bluuebunny/crossref_metadata_2025 huggingface dataset:
Facilitating agency and engagement: Visual methodologies and pedagogical interventions for working with culturally and linguistically diverse young people
Authors: D’warte Jacqueline
Published: July 2020

The 21st century has brought rapid global change to the cultural and linguistic landscape of many nations; this rapidly changing landscape has prompted educators to argue that the lived and evolving reality of contemporary classrooms demands a re-examination of current curriculum, pedagogies and assessment practices. Australian classrooms now include young people who speak many different languages and dialects of English; these young people draw on multiple ways of learning and understanding and are increasingly mobile and connected across time and space. Over the last two decades, rather than building on this linguistic diversity Australia’s national assessment program has relegated difference to a problem fixed by further commitment to standardized English curriculum and assessment practices. In this environment, attention is given to what is perceived as limited or lacking in young people’s knowledge of the English language and literacies practices most valued in school. This article presents research that aimed to acknowledge and build on the foundational linguistic resources of young people in super-diverse mainstream primary classrooms through the application of visual methodologies (language mapping) and corresponding pedagogical work. This research, undertaken in Western Sydney, one of the most diverse regions in Australia, offers possibilities for perpetuating and fostering a pluralist present and future in 21st century classrooms.
Being positive, being hopeful, being happy: Young adults reflecting on their future in times of austerity
Authors: Nikunen Minna , Korvajärvi Päivi
Published: July 2020

The aim of this article is to analyse the ways in which young adults reflect on their futures. We are particularly interested in how they expect to organize their lives in conditions that seem to offer pessimistic rather than hopeful prospects. How does this happen under social conditions where the major public and individual concerns are with how young adults organize their material lives and how they earn sufficient livelihoods to become good citizens? What are the grounds for their future visions? In our analysis we use 40 interviews with young Finnish adults aged between 18 and 30. The respondents are students, as well as employed and unemployed young adults. Our findings show that the young adults’ anticipated future experiences – contrary to common expectations – are positive. These conclusions are often drawn from social comparisons, especially with imagined peers. Those who saw their own and their peers’ future as depending more on luck focused on societal insecurity. One group that had positive expectations emphasized happiness. Instead of seeking material success, many of the young adults reported that their goal was to be happy in their future lives. Happiness appears to involve both living according to, and coping with, the demands of the economy and employment.
Is the right of return still desirable and sacred among Palestinian refugees?
Authors: Albadawi Sobhi
Published: July 2020

The right of return has been a fundamental claim by Palestinian people since 1948. The ‘right’ refers to the political position or principle that all generations of Palestinian refugees have the right to return to the property they or their forebears left behind during the 1948 Palestinian exodus, and following the 1967 Six-Day War. This study examines and updates Palestinian refugees’ views of the right of return claim, adopting a quantitative research design surveying 1200 participants from five refugee camps located in Hebron and Bethlehem in the West Bank. The study finds that even after 72 years of displacement, the right of return remains an active but changing political construct among surveyed Palestinians living in the West Bank. As such, future negotiations must consider the generational narratives and ensure that the right of return claim, resettlement, and compensation particularly are not treated as mutually exclusive in the delivery of a just solution to the displacement of Palestinian refugees.
Managing labour market re-entry following maternity leave among women in the Australian higher education sector
Authors: Gregory Sheree K
Published: July 2020

Paid maternity leave policy attracts considerable attention in Australia and internationally, not least because taking a maternity break and employment re-entry benefits economies, businesses and well-being. The literature on factors contributing to a positive relationship between paid employment, reproduction and caring is fragmented and continues to highlight the complexity of the matter. Drawing on qualitative interviews, and Williams’ theory of domesticity ideology and Pocock’s work/care regimes, I examine women’s paid employment re-entry experiences and management strategies following maternity leave in higher education in Australia. This analysis develops a critical conceptualisation of women making ‘constrained choices’ and ‘forced decisions’ to manage work/care, and relates to gender inequality in the workplace–household intersection; taking a step back in paid employment; outsourcing housework; and the complexity of childcare. Findings highlight the need for support models to promote work/life balance in the context of debates about gender equality and flexibility, and the workplace–household intersection.
Early versus late decompressive craniectomy in traumatic brain injury: A retrospective comparative case study
Authors: Fatima Nida , Mujeeb-Ur-Rehman  , Shaukat Samia , Shuaib Ashfaq , Raza Ali , Ayyad Ali , Saqqur Maher
Published: July 2020

Objectives

Decompressive craniectomy is a last-tier therapy in the treatment of raised intracranial pressure after traumatic brain injury. We report the association of demographic, radiographic, and injury characteristics with outcome parameters in early (<24 h) and late (≥24 h) decompressive craniectomy following traumatic brain injury.

Methods

We retrospectively identified 204 patients (158 (early decompressive craniectomy) and 46 (late decompressive craniectomy)), with a median age of 34 years (range 2–78 years) between 2015 and 2018. The primary endpoint was Glasgow Outcome Scale Extended (GOSE) at 60 days, while secondary endpoints included Glasgow Coma Score (GCS) at discharge, mortality at 30 days, and length of hospital stay. Regression analysis was used to assess the independent predictive variables of functional outcome.

Results

With a clinical follow-up of 60 days, the good functional outcome (GOSE = 5–8) was 73.5% versus 74.1% (p = 0.75) in early and late decompressive craniectomy, respectively. GCS ≥ 9 at discharge was 82.2% versus 91.3% (p = 0.21), mortality at 30 days was 10.8% versus 8.7% (p = 0.39), and length of stay in the hospital was 21 days versus 28 days (p = 0.20), respectively, in early and late decompressive craniectomy groups. Univariate analysis identified that GCS at admission (0.07 (0.32–0.18; < 0.05)) and indication for decompressive craniectomy (3.7 (1.3–11.01; 0.01)) are significantly associated with good functional outcome. Multivariate regression analysis revealed that GCS at admission (<9/≥9) (0.07 (0.03–0.16; <0.05)) and indication for decompressive craniectomy (extradural alone/ other hematoma) (1.75 (1.09–3.25; 0.02)) were significant independent predictors of good functional outcome irrespective of the timing of surgery.

Conclusions

Our results corroborate that the timing of surgery does not affect the outcome parameters. Furthermore, GCS ≥ 9 and/or extra dural hematoma are associated with relatively good clinical outcome after decompressive craniectomy.
Promoting health literacy: What potential does nursing informatics offer to support older adults in the use of technology? A scoping review
Authors: Haupeltshofer Anna , Egerer Vicky , Seeling Stefanie
Published: July 2020

Digitalization is the future and, simultaneously, a challenge for nursing. In addition, health literacy is increasingly associated with the use of technology. Older adults are greatly underrepresented in the use of digital technology and regarded as a vulnerable group. Consequently, training programs for technological knowledge and improving technological competencies are indispensable to promote equal opportunities and health literacy. The researchers inquire what characterizes nursing informatics as an expanding field in relation to the roles and competencies of nurses in technical appropriation processes of older adults. We conducted a scoping review based on a systematic literature search. We identified 23 relevant studies and developed a modular system to characterize the potential of nursing informatics: nursing informatics as a profession, competencies of nurses and nursing informatics, assessments, and eHealth literacy. Nursing informatics is a new field in some countries, but competence profiles and role descriptions clearly show that nurses act as educators, supporters, advocates, and mediators.
Capturing emotions in qualitative strategic organization research
Authors: Kouamé Saouré , Liu Feng
Published: July 2020

This essay offers insight into methods for qualitatively capturing emotions in strategic organization research, a theme that has attracted increasing interest in the literature, but that raises methodological challenges. We review how researchers have examined emotions in the following three domains of strategic organization research—organizational processes, institutional processes, and strategizing activities. We discuss the ontological assumptions about emotion in each of these areas, and explain how researchers in each area examine particular aspects of the multi-dimensional phenomenon of emotion. We identify specific challenges in capturing emotions in each area, as well as the strategies that researchers use to address them. We outline a repertoire of coding resources and guidelines for the convenient use of future researchers. Finally, we evaluate the strengths and limits of each approach, and identify avenues for future research.
Connective Use in Academic Writing by Students With Language Learning Disabilities From Diverse Linguistic Backgrounds
Authors: Wood Carla L.
Published: July 2020

The aims of the current project included to (a) describe the use of connectives in written language samples by fifth grade students, (b) examine differences in connective use between groups who differed in English proficiency and exceptionalities, and (c) examine the predictive relationship between connective measures and writing quality ratings. Investigators utilized written expository responses of 1,128 students in fifth grade who differed in English proficiency and language ability. The sample included 214 English learners and 144 students with language learning disabilities (LLD). Group differences were examined in the use of advanced connective words in academic writing. Regression analysis was used to examine connective measures as predictors of overall writing quality rating. Students with LLD used advanced connectives less frequently than their peers and demonstrated less variety in their connective word use. Two connective measures (total number of advanced connectives and the ratio of connectives) were significant predictors of writing quality. Findings support the need for additional efforts to improve the use of cohesive devices in academic writing for students with LLD to minimize achievement gaps.
The Swinging Self: The Costs of Shifting Between Self-Images in Alzheimer’s Disease
Authors: Altintas Emin , Moustafa Ahmed A. , Gallouj Karim , Haj Mohamad El
Published: July 2020

Background:

We investigated the ability of patients with Alzheimer’s disease (AD) to shift between different self-images.

Methods:

We developed an original task (shifting-self task) in which we invited 28 patients with AD and 30 control participants to generate “who am I” statements that describe 2 alternative self-images (ie, physical-self vs psychological-self). In a control task, participants had to generate 2 blocks of “who am I” statements (ie, physical-self block and psychological-self block).

Results:

Analyses showed longer completion time in both the shifting-self and control task in patients with AD than in control participants. Completion time on the shifting-self task was longer than that on the control task in patients with AD, suggesting a shifting cost in AD.

Conclusion:

We propose that one feature of the diminished sense of self in AD is the difficulty of patients to shift between different alternating self-images.
Impact of a Music Intervention on Quality of Life in Breast Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial
Authors: Lima Talita Uchoa , Moura Ed Carlos Rey , Oliveira Caio Márcio Barros de , Leal Rachel Jorge Dino Cossetti , Nogueira Neto João , Pereira Emanuel Cabral , Nascimento Raniere Victor Braga , Oliveira Eduardo José Silva Gomes de , Leal Plínio da Cunha
Published: July 2020

Background: Music can influence human behavior and may be used as a complementary therapy in health care. Objectives: To assess the effect of music interventions on symptoms, adverse events, and quality of life (QoL) of breast cancer patients undergoing chemotherapy (CT). Design: Nonblinded, randomized clinical trial. Women with breast cancer undergoing adjuvant CT were randomized into 2 groups—Group Music (GM) or Group Control (GC)—and followed during the first 3 cycles of treatment. Measurements: Sociodemographic data, WHOQOL-BREF, BDI-II, BAI, and Chemotherapy Toxicity Scale were assessed. Patients were evaluated after each session of the first 3 CT cycles. GM underwent a 30-minute musical intervention before CT. There was no intervention in the GC. Continuous data were analyzed by Student’s t test, and χ2 test was used to compare qualitative variables. Results: Higher QoL scores on functional scales were observed for the GM in comparison to the GC after the first and third sessions of CT. Depression ( P < .001) and anxiety scores ( P < .001) and vomiting ( P < .01) incidence were lower for the GM in the third session of CT. All the participants in the GM reported positive changes in life in the Subjective Impression of the Subject questionnaire, as well as improvement in fatigue and reduced stress levels. Conclusions: Improvements in QoL, anxiety, depression, and incidence of vomiting were associated with the music intervention, suggesting a positive effect of the music intervention on adverse events of cancer CT.
Considering Transformative Learning for Adolescents Enrolled at Semester Schools
Authors: Meerts-Brandsma Lisa , Sibthorp Jim
Published: July 2020

This study examines semester schools, which have elements associated with transformative learning, and an adolescent population, where transformative learning has less commonly been studied. We administered the Learning Activities Survey pre/post semester ( n = 173) and followed the survey with semistructured interviews ( n = 30) to assess whether students experienced Mezirow’s stages of transformative learning and achieved perspective transformation. Our results suggest that adolescents experience the stages of transformative learning more frequently at semester schools than at their originating schools. However, while students said they achieved perspective transformation on the surveys, interviews revealed that the outcome might better be described as a cycle of identity formation. Students said that the relationships with teachers and students, time for reflection, and the structure of the semester were important to their learning. Specifically, a supportive but challenging environment provided content that they reflected on to gain insight into their values and beliefs.
Application of Dexmedetomidine in Cardiopulmonary Bypass Prefilling
Authors: Wang Li , Wang Shaowei , Xing Zhen , Li Fulong , Teng Jinliang , Jia Tong
Published: July 2020

Objective:

The purpose of this study was to explore the application of dexmedetomidine (Dex) in cardiopulmonary bypass.

Methods:

A total of 60 patients undergoing elective cardiopulmonary bypass were divided into control (C) group and Dex group. In the Dex group, appropriate amount of Dex was added into the membrane lung prefilling solution before anesthesia induction, while those in control group were given normal saline. The levels of mean arterial pressure (MAP) and heart rate (HR) at different times were measured. The levels of cardiac troponin I (CTNI), malondialdehyde (MDA), interleukin 6 (IL-6), and tumor necrosis factor α (TNF-α) at different points (T0/T1/T2/T3/T4) in both groups were measured by enzyme-linked immunosorbent assay kits.

Results:

The intraoperative and postoperative levels of MAP and HR in the 2 groups were significantly lower than those preoperatively ( P < .05). The levels of MAP and HR in the Dex group were significantly lower than those of the C group ( P < .05). The levels of CTNI/MDA/IL-6/TNF-α at different points in both groups were significantly higher than those at T0 ( P < .05). The serum levels of CTNI, MDA, IL-6, and TNF-α in the Dex group at T1/T2/T3/T4 were significantly lower than those in the C group ( P < .05). The rate of arrhythmia in the Dex group was significantly lower than that in the C group ( P < .05).

Conclusion:

Dexmedetomidine has a stable effect in cardiopulmonary priming solution.
A novel prediction method for rail grinding profile based on an interval segmentation approach and accurate area integral with cubic NURBS
Authors: Xie Huan , Chen Xiang , Zeng Wei , Qiu Wensheng , Ren Tao
Published: July 2020

Rail grinding profile prediction in different grinding patterns is important to improve the grinding quality for the rail grinding operation site. However, because of high-dimensional and strong nonlinearity between grinding amount and grinding parameters, the prediction error and computational cost is relatively high. As a result, the accuracy and efficiency of conventional methods cannot be guaranteed. In this article, an accurate and efficient rail grinding profile prediction method is proposed, in which an interval segmentation approach is proposed to improve the prediction efficiency based on the geometric characteristic of a rail profile. Then, the accurate area integral approach with cubic NURBS is used as the grinding area calculation approach to improve the prediction accuracy. Finally, the normal length index is introduced to evaluate the prediction accuracy. The accuracy and stability of the proposed method are verified by comparing a conventional approach based on a practical experiment. The results demonstrate that the proposed method can predict the rail grinding profile in any grinding pattern with high accuracy and efficiency. Meanwhile, its prediction stability basically agrees with the conventional approach.
Experimental assessment of regenerated lube oil in spark-ignition engine for sustainable environment
Authors: Usman Muhammad , Saqib Syed , Zubair Syed Wasim Hassan , Irshad Muneeb , Kazmi Ammar Hussain , Noor Ahmed , Zaman Hafiz Umer , Nasir Zaheer , Ijaz Malik Muhammad Ali
Published: July 2020

Lube oils are the viscous petroleum products used in automobiles to reduce the friction. The eventual fate of lube oil is either incineration or dumping off into ground, but these resources cannot be disposed off easily due to their libellous effects on environment. This article aims to study the regeneration of deteriorated oil and impact of regenerated oil on engine performance and engine emissions. The effectuality of regeneration is studied by comparing the results of the key parameters (specific gravity, viscosity, total acid number, flash point and ash contents) of regenerated oil with that of non-deteriorated and deteriorated oil. Engine performance and emissions for regenerated oil were compared with non-deteriorated and deteriorated oil. The brake power and torque increased by 4.1% and 4.6%, respectively, following the regeneration process. After re-refining of lube oil, specific gravity, flash point, kinematic viscosity, ash content and total acid number improved by 6.75%, 2.66%, 15.6%, 1.7% and 10.64%, respectively. In case of deteriorated oil, HC, NOx and CO increased by 23.6%, 42.2% and 11.8%, respectively. But after regeneration of oil, these emissions decreased as compared with deteriorated oil. It can be reasoned out that regeneration mends oil properties and has positive impact over engine performance and emissions.
Analytical study of floating effects on load sharing characteristics of planetary gearbox for off-road vehicle
Authors: Chung Woo-Jin , Oh Joo-Seon , Han Hyun-Woo , Kim Ji-Tae , Park Young-Jun
Published: July 2020

Uneven load sharing of a planetary gear set is the main cause of preventing the miniaturization and weight reduction of a planetary gearbox. Non-torque loads and carrier pinhole position errors are the main factors that worsen the load-sharing characteristics. However, their effects are seldom analyzed at a system level especially for an off-road vehicle. To make up this gap, some simulation models are proposed to investigate the effects of floating members on the load-sharing characteristics and the strength of a planetary gear set with non-torque load and carrier pinhole position error. When the error is not considered, the mesh load factor converges to unity irrespective of the type and number of floating members and the safety factors for pitting and bending are increased slightly. When the carrier pinhole position error is considered, the mesh load factor dramatically worsens. Although it is improved using the floating members, it does not converge to unity. However, the bending safety factor of the planet gear with the error is increased by 26%. This indicates that the design modification for the original planetary gearbox is needed to satisfy the safety factor requirement, but the problem is solved using only floating members.
Preceding infection and risk of stroke: An old concept revived by the COVID-19 pandemic
Authors: South Kieron , McCulloch Laura , McColl Barry W , Elkind Mitchell SV , Allan Stuart M , Smith Craig J
Published: July 2020

Anecdotal reports and clinical observations have recently emerged suggesting a relationship between COVID-19 disease and stroke, highlighting the possibility that infected individuals may be more susceptible to cerebrovascular events. In this review we draw on emerging studies of the current pandemic and data from earlier, viral epidemics, to describe possible mechanisms by which SARS-CoV-2 may influence the prevalence of stroke, with a focus on the thromboinflammatory pathways, which may be perturbed. Some of these potential mechanisms are not novel but are, in fact, long-standing hypotheses linking stroke with preceding infection that are yet to be confirmed. The current pandemic may present a renewed opportunity to better understand the relationship between infection and stroke and possible underlying mechanisms.
Work ethos in American ceremonial discourse addressed to the young
Authors: Bogdanowska-Jakubowska Ewa
Published: July 2020

The article discusses work ethos in American ceremonial discourse addressed to the young entering adult life. Its aim is to investigate whether the Protestant work ethic still pervades the American thinking about work. Through a qualitative analysis of the corpus of 100 randomly selected commencement addresses delivered during 2016 and 2017 graduation ceremonies in American universities, it is shown how work-related topics are employed by the speakers celebrating the graduates’ academic achievements and providing them with advice for the future. The Discourse-Historical Approach, committed to Critical Discourse Analysis, has been chosen as a methodological approach, integrating the interpretation of discourses and texts with sociological and historical research, studies on narration, stylistics, rhetoric and argumentation theory. As the discourse to be analyzed is culture-specific, I have decided to combine the Discourse-Historical Approach with Cultural Studies.
A case series of non-valvular cardiac aspergillosis in critically ill solid organ transplant and non-transplant patients and systematic review
Authors: Navaratnam Annalan MD , Al-Freah Mohammad , Cavazza Anna , Auzinger Georg
Published: July 2020

Introduction

Non-valvular cardiac aspergillosis is a rare infection of the pericardium, myocardium or endocardium and is associated with a high mortality. There is a paucity of reports of non-valvular cardiac aspergillosis in critically ill and solid organ transplant (SOT) patients. The majority of cases have been reported in haemato-oncology patients, some of whom have undergone a bone marrow transplant.

Objectives

We describe four cases affected by non-valvular cardiac aspergillosis in the intensive care setting including a systematic review of this extremely rare infection which is associated with high mortality.

Results

All four-patients died but presented with varying clinical, radiological and microbiological evidence of the disease. Three patients presented following complications after solid organ transplantation, two in the context of acute liver failure and emergency liver transplant and one several years after a double lung transplant. The last patient presented with necrotising gall stone pancreatitis, multi-organ failure and subsequently a prolonged intensive care unit (ICU) stay. On review of the literature, January 1955 to July 2019, 45 cases were identified, with different risk factors, clinical and radiological manifestations, treatment regimen and outcome.

Conclusion

Antemortem diagnosis of cardiac aspergillosis is difficult and rare, with no cases reporting positive blood culture results. Galactomannan serology has poor sensitivity in solid organ transplant patients, further reduced by prophylactic antimicrobial treatment, which is common in the ICU setting especially post-transplant patients. Due to the scarcity of cases, treatment is extrapolated from invasive aspergillosis management, with emphasis on early treatment with combination therapy.
An ulnar parametacarpal perforator flap for volar digital soft tissue reconstruction
Authors: Usami Satoshi , Inami Kohei , Hirase Yuichi , Mori Hiroki
Published: July 2020

We present outcomes of using a perforator-based ulnar parametacarpal flap in 25 patients for digital pulp defects. These included 17 free transfers to the thumb, index, middle and ring fingers and eight reverse pedicled transfers to the little fingers. This flap includes a dorsal sensory branch of the ulnar nerve, which was sutured to the digital nerve in all transfers. Each flap had one to three reliable perforators (mean 0.44 mm diameter) to the ulnar parametacarpal region and contained at least one perforator within 2 cm proximal to the palmar digital crease. All the 25 flaps survived completely. Twenty-two patients were followed for 15 months (range 12 to 24), and three were lost to follow-up. The mean static and moving two-point discrimination of the flap was 7 mm and 5 mm, respectively. At the donor site, sensory reinnervation was acceptable. We conclude that ulnar parametacarpal perforator flaps offer sensate, thick and glabrous skin for finger pulp repair, all in a single operative field.

Level of evidence: IV
Inhaled antibiotics therapy for stable non-cystic fibrosis bronchiectasis: a meta-analysis
Authors: Xu Meng-Jiao , Dai Bing
Published: July 2020

Background:

The optimum antibiotic therapy for non-cystic fibrosis bronchiectasis (NCFB) has yet to be determined. A meta-analysis was conducted to evaluate the efficacy and safety of inhaled antibiotics in adults with stable NCFB.

Methods:

PubMed, EMBASE, MEDLINE and the Cochrane Central Register of Controlled Trials were searched through November 2019.

Results:

A total of 16 randomized controlled trials (RCTs), recruiting 2748 NCFB patients, were finally included. Inhaled antibiotics treatment significantly reduced the sputum bacterial load [standard mean difference (SMD) = –0.74, 95% CI: –1.16–0.32, p < 0.001, I2 = 68.1%], prolonged median time [hazard risk (HR) = 0.73, 95% confidence interval (CI): 0.57–0.93, p < 0.001, I2 = 53.6%] and reduced frequency [incidence rate ratio (IRR) = 0.74, 95% CI 0.63–0.87, p < 0.001, I2 = 20.5%] of exacerbations, with good tolerance. However, it failed to improve Pseudomonas aeruginosa eradication, [forced expiratory volume in 1 s (FEV1)] % predicted, quality of life questionnaire (QoL-B) and St. George’s respiratory questionnaire (SGRQ) scores, and may induce higher risk of P. aeruginosa resistance. Subgroup analysis showed Ciprofloxacin was more effective than other antibiotics in reducing bacterial load (SMD = –1.35, 95% CI: –1.85–0.85, I2 = 63.4%, p = 0.042).

Conclusion:

Inhaled antibiotics therapy holds great promise for stable NCFB as it is effective in reducing sputum bacterial load and the risk of acute attack, delaying disease progression, and is well tolerated. Although this study brings some constructive ideas in the field of clinical medication, further clinical trials should be carried out, particularly in solving drug-resistance and improving health-related quality of life (HRQoL), which we believe will finally provide benefits for patients suffering from bronchiectasis. The reviews of this paper are available via the supplemental material section.
Clinical predictive efficacy of C-reactive protein for diagnosing infectious complications after gastric surgery
Authors: Shi Jinyao , Wu Zhouqiao , Wang Qi , Zhang Yan , Shan Fei , Hou Shiyang , Ying Xiangji , Huangfu Longtao , Li Ziyu , Ji Jiafu
Published: July 2020

Background:

With the popularization of Enhanced Recovery After Surgery (ERAS), identifying patients with complications before discharging becomes important. This study aimed to explore the efficacy of C-reactive protein (CRP) in predicting infectious complications after gastrectomy.

Methods:

Patients with gastric cancer who underwent gastrectomy at Beijing Cancer Hospital from March 2017 to April 2018 were enrolled in the training set. Complications were prospectively registered. Receiver operating characteristic analysis was performed to assess the diagnostic accuracy of CRP via evaluating the area under the curve (AUC). Patients who had CRP tested on postoperative day (POD) 5 and accepted gastrectomy from April to December 2018 were included in the validation set to validate the cut-off value of CRP obtained from the training set.

Results:

A total of 350 patients were included (263 patients in the training set and 87 patients in the validation set). Out of these, 24 patients were diagnosed with infectious complications and 17 patients had anastomotic leakage in the training set. The CRP level on POD5 had superior diagnostic accuracy for infectious complications with an AUC of 0.81. The cut-off value of CRP on POD5 at 166.65 mg/L yielded 93% specificity and 97.2% negative predict value (NPV); For anastomotic leakage, the AUC of CRP on POD5 was 0.81. Using the cut-off value of CRP at 166.65 mg/L on POD5 achieved 92% specificity and 98.6% NPV. The optimal cut-off value (CRP 166.65 mg/L on POD5) was validated in the validation set. It achieved 97.5% specificity and 94.0% NPV for infectious complications, and 97.6% specificity and 96.4% NPV for anastomotic leakage.

Conclusion:

CRP is a reliable predictive marker for the diagnosis of inflammatory complications following gastric surgery. However, this study was based on preliminary data. The validity of this data needs confirmation by a larger number of cases.
Reverse shoulder arthroplasty glenoid lateralization influences scapular spine strains
Authors: Kerrigan Alicia M , Reeves Jake , Langohr G Daniel G , Johnson James A , Athwal George S
Published: July 2020

Background

Scapular spine insufficiency fractures following reverse shoulder arthroplasty are poorly understood. There exists limited literature regarding the role of reverse shoulder arthroplasty lateralization on scapular spine strains and fractures. The purpose of this cadaveric biomechanical simulator study was to evaluate the role of glenoid lateralization on scapular spine strain.

Methods

Eight cadaveric shoulders were tested using an in-vitro simulator. A custom modular reverse shoulder arthroplasty was implanted that allowed for in-situ glenoid lateralization adjustment. Scapular spine strain was measured by strain gauges placed in clinically relevant Levy zones along the scapular spine. All specimens were tested in loaded forward elevation and abduction.

Results

Glenoid lateralization from 0 to 5 mm caused negligible changes in scapular spine strains. Lateralization from 5 to 10 mm, however, caused significant increases in strain at 0° forward elevation in all strain gauges (p < 0.026). Strains measured in Levy zone 2 were significantly higher than all other locations (p < 0.039). Additionally, forward elevation resulted in significantly higher strain values than abduction (p = 0.001).

Conclusions

Glenoid lateralization is an important parameter in reverse shoulder arthroplasty; however, our results demonstrate higher degrees of lateralization may place higher strains on the scapular spine. An understanding of reverse shoulder arthroplasty lateralization and scapular spine strains is important to optimize parameters and to mitigate negative effects.

Level of evidence

Basic Sciences Study, Cadaveric Model, Biomechanics.
Use of patient derived orthotopic xenograft models for real-time therapy guidance in a pediatric sporadic malignant peripheral nerve sheath tumor
Authors: Fernández-Rodríguez Juana , Morales La Madrid Andrés , Gel Bernat , Castañeda Heredia Alicia , Salvador Héctor , Martínez-Iniesta María , Moutinho Catia , Morata Jordi , Heyn Holger , Blanco Ignacio , Creus-Bachiller Edgar , Capella Gabriel , Farré Lourdes , Vidal August , Soldado Francisco , Krauel Lucas , Suñol Mariona , Serra Eduard , Villanueva Alberto , Lázaro Conxi
Published: July 2020

Background:

The aim of this study was to test the feasibility and utility of developing patient-derived orthotopic xenograft (PDOX) models for patients with malignant peripheral nerve sheath tumors (MPNSTs) to aid therapeutic interventions in real time.

Patient & Methods:

A sporadic relapsed MPNST developed in a 14-year-old boy was engrafted in mice, generating a PDOX model for use in co-clinical trials after informed consent. SNP-array and exome sequencing was performed on the relapsed tumor. Genomics, drug availability, and published literature guided PDOX treatments.

Results:

A MPNST PDOX model was generated and expanded. Analysis of the patient’s relapsed tumor revealed mutations in the MAPK1, EED, and CDK2NA/B genes. First, the PDOX model was treated with the same therapeutic regimen as received by the patient (everolimus and trametinib); after observing partial response, tumors were left to regrow. Regrown tumors were treated based on mutations (palbociclib and JQ1), drug availability, and published literature (nab-paclitaxel; bevacizumab; sorafenib plus doxorubicin; and gemcitabine plus docetaxel). The patient had a lung metastatic relapse and was treated according to PDOX results, first with nab-paclitaxel, second with sorafenib plus doxorubicin after progression, although a complete response was not achieved and multiple metastasectomies were performed. The patient is currently disease free 46 months after first relapse.

Conclusion:

Our results indicate the feasibility of generating MPNST-PDOX and genomic characterization to guide treatment in real time. Although the treatment responses observed in our model did not fully recapitulate the patient’s response, this pilot study identify key aspects to improve our co-clinical testing approach in real time.
Procedure-specific prognostic impact of micropapillary subtype may guide resection strategy in small-sized lung adenocarcinomas: a multicenter study
Authors: Su Hang , Xie Huikang , Dai Chenyang , Zhao Shengnan , Xie Dong , She Yunlang , Ren Yijiu , Zhang Lei , Fan Ziwen , Chen Donglai , Jiang Feng , Liu Jinshi , Zhu Quan , Yao Jie , Ke Honggang , Zhang Lei , Wu Chunyan , Jiang Gening , Chen Chang
Published: July 2020

Background:

Limited resection has gradually become an acceptable treatment for lung adenocarcinomas (ADCs) presenting as ground-glass nodules (GGNs). However, its role in lung ADCs presenting as pure solid nodules (PSN) remains unclear. In this study, we aimed to identify potential candidates for limited resection in lung ADCs presenting as PSN.

Methods:

We retrospectively reviewed 772 patients from seven hospitals with lung ADCs ⩽2 cm, presenting as PSN on computed tomography scans, who had undergone surgery between 2009 and 2013. Histological subtypes were listed in 5% increments. To investigate the value of histological subtypes in surgical decision making, five pathologists prospectively evaluated the feasibility of identifying histological subtypes using frozen section (FS) in two cohorts.

Results:

The percentage of micropapillary (MIP) subtype had a striking impact on recurrence-free survival (RFS) and overall survival (OS) for lung ADCs ⩽2 cm presenting as PSNs. In multivariable Cox analysis, segmentectomy was significantly associated with worse RFS and OS in patients with MIP >5% than lobectomy, but not in those with MIP ⩽5%. With wedge resection, worse RFS and OS were observed in patients with MIP >5% and those with MIP ⩽5% than lobectomy. The sensitivity and specificity for detecting MIP by FS were 74.2% and 85.6%, respectively, with substantial inter-rater agreement.

Conclusion:

Segmentectomy and lobectomy had similar oncological outcomes in patients with lung ADCs ⩽2 cm presenting as PSN with MIP ⩽5%. Randomized trials are necessary to validate the feasibility of intraoperative FS to choose candidates for segmentectomy.
Reassessing Downs: Testing the Influence of Voters’ Characteristics in a Chilean Presidential Election
Authors: Santana Andrés , Montero José Ramón , Rama José
Published: July 2020

This article puts Down’s instrumental voter model (IVM) to a formal test using data of the 2017 Chilean national elections. It aims at two novel exercises in the research in the calculus of voting. Using a brand-new questionnaire with indicators on instrumental and consumption motivations for voting, we reassess the voting equation in Santiago de Chile. Furthermore, we analyse whether instrumental and consumption motivations have distinctive effects for individuals with different socio-demographic characteristics. Our results show that they do: women, younger, lower educated, and unmarried citizens are more responsive to both instrumental and consumption motivations. Moreover, the factors of the IVM travel better to Santiago de Chile than those of the consumption model.
Aloe barbadensis: A Plant of Nutricosmetic Interest
Authors: Laneri S , Di Lorenzo RM , Bernardi A , Sacchi A , Dini I
Published: July 2020

Aloe barbadensis Miller (Aloe Vera Linne) products have long been employed in health foods and for medical purposes. It has anti-inflammatory, antifungal, antioxidant properties, which indicates excellent potential in antiaging cosmetic and skin protection products. The objective of this study is to evaluate the antiaging efficacy of dermocosmetic formulations containing A. barbadensis extract on young and mature skin using biophysical and skin imaging techniques. Twenty healthy adult volunteers participated in the study, aged between 20 and 65. The cream formulation, with 10% (w/w) of A. barbadensis extract, and placebo, were applied to the face of the volunteers. The effects were evaluated in terms of skin hydration and barrier effect by the measurement of transepidermal water loss (TEWL), derma firmness, and elasticity. The formulation containing A. barbadensis extract significantly improves water contained in the stratum corneum, firmness, elasticity of the skin, and decreased TEWL.
CAD/CAM Engineered Patient-Specific Impants as a Reposition Device in Le Fort I and Modified Subcondylar Osteotomies: Case Report of Facial Deformity Correction in Acromegaly
Authors: Suojanen Juho , Hodzic Zlatan , Palotie Tuula , Stoor Patricia
Published: July 2020

Acromegaly is a medical condition where elevated growth hormone or insulin-like growth factor I levels cause several changes in the craniofacial soft and hard features. We report the correction of facial deformity and posterior open bite with Le Fort I and modified subcondylar osteotomies in a patient affected by acromegaly. Computer-aided design and manufacturing generated saw and drill guides were used to perform osteotomies and segment removal. The placement of the patient-specific implants (PSIs) was guided by predesigned drill holes ensuring the required and planned movement of the jaws and position of the PSIs. After segment removal, the PSIs fitted the predesigned drill holes with high precision and were secured without problems. The planned amount of mandibular and maxillary movement was achieved. The occlusion and osteotomies remained stable for the follow-up of 22 months. The use of PSIs combined with guided surgery can be beneficial for selected cases with asymmetry or posterior open bite enabling new approaches and yielding good functional and aesthetic outcome. The modification of conventional ramus osteotomy combined with utilization of ramus segment removal and the use of PSI for reposition is an interesting and promising technique for rare conditions with ramus height asymmetry.
Transoral endoscopic surgical approach to venous malformation of the parapharyngeal space
Authors: Kimura Akari , Seino Yutomo , Yamashita Taku
Published: July 2020

We encountered a rare case of venous malformation located in the parapharyngeal space. The 65-year-old female patient did not have any symptoms, and the malformation was discovered incidentally during a clinical survey. Examination of the oral cavity revealed a mass in the left soft palate. Magnetic resonance imaging showed a well-defined mass in the left parapharyngeal space. Fine needle aspiration cytology suggested no malignancy. Four years after the first visit, she underwent surgery for diagnosis and treatment. We safely removed the mass with a rigid videoendoscope trans-orally. No postoperative complications arose, and she was discharged 7 days after the operation. Histopathological examination identified cavernous hemangioma. Venous malformation (cavernous hemangioma) of the parapharyngeal space is very rare, and few cases of removal under a transoral approach using a rigid endoscope with a flexible tip have been reported. This approach is safe and can be recommended for selected tumors of the parapharyngeal space.
The role of intraoperative kidney mucosal biopsy on screening of squamous cell carcinoma of the kidney in nephrolithiasis patients with stones larger than 20 mm
Authors: Nugroho Tri Sunu Agung , Safriadi Ferry , Noegroho Bambang Sasongko
Published: July 2020

Introduction:

Renal pelvic squamous cell carcinoma is a very rare tumor, with a prevalence <1% of all urinary tract tumors, about 0.5–8% of all kidney tumors, and the average age is 50–70 years. Although the incidence of renal squamous cell carcinoma is less common than renal cell carcinoma and renal transitional cell carcinoma, due to its more aggressive nature renal squamous cell carcinoma is often found intraoperatively and is already in an advanced stage or metastasis. The relevant medical history of squamous cell carcinoma is pyelonephritis, chronic nephrolithiasis, and a history of kidney stone surgery. Data which was obtained from previous research at Hasan Sadikin Hospital, from January 2014–December 2017, found the incidence of renal squamous cell carcinoma from nephrectomy procedures was 6%.

Methods:

This study was a cross-sectional study with a correlative analytic study, samples were taken consecutively from biopsy of kidney mucosa intraoperatively in hospitalized patients with kidney stones with size larger than 20 mm at the Department of Urology, Hasan Sadikin Hospital Bandung, which performed open kidney surgery or percutaneous nephrolithotomy from January–May 2019.

Results:

The number of samples in this study were from 30 patients, consisting of 16 males and 14 females. Five patients underwent open kidney surgery and 25 patients underwent percutaneous nephrolithotomy surgery, with an average of age of 49.5±11.8 years and 63.3% of patients were aged from 40–60 years. In this study, one patient (3.3%) showed squamous cell carcinoma of the kidney, a 57-year-old male patient with a left staghorn kidney stone who underwent left percutaneous nephrolithotomy surgery.

Conclusion:

There is a benefit for intraoperative kidney mucosal biopsy as a screening for squamous cell carcinoma of the kidney in nephrolithiasis patients with stones larger than 20 mm.

Level of evidence:

3
A previously treated severe haemophilia A patient developed high-titre inhibitor after vaccinations
Authors: Li Zekun , Chen Zhenping , Cheng Xiaoling , Wu Xinyi , Li Gang , Zhen Yingzi , Poon Man-Chiu , Wu Runhui
Published: July 2020

The factor VIII (FVIII)-neutralizing antibody (inhibitor) seen in 25%–30% of patients with severe haemophilia A (SHA). Vaccination is a non-genetic risk factor of inhibitor development as ‘danger signal’ which may provide a pro-inflammatory microenvironment to increase FVIII immunogenicity. We reported a previously treated SHA patient postponed the first vaccination to 15-month age received diphtheria-pertussis-tetanus intramuscularly. At 18-month age, the patient received Hepatitis A intramuscularly and Varicella Zoster Virus subcutaneously with 2 weeks interval and FVIII infusion was given <24 h prior for each. Successive bleedings occurred 1 week later with inefficacy of FVIII replacement. High-titre inhibitor was tested at 117 exposure days. This case suggested that continuous vaccinations in close proximity to FVIII could induce inhibitor. The relationship between vaccination and FVIII immunogenicity still needs to be revealed by further study.
A mixed methods approach to understanding streetscape preferences in a multicultural setting
Authors: Lesan Maryam , Gjerde Morten
Published: July 2020

Relationships between people and their environments are continually reconstituted through public space. Culture and background are important influences on how people respond to their environments and, as populations become more diverse, it might be expected that public spaces respond to more diverse preferences. In New Zealand, despite its bi-cultural history, it is largely European preferences that have shaped public spaces. However, with immigration and travel, the country is rapidly becoming multicultural, with Pasifika people and Asians making up larger proportions of the population alongside those who identify as Māori and European. If public spaces are to respond to these changing demographics, there is little empiric evidence to inform urban designers and public space managers. This article discusses the methods used to examine streets as one of the most relevant types of public space in New Zealand. The methodology was deployed in two distinct stages, the first of which made use of ethnographic fieldwork and provided data on specific public spaces and their usage through a range of case studies. The second stage utilised online surveys to probe people’s preferences for a series of visualisations of street environments. Most research on public space design has to date been focussed on one or the other of these methods (field research or visual preference surveys). The combination of methods used in this research enables a deeper understanding of which public space attributes foster lingering and social activities among people from different cultural backgrounds. This methodology is feasible and comprehensive, clearly identifying the important relationships between design, use and preference in multicultural societies. The findings will be of interest to other researchers, urban practitioners and city officials.