bluuebunny/crossref_metadata_2025 huggingface dataset:
Health Inequities and the Shifting Paradigms of Food Security, Food Insecurity, and Food Sovereignty
Authors: Borras Arnel M. , Mohamed Faisal Ali
Published: March 2020

Global hunger, food insecurity, and malnutrition are on the rise, partly resulting in furthering health inequities between classes and groups of peoples among and within countries. A systematic understanding of the links between inequities in food politics and health issues is a challenge, and it is partly complicated by the presence of 3 contending and shifting paradigms in food politics, namely, food security, food insecurity, and food sovereignty. These paradigms suggest competing views as to the causes of and solutions to hunger, food insecurity, and malnutrition. We argue that food sovereignty offers a better alternative for understanding and responding to food issues in relation to the challenge of tackling health inequities. However, the ways in which and the degree to which the issues of health inequities are incorporated in the current narratives and practices of food sovereignty is rather thin, and vice versa. Our concluding argument is that an interactive dialogue in research and social actions between food sovereignty, on the one hand, and health inequity, on the other hand, can mutually enrich and strengthen both fields of research and spheres of social actions.
Mechanical and thermal behavior of cellulose nanocrystals-incorporated Acrodur® sustainable hybrid composites for automotive applications
Authors: Amini Ezatollah (Nima) , Tajvidi Mehdi
Published: March 2020

Utilization of cellulose nanocrystals as an additive in the formulation of biocomposites made with Acrodur® resin is presented. Natural fibers/polyethylene terephthalate mats were impregnated with Acrodur® and hot-pressed into the final thickness of 3 mm after drying. Biocomposites with 2 wt.% and 5 wt.% cellulose nanocrystal (dry-basis) were also produced. The produced biocomposite panels were then tested to determine the flexural strength, flexural modulus and Izod impact strength. The results revealed that adding cellulose nanocrystal to the composite formulation increased flexural modulus significantly up to 970 MPa (17.5% increase) at a panel density of 0.5 g/cm3, while it did not significantly affect flexural strength values. A slight reduction was observed in the impact strength of the samples by adding cellulose nanocrystal. The fractured samples of impact test were observed under a scanning electron microscope. It was shown that in all cases, the fracture happened due to the failure of the fibrous system and in particular natural fibers. Thermal stability of the composites was also investigated using thermo-gravimetric analysis. It was found that adding cellulose nanocrystal slightly reduced the thermal stability of the biocomposites. Potential compatibility of cellulose nanocrystal particles with Acrodur® resin is promising and the improvement in flexural modulus can lead to the design of lighter parts for automotive applications such as door panels, headliners, and underbody shields.
Effect of the proximity to the 0°/90° interface on Energy Release Rate of fiber/matrix interface crack growth in the 90°-ply of a cross-ply laminate under tensile loading
Authors: Stasio Luca Di , Varna Janis , Ayadi Zoubir
Published: March 2020

Models of Representative Volume Elements of cross-ply laminates with different geometric configurations and damage states are studied. Debond growth is characterized by the estimation of the Mode I and Mode II Energy Release Rate using the Virtual Crack Closure Technique. It is found that the presence of the [Formula: see text] interface and the thickness of the [Formula: see text] layer has no effect, apart from laminates with ultra-thin [Formula: see text] plies where it is however modest. The present analysis supports the claim that debond growth is not affected by the ply-thickness effect.
Processing and evaluation of thermal-sprayed high-performance polymer fiber reinforced Zn metal matrix composites
Authors: Kumaran D , Rajadurai A , Padmanabhan K
Published: March 2020

This novel research work reports the possibility of using a high-performance polymer fiber as a potential reinforcement in a suitable metal matrix for the development of composites. The manufacturing route is an additive process using High-Velocity Oxy-Fuel Thermal-Spray technique. Continuous strands of Poly-benzobisoxazole and para-aramid were used as high-performance polymer reinforcement in a uni-directional configuration, and Zinc metal was used as matrix material. The developed Thermal-Spray composites were subjected to mechanical tensile test and characterized by Scanning Electron Microscopy and Optical Microscopy. The results of the tensile tests revealed a substantial increase in the tensile properties and the investigation of Scanning Electron Microscopy and optical images showed a good deposition of matrix material on the reinforcing polymer fibers. The testing and characterization results were conclusive of the fact that Poly-benzobisoxazole and para-aramid can be used as an effective reinforcement even at low volume content for high strength structural applications.
Investigating school children’s behavioral and emotional problems using pediatric symptoms checklist-17 in a structural equation modeling framework
Authors: Liu Jin , Guo Siying , Gao Ruiqin , DiStefano Christine
Published: March 2020

The Pediatric Symptom Checklist-17 was originally used in primary care settings with parents to identify their children’s behavioral and emotional problems, but there has been some research supporting use of this scale in school settings. This study examined: (a) the factor structure and measurement invariance of the teacher-rated Pediatric Symptom Checklist-17 and (b) complex relationships among demographic characteristics, behavioral and emotional problems, and learning outcomes using structural equation modeling in elementary schools. A sample of 508 children in grades one and two were rated by their teachers with the Pediatric Symptom Checklist-17. Measures of Academic Progress test was utilized to measure participants’ learning outcomes in reading and math. The results confirmed a three-factor structure of the Pediatric Symptom Checklist-17 (internalizing problems, externalizing problems, and attention problems) and attested the measurement invariance across different demographic groups (i.e. gender, ethnicity, and grade levels). Boys were more likely to have severe attention problems which were associated with lower learning outcomes as seen by Measures of Academic Progress reading and math scores. Attention problems mediated the relationship between gender and learning outcomes. This study has implications for the use of the Pediatric Symptom Checklist-17 in school-based settings. Additionally, it highlights the potential relationships among gender, attention problems, and learning outcomes.
Powerful and confident children through expansive body postures? A preregistered study of fourth graders
Authors: Körner Robert , Köhler Hannes , Schütz Astrid
Published: March 2020

Do expansive body postures increase self-esteem in children? Power posing is a popular but also controversial topic. Still, there has been no research on the possible effects in children. To investigate the influence of power posing in children, 108 German fourth graders were randomly assigned to a high versus a low power posing group. Self-esteem was self-reported; feelings were assessed indirectly. There was an effect of power posing on self-reported global and school self-esteem. Furthermore, children who had performed high power poses in comparison with those who had performed low power poses mentioned more positive feelings, higher power feelings, and a more positive student–teacher relationship. Results are interpreted with regard to the context and the cultural dependency of the power posing effect. Implications for school practice are addressed.
Efficacy and safety of high-intensity focused ultrasound (HIFU) for treating benign thyroid nodules: a systematic review and meta-analysis
Authors: Chung Sae Rom , Baek Jung Hwan , Suh Chong Hyun , Choi Young Jun , Lee Jeong Hyun
Published: March 2020

Background

High-intensity focused ultrasound (HIFU) is an emerging thermal ablation technique that has been successfully applied to various benign thyroid nodules.

Purpose

To evaluate the efficacy and safety of HIFU for the treatment of benign thyroid nodules.

Material and Methods

The Ovid-MEDLINE and EMBASE databases were searched up to 9 July 2018 for studies describing the use of HIFU to treat benign thyroid nodules. We included studies that have outcomes with sufficient detail to evaluate the volume reduction rate (VRR). The pooled proportions of VRR ≥50% and pooled VRR at one, three, and six months after HIFU were assessed using random-effects modeling. Heterogeneity among studies was determined using Chi-square statistics for pooled estimates and the inconsistency index I2.

Results

Seven studies were included in the systematic review and four in the meta-analysis. The pooled VRR at one, three, and six months after HIFU were 17.59 (95% confidence interval [CI] 12.56–22.62), 48.93 (95% CI 42.20–55.66), and 60.43 (95% CI 51.88–68.98). The pooled proportions of VRR ≥50% at six months after HIFU were 75% (95% CI 53–89; I2=73.6%). There were no major complications of HIFU.

Conclusion

HIFU may be a safe and effective treatment modality for benign thyroid nodules, especially for small nodules.
Diffusion tensor imaging in hyperthyroidism: assessment of microstructural white matter abnormality with a tract-based spatial statistical analysis
Authors: Aslan Kerim , Gunbey Hediye Pinar , Cortcu Sumeyra , Ozyurt Onur , Avci Ugur , Incesu Lutfi
Published: March 2020

Background

Metabolic, morphological, and functional brain changes associated with a neurological deficit in hyperthyroidism have been observed. However, changes in microstructural white matter (WM), which can explain the underlying pathophysiology of brain dysfunctions, have not been researched.

Purpose

To assess microstructural WM abnormality in patients with untreated or newly diagnosed hyperthyroidism using tract-based spatial statistics (TBSS).

Material and Methods

Eighteen patients with hyperthyroidism and 14 age- and sex-matched healthy controls were included in this study. TBSS were used in this diffusion tensor imaging study for a whole-brain voxel-wise analysis of fractional anisotropy, mean diffusivity, axial diffusivity (AD), and radial diffusivity (RD) of WM.

Results

When compared to the control group, TBSS showed a significant increase in the RD of the corpus callosum, anterior and posterior corona radiata, posterior thalamic radiation, cingulum, superior longitudinal fasciculus, and the retrolenticular region of the internal capsule in patients with hyperthyroidism ( P < 0.05), as well as a significant decrease in AD in the anterior corona radiata and the genu of corpus callosum ( P < 0.05).

Conclusion

This study showed that more regions are affected by the RD increase than the AD decrease in the WM tracts of patients with hyperthyroidism. These preliminary results suggest that demyelination is the main mechanism of microstructural alterations in the WM of hyperthyroid patients.
Inhabiting the Self-Work Romantic Utopia: Positive Psychology, Life Coaching, and the Challenge of Self-Fulfillment at Work
Authors: Pagis Michal
Published: March 2020

Much has been said about the rise of work as a central identity marker in modern society. With the recent popularization of self-help and positive psychology, this identity marker broadened its signification to include new emotional needs such as love and passion, creating a new cultural imaginary: the “self-work romantic utopia.” Sociological studies have criticized this utopia as a myth that serves capitalist neoliberal structures, leading to frustration and self-blame. However, little is known about how workers themselves confront this myth and the strategies they employ when attempting to inhabit it in today’s precarious job market. Based on 60 in-depth interviews with upper-middle class Israeli workers who hired life coaches to improve their work experience, the author identifies five strategies used to inhabit this romantic utopia: starting over, healing, idealization, polygamy, and vision. Through the analysis of these strategies, the author illustrates how even the relatively privileged workers need to adapt the self-work romantic utopia to their life circumstances, inhabiting the myth in partial degrees. Such flexible implementation turns the “myth” into a cultural tool that directs workers’ lives and actions even in a precarious, unstable job market, maintaining subjective experiences of agency in a sphere characterized by growing structural constraints. Yet paradoxically, these strategies eventually strengthen the precarious, noncommitted, and individual-oriented structure of the job market, yielding flexible, individualistic solutions that replace workplace responsibility.
Recent developments in experimental and computational studies of hygrothermal effects on the bond between FRP and concrete
Authors: Mukhtar Faisal M , Arowojolu Olaniyi
Published: March 2020

The performance of fiber reinforced polymer externally bonded to concrete is greatly influenced by the environmental conditions to which it is exposed during service. Temperature and humidity are the two common environmental factors that alter the bond behavior of externally bonded fiber reinforced polymer. This paper reviews the experimental and computational approaches used to evaluate the hygrothermal effects—that is, the effect of temperature and humidity—on the durability of the fiber reinforced polymer–concrete bond, as well as on the bond’s performance under loading conditions. Some experimental testing conducted in the laboratory and in situ are critically reviewed and presented. Implemented approaches for improving bond performance under hygrothermal conditions and their modeling techniques are also presented. The paper concludes by discussing the review’s salient issues. The ongoing wide application of externally bonded fiber reinforced polymer creates opportunities for new research on improving and predicting the bond strength of fiber reinforced polymer concrete under hygrothermal conditions.
Preparation and anti-cancer activity of transferrin/folic acid double-targeted graphene oxide drug delivery system
Authors: Lu Taicheng , Nong Zhenzhen , Wei Liying , Wei Mei , Li Guo , Wu Nini , Liu Cheng , Tang Bingling , Qin Qixiao , Li Xuehua , Meng Fayan
Published: March 2020

In this study, a transferrin/folic acid double-targeting graphene oxide drug delivery system loaded with doxorubicin was designed. Graphene oxide was prepared by ultrasound improved Hummers method and was modified with Pluronic F68, folic acid, and transferrin to decrease its toxicity and to allow dual-targeting. The results show that the double target drug delivery system (TFGP*DOX) has good and controllable drug delivery performance with no toxicity. Moreover, TFGP*DOX has a better inhibitory effect on SMMC-7721 cells than does a single target drug delivery system (FGP*DOX). The results of drug release analysis and cell inhibition studies showed that TFGP*DOX has a good sustained release function that can reduce the drug release rate in blood circulation over time and improve the local drug concentration in or near a targeted tumor. Therefore, the drug loading system (TFGP*DOX) has potential application value in the treatment of hepatocellular carcinoma.
Digital twin-based production scheduling system for heavy truck frame shop
Authors: Wang Yunrui , Wu Zhengli
Published: March 2020

Existing scheduling systems cannot respond quickly and efficiently to the appearance of uncertain variable interference factors in the scheduling process. The efficiency of the enterprise is hence seriously affected by these factors. The concept of the digital twin provides new research directions for scheduling systems. In order to improve the overall performance of the production scheduling system in a frame shop, virtual-real fusion technology utilizing the digital twin is first introduced to integrate the information and logistics flows in the scheduling process as part of the manufacturing execution system-based production scheduling mechanism. The balance optimization of the mixed-flow production line is then carried out, and the mixed-flow production line balance and sequencing models are established. A scheduling system for the frame shop combining various system functions is finally designed based on the sequencing model and production status. The scheduling system comprehensively considers the two uncertain factors of materials and orders to generate scheduling information through an intelligent scheduling mode while realizing real-time synergy between the information and logistics flows. The system has achieved excellent implementation results in the frame shop and provides a reference for the application of digital twins in production workshops.
Self-synchronization theory of tri-motor excitation with double-frequency in far resonance system
Authors: Zou Min , Fang Pan , Hou Yongjun , Chai Guodong , Chen Jinsong
Published: March 2020

With the rapid development of petroleum exploitation industry, vibrating screen actuated with a single frequency is unsuitable to separate cuttings from drilling fluid, since it usually results in screen blocking. Hence, for solving the above-mentioned problem, tri-motor excitation with double-frequency in far resonance system is introduced. This paper aims to explore the self-synchronization mechanism of the proposed system. First, dynamic equation is established according to physical model of the system. Then, displacement response of the system in steady state is obtained with dynamic formulas. Subsequently, synchronous condition among the three exciters is determined by small parameters method, and criterion of synchronous stability among the three exciters is derived by Poincare-Lyapunov method. Finally, in light of the differential motion equation, Runge-Kutta principle is assigned to validate the reliability of self-synchronous theory and the stability of the double-frequency system. The results indicate that electromagnetic torques of low-frequency motors are dynamically antisymmetric in synchronous operation, and synchronous ability of the system is determined by the mass ratio among the rotors. In addition, stable phase difference among the rotors is significantly influenced by the structural parameters of the system. And this study will be helpful for the improvement of separation technology.
High-frequency random vibrations of a stiffened plate with a cutout using energy finite element and experimental methods
Authors: Nokhbatolfoghahai A , Navazi HM , Haddadpour H
Published: March 2020

In this paper, by employing the energy finite element analysis, the high-frequency vibrations of a stiffened plate having a cutout, subjected to random vibrations, have been analyzed, and the obtained results have been validated by use of experimental methods. By using equations for joining of structures, energy finite element analysis computer codes were developed for the coupling of beam-plate elements. Finally, a plate containing a cutout and three stiffeners was fabricated and subjected to high-frequency random vibration tests. The results of the prepared codes were compared with the results of experiments. These comparisons indicated that at high frequencies, the energy finite element analysis can be used as an effective tool in the analysis of high-frequency vibrations.
Cutaneous squamous cell carcinoma causing a rhinophymatous mass in a patient with clinically occult hypertrophic lupus erythematosus
Authors: Cohen Leah , Shah Vidhi , Chen Pei-Ling , Messina Jane , Seminario-Vidal Lucia
Published: March 2020

Hypertrophic lupus erythematosus is a variant of discoid lupus erythematosus, which manifests as verrucous plaques and/or keratoacanthoma-like nodules on the face and arms. Diagnosis and treatment of hypertrophic lupus erythematosus can be challenging as it can resemble cutaneous squamous cell carcinoma clinically and histopathologically. Furthermore, cutaneous squamous cell carcinoma is a known complication of discoid lupus erythematosus. We present a diagnostically challenging case of a patient with a rapidly enlarging rhinophymatous mass and multiple keratoacanthoma-like lesions of the bilateral upper extremities whose work-up was initially equivocal. CD123 staining helped to elucidate a final diagnosis of cutaneous squamous cell carcinoma arising in a background of occult hypertrophic lupus erythematosus.
Predictors of splenectomy after failure of non-operative management: An analysis of the nation trauma database from 2013 to 2014
Authors: Nguyen Allan , Orlando Alessandro , Yon James R , Mentzer Caleb J , Banton Kaysie , Bar-Or David
Published: March 2020

Introduction

There is practice variability in non-operative management (NOM) of blunt splenic trauma. This is particularly true for management decisions following failure of NOM, i.e. splenectomy versus angioembolization (AE). The objective of this study was to identify predictors of splenectomy versus AE in patients who failed NOM.

Methods

We included adult patients from the National Trauma Data Bank for 2013–2014, who had a splenic injury and who were admitted to a Level I Trauma Center (L1TC). Patients undergoing splenectomy after 2 h of emergency department arrival were deemed to have failed NOM. Multivariate logistic regression modeling was used to identify independent predictors of intervention after failed NOM.

Results

There were 2284 patients admitted for splenic injury between 2013 and 2014 who failed NOM. A total of 1253 patients underwent AE and 1031 patients underwent splenectomy. Seven independent factors were identified that predicted failure of NOM: penetrating injury, community L1TC, hospital bed size, number of trauma surgeons on call, functional dependence, chronic steroid use, and cirrhosis.

Conclusions

Seven independent variables were identified that predicted failure of NOM. These results contribute to the body of data regarding management of blunt splenic injury. Knowing predictive factors could help personalize management of patients, minimize delay of care, efficient resource allocation, and inform future studies.
Friction stir butt-lap welding of A7N01P-T4 aluminum alloy: Efforts to mitigate defects and the resultant mechanical properties
Authors: Xu Rongzheng , Wei Zhicheng , Jiang Jianbo , Hou Yanxi , Li Hui , Cui Shenglin
Published: March 2020

Butt-lap configuration of aluminum alloys was friction stir welded under various tool offsets, rotational speeds, and tool geometries. The tool offset was introduced to mitigate the inherent retreating side hook. As the probe was placed inwards, the retreating side hook was mitigated, but a severe S-line was formed. Since the inherent retreating side hook was difficult to further mitigate, the S-line was selected to be mitigated by increasing the rotational speed. But an excessive rotational speed (2000 r/min) could cause a severe upward-bending retreating side hook, which decreased the effective plate thickness. Subsequently, two-section stepped probes were employed to mitigate the defects. The S-line and retreating side hook were both mitigated and its ultimate tensile strength (369 MPa) reached 91% of the base material.
Social workers and recovery from stress
Authors: van Dam Arjan , Noordzij Gera , Born Marise
Published: March 2020

Recovery from stress is essential for employees’ well-being, even more so in jobs where high stress is inevitable. The purpose of this study was to examine the influence of achievement goal orientation on recovery from stress (i.e. need for recovery and vigour) over several years. We followed a sample of social workers in the Netherlands (N = 238) across four years, with three measurement points (T1–T3). Data were analysed with latent growth curve modelling.

Findings

Results showed that need for recovery and vigour were fairly stable over time and therefore we could not examine the effects of achievement goal orientation on change in vigour and need for recovery over time. However, level of mastery goal orientation (mastery-approach and mastery-avoidance goal orientation) at T1 was positively related to the initial level of vigour at T1, even after controlling for job autonomy and workload. Our results indicate that mastery goal orientation is relevant for employees to feel energetic and vital in a job with high stress.

Practical implications

Our results showed that organizations can prevent depletion among social workers by ensuring an acceptable workload, while vigour can be enhanced by selecting employees with high mastery goal orientation. Organizations can also contribute to the vitality of social workers by stimulating and fostering mastery goal orientation.
Fifty years of social work education: Analysis of motivations and outcomes
Authors: Butler-Warke Alice , Bolger Janine
Published: March 2020

This article uses the 50th anniversary of social work education provision at one of north-east Scotland’s universities as an opportunity to reflect on social work education outcomes and motivations for undertaking training. This empirical assessment is based on the detailed responses to questionnaires and interviews with social work graduates who studied between 1968 and 2012 to evaluate social work training and education among graduates. We use the Kirkpatrick model to evaluate social work education.

Findings

We highlight the combination of prior experience with social work and a sense of altruism that served to motivate students to engage in training. We discuss the levels of preparedness for practice based on training and note that it is the combination of teaching and placements that benefits students most. We reflect on the centrality of a common set of social work values that arise from a period of introspection during education, and we show that these values are incorporated into both professional and personal life.

Applications

We show that ‘big picture’ and evaluations of social work education are important in order to orient social work education in line with political and social change. We also suggest that educators should be cognisant of the importance of personal development and growth that are central to the training of social workers. Rather than seeing personal development as a by-product of social work education, we argue that training that strengthens social work values of justice and empathy is imperative.
Academic Skills, Community Engaged, Leadership, and Global Themed First-Year Seminars: Comparisons in Student Success
Authors: Boettler Lynn M. , Goldfine Ruth A. , Leech Don W. , Siegrist Gerald R. (Jerry)
Published: March 2020

In this study, retention and academic performance of students enrolled in four different versions of a first-year seminar at a large, public 4-year university were compared for a 2-year period. The first-year seminars examined were 3-credit courses with either traditional, global, community engagement, or leadership themes and were essentially required of all first-year, full-time students. Statistical analysis using logistic regression and analysis of covariance were employed to determine whether differences existed. In addition, the variables of gender, race, high school grade point average, American College Testing/Scholastic Aptitude Test scores, type of instructor (full time or part time), and enrollment in a learning community were considered covariates in data analysis. The study revealed no significant differences in first-year to second-year retention rate or in academic performance as measured by college grade point average for the four different versions of the seminar; however, enrollment in a learning community did have significant impact on retention, even after controlling for covariates known to strongly affect retention.
Objective evaluation of sizing morphology of E-glass filament yarn
Authors: Zheng Tianyong , Yang Kaidao , Wang Xi , Ning Xiangchun
Published: March 2020

In spinning, sizing agent makes originally rigid glass filament yarn soft, smooth, reduces mechanical wear, and alleviates static electricity. In order to produce “stronger, thinner, and more uniform” E(Electronic) fiberglass cloth, the sized filament yarn is required to have good strand integrity and uniform belt-like shape. Currently, the sizing effect can only be evaluated artificially according to the image of cross section or longitudinal section of yarns. The goal of the paper is to find an objective evaluation method for sizing effects on strand integrity and performance of belt-forming of E-glass filament yarn. The image of cross section of yarn is captured by Keyence VK-X110 and analyzed by Image-Pro Plus to obtain the central position and diameter of each filament. The threshold of fiber spacing is set to determine whether filaments are clustered in group. The area of outer enveloping convex polygon containing all the clustered filaments is calculated and fiber-filling rate is calculated accordingly. By using the least square method, the minimum rectangle containing all groups of filaments is obtained to describe the basic contour of yarn cross section. The outer envelope polygon is divided into several equal parts to calculate the coefficient variation of thickness distribution and yarn distribution. These objective values well reflect the strand integrity and feature of belt-forming of yarn, and are consistent with the subjective evaluation. Rank order method is used to compare the sizing morphology of the yarns based on the values. A standard is also suggested for objective grade assessment of sized E-Glass yarns.
Getting to first base: Running is faster than sliding in collegiate baseball and softball players
Authors: Haag Samuel J
Published: March 2020

Previous research has shown no significant differences in time required to reach a base when sliding head-first or feet-first, but few studies have compared running through and sliding into first base in baseball players, and none have included softball players. The purpose of the present study was to examine differences in time required to reach first base when running, sliding head-first, and sliding feet-first. Twelve female collegiate softball players (20.0 ± 1.3 years old) and 14 male collegiate baseball players (20.6 ± 1.6 years old) performed three trials each of running, sliding head-first, and sliding feet-first in a randomized, counterbalanced order with 1–2 min of rest between each trial. Testing was conducted in an indoor practice facility and trials were timed using a dual-beam wireless infrared timing system. Significant differences between the three approaches were found for both softball ( p <  .001) and baseball players ( p <  .001), and follow-up pairwise comparisons showed running through the base was significantly faster than sliding head-first ( p =  .001 for softball, p =  .009 for baseball) and feet-first ( p <  .001 for softball, p =  .002 for baseball). Differences between sliding head-first and feet-first were not significant in either group. Running through first base is significantly faster than sliding in collegiate baseball and softball players. Sliding into first base should only be attempted when avoiding a tag from or a collision with a fielder.
Influence of microcirculation load on FFR in coronary artery stenosis model
Authors: Xu Hongzeng , Liu Jing , Zhou Donghui , Jin Yuanzhe
Published: March 2020

Background

The coronary artery hemodynamics are impacted by both the macrocirculation and microcirculation. Whether microcirculation load impact the functional assessment of a coronary artery stenosis is unknown. The purpose of this study is to investigate the effect of porous media of the microcirculation on fractional flow reserve (FFR) in stenotic coronary artery model.

Methods

A three dimensional computational simulation of blood flow in coronary artery symmetric stenotic model was constructed. The computational fluid dynamics (CFD) model was developed with Fluent 16.0. Blood was modeled as a shear thinning, non-Newtonian fluid with the Carreau model. A seepage outlet boundary condition and transient inlet conditions were imposed on the model. Coronary physiologica diagnostic parameter such as pressure, velocity and fractional flow reserve (FFR) were investigated in the model and compared with the microcirculation load (ML) and constant pressure load (PL) condition.

Results

The present study showed the different hemodynamics in the ML and PL condition. The pre-stenotic pressure is almost the same in the two model. However the pressure in the post-stenotic artery domain is much lower in the PL model. The fluctuation range of the pressures is much higher in ML model than those in PL model. The velocity flow was more steady and lower in the ML model. For the PL model with 75% artery stenosis the FFR was 0.776, while for the ML model with the same stenosis, the FFR was 0.813.

Conclusions

This study provides evidence that FFR increased in the presentation of ML condition. There is a strong hemodynamic effect of microcirculation on coronary artery stenosis.
Machine learning analysis of motor evoked potential time series to predict disability progression in multiple sclerosis
Authors: Yperman Jan , Becker Thijs , Valkenborg Dirk , Popescu Veronica , Hellings Niels , Wijmeersch Bart Van , Peeters Liesbet M.
Published: March 2020

Background

Evoked potentials (EPs) are a measure of the conductivity of the central nervous system. They are used to monitor disease progression of multiple sclerosis patients. Previous studies only extracted a few variables from the EPs, which are often further condensed into a single variable: the EP score. We perform a machine learning analysis of motor EP that uses the whole time series, instead of a few variables, to predict disability progression after two years. Obtaining realistic performance estimates of this task has been difficult because of small data set sizes. We recently extracted a dataset of EPs from the Rehabiliation & MS Center in Overpelt, Belgium. Our data set is large enough to obtain, for the first time, a performance estimate on an independent test set containing different patients.

Methods

We extracted a large number of time series features from the motor EPs with the highly comparative time series analysis software package. Mutual information with the target and the Boruta method are used to find features which contain information not included in the features studied in the literature. We use random forests (RF) and logistic regression (LR) classifiers to predict disability progression after two years. Statistical significance of the performance increase when adding extra features is checked.

Results

Including extra time series features in motor EPs leads to a statistically significant improvement compared to using only the known features, although the effect is limited in magnitude (ΔAUC = 0.02 for RF and ΔAUC = 0.05 for LR). RF with extra time series features obtains the best performance (AUC = 0.75±0.07 (mean and standard deviation)), which is good considering the limited number of biomarkers in the model. RF (a nonlinear classifier) outperforms LR (a linear classifier).

Conclusions

Using machine learning methods on EPs shows promising predictive performance. Using additional EP time series features beyond those already in use leads to a modest increase in performance. Larger datasets, preferably multi-center, are needed for further research. Given a large enough dataset, these models may be used to support clinicians in their decision making process regarding future treatment.
CD3+T-lymphocyte infiltration is an independent prognostic factor for advanced nasopharyngeal carcinoma
Authors: Al-Rajhi Nasser , Soudy Hussein , Ahmed Shoaib A. , Elhassan Tusneem , Mohammed Shamayel F. , Khoja Hatim A. , Ghebeh Hazem
Published: March 2020

Background

Locally advanced nasopharyngeal carcinoma (LA-NPC) is a relatively rare disease in the west but more common in East Asia and areas of the Middle East like Saudi Arabia. Despite the advances in radiation therapy techniques, some patients relapse after treatment. In the coming era of cancer immunotherapy, prognostic factors for LA-NPC need to be further defined using immune-relevant markers. Several markers are available; however, the most robust and accessible/affordable marker is not well-defined.

Methods

Retrospectively, tumor-infiltrating lymphocytes (TIL), their subsets as well as tumoral PD-L1 expression were analyzed in tumor tissues from 63 LA-NPC patients treated with platinum-based concurrent chemo-radiotherapy (CCRT) in addition to 20 cases with metastatic (MET) disease. Immunostaining was done using a validated and fully automated system. Scoring was done by two independent pathologists and results were compared.

Results

There was no statistical difference between LA-NPC and MET disease in terms of CD3+, CD8+ TIL infiltration, or tumoral PD-L1 expression.

In LA-NPC, low CD3+ TIL infiltration highly correlated with shorter disease-free survival (DFS, HR = 8.5, p = < 0.001) and overall survival (OS, HR = 13, p = 0.015) with substantial agreement between scoring pathologists. A similar correlation was found between low CD8+ TIL and survival. Correlation of total TIL was significant with DFS (HR = 4.0, p = 0.008), borderline with OS and the correlation was dependent on the scoring pathologist. Having histological WHO type I&II correlated significantly with shorter DFS (HR 4.03, p = 0.008) and low CD3+ TIL (p = 0.009). Subgroup analysis of LA-NPC that included undifferentiated type (WHO type III) cases only (n = 58), showed a strong correlation between low CD3+ TIL and shorter DFS (HR = 7.2, p = < 0.001) and OS (HR = 17.3, p = 0.008). PD-L1 was expressed in 72% of type III LA-NPC cases while lacking PD-L1 expression correlated with shorter OS (HR = 6.1, p = 0.031). Patients with a combination of low CD3+ TIL and lack of PD-L1 expression had the worst OS (p < 0.001).

Conclusions

CD3+ TIL is promising as a robust and independent prognostic marker for DFS and OS of LA-NPC patients treated with platinum-based CCRT. We would suggest the use of CD3 + TIL as a stratifying factor for LA-NPC, which warrants further validation in prospective trials.
Investigating musculoskeletal health and wellbeing; a cohort study protocol
Authors: Millar Bonnie , McWilliams Daniel F. , Abhishek Abhishek , Akin-Akinyosoye Kehinde , Auer Dorothee P. , Chapman Victoria , Doherty Michael , Ferguson Eamonn , Gladman John R. F. , Greenhaff Paul , Stocks Joanne , Valdes Ana M. , Walsh David A.
Published: March 2020

Background

In an ageing population, pain, frailty and disability frequently coexist across a wide range of musculoskeletal diagnoses, but their associations remain incompletely understood. The Investigating Musculoskeletal Health and Wellbeing (IMH&W) study aims to measure and characterise the development and progression of pain, frailty and disability, and to identify discrete subgroups and their associations. The survey will form a longitudinal context for nested research, permitting targeted recruitment of participants for qualitative, observational and interventional studies; helping to understand recruitment bias in clinical studies; and providing a source cohort for cohort randomised controlled trials.

Methods

IMH&W will comprise a prospective cohort of 10,000 adults recruited through primary and secondary care, and through non-clinical settings. Data collection will be at baseline, and then through annual follow-ups for 4 years. Questionnaires will address demographic characteristics, pain severity (0–10 Numerical Rating Scale), pain distribution (reported on a body Manikin), pain quality (McGill Pain Questionnaire), central aspects of pain (CAP-Knee), frailty and disability (based on Fried criteria and the FRAIL questionnaire), and fracture risk. Baseline characteristics, progression and associations of frailty, pain and disability will be determined. Discrete subgroups and trajectories will be sought by latent class analysis. Recruitment bias will be explored by comparing participants in nested studies with the eligible IMH&W population.

Discussion

IMH&W will elucidate associations and progression of pain, frailty and disability. It will enable identification of people at risk of poor musculoskeletal health and wellbeing outcomes who might be suitable for specific interventions, and facilitate generalisation and comparison of research outcomes between target populations. The study will benefit from a large sample size and will recruit from diverse regions across the UK. Purposive recruitment will enrich the cohort with people with MSK problems with high representation of elderly and unwell people.

Trial registration

Clinicaltrials.govNCT03696134. Date of Registration: 04 October 2018.
Ceftobiprole: a potential empirical post-operative monotherapy in prosthetic joint infections
Authors: Duployez Claire , Wallet Frédéric , Migaud Henri , Senneville Eric , Loiez Caroline
Published: March 2020

Background

This study aimed to evaluate in vitro susceptibility to ceftobiprole of clinical strains identified from prosthetic joint infections (PJIs) compared to that of the associations currently recommended for post-operative empirical antibiotic therapy (PEAT) (vancomycin with either cefepime, third-generation cephalosporin or piperacillin–tazobactam).

Methods

We performed a 1-year retrospective study on all the surgical procedures performed in our hospital for PJI. Susceptibility profiles of all the strains cultured from surgical samples were reviewed to compare ceftobiprole to current used associations.

Results

During the study period (from January 2018 to December 2018), we identified 106 patients managed for PJI and a total of 216 surgical interventions. One hundred-fifty strains were identified from intraoperative samples, excluding redundant strains. Staphylococcus spp. represented 52.7% of all strains and Enterobacteriales 13.3%. Twenty-three patients had polymicrobial infection (22%). Among 149 surgical procedures with positive culture results, ceftobiprole covered the bacterial strains in 138 (92.6%) cases. In comparison, this percentage was 94.6% for vancomycin plus cefepime (p = 0.64), 92.6% for vancomycin plus a third-generation cephalosporin in 138 cases (p = 1) and 94.6% for vancomycin plus piperacillin–tazobactam) (p = 0.64).

Conclusion

Based on antimicrobial susceptibility testing, our results suggest that ceftobiprole could be an interesting option for PEAT in PJIs, allowing the use of a single agent.
Neoadjuvant strategies in resectable carcinoma esophagus: a meta-analysis of randomized trials
Authors: Kumar Tarun , Pai Esha , Singh Rajesh , Francis Neville J. , Pandey Manoj
Published: March 2020

Background

The survival benefit of neoadjuvant therapy in resectable carcinoma esophagus has been elucidated. We performed a meta-analysis in light of new studies and long-term results of past trials. The search strategy was refined to include only “neoadjuvant” so that any bias by adjuvant treatment is eliminated.

Methods

A detailed search of MEDLINE, Embase, and Cochrane Library was done. Only published randomized English language trials were included. Data were categorized as neoadjuvant concurrent chemoradiation (NACRT), neoadjuvant chemotherapy (NACT), neoadjuvant radiotherapy (NART), and neoadjuvant sequential chemoradiotherapy (SCRT). Meta-analysis was done using odds ratio (OR) and 95% CI using fixed/random effects model. Heterogeneity was tested by chi-square and I2 test. Z probability calculated significant difference across subgroups. Outcomes assessed were overall survival (OS) and disease-free survival (DFS) at 3 and 5 years, respectively, mortality (30/90 day) and failures (local/systemic).

Results

Twenty-five randomized trials involving 5272 patients were included for quantitative analysis. NACRT was evaluated in 12 studies (2676 patients). Superior 3-year OS (OR = 0.68 CI 0.52–0.90, p = 0.007), 3-year DFS (OR = 0.55 CI 0.45–0.68, p = 0.00001), and 5-year DFS (OR = 0.59 CI 0.47–0.74, p = 0.00001), with lower failures (OR = 0.52 CI 0.37–0.73, p = 0.0001), were seen in favor of NACRT at the cost of increased perioperative mortality (OR = 1.79 CI 1.15–2.80, p = .01). However, 5-year OS (OR = 0.78 CI 0.60–0.1.01, p = 0.06) was not found to be significantly superior. NACT, NART, and SCRT were not found to have any benefit over surgery alone.

Conclusion

This meta-analysis presents strong evidence favoring NACRT over upfront surgery. It also shows no survival advantage of neoadjuvant chemotherapy.
A case of primary ovarian signet-ring cell carcinoma treated with S-1/CDDP therapy
Authors: Shoji Tadahiro , Takeshita Ryosuke , Saito Tatsunori , Aida Takeshi , Sasou Shunichi , Baba Tsukasa
Published: March 2020

Background

Primary ovarian signet-ring cell carcinoma is extremely rare, with only five recent case reports. Almost all reported cases of ovarian signet-ring cell carcinoma have been treated with TC therapy and none have reported regarding the use of S-1/CDDP therapy. We report a case of primary ovarian signet-ring cell carcinoma treated postoperatively with S-1/CDDP therapy.

Case presentation

We describe a 55-year-old woman diagnosed with stage IB primary ovarian signet-ring cell carcinoma that was treated with S-1/CDDP therapy. Preoperative transvaginal ultrasonography and contrast-enhanced computed tomography (CT) revealed a solid tumor measuring 10 cm in diameter in the pelvis. The tumor marker levels were as follows: CA125, 41.6 U/mL; CA19–9, < 2.0 U/mL; and CEA, 2.2 ng/mL. Ovarian cancer was suspected, and total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy were performed. The left ovary was enlarged to greater than fist-sized, and there was a small amount of clear yellow ascites. Histological examination of the left ovary led to the diagnosis of signet-ring cell carcinoma. Histological examination of the right ovary also showed the presence of a signet-ring cell carcinoma. After surgery, upper and lower gastrointestinal endoscopy and positron-emission tomography-CT were performed to search for a possible primary lesion, but none was found. The patient was diagnosed with primary ovarian signet-ring cell carcinoma with FIGO Stage IB (PT1b, NX, M0). As postoperative adjuvant chemotherapy, S-1/CDDP therapy (S-1120 mg/day/body × 14 days, CDDP 50 mg/m2 day 8, q 21 days) was administered for six cycles. There was no recurrence 27 months after the initial treatment.

Conclusions

We considered S-1/CDDP therapy was effective for primary ovarian signet-ring cell carcinoma. This is the first case report of primary ovarian signet-ring cell carcinoma treated with S-1/CDDP therapy in the world.