bluuebunny/crossref_metadata_2025 huggingface dataset:
“Song of Life”: Results of a multicenter randomized trial on the effects of biographical music therapy in palliative care
Authors: Warth Marco , Koehler Friederike , Brehmen Martin , Weber Martin , Bardenheuer Hubert J , Ditzen Beate , Kessler Jens
Published: April 2021

Background:

Awareness for the importance of psychological and spiritual needs in patients with terminal diseases has increased in recent years, but randomized trials on the effects of psychosocial interventions are still rare.

Aim:

To investigate the efficacy of the “Song of Life” music therapy intervention regarding the emotional and psycho-spiritual dimensions of quality of life.

Design:

Patients were randomly assigned to either “Song of Life” or a relaxation intervention. “Song of Life” is a novel three-session music therapy intervention working with a biographically meaningful song. Primary outcome was the improvement in psychological quality of life. Secondary outcomes included spiritual well-being, ego-integrity, momentary distress, and global quality of life and the explorative assessment of treatment satisfaction (patient and family member version). Intention-to-treat analysis was conducted including adjustment for multiple testing in secondary outcomes.

Setting/participants:

Between December 2018 and August 2020, 104 patients receiving specialized palliative care were recruited from two palliative care wards.

Results:

No significant differences were found regarding psychological and global quality of life, but “Song of Life” participants reported significantly higher spiritual well-being ( p = 0.04) and ego-integrity ( p < 0.01), as well as lower distress ( p = 0.05) than patients in the control group. Both patients’ and family members’ treatment satisfaction was higher after “Song of Life” with large between-group effect sizes on items asking for meaningfulness ( d = 0.96) and importance ( d = 1.00).

Conclusions:

Our findings provide evidence that “Song of Life” is an effective and meaningful biographical music therapy intervention to facilitate psycho-spiritual integration in terminally ill patients.

Trial Registration:

German Clinical Trials Register (DRKS)—DRKS00015308 (date of registration: September 7th 2018).
Towards 3D LiDAR-based semantic scene understanding of 3D point cloud sequences: The SemanticKITTI Dataset
Authors: Behley Jens , Garbade Martin , Milioto Andres , Quenzel Jan , Behnke Sven , Gall Jürgen , Stachniss Cyrill
Published: April 2021

A holistic semantic scene understanding exploiting all available sensor modalities is a core capability to master self-driving in complex everyday traffic. To this end, we present the SemanticKITTI dataset that provides point-wise semantic annotations of Velodyne HDL-64E point clouds of the KITTI Odometry Benchmark. Together with the data, we also published three benchmark tasks for semantic scene understanding covering different aspects of semantic scene understanding: (1) semantic segmentation for point-wise classification using single or multiple point clouds as input; (2) semantic scene completion for predictive reasoning on the semantics and occluded regions; and (3) panoptic segmentation combining point-wise classification and assigning individual instance identities to separate objects of the same class. In this article, we provide details on our dataset showing an unprecedented number of fully annotated point cloud sequences, more information on our labeling process to efficiently annotate such a vast amount of point clouds, and lessons learned in this process. The dataset and resources are available at http://www.semantic-kitti.org .
Childhood cancer in Italy: background, goals, and achievements of the Italian Paediatric Hematology Oncology Association (AIEOP)
Authors: Zecca Marco , Ferrari Andrea , Quarello Paola , Rabusin Marco , Balduzzi Adriana , Buldini Barbara , Rostagno Elena , Prete Arcangelo , Favre Claudio , Massimino Maura , Biondi Andrea , Porta Fulvio , Biffi Alessandra , Locatelli Franco , Pession Andrea , Fagioli Franca
Published: April 2021

This article reviews the primary goals and achievements of the Italian Association for Pediatric Hematology-Oncology (Associazione Italiana Ematologia Oncologia Pediatrica [AIEOP]), a national cooperative group that has been working for children and adolescents with cancer in Italy since 1975.
Controversies on the possible role of immune checkpoint inhibitors in pediatric cancers: balancing irAEs and efficacy
Authors: Nigro Olga , Ferrari Andrea , Casanova Michela , Orbach Daniel , Leruste Amaury , Gatz Susanne A. , Frappaz Didier , Massimino Maura
Published: April 2021

Pediatric cancers are not the equivalent of adult cancers occurring at a younger age and the prospect of immunotherapy in children has not been received with the same enthusiasm as in the adult setting. Although most pediatric malignancies are considered immunologically cold, we are learning more about PD-L1 expression, tumor mutational burden, and microsatellite instability in several pediatric cancers. The side effects of immunotherapy are an important consideration. Immune checkpoint inhibitors (ICIs) engender a unique constellation of inflammatory toxicities known as immune-related adverse events (irAEs). Three early-phase trials—KEYNOTE-051, iMATRIX, and ADVL1412—were the first to describe irAEs in pediatric patients and ICIs were well tolerated. There was concern about unknown late irAEs in pediatric patients, as they have much more time to develop than in adult or elderly patients. Academic clinicians, biopharmaceutical companies, and parents’ advocates concluded that no benefit could be expected from further monotherapy trials employing other ICIs with the same mechanism of action until more scientific knowledge becomes available. On the other hand, ICIs could be useful in combination with other therapies to prevent the functional inactivation of several pathways in the hostile microenvironment. Future clinical studies on ICIs in children need to build on strong biological premises, taking into account the distinctive immunobiology of pediatric cancers vis-à-vis ICI-responsive adult cancers. We need to gain and share experiences of new therapies for managing pediatric patients with cancer, clarifying to what extent we can extrapolate the data obtained in adults.
Face the music: Children’s facial affect in musical imitation and improvisation tasks
Authors: Bugos Jennifer , DeMarie Darlene , Torres Miranda , Fuller Nicole
Published: April 2021

The purpose of this study was to examine facial affect of young children who completed a singing task that included imitation and improvisation. Eighty-nine children (4–6 years: 45 male and 44 female participants) completed three singing conditions from a standard singing test battery (i.e., Advancing Interdisciplinary Research in Singing-Test Battery of Singing Skills [AIRS-TBSS]). These included singing a favorite song, imitating a song, and improvising a song ending. Facial affect was analyzed with Noldus FaceReader software, and subjective responses also were collected. Results revealed children exhibited a happy emotion most prominently during the improvisation and favorite song conditions compared with the imitation condition. However, a higher percentage of surprised emotions were found during the imitation condition. Frequency analysis revealed a significantly different range and final note for the improvisation condition compared with imitation. Children’s self-reported ratings of happiness were related to their displayed facial affect (i.e., happiness) scores in FaceReader ( p < .05). Qualitative data analysis revealed three emerging themes of song familiarity, object association, and song preference. Children exhibited more positive affect when singing a favorite song or improvising. Based on the type of vocal performance task, it is necessary to consider how young children respond to vocal tasks.
Using Probabilistic Fault Tree Analysis and Monte Carlo Simulation to Examine the Likelihood of Risks Associated with Ballasted Railway Drainage Failure
Authors: Usman Kristianto , Peter Nicholas Burrow Michael , Singh Ghataora Gurmel , Sasidharan Manu
Published: April 2021

Inadequate track drainage can lead to a variety of issues, including flooding, accelerated track degradation, and progressive or sudden failure of railway track, slope, or embankment. These can result in unplanned track maintenance, additional passenger travel costs, and damage to third party property. However, railway drainage asset management is challenging because it involves the consideration of large interconnected assets, limited maintenance budgets, and unknown failure probabilities. To address this issue, this paper introduces a risk-informed approach for railway drainage asset management that uses fault tree analysis to identify the factors that contribute to railway drainage flood risk and quantifies the likelihood of the occurrence of these factors using Monte Carlo simulation. This rational approach enables drainage asset managers to evaluate easily the factors that affect the likelihood of railway track drainage failure, thereby facilitating the prioritization of appropriate mitigation measures and in so doing improve the allocation of scarce maintenance resources. The analysis identified 46 basic and 49 intermediate contributing factors associated with drainage failure of ballasted railway track (undesired event). The usefulness of the approach is demonstrated for three sites on the UK railway network, namely, Ardsley Tunnel, Clay Cross Tunnel, and Draycott. The analysis shows that the Clay Cross Tunnel had the highest probability of drainage failure and should be prioritized for maintenance over the other two sites. The maintenance required should focus on blockages because of vegetation overgrowth or debris accumulation.
Chronotype-specific Sleep in Two Versus Four Consecutive Shifts
Authors: Fischer Dorothee , Roenneberg Till , Vetter Céline
Published: April 2021

The study aimed to explore chronotype-specific effects of two versus four consecutive morning or night shifts on sleep-wake behavior. Sleep debt and social jetlag (a behavioral proxy of circadian misalignment) were estimated from sleep diary data collected for 5 weeks in a within-subject field study of 30 rotating night shift workers (29.9 ± 7.3 years, 60% female). Mixed models were used to examine whether effects of shift sequence length on sleep are dependent on chronotype, testing the interaction between sequence length (two vs. four) and chronotype (determined from sleep diaries). Analyses of two versus four morning shifts showed no significant interaction effects with chronotype. In contrast, increasing the number of night shifts from two to four increased sleep debt in early chronotypes, but decreased sleep debt in late types, with no change in intermediate ones. In early types, the higher sleep debt was due to accumulated sleep loss over four night shifts. In late types, sleep duration did not increase over the course of four night shifts, so that adaptation is unlikely to explain the observed lower sleep debt. Late types instead had increased sleep debt after two night shifts, which was carried over from two preceding morning shifts in this schedule. Including naps did not change the findings. Social jetlag was unaffected by the number of consecutive night shifts. Our results suggest that consecutive night shifts should be limited in early types. For other chronotypes, working four night shifts might be a beneficial alternative to working two morning and two night shifts. Studies should record shift sequences in rotating schedules.
The role and relevance of public private partnerships in English healthcare
Authors: Tonge Alison
Published: April 2021

Health systems are now organized across England to deliver a more integrated population-based approach, not competing for services, rather collaborating and driving better value for the population from a fixed resource. This approach of health system leadership and collaboration has resulted in governance including a mixed economy of public-private provision but with greater alignment to delivering an agreed set of outcomes and value-based healthcare for the population. This dramatic shift from provider competition to collaboration and integration means a reframing of contracting and partnerships with the independent sector.
Nonprofit Online Responsiveness: An Exploratory Field Experiment in China
Authors: Nie Lin , Lam Wai-Fung
Published: April 2021

This article assesses sources of nonprofit responsiveness and identifies potential drivers for responsiveness, using an online field experiment involving philanthropic foundations in China ( N = 3,254). Baseline requests were sent out to the foundations through emails and vignettes were applied to treatment groups by inserting different identity claims or prompts into the contents of the emails. Experimental results showed that, compared with the control group, potential donors were more likely to receive responses, claims concerning government ties or media backgrounds resulted in fewer responses, and citing legal obligations could increase the odds of receiving satisfactory responses. Interpreting the results with reference to stakeholder salience theory, we argue that potential donors are the most salient stakeholders to foundations. Donor requests and legal obligations are the most effective forces driving foundations’ responsiveness in China.
Experimental investigation of the effect of machinability on surface quality and vibration in hard turning of hardened AISI 4140 steels using ceramic cutting tools
Authors: Kam Menderes , Şeremet Musa
Published: April 2021

In industry, hardened steels are used in manufacturing of the products such as machine parts and components. In this context, surface quality and vibration play a significant role for control of cutting parameters and cutting conditions in turning process of hardened steel materials. In this study, it was aimed to investigate the effect of machinability on surface quality (Ra and Rz) and vibration in hard turning of conventional heat treated (CHT) and tempered (T) AISI 4140 (42CrMo4) steel samples using ceramic cutting tools under dry environment. They were selected as cutting parameters; four different cutting speeds (120, 160, 200, and 240 m/min), three different feed rates (0.05, 0.10, and 0.15 mm/rev), and depth of cut (0.2 mm). To make the turning process more efficient and to measure the occurring vibrations, the data were obtained online from the ceramic cutting tool by accelerometers in three axes (x-Ch1, y-Ch2, and z-Ch3 directions). In addition, test results of hardness, tensile, microstructure images, Ra - Rz values, and chip thickness values of the experiment samples were analyzed and compared. With the microstructure obtained after the tempering process applied to the T sample, it was seen that it is more machinable and affects the surface quality - vibration positively. The results showed that the most important cutting parameter affecting vibration and surface quality was found to be the feed rate. The lowest Ra value was found as 0.144 μm at 200 m/min of cutting speed and 0.05 mm/rev of feed rate in the T sample. The lowest vibration amplitude value (Ch3) was measured as 0.0023 gRMS (Root Mean Square) at 120 m/min of cutting speed and 0.05 mm/rev of feed rate. According to the Ra and Rz values found in the literature studies, better surface qualities were obtained in the present study.
Investigating ERP Readiness Enablers and Inhibitors Among Egyptian Higher Education Institutions
Authors: Soliman Mohamed , Karia Noorliza
Published: April 2021

In light of higher education institutions (HEIs) need to implement intelligent, innovative systems for their digital strategic transformation to stay competitive, the enterprise resource planning (ERP) system can tailor solutions to such technological problems through its integration characteristic. The present study sheds light on the emergence of enablers and inhibitors, explaining technological readiness insight for ERP adoption. The study aims to understand better ERP readiness among HEIs to ease the substantial change required for the adoption process. The findings show a profound perception of ERP systems among 112 Egyptian HEIs, demonstrating that HEIs are technologically ready for adoption. Results reveal that HEIs have positive ERP readiness, although HEIs’ managers are still uncertain and expect some ERP inhibitors. Therefore, ERP adoption is principally contingent on perceiving enablers and eliminating any inhibitors comprising ERP technological readiness. This study delivers practical verification to the higher education context by advancing ERP concepts and characteristics from the HEIs’ perspective. This study, finally, suggests that ERP adoption is beneficial for HEIs
Retinopathy of Prematurity—Using Electronic Medical Records to Efficiently Follow Patients at Multiple Hospitals
Authors: Schultz Gwendolyn , Gaffar Majida
Published: April 2021

Purpose:

To report the use of a centralized electronic medical record (EMR) to provide timely retinopathy of prematurity (ROP) screening in a previously fragmented monitoring system in a standalone children’s hospital in Connecticut.

Methods:

A chart review of 306 visits for ROP screening in 3 neonatal intensive care units (NICUs) over a time period of 24 months.

Results:

All infants born at <30 weeks gestational age or birth weight <1,500g (N = 107) at these NICUs were screened for ROP according to the American Academy of Pediatrics guidelines. Data was collected before the implementation of our centralized EMR list, during a transitional period, and once the list was established. Our analysis of the data found an improvement in delay of care from 16.85% to 10.83% of visits, and a decrease in number of visits done during off hours from 20.4% to 5% of visits.

Conclusion:

Our tool was a free and cost-efficient centralization of a once difficult-to-manage process for ROP screenings in Connecticut. The decrease in delay of care and improvement in physician scheduling will lead to better outcomes for our patients and better sustainability of practice for our providers.
Supporting All Students: Productive Mathematical Discourse in Online Environments
Authors: Harbour Kristin E. , Denham André R.
Published: April 2021

Classroom instruction focused on discussion-based learning opportunities can provide productive and inclusive learning experiences for all students, including students with learning disabilities in mathematics and those without learning disabilities. Mathematical discourse allows students to share their ideas, justify their thinking, critique the reasoning of others, and refine their thought processes. While one might typically envision mathematical discourse happening during face-to-face instruction, meaningful discourse can also occur in online learning environments. This article presents a blended format of both synchronous and asynchronous learning opportunities, coupled with Smith and Stein’s (2018) “5 Practices” for productive mathematical discourse, to support teachers in designing and facilitating lessons in which all students are actively engaged in the learning processes both for themselves and their classmates.
A Longitudinal and Gender Invariance Analysis of the Strengths and Difficulties Questionnaire Across Ages 3, 5, 7, 11, 14, and 17 in a Large U.K.-Representative Sample
Authors: Murray Aja Louise , Speyer Lydia Gabriela , Hall Hildigunnur Anna , Valdebenito Sara , Hughes Claire
Published: April 2021

Developmental invariance is important for making valid inferences about child development from longitudinal data; however, it is rarely tested. We evaluated developmental and gender invariance for one of the most widely used measures of child mental health: the parent-reported Strengths and Difficulties Questionnaire (SDQ). Using data from the large U.K. population-representative Millennium Cohort Study ( N = 10,207; with data at ages 3, 5, 7, 11, 14, and 17 years), we tested configural, metric, scalar, and residual invariance in emotional problems, conduct problems, hyperactivity/inattention, prosociality, and peer problems. We found that the SDQ showed poor fit at age 3 in both males and females and at age 17 in males; however, it fit reasonably well and its scores were measurement invariant up to the residual level across gender at ages 5, 7, 11, and 14 years. Scores were also longitudinally measurement invariant across this age range up to the partial residual level. Results suggest that the parent-reported SDQ can be used to estimate developmental trajectories of emotional problems, conduct problems, hyperactivity/inattention, prosociality, and peer problems and their gender differences across the age range 5 to 14 years using a latent model. Developmental differences outside of this range may; however, partly reflect measurement differences.
Anticoagulation and In-Hospital Mortality From Coronavirus Disease 2019: A Systematic Review and Meta-Analysis
Authors: Moonla Chatphatai , Sosothikul Darintr , Chiasakul Thita , Rojnuckarin Ponlapat , Uaprasert Noppacharn
Published: April 2021

Hypercoagulability in coronavirus disease 2019 (COVID-19) may aggravate disease severity during hospitalization but the reported survival benefits from anticoagulation (AC) vary among studies. We performed a literature research to estimate pooled odds ratios (ORs) of in-hospital mortality and major bleeding comparing among intermediate-to-therapeutic dose AC, prophylactic dose AC, and no AC. Until October 22, 2020, PubMed, EMBASE, and Cochrane Library Database were searched for studies reporting AC utilization and mortality in COVID-19. Studies with suspected risk of bias were excluded before the synthesis of pooled ORs with 95% confidence intervals (CIs) using random-effects models. Of 37 identified studies (N = 19,510), 17 (N = 17,833) were aggregated in the meta-analysis. The overall mortality rate was 23.1% (95% CI 18.7-28.2). The pooled odds of mortality comparing anticoagulated to non-anticoagulated patients were similar, but lower in prophylactic dose AC group (OR 0.83; 95% CI 0.73-0.95). Notably, intermediate-to-therapeutic dose AC increased mortality (OR 1.60; 95% CI 1.11-2.31) and major bleeding compared to prophylactic dose AC (OR 3.33; 95% CI 2.34-4.72). Our findings support the optimal efficacy and safety profiles of prophylactic dose AC in hospitalized COVID-19 patients.
The case for reviewing broadcasting co-regulation
Authors: Lee Karen , Wilding Derek
Published: April 2021

This article applies principles from the Department of Communications’ policy review of telecommunications consumer protection to broadcasting co-regulation. The Consumer Safeguards Review establishes six principles for good regulation, including that rule-making processes should ‘enable a wide range of views to be considered’. It notes that processes for developing telecommunications codes of practice are likely to lead to ‘sub-optimal’ consumer protection measures. The article draws on original empirical research to assess development of commercial television and commercial radio codes of practice, with particular emphasis on public engagement in co-regulation. It finds the broadcasting codes of practice fail to meet the principles adopted by the Department for good co-regulation. It concludes by arguing there is a pressing need for a more holistic review of communications co-regulation, as broadcasting legislation is similar to the telecommunications legislation, and there is a risk that ‘sub-optimal’ practices could be applied in attempts to regulate digital platforms.
Which exercise and behavioural interventions show most promise for treating fatigue in multiple sclerosis? A network meta-analysis
Authors: Harrison Anthony M , Safari Reza , Mercer Tom , Picariello Federica , van der Linden Marietta L , White Claire , Moss-Morris Rona , Norton Sam
Published: April 2021

Background:

Fatigue is a common, debilitating symptom of multiple sclerosis (MS) without a current standardised treatment.

Objective:

The aim of this systematic review with network meta-analyses was to estimate the relative effectiveness of both fatigue-targeted and non-targeted exercise, behavioural and combined (behavioural and exercise) interventions.

Methods:

Nine electronic databases up to August 2018 were searched, and 113 trials ( n = 6909) were included: 34 were fatigue-targeted and 79 non-fatigue-targeted trials. Intervention characteristics were extracted using the Template for Intervention Description and Replication guidelines. Certainty of evidence was assessed using GRADE.

Results:

Pairwise meta-analyses showed that exercise interventions demonstrated moderate to large effects across subtypes regardless of treatment target, with the largest effect for balance exercise (SMD = 0.84). Cognitive behavioural therapies (CBTs) showed moderate to large effects (SMD = 0.60), with fatigue-targeted treatments showing larger effects than those targeting distress. Network meta-analysis showed that balance exercise performed significantly better compared to other exercise and behavioural intervention subtypes, except CBT. CBT was estimated to be superior to energy conservation and other behavioural interventions. Combined exercise also had a moderate to large effect.

Conclusion:

Treatment recommendations for balance and combined exercise are tentative as the certainty of the evidence was moderate. The certainty of the evidence for CBT was high.
Systematic literature review on computable general equilibrium applications in tourism
Authors: Wickramasinghe Kanchana , Naranpanawa Athula
Published: April 2021

Assessment of the economy-wide impacts of tourism has increased importance due to the unprecedented impacts of COVID-19. Computable general equilibrium (CGE) approach is a versatile tool for estimating the economy-wide impacts of tourism, as opposed to alternative general equilibrium approaches and partial equilibrium approaches. However, there has not been any systematic review done on CGE applications in tourism literature. The article reviews CGE applications in tourism over the past 25 years using a systematic quantitative literature review approach. This review presents potentially important applications of CGE models in guiding post-COVID tourism. Further, the article highlights the new developments in CGE modelling, which are yet to be adopted in tourism economics. Existing studies show a strong geographical bias. Notable research gaps exist in the areas of poverty, inequality, gender, environmental and the climate change impacts of tourism. Future research in these areas will be vital to effectively guide post-COVID tourism recovery.
Does EU funding improve local state capacity? Evidence from Polish municipalities
Authors: Charasz Paweł , Vogler Jan P
Published: April 2021

Does EU funding improve local state capacity? We focus on two specific types of state capacity, namely (a) the ability to provide information to third parties and (b) to discriminate between different kinds of inquiries. Because the EU’s structural funds are distributed through a competitive mechanism and incentivize expansions in administrative personnel, our theory predicts that high levels of EU funding bring about a higher bureaucratic capacity equilibrium. Empirically, we analyze the effect of structural funds on local government capacity in the largest recipient country: post-communist Poland. Through a randomized survey with more than 2400 municipal administrations, we find that administrations that have benefited more from EU funding, have developed higher levels of discrimination capacity. Yet we find no evidence for higher information provision capacity.
An automated hypersphere-based healthy subspace method for robust and unsupervised damage detection via random vibration response signals
Authors: Kyriakos Vamvoudakis-Stefanou , Spilios Fassois , John Sakellariou
Published: April 2021

A novel, unsupervised, hypersphere-based healthy subspace method for robust damage detection under non-quantifiable uncertainty via a limited number of random vibration response sensors is postulated. The method is based on the approximate construction, within a proper feature space, of a healthy subspace representing the healthy structural dynamics under uncertainty as the union of properly selected hyperspheres. This is achieved via a fully automated algorithm eliminating user intervention, and thus subjective selections, or complex optimization procedures. The main asset of the proposed method lies in combining simplicity and full automation with high performance. Its performance is systematically assessed via two experimental case studies featuring various uncertainty sources and distinct healthy subspace geometries, while interesting comparisons with three well-known robust damage detection methods are also performed. The results indicate excellent detection performance, which also compares favorably to that of alternative methods.
Participatory Research Approaches in Times of Covid-19: A Narrative Literature Review
Authors: Hall Johanna , Gaved Mark , Sargent Julia
Published: April 2021

This review aims to collate and organize the current literature base on the use of participatory research methods within Covid-19 and pandemic contexts. Participatory approaches rely on establishing trust and rapport between researchers and participants and advocate actively involving participants in the planning, implementation and evaluation of a research issue. However, by transitioning such approaches to an online and geographically distributed context, the openness and equitability of participatory approaches may be reduced or lost. By providing an overview of current empirical and guidance literature on the use of participatory approaches within the context of Covid-19, this review not only offers a basis for how a variety of methods may be used and adapted to distanced contexts, but also explicates the challenges associated with the use of these methods and the wider methodological implications posed by the Covid-19 pandemic. Furthermore, this review outlines the issues associated with conducting this type of research more generally, providing implications for how distance-based participatory methods may be used in wider contexts where face-to-face interaction may not be appropriate, or fieldwork may be disrupted due to logistical reasons.
PreScribed (A Life Written for Me): A Theatrical Qualitative Research-Based Performance Script Informed by General Practitioners’ Experiences of Emotional Distress
Authors: Riley Ruth , Spiers Johanna , Gordon Viv
Published: April 2021

This paper includes the script from a research-informed, theater-based production titled PreScribed (A Life Written for Me), which depicts the life of a distressed General Practitioner (GP) who is on the verge of breaking down and burning out. The authors provide context for the collaboration between artist and researchers and report on the creative methodological process involved in the co-production of the script, where research findings were imaginatively transformed into live theater. The researchers provide their reflections on the process and value of artistic collaboration and use of theater to disseminate research findings about emotions to wider audiences. It is concluded that qualitative researchers and artists can collaborate to co-create resonant and powerful pieces of work which communicate the emotions and experiences of research participants in ways that traditional academic dissemination methods cannot. The authors hope that sharing their experiences and this script as well as their reflections on the benefits of this approach may encourage researchers and artists to engage in this type of methodological collaboration in the future.
Adherence to instruction for use after endovascular repair of popliteal artery aneurysm
Authors: Wrede Axel , Lehti Leena , Eiberg Jonas Peter , Acosta Stefan
Published: April 2021

Objectives

Endovascular repair (ER) of popliteal artery aneurysm (PAA) is an alternative to open repair. However, there is no standardized protocol for when to opt for ER and the decision is therefore at the discretion of the clinician. This study aims to evaluate the adherence to the Instruction For Use (IFU) in patients undergoing ER for PAA and factors associated with stent graft patency at one year.

Methods

The adherence to IFU provided by the manufacturer in 55 patients treated with Gore Viabahn® Endoprosthesis with Heparin Bioactive Surface for PAA between 2009 and 2019 were retrospectively analyzed. Duplex follow-up was performed at 30 days and one year.

Results

The two groups of patients treated within ( n = 10) and not within ( n = 45) IFU did not differ in patient demographics, diagnostic assessment, treatment or outcome. Forty-five patients (81.8%) received stent graft placement with at least one deviation according to IFU. Distal oversizing >20% was the most frequent deviation against IFU ( n = 22, 40.0%). Primary patency at one year was 72%. Diameter size difference >1 mm between overlapping stent grafts (6/14 [43%], p = 0.013) and renal insufficiency (5/12 [42%], p = 0.0086) were associated with lower primary patency at one year. Age-adjusted analysis of tortuosity index (HR 1.78/SD, 95% CI 1.17–2.71; p = 0.0071) and maximal PAA angle (HR 1.73/SD, 95% CI 1.018–2.95; p = 0.043) were associated with major amputation/mortality at end of follow-up.

Conclusion

The majority of patients undergoing ER for PAA were not treated within IFU. Diameter size difference >1 mm between overlapping stent grafts was associated with a higher loss of primary patency at one year. Multi-center studies with larger sample size and long-term follow up of patency are warranted.
Should patients receive consolidation chemotherapy before reduced intensity allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia in first complete remission?
Authors: Byun Ja Min , Shin Dong-Yeop , Koh Youngil , Hong Junshik , Kim Inho , Yoon Sung-Soo , Lee Ji Yun , Bang Soo-Mee , Lee Jeong-Ok
Published: April 2021

Background:

For acute myeloid leukemia (AML) patients, the role of bridging consolidation chemotherapy after achieving first complete remission (CR1) in the transplant setting is a frequently debated issue. The lack of data from Asian patients led us to conduct this study.

Methods:

We retrospectively studied outcomes of 106 patients in CR1 undergoing allogeneic stem cell transplantation (alloSCT) with reduced intensity conditioning (RIC) based on their exposure to pre-transplant consolidation chemotherapy. There were 35 in the no consolidation group versus 71 in the consolidation group.

Results:

The median relapse free survival (RFS) was 9 months for the no consolidation group and 51 months for consolidation group ( p = 0.023). The median overall survival was 32 months for the no consolidation group and not reached for the consolidation group ( p = 0.034). Multivariate analysis recognized consolidation and poor cytogenetics as adverse prognostic factors for RFS. Moreover, RFS was better in patients with a shorter time lapse between last chemotherapy and alloSCT in both the no consolidation group and the consolidation group. Consolidation chemotherapy did not negatively affect neutrophil and platelet engraftment, infection rates, or acute graft- versus-host disease (GVHD) incidence. On the other hand, patients undergoing consolidation chemotherapy showed trends towards a more severe degree of chronic GVHD.

Conclusion:

The exposure to consolidation chemotherapy in CR1 prior to alloSCT with RIC conditioning did not negatively impact the outcomes in Korean AML patients, for whom a suitable donor is rarely immediately available. Therefore, post-remission consolidation chemotherapy is a reasonable option if required.
Augmentation of the insufficient tissue bed for surgical repair of hypospadias using acellular matrix grafts: A proof of concept study
Authors: Morgante Debora , Radford Anna , Abbas Syed K , Ingham Eileen , Subramaniam Ramnath , Southgate Jennifer
Published: April 2021

Acellular matrices produced by tissue decellularisation are reported to have tissue integrative properties. We examined the potential for incorporating acellular matrix grafts during procedures where there is an inadequate natural tissue bed to support an enduring surgical repair. Hypospadias is a common congenital defect requiring surgery, but associated with long-term complications due to deficiencies in the quality and quantity of the host tissue bed at the repair site. Biomaterials were implanted as single on-lay grafts in a peri-urethral position in male pigs. Two acellular tissue matrices were compared: full-thickness porcine acellular bladder matrix (PABM) and commercially-sourced cross-linked acellular matrix from porcine dermis (Permacol™). Anatomical and immunohistological outcomes were assessed 3 months post-surgery. There were no complications and surgical sites underwent full cosmetic repair. PABM grafts were fully incorporated, whilst Permacol™ grafts remained palpable. Immunohistochemical analysis indicated a non-inflammatory, remodelling-type response to both biomaterials. PABM implants showed extensive stromal cell infiltration and neovascularisation, with a significantly higher density of cells ( p < 0.001) than Permacol™, which showed poor cellularisation and partial encapsulation. This study supports the anti-inflammatory and tissue-integrative nature of non-crosslinked acellular matrices and provides proof-of-principle for incorporating acellular matrices during surgical procedures, such as in primary complex hypospadias repair.
COVID-19 and post-infectious myalgic encephalomyelitis/chronic fatigue syndrome: a narrative review
Authors: Poenaru Sonia , Abdallah Sara J. , Corrales-Medina Vicente , Cowan Juthaporn
Published: April 2021

Coronavirus disease 2019 (COVID-19) is a viral infection which can cause a variety of respiratory, gastrointestinal, and vascular symptoms. The acute illness phase generally lasts no more than 2–3 weeks. However, there is increasing evidence that a proportion of COVID-19 patients experience a prolonged convalescence and continue to have symptoms lasting several months after the initial infection. A variety of chronic symptoms have been reported including fatigue, dyspnea, myalgia, exercise intolerance, sleep disturbances, difficulty concentrating, anxiety, fever, headache, malaise, and vertigo. These symptoms are similar to those seen in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a chronic multi-system illness characterized by profound fatigue, sleep disturbances, neurocognitive changes, orthostatic intolerance, and post-exertional malaise. ME/CFS symptoms are exacerbated by exercise or stress and occur in the absence of any significant clinical or laboratory findings. The pathology of ME/CFS is not known: it is thought to be multifactorial, resulting from the dysregulation of multiple systems in response to a particular trigger. Although not exclusively considered a post-infectious entity, ME/CFS has been associated with several infectious agents including Epstein–Barr Virus, Q fever, influenza, and other coronaviruses. There are important similarities between post-acute COVID-19 symptoms and ME/CFS. However, there is currently insufficient evidence to establish COVID-19 as an infectious trigger for ME/CFS. Further research is required to determine the natural history of this condition, as well as to define risk factors, prevalence, and possible interventional strategies.
Hepatosplenic T-cell lymphoma with hepatocytotropism in a cat
Authors: Ii Tatsuhito , Chambers James K , Segawa Kazuhito , Uchida Kazuyuki
Published: April 2021

Case summary

A 14-year 3-month-old spayed female mixed-breed cat presented with jaundice, anaemia and thrombocytopenia. Haemophagocytic syndrome associated with lymphoma was suspected after cytological examination of the spleen. Despite treatment with prednisolone, L-asparaginase and nimustine, the cat died 176 days after the initial presentation. Necropsy revealed splenomegaly and hepatomegaly, without lymphadenopathy. Histopathologically, neoplastic lymphoid cells infiltrated the hepatic sinusoid and splenic sinus. The neoplastic lymphoid cells showed marked hepatocytotropism and contained erythrocytes, which was also confirmed by electron microscopy. Immunohistochemically, neoplastic lymphoid cells were positive for CD3, TIA1 (GMP-17) and granzyme B, and negative for CD8, CD20, CD56, CD57, CD79a and Iba1. Based on these findings, the cat was diagnosed with hepatosplenic T-cell lymphoma (HS-TCL) with hepatocytotropism.

Relevance and novel information

This case shows cytotoxic immunophenotype of HS-TCL in a cat, which has not been demonstrated before. Severe hepatocytotropism and haemophagocytosis of the neoplastic cells were likely to be associated with jaundice and anaemia, respectively, and the poor outcome of the present case.
Complications and visual outcome of sutureless, scleral fixated intraocular lens in cases with traumatic aphakia
Authors: Deb Amit Kumar , Sarkar Sandip , Natarajan Kaviyapriya , Elamurgan Vignesh , Jayaseelan Jagadeeswari , Gokhale Tanmay , Jacob Ninan
Published: April 2021

Purpose:

The aim of this study is to describe the complications and outcome of sutureless scleral fixated intraocular lens (SFIOL) implantation in traumatic aphakia.

Setting:

The study was conducted in a tertiary eye care centre in South India.

Design:

The study involved a retrospective data analysis.

Methods:

Medical records of cases with traumatic aphakia who had undergone sutureless SFIOL implantation in the last 2 years were included in the study. Data on intraoperative and postoperative complications and visual outcome were collected and analysed.

Results:

In total, 45 cases were recruited. Mean logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) improved from preoperative 1.64 ± 0.45 to 0.63 ± 0.36 at last follow-up visit, and the difference was statistically significant ( p < 0.0001). Final logMAR BCVA was worse than one in three patients who had associated posterior segment pathology. There was no incidence of intraoperative haptic rebound into the vitreous cavity or intraocular lens (IOL) drop. Four cases had hypotony, two cases had choroidal detachment, four cases had raised intraocular pressure (IOP), eight cases had transient corneal oedema and six patients had mild dispersed vitreous haemorrhage during immediate postoperative period. Six patients had postoperative cystoid macular oedema (CME). Two cases developed glaucoma. None of the patients had postoperative haptic exposure, retinal detachment (RD), iris capture of IOL or SFIOL dislocation till the last follow-up.

Conclusion:

Final visual outcome of sutureless SFIOL implantation in traumatic aphakia may be affected by concomitant posterior segment pathology. The immediate and late postoperative complications noted in our study were comparable with other similar studies. However, longer follow-up is needed to detect RD and angle recession glaucoma at the earliest and initiate therapy.
On the improvement of process performance of hard turning using vibration-assisted machining
Authors: Dutta Pranesh , Bartarya Gaurav
Published: April 2021

In hard turning, the cutting forces are large, which leads to tool wear and tensile nature of residual stresses. Vibration-assisted machining (VAM), where the tool is provided with a low amplitude vibration at significantly high frequency, might improve the process performance of hard turning in terms of cutting forces, residual stress, etc., as VAM helps in reduction of cutting forces and tool wear significantly. To improve the machining operation, a comparative study of VAM with conventional machining is undertaken to study and improve the hard turning performance. A two-dimensional (2D) finite element (FE) model is developed to understand the effect of process parameters better and to study the effect on machining performance by applying one-dimensional ultrasonic vibration to the tool. The model developed is validated with results from a previous work for continuous hard turning conditions. The effect of vibrations induced in cutting velocity direction is studied on the cutting forces and residual stresses induced on the machined workpiece. The ratio of cutting velocity to critical vibrating velocity is an important process parameter that affects the average cutting forces during hard turning using VAM. The nature of cutting force and temperature for a complete cycle of vibration is also studied. The simulation results establish that hard turning using VAM yields lower average cutting forces and more compressive residual stresses in comparison to conventional hard turning.
Vitamin K antagonists did not increase the risk of myelodysplastic syndrome in a large-scale cohort study
Authors: Neumann Anke , Jabagi Marie-Joelle , Zureik Mahmoud
Published: April 2021

It has recently been reported that vitamin K antagonists (VKAs) impair the bone marrow microenvironment and may predispose to myelodysplastic syndrome (MDS). In a study of the French national health care database, Neumann et al examined data on this issue for more than 120 000 individuals on oral anticoagulation for atrial fibrillation, confirming that there is no increase in MDS in patients treated with VKAs in comparison with those treated with direct oral anticoagulants.
Complex sexually dimorphic traits shape the parallel evolution of a novel reproductive strategy in Sulawesi ricefishes (Adrianichthyidae)
Authors: Spanke Tobias , Hilgers Leon , Wipfler Benjamin , Flury Jana M. , Nolte Arne W. , Utama Ilham V. , Misof Bernhard , Herder Fabian , Schwarzer Julia
Published: April 2021

Background

Pelvic brooding is a form of uni-parental care, and likely evolved in parallel in two lineages of Sulawesi ricefishes. Contrary to all other ricefishes, females of pelvic brooding species do not deposit eggs at a substrate (transfer brooding), but carry them until the fry hatches. We assume that modifications reducing the costs of egg carrying are beneficial for pelvic brooding females, but likely disadvantageous in conspecific males, which might be resolved by the evolution of sexual dimorphism via sexual antagonistic selection. Thus we hypothesize that the evolution of pelvic brooding gave rise to female-specific skeletal adaptations that are shared by both pelvic brooding lineages, but are absent in conspecific males and transfer brooding species. To tackle this, we combine 3D-imaging and morphometrics to analyze skeletal adaptations to pelvic brooding.

Results

The morphology of skeletal traits correlated with sex and brooding strategy across seven ricefish species. Pelvic brooding females have short ribs caudal of the pelvic girdle forming a ventral concavity and clearly elongated and thickened pelvic fins compared to both sexes of transfer brooding species. The ventral concavity limits the body cavity volume in female pelvic brooders. Thus body volumes are smaller compared to males in pelvic brooding species, a pattern sharply contrasted by transfer brooding species.

Conclusions

We showed in a comparative framework that highly similar, sexually dimorphic traits evolved in parallel in both lineages of pelvic brooding ricefish species. Key traits, present in all pelvic brooding females, were absent or much less pronounced in conspecific males and both sexes of transfer brooding species, indicating that they are non-beneficial or even maladaptive for ricefishes not providing extended care. We assume that the combination of ventral concavity and robust, elongated fins reduces drag of brooding females and provides protection and stability to the egg cluster. Thus ricefishes are one of the rare examples where environmental factors rather than sexual selection shaped the evolution of sexually dimorphic skeletal adaptations.