a match-to-sample task in children and adults with and without dyscalculia
Authors: Bhatia Parnika , Delem Maël , Léone Jessica , Boisin Esther , Cheylus Anne , Gardes Marie-Line , Prado Jérôme
Published: June 2020

It has been hypothesised that the human neurocognitive architecture may include a perceptual ratio processing system (RPS) that supports symbolic fraction understanding. In the present study, we aimed to provide further evidence for the existence of the RPS by exploring whether individuals with a range of math skills are indeed perceptually sensitive to non-symbolic ratio magnitudes. We also aimed to test to what extent the RPS may underlie symbolic fraction processing in those individuals. In a match-to-sample task, typical adults, elementary school children, and adults with dyscalculia were asked to match a non-symbolic ratio (i.e., target) to one of two non-symbolic ratios (i.e., the match and distractor). We found that all groups of participants were sensitive to the ratio between the match and the distractor, suggesting a common reliance on the RPS. This ratio sensitivity was also observed in another group of typical adults who had to choose which of two symbolic fractions match a non-symbolic ratio, indicating that the RPS may also contribute to symbolic fraction understanding. However, no ratio dependence was observed when participants had to choose which of two symbolic fractions match another symbolic fraction, suggesting that reliance on the RPS in symbolic fraction processing is limited and may not support exact fraction processing.
Surgical and local treatment of hepatic metastasis in pancreatic ductal adenocarcinoma: recent advances and future prospects
Authors: Jin Tianqiang , Dai Chaoliu , Xu Feng
Published: June 2020

Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease with increasing incidence and mortality. More than half of PDAC patients develop metastases, with the liver being the most common site. Patients with pancreatic ductal adenocarcinoma with liver metastases (PCLM) have a very limited scope for surgery due to aggressive tumor behavior and poor prognosis. However, with the improvements in preoperative systemic therapy and perioperative outcomes, an increasing number of patients are being considered for surgical management. However, the best choice of surgical treatment and criteria for selecting suitable PCLM patients who may benefit from surgical treatment remains controversial. Palliative local treatments, such as ablation, locoregional chemotherapy, and brachytherapy, which are less invasive and have fewer contraindications and complications, are the preferred alternatives to surgery. The present study reviews the advances in the management of PCLM, with focus on resection and local therapies.
Cardiac injury is associated with severe outcome and death in patients with Coronavirus disease 2019 (COVID-19) infection: A systematic review and meta-analysis of observational studies
Authors: Parohan Mohammad , Yaghoubi Sajad , Seraji Asal
Published: June 2020

Coronavirus disease 2019 (COVID-19) is a global pandemic impacting 213 countries/territories and more than 5,934,936 patients worldwide. Cardiac injury has been reported to occur in severe and death cases. This meta-analysis was done to summarize available findings on the association between cardiac injury and severity of COVID-19 infection. Online databases including Scopus, PubMed, Web of Science, Cochrane Library and Google Scholar were searched to detect relevant publications up to 20 May 2020, using relevant keywords. To pool data, a fixed- or random-effects model was used depending on the heterogeneity between studies. In total, 22 studies with 3684 COVID-19 infected patients (severe cases=1095 and death cases=365) were included in this study. Higher serum levels of lactate dehydrogenase (weighted mean difference (WMD) =108.86 U/L, 95% confidence interval (CI)=75.93–141.79, p<0.001) and creatine kinase-MB (WMD=2.60 U/L, 95% CI=1.32–3.88, p<0.001) were associated with a significant increase in the severity of COVID-19 infection. Furthermore, higher serum levels of lactate dehydrogenase (WMD=213.44 U/L, 95% CI=129.97–296.92, p<0.001), cardiac troponin I (WMD=26.35 pg/mL, 95% CI=14.54–38.15, p<0.001), creatine kinase (WMD=48.10 U/L, 95% CI=0.27–95.94, p = 0.049) and myoglobin (WMD=159.77 ng/mL, 95% CI=99.54–220.01, p<0.001) were associated with a significant increase in the mortality of COVID-19 infection. Cardiac injury, as assessed by serum analysis (lactate dehydrogenase, cardiac troponin I, creatine kinase (-MB) and myoglobin), was associated with severe outcome and death from COVID-19 infection.
Cyborg finance mirrors cyborg social media
Authors: Ajji Kamel
Published: June 2020

This article aims at showing the similarities between the financial and the tech sectors in their use and reliance on information and algorithms and how such dependency affects their attitude towards regulation. Drawing on Pasquale’s recommendations for reform, it sets out a proposal for a constant and independent scrutiny of internet service providers.
Personalization as a promise: Can Big Data change the practice of insurance?
Authors: Barry Laurence , Charpentier Arthur
Published: June 2020

The aim of this article is to assess the impact of Big Data technologies for insurance ratemaking, with a special focus on motor products.The first part shows how statistics and insurance mechanisms adopted the same aggregate viewpoint. It made visible regularities that were invisible at the individual level, further supporting the classificatory approach of insurance and the assumption that all members of a class are identical risks. The second part focuses on the reversal of perspective currently occurring in data analysis with predictive analytics, and how this conceptually contradicts the collective basis of insurance. The tremendous volume of data and the personalization promise through accurate individual prediction indeed deeply shakes the homogeneity hypothesis behind pooling. The third part attempts to assess the extent of this shift in motor insurance. Onboard devices that collect continuous driving behavioural data could import this new paradigm into these products. An examination of the current state of research on models with telematics data shows however that the epistemological leap, for now, has not happened.
TLR-mediated activation of Waldenström macroglobulinemia B cells reveals an uncoupling from plasma cell differentiation
Authors: Shrimpton Jennifer , Care Matthew A. , Carmichael Jonathan , Walker Kieran , Evans Paul , Evans Charlotte , de Tute Ruth , Owen Roger , Tooze Reuben M. , Doody Gina M.
Published: June 2020

Waldenström macroglobulinemia (WM) is a rare malignancy in which clonal B cells infiltrate the bone marrow and give rise to a smaller compartment of neoplastic plasma cells that secrete monoclonal immunoglobulin M paraprotein. Recent studies into underlying mutations in WM have enabled a much greater insight into the pathogenesis of this lymphoma. However, there is considerably less characterization of the way in which WM B cells differentiate and how they respond to immune stimuli. In this study, we assess WM B-cell differentiation using an established in vitro model system. Using T-cell–dependent conditions, we obtained CD138+ plasma cells from WM samples with a frequency similar to experiments performed with B cells from normal donors. Unexpectedly, a proportion of the WM B cells failed to upregulate CD38, a surface marker that is normally associated with plasmablast transition and maintained as the cells proceed with differentiation. In normal B cells, concomitant Toll-like receptor 7 (TLR7) activation and B-cell receptor cross-linking drives proliferation, followed by differentiation at similar efficiency to CD40-mediated stimulation. In contrast, we found that, upon stimulation with TLR7 agonist R848, WM B cells failed to execute the appropriate changes in transcriptional regulators, identifying an uncoupling of TLR signaling from the plasma cell differentiation program. Provision of CD40L was sufficient to overcome this defect. Thus, the limited clonotypic WM plasma cell differentiation observed in vivo may result from a strict requirement for integrated activation.
Pharmacologic thromboprophylaxis in adult patients undergoing neurosurgical interventions for preventing venous thromboembolism
Authors: Yepes-Nuñez Juan José , Rajasekhar Anita , Rahman Maryam , Dahm Philipp , Anderson David R. , Colunga-Lozano Luis Enrique , Ross Stephanie , Bhatt Meha , Orozco Kelly Estrada , Popoff Federico , Ventresca Matthew , Barbara Angela M. , Balduzzi Sara , Begum Housne , Agarwal Arnav , Wiercioch Wojtek , Nieuwlaat Robby , Morgano Gian Paolo , Schünemann Holger J.
Published: June 2020

The impact of pharmacologic prophylaxis for venous thromboembolism in patients undergoing neurosurgical intervention remains uncertain. We reviewed the efficacy and safety of pharmacologic compared with nonpharmacologic thromboprophylaxis in neurosurgical patients. Three databases were searched through April 2018, including those for randomized controlled trials (RCTs) and for nonrandomized controlled studies (NRSs). Independent reviewers assessed the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Seven RCTs and 3 NRSs proved eligible. No studies reported on symptomatic proximal and distal deep vein thrombosis (DVT). Two RCTs reported on screening-detected proximal and distal DVTs. We used the findings of these 2 RCTs as the closest surrogate outcomes to inform the proximal and distal DVT outcomes. These 2 RCTs suggest that pharmacologic thromboprophylaxis may decrease the risk of developing asymptomatic proximal DVT (relative risk [RR], 0.50; 95% confidence interval [CI], 0.30-0.84; low certainty). Findings were uncertain for mortality (RR, 1.27; 95% CI, 0.57-2.86; low certainty), symptomatic pulmonary embolism (PE) (RR, 0.84; 95% CI, 0.03-27.42; very low certainty), asymptomatic distal DVT (RR, 0.54; 95% CI, 0.27-1.08; very low certainty), and reoperation (RR, 0.43; 95% CI, 0.06-2.84; very low certainty) outcomes. NRSs also reported uncertain findings for whether pharmacologic prophylaxis affects mortality (RR, 0.72; 95% CI, 0.46-1.13; low certainty) and PE (RR, 0.18; 95% CI, 0.01-3.76). For risk of bleeding, findings were uncertain in both RCTs (RR, 1.57; 95% CI, 0.70-3.50; low certainty) and NRSs (RR, 1.45; 95% CI, 0.30-7.12; very low certainty). In patients undergoing neurosurgical procedures, low certainty of evidence suggests that pharmacologic thromboprophylaxis confers benefit for preventing asymptomatic (screening-detected) proximal DVT with very low certainty regarding its impact on patient-important outcomes.