bluuebunny/crossref_metadata_2025 huggingface dataset:
Study on the Rock Size Effect of Quasistatic and Dynamic Compression Characteristics
Authors: Zhou Jun , Meng Xiangrui , Liu Chongyan , Liu Zhixi , Xu Wensong , Cheng Xiang
Published: June 2021

To study the size effect of rock under quasistatic and dynamic conditions, the changes in compressive strength with the change in specimen size are measured. Cylindrical granite specimens with length‐diameter ratios in the range of 0.5∼1 are used for uniaxial compression tests using an RMT testing machine and an SPHB impact testing machine. Under quasistatic loading, the failure modes of the specimens with different length‐diameter ratios are different. The larger the size of the specimen structure is, the greater the probability of defects such as joints and micro cracks is and the smaller the influence of the specimen on the distribution of a three‐dimensional stress state is. The rock strength decreases with increasing length‐diameter ratio. Using the improved Weibull formula, the size of the specimen is expressed by the volume, and the calculated rock strength of different volumes is similar to the compressive strength from the quasistatic tests. Under dynamic loading, the dynamic compressive strengths of the specimens with different length‐diameter ratios are similar, and the failure mode of the specimens is different from that under quasistatic loading. Soon after a crack appears in a specimen, the specimen splits. As the size of the specimens decreases, the fragments size to approach the millimeter scale. By improving the Weibull distribution formula and considering variation in strain rate caused by the size of the specimen, the dynamic compressive strength of rocks of different volumes is calculated by introducing the critical strain rate and related parameters, and the results are similar to the experimental dynamic compressive strength obtained. The improved Weibull formula based on the strength size effect can accurately describe the quasistatic and dynamic compressive strength laws.
Gene Fusions Create Partner and Collateral Dependencies Essential to Cancer Cell Survival
Authors: Gillani Riaz , Seong Bo Kyung A. , Crowdis Jett , Conway Jake R. , Dharia Neekesh V. , Alimohamed Saif , Haas Brian J. , Han Kyuho , Park Jihye , Dietlein Felix , He Meng Xiao , Imamovic Alma , Ma Clement , Bassik Michael C. , Boehm Jesse S. , Vazquez Francisca , Gusev Alexander , Liu David , Janeway Katherine A. , McFarland James M. , Stegmaier Kimberly , Van Allen Eliezer M.
Published: June 2021

Gene fusions frequently result from rearrangements in cancer genomes. In many instances, gene fusions play an important role in oncogenesis; in other instances, they are thought to be passenger events. Although regulatory element rearrangements and copy number alterations resulting from these structural variants are known to lead to transcriptional dysregulation across cancers, the extent to which these events result in functional dependencies with an impact on cancer cell survival is variable. Here we used CRISPR-Cas9 dependency screens to evaluate the fitness impact of 3,277 fusions across 645 cell lines from the Cancer Dependency Map. We found that 35% of cell lines harbored either a fusion partner dependency or a collateral dependency on a gene within the same topologically associating domain as a fusion partner. Fusion-associated dependencies revealed numerous novel oncogenic drivers and clinically translatable alterations. Broadly, fusions can result in partner and collateral dependencies that have biological and clinical relevance across cancer types.

Significance:

This study provides insights into how fusions contribute to fitness in different cancer contexts beyond partner-gene activation events, identifying partner and collateral dependencies that may have direct implications for clinical care.
RAD51AP1 Loss Attenuates Colorectal Cancer Stem Cell Renewal and Sensitizes to Chemotherapy
Authors: Bridges Allison E. , Ramachandran Sabarish , Tamizhmani Kavin , Parwal Utkarsh , Lester Adrienne , Rajpurohit Pragya , Morera Daley S. , Hasanali Sarrah L. , Arjunan Pachiappan , Jedeja Ravirajsinh N. , Patel Nikhil , Martin Pamela M. , Korkaya Hasan , Singh Nagendra , Manicassamy Santhakumar , Prasad Puttur D. , Lokeshwar Vinata B. , Lokeshwar Bal L. , Ganapathy Vadivel , Thangaraju Muthusamy
Published: June 2021

DNA damage, induced by either chemical carcinogens or environmental pollutants, plays an important role in the initiation of colorectal cancer. DNA repair processes, however, are involved in both protecting against cancer formation, and also contributing to cancer development, by ensuring genomic integrity and promoting the efficient DNA repair in tumor cells, respectively. Although DNA repair pathways have been well exploited in the treatment of breast and ovarian cancers, the role of DNA repair processes and their therapeutic efficacy in colorectal cancer is yet to be appreciably explored. To understand the role of DNA repair, especially homologous recombination (HR), in chemical carcinogen-induced colorectal cancer growth, we unraveled the role of RAD51AP1 (RAD51-associated protein 1), a protein involved in HR, in genotoxic carcinogen (azoxymethane, AOM)–induced colorectal cancer. Although AOM treatment alone significantly increased RAD51AP1 expression, the combination of AOM and dextran sulfate sodium (DSS) treatment dramatically increased by several folds. RAD51AP1 expression is found in mouse colonic crypt and proliferating cells. RAD51AP1 expression is significantly increased in majority of human colorectal cancer tissues, including BRAF/KRAS mutant colorectal cancer, and associated with reduced treatment response and poor prognosis. Rad51ap1-deficient mice were protected against AOM/DSS-induced colorectal cancer. These observations were recapitulated in a genetically engineered mouse model of colorectal cancer (ApcMin/+). Furthermore, chemotherapy-resistant colorectal cancer is associated with increased RAD51AP1 expression. This phenomenon is associated with reduced cell proliferation and colorectal cancer stem cell (CRCSC) self-renewal. Overall, our studies provide evidence that RAD51AP1 could be a novel diagnostic marker for colorectal cancer and a potential therapeutic target for colorectal cancer prevention and treatment.

Implications:

This study provides first in vivo evidence that RAD51AP1 plays a critical role in colorectal cancer growth and drug resistance by regulating CRCSC self-renewal.
Clinicopathological Features of BRCA1/2 Mutation-Positive Breast Cancer
Authors: Paik Hyun-June , Jung Youn Joo , Kim Dong Il , Lee Seungju , Jung Chang Shin , Kang Seok Kyung , Kim Jae-Joon , Oh So Yeon , Joo Ji Hyeon , Kim Hyun Yul
Published: June 2021

Purpose: The BRCA1/2 gene is the most well-known and studied gene associated with hereditary breast cancer. BRCA1/2 genetic testing is widely performed in high-risk patients of hereditary breast cancer in Korea. This study aimed to investigate the clinicopathological characteristics of BRCA1/2 mutation-positive breast cancer patients. Methods: The clinical data of 188 Korean breast cancer patients who underwent genetic testing of BRCA1/2 mutation between March 2015 and February 2020 at Pusan National University Yangsan Hospital were retrospectively reviewed. The characteristics of breast cancer according to the expression of BRCA1 and BRCA2 mutations were analyzed using the Health Insurance Review and Assessment Service guideline criteria and other clinicopathological factors. Results: The factor associated with BRCA1/2 gene expression was cancer stage, and mutation expression was significantly decreased in stage I compared to stage 0 (p = 0.033; odds ratio [OR], 0.169; 95% confidence interval [CI], 0.033–0.867), and there was a tendency to increase in stage II (p = 0.780; OR, 1.150; 95% CI, 0.432–3.064). BRCA1 was significantly associated with triple-negative breast cancer (TNBC) (p = 0.004; OR, 5.887; 95% CI, 1.778–19.498). Gene expression of BRCA2 was significantly reduced under 40 years of age (p = 0.040; OR, 0.198; 95% CI, 0.042–0.930). There was no difference in disease-free survival (p = 0.900) and overall survival (p = 0.733) between the BRCA1/2 mutation-positive and -negative groups. Conclusion: In this study, the clinicopathological characteristics of breast cancer patients with BRCA1/2 gene mutations were identified. BRCA1 gene expression was highly correlated with TNBC. BRCA1/2 mutation did not have a poor prognosis regarding recurrence and death.
Persistence and Severity of Cutaneous Manifestations in IgA Vasculitis Is Associated with Development of IgA Vasculitis Nephritis in Children
Authors: Sestan Mario , Srsen Sasa , Kifer Nastasia , Sapina Matej , Batnozic Varga Mateja , Ovuka Aleksandar , Held Martina , Kozmar Ana , Frkovic Marijan , Laskarin Gordana , Gagro Alenka , Jelusic Marija
Published: June 2021

Background/Objective: The purpose of this study was to evaluate the prevalence and severity of skin involvement in children with IgA vasculitis (IgAV) and its relationship with clinical and biochemical parameters and the risk of developing IgA vasculitis nephritis (IgAVN), the only cause of long-term morbidity and the main prognostic factor in IgAV patients. Methods: This national multicenter retrospective study included 611 patients under the age of 18 years with IgAV referred to five Croatian tertiary hospitals between 2009 and 2019. Patient data were collected from a database with systematic analysis of IgAV patients in the Croatian population. Results: Among the 611 children, 205 (33.55%) had purpura on the lower extremities, in 207 (33.88%) the rash extended on the trunk, in 149 (24.39%) it extended to the upper extremities, in 32 (5.24%) the rash was generalized, while 15 (2.47%) had the most severe skin symptoms: bullae, ulcerations, and necroses. IgAVN developed in 130 (21.28%) and persistent IgAVN (present for >3 months) in 48 (7.86%) children. Multivariate logistic regression found that presence of ulcerations and necroses (OR 3.20 [95% CI 1.03–9.91]), persistent purpura (OR 2.89 [95% CI 1.71–4.88]), and higher age (OR 1.16 [95% CI 1.09–1.23]) were significant predictors of IgAVN, whereas persistent purpura (OR 20.11 [95% CI 1.09–372.52]), male sex (OR 3.32 [95% CI 1.13–9.80]), and higher age (OR 1.15 [95% CI 1.00–1.30]) were predictors of persistent IgAVN. Among the laboratory parameters, higher serum urea (OR 1.43 [95% CI 1.03–2.00]) and reduction in activated partial thromboplastin time (OR 0.83 [95% CI 0.74–0.93]) were shown to have a significant impact on increasing the risk of persistent IgAVN. Conclusion: With increasing severity and duration of cutaneous manifestations in IgAV, the risk of developing IgAVN increases, making the prognosis worse, with a greater likelihood to need more aggressive treatment.
Capacitance study of integrated circuits matrix interconnects
Authors: Lakhlef Ahcene , Benfdila Arezki , Belhimer Lounas
Published: June 2021

Propagation delays and couplings between nearby lines affect the circuit performances (speed, power consumption) and operations. Propagation delays in longer lines can become critical compared to the clock frequency and can induce unwanted signals in neighboring lines ("crosstalk" phenomenon). Induced line capacitances can induce parasitic signals. Hence characterizing of these capacitances is of paramount importance. The present work deals with the analysis of capacitance of a multilayer conductor interconnect aiming for their possible exact extraction. We used three topologies of a microstrip conductor interconnects and identified the potential distributor and then computed the capacitance and inductance matrix using a finite element method. The first analysis dealt with parallel microstrip conductors and the second with two levels (plan) of a microstrip conductors the results are compared to those obtained by other methods and found quite encouraging.
Design feedback controller of six pulse three phase rectifier based on differential evolution algorithm
Authors: Setiadi Herlambang , Swandaru Akbar , Nugroho Teguh Aryo
Published: June 2021

The application of power electronics devices is increasing significantly in this past few year. This condition could happen due to the development of semiconductor technology. The application of power electronics is varied from power plant application to vehicles application. One of the power electronics devices that becoming popular is rectifier. Rectifier can be used to transform AC electricity to DC. This paper presents fully controlled six pulse three phase rectifier which designed to stabilize the DC voltage output on a certain loads variation. PID controller is used as the close loop controller system of the rectifier. To get optimal coordination differential evolution algorithm is used to tune the parameter of PID controller. simulation is carried out in MATLAB/SIMULINK environment. From the simulation results, it is found that the performance of six pulse three phase rectifier can be enhanced significantly by using PID controller based on differential evolution algorithm.
Correlation of Intravascular Ultrasound and Instantaneous Wave-Free Ratio in Patients With Intermediate Left Main Coronary Artery Disease
Authors: El Hajj Stephanie C. , Toya Takumi , Warisawa Takayuki , Nan John , Lewis Bradley R. , Cook Christopher M. , Rajkumar Christopher , Howard James P. , Seligman Henry , Ahmad Yousif , Doi Shunichi , Nakajima Akihiro , Nakayama Masafumi , Goto Sonoka , Vera-Urquiza Rafael , Sato Takao , Kikuta Yuetsu , Kawase Yoshiaki , Nishina Hidetaka , Nakamura Sunao , Matsuo Hitoshi , Escaned Javier , Akashi Yoshihiro J. , Davies Justin E. , Lerman Amir
Published: June 2021

Background:

There is great degree of interobserver variability in the visual angiographic assessment of left main coronary disease (LMCD). Fractional flow reserve and intravascular ultrasound are often used in this setting. The use of instantaneous wave-free ratio (iFR) for evaluation of LMCD has not been well studied. The aim of this study is to evaluate the use of iFR in the assessment of angiographically intermediate LMCD.

Methods:

This is an international multicenter retrospective observational study of patients who underwent both iFR and intravascular ultrasound evaluation for angiographically intermediate LMCD. An independent core laboratory performed blinded off-line analysis of all intravascular ultrasound data. A minimum lumen area of 6 mm
2
was used as the cutoff for significant disease.

Results:

One hundred twenty-five patients (mean age, 68.4±9.5 years, 84.8% male) were included in this analysis. Receiver operating curve analysis showed that an iFR of ≤0.89 identified minimum lumen area <6 mm
2
with an area under the curve of 0.77 (77% sensitivity, 66% specificity;
P
<0.0001). Among the 69 patients without ostial left anterior descending artery or left circumflex artery disease, receiver operating curve analysis showed that an iFR of ≤0.89 identified minimum lumen area <6 mm
2
with an area under the curve of 0.84 (70% sensitivity, 84% specificity;
P
<0.0001). The correlation was not significantly different when the body surface area was considered.

Conclusions:

In this study, in patients with intermediate LMCD, iFR of ≤0.89 correlates with intravascular ultrasound minimum lumen area <6 mm
2
regardless of body surface area. The current study supports the use of iFR for the evaluation of intermediate LMCD.
Prognostic Utility of Risk Enhancers and Coronary Artery Calcium Score Recommended in the 2018 ACC/AHA Multisociety Cholesterol Treatment Guidelines Over the Pooled Cohort Equation: Insights From 3 Large Prospective Cohorts
Authors: Akintoye Emmanuel , Afonso Luis , Bengaluru Jayanna Manju , Bao Wei , Briasoulis Alexandros , Robinson Jennifer
Published: June 2021

Background

Limited data exist on the incremental value of the risk enhancers recommended in the 2018 American Heart Association/American College of Cardiology (ACC/AHA) cholesterol treatment guidelines in addition to the pooled cohort equation.

Methods and Results

Using pooled individual‐level data from 3 epidemiological cohorts involving 22 942 participants (56% women, mean age 59 years), we evaluated the predictive ability of the risk enhancers and coronary artery calcium (CAC) score for atherosclerotic cardiovascular disease, and determined their incremental utility using the C statistic, net reclassification index, and integrated discrimination index. A total of 1960 (8.5%) atherosclerotic cardiovascular disease events were accrued over 10 years. Of the 10 risk enhancers evaluated, only 6 predicted atherosclerotic cardiovascular disease independent of the pooled cohort equation. However, the individual enhancers demonstrated little or no incremental benefit. There was more incremental value from combining the 6 enhancers into an aggregate score (hazard ratio [HR], 1.21; 95% CI, 1.08–1.37 for each additional enhancer), and having ≥3 enhancers represents an optimum threshold for incremental prediction (C statistic, 0.766; net reclassification index, 0.041; integrated discrimination index, 0.010;
P
≤0.007). On the other hand, CAC was superior to individual enhancers (C statistic, 0.774; net reclassification index, 0.073; integrated discrimination index, 0.010;
P
<0.001), reliably reclassifies intermediate‐risk participants with <3 risk enhancers (event rate, 3.5% if no CAC and 9.8% if positive CAC), but offered no reclassification among participants with ≥3 enhancers.

Conclusions

The individual risk enhancers evaluated in this study provided no or only marginal incremental information added to the pooled cohort equation. However, the presence of ≥3 risk enhancers reliably identified intermediate‐risk patients that will benefit from statin therapy, and further CAC testing may be considered among those with <3 risk enhancers.
Learning Brain Dynamics With Coupled Low-Dimensional Nonlinear Oscillators and Deep Recurrent Networks
Authors: Abrevaya Germán , Dumas Guillaume , Aravkin Aleksandr Y. , Zheng Peng , Gagnon-Audet Jean-Christophe , Kozloski James , Polosecki Pablo , Lajoie Guillaume , Cox David , Dawson Silvina Ponce , Cecchi Guillermo , Rish Irina
Published: June 2021

Many natural systems, especially biological ones, exhibit complex multivariate nonlinear dynamical behaviors that can be hard to capture by linear autoregressive models. On the other hand, generic nonlinear models such as deep recurrent neural networks often require large amounts of training data, not always available in domains such as brain imaging; also, they often lack interpretability. Domain knowledge about the types of dynamics typically observed in such systems, such as a certain type of dynamical systems models, could complement purely data-driven techniques by providing a good prior. In this work, we consider a class of ordinary differential equation (ODE) models known as van der Pol (VDP) oscil lators and evaluate their ability to capture a low-dimensional representation of neural activity measured by different brain imaging modalities, such as calcium imaging (CaI) and fMRI, in different living organisms: larval zebrafish, rat, and human. We develop a novel and efficient approach to the nontrivial problem of parameters estimation for a network of coupled dynamical systems from multivariate data and demonstrate that the resulting VDP models are both accurate and interpretable, as VDP's coupling matrix reveals anatomically meaningful excitatory and inhibitory interactions across different brain subsystems. VDP outperforms linear autoregressive models (VAR) in terms of both the data fit accuracy and the quality of insight provided by the coupling matrices and often tends to generalize better to unseen data when predicting future brain activity, being comparable to and sometimes better than the recurrent neural networks (LSTMs). Finally, we demonstrate that our (generative) VDP model can also serve as a data-augmentation tool leading to marked improvements in predictive accuracy of recurrent neural networks. Thus, our work contributes to both basic and applied dimensions of neuroimaging: gaining scientific insights and improving brain-based predictive models, an area of potentially high practical importance in clinical diagnosis and neurotechnology.
Hymenopteran Colony Stream Clustering Algorithm and Comparison with Particle Swarm Optimization and Genetic Optimization Clustering
Authors: Parafe Nikhil , Venkatesan M. , Panner Prabhavathy
Published: June 2021

Stream is endlessly inbound sequence of information, streamed information is unbounded and every information are often examined one time. Streamed information are often noisy and therefore the variety of clusters within the information and their applied mathematics properties will change
over time, wherever random access to the information isn’t possible and storing all the arriving information is impractical. When applying data set processing techniques and specifically stream clustering Algorithms to real time information streams, limitation in execution time and memory
have to be oblige to be thought-about carefully. The projected hymenopteran colony stream clustering Algorithmic is a clustering Algorithm which forms cluster according to density variation, in which clusters are separated by high density features from low density feature region with mounted
movement of hymenopteran. Result shows that it created denser cluster than antecedently projected Algorithmic program. And with mounted movement of ants conjointly it decreases the loss of data points. And conjointly the changed radius formula of cluster is projected so as to increase performance
of model to create it a lot of dynamic with continuous flow of information. And also we changed probability formula for pick up and drop to reduce oulier. Results from hymenopteran experiments conjointly showed that sorting is disbursed in 2 phases, a primary clustering episode followed by
a spacing part. In this paper, we have also compared proposed Algorithm with particle swarm optimization and genetic optimization using DBSCAN and k -means clustering.
On the Estimation of Deep Atlantic Ventilation from Fossil Radiocarbon Records. Part II. (In)consistency with Modern Estimates
Authors: Marchal Olivier , Zhao Ning
Published: June 2021

Measurements of radiocarbon concentration (Δ14C) in fossil biogenic carbonates have been interpreted as reecting a reduced ventilation of the deep Atlantic during the last ice age. Here we evaluate the (in)consistency of an updated compilation of fossil Δ14C data for the last deglaciation with the abyssal circulation in the modern Atlantic. A 14C transport equation, in which the mean velocity field is a modern field estimate and turbulent flux divergence is treated as a random fluctuation, is fitted to deglacial Δ14C records by using recursive weighted least-squares. This approach allows us to interpret the records in terms of deviations from the modern flow with due regard for uncertainties in the fossil data, the 14C transport equation, and its boundary conditions.

We find that the majority of fit residuals could be explained by uncertainties in fossil Δ14C data, for two distinct estimates of the modern flow and of the error variance in the boundary conditions. Thus, most, not all, deglacial data appear consistent with present-day ventilation rates. From 20 to 32% of the residuals exceed in magnitude the published errors in the fossil data by a factor of two. Residuals below 4000 m in the western North Atlantic are all negative, suggesting that deglacial Δ14C values from this region are too low to be explained by modern ventilation. Whilst deep water ventilation appeared different from today at some locations, a larger database and a better understanding of error (co)variances are needed to make reliable paleoceanographic inferences from fossil Δ14C records.
Understanding Internships for Transition-Age Students With Disabilities
Authors: Riesen Tim , Trainor Audrey A. , Traxler Rachel Elizabeth , Padia Lilly B. , Remund Corban
Published: June 2021

Secondary educators implement an array of work-based learning activities that expose transition-age students to the demands of post-secondary employment. One such strategy, internships, provides students with a formal opportunity to acquire transferable employment skills that lead to meaningful post-secondary employment outcomes. Facilitating internships for transition-aged students with disabilities, however, presents challenges for educators because internships often involve complicated and sometimes ambiguous labor laws, regulations, and provisions. This article provides secondary educators with information about how to facilitate unpaid and paid internships for students with disabilities that align with requirements established by the Fair Labor Standards Act. The article provides a case study to illustrate how schools can develop both unpaid and paid internships and concludes with recommendations for best practices.
Centralized unidirectional consensus of connected automated vehicles convoys with sample delayed data control
Authors: Chehardoli Hossein
Published: June 2021

This paper investigates the problem of centralized look ahead (CLA) consensus of connected automated vehicles convoys (CAVC) based on sample data control in the presence of measurement delay and engine’s lag. A double-integrator model is considered to describe the 1-D motion of automated vehicles (AVs). In the practical implementation, data loss and time delay are unavoidable in CAVC networks. Therefore, these issues are considered in modeling and control design of CAVCs and a CLA consensus is defined for all following AVs. By employing the Lyapunov-Krassovskii theorem, the sufficient conditions guaranteeing the zero tracking error of CAVCs in the presence of delay and data loss are derived. Then, by doing the error proliferation analysis in the frequency domain, sufficient conditions on control parameters assuring string stability are attained. Numerical studies are carried out to confirm the performance of the proposed consensus algorithm.
Diagnosis and Management of Orbital Fat Exposure During Endoscopic Sinus Surgery
Authors: Westfall Edward , Fridirici Zachary , El-Kouri Nadeem , McSpadden Ryan , Loochtan Mike , Stankiewicz James
Published: June 2021

Background:

The orbital complication rate during endoscopic sinus surgery (ESS) is <1%. Orbital fat exposure during ESS can herald orbital complications including orbital hematoma, extraocular muscle trauma, optic nerve injury, or blindness. The objective of this study was to evaluate the current consensus regarding diagnosis and management of orbital fat exposure during ESS.

Methods:

A 24-point survey focused on orbital fat exposure during ESS was distributed to American Rhinologic Society members. Also, a retrospective review of 25 cases of orbital fat exposure drawn from the principal investigator’s 30-year experience was performed.

Results:

Over 10 000 surgical cases of the principal investigator were reviewed. Twenty-five patients had orbital fat exposure. Five developed minor complications while 2 were major (ie, temporary vision changes). Two hundred thirty-six surgeons responded to the survey; 93% had encountered orbital fat during ESS; 88% of surgeons identify orbital fat by either its appearance endoscopically or the “bulb press” test. Almost every responding surgeon will cautiously avoid further manipulation in the area of orbital fat exposure. Nearly half will immediately curtail the extent of surgery. Surgeons do not significantly change postoperative management. Considerations regarding observation in postanesthesia care unit, close follow-up, and strict nose blowing precautions are common.

Conclusion:

Orbital fat exposure during ESS is a rarely discussed, but clinically important. Orbital fat exposure can be a harbinger for major orbital complications that should be recognized by endoscopic appearance and confirmed with the bulb press test. Caution with “no further manipulation” of orbital fat is the guiding principle for intraoperative management, while postoperative management is generally expectant. Level 4 Evidence
Involvement of stakeholders during the preparedness phase of post-accident situation management
Authors: Bertho J.M. , Gabillaud-Poillion F. , Reuter C. , Rivière O. , Lachaume J.L.
Published: June 2021

The Steering Committee for Post-accident Management Preparedness (CODIRPA) was commissioned by the French Government in 2005 with the aim of establishing the main principles to be set up for population protection and recovery in the long term. From the beginning, one of the main principles was the pluralistic nature of the working groups (WGs), including scientific and technical experts, representatives from state departments, nuclear operators, and representatives of civil society (i.e. stakeholders). Stakeholders were mainly associated with the various WGs of CODIRPA. In order to foster the involvement of stakeholders from civil society in the works of CODIRPA, a new organisation was implemented with two WGs: one mainly composed of technical experts for tackling technical issues, and one for evaluating the proposals made by the experts from the stakeholders’ point of view. This article presents the results of this new strategy.
ICRP recommendations for recovery
Authors: Kai M.
Published: June 2021

In 2020, the International Commission on Radiological Protection (ICRP) issued Publication 146 which provides a framework of the radiological protection of people and the environment in the case of a large nuclear accident. Mitigation of radiological consequences is achieved using the fundamental principles of justification of decisions and optimisation of protection. These recommendations emphasise the importance of the optimisation of protection for the rehabilitation of living and working conditions in the affected areas during the intermediate and long-term phases. They underline the role of co-operation between the authorities, experts, and the affected population in the co-expertise process to facilitate informed decisions about their own protection. ICRP deﬁnes reference levels to be selected within generic bands of exposure considering the induced risk of radiation, as well as the feasibility of controlling the situation.
Long-term (re)integration of persons trafficked for the purpose of sexual exploitation
Authors: Meshkovska Biljana , Bos Arjan E.R. , Siegel Melissa
Published: June 2021

This paper focuses on the recovery and (re)integration processes of women victims of trafficking for the purpose of sexual exploitation in Europe. It looks at their life not just following a trafficking experience, but for several years afterwards, answering the questions: Are some factors more important than others, in the short and long run? What are the overall dynamics of the (re)integration process? How do the relevant influencing factors interact? What factors are crucial for a positive (re)integration immediately after the experience and how do they differ from what becomes important as the years go by? And what is crucial in order to ensure sustainable (re)integration? Fifty-two semi-structured, in-depth interviews were conducted with service providers, trafficked persons, and family members of trafficked persons. A variety of factors influencing the (re)integration process were identified, such as: (a) the background of the individual; (b) trafficking experience – who the trafficker was and its severity; (c) the role of institutions, NGOs, and service providers; (d) economic factors; (e) the personal characteristics, challenges, motivations, and coping mechanisms of the victim; and finally (f) social support. However, what was identified as particularly important for the sustainability of the (re)integration process was relationships built with service providers, relationships rebuilt with existing family members, or relationships built with new families that were established after the trafficking experience.
Surgical treatment of liver and kidney metastasis from an adenoid cystic carcinoma of the submandibular gland: case report
Authors: Ferrari Cecilia , Franceschi Angelo , Percivale Andrea , Griseri Guido
Published: June 2021

Introduction:

Adenoid cystic carcinomas (ACCs) account for 10% of all malignant salivary tumours. They are slow-growing but locally aggressive. Reports of liver and renal metastases are rare.

Case description:

A 58-year-old woman who had undergone resection of a left submandibular ACC in 1995 was referred to our centre for follow-up in 2018. A computed tomography scan revealed two lesions: one on segment six of the liver and the other on a kidney. A hepatic wedge resection and right nephrectomy were performed. The postoperative course was uneventful. At 2-year follow-up, the patient was alive and well with no evidence of disease.

Conclusion:

Management of ACC is a therapeutic challenge because of its tendency for distant metastases. The literature recommends regular follow-up imaging and radical surgical treatment but specific guidelines for the approach to recurrence are lacking.
Modified Spring for Uprighting Mesioangular Impacted Molars
Authors: Ravikumar Prasanna Arvind , Ramasamy Navaneethan
Published: June 2021

Uprighting molar that is mesially angulated improves its periodontal status, coupled with bone deposition at the distal surface. 1 , 2 It also provides adequate support to its occlusal antagonist and maintains a stable occlusal pattern. Various methods for uprighting molars using springs, nickel-titanium superelastic wires, and miniscrews have been elucidated in literature. 3 - 5 This article presents a modification of spring fabricated of nickel-titanium that is effective in uprighting mesially angulated molars with minimal invasiveness. The proposed advantage of using this spring was that buccal flaring of the angulated molar was not observed due to the mild distalizing force applied against the molar by the tugging action of the spring.
Role of expectancy in physiological responses to sound recognition of musical dissonance and timbral change
Authors: Jover-Fernández Marino , Serrano Miguel-Angel , Saiz-Clar Elena , Reales José-Manuel
Published: June 2021

Recently, it has been suggested that tonal violations produce greater skin conductance response (SCR) than timbral violations in music listening. However, it is unknown how people focus their attention during musical excerpts. The aim of this study is to replicate previous research considering two psychophysiological mechanisms: prediction error and brain stem reflex. Twenty-seven nonmusicians were instructed to listen six melodies and detect three altered conditions in one note: a dissonance (note out-of-key), a timbral change, and dissonance which changes in timbre and tone ( timdis). Amplitudes of SCR, heart rate (HR), and respiration rate (RSPR) were analyzed. In addition, the frequency of SCR and the percentage of musical events detection were measured. Results showed no significant differences either on amplitude of SCR or on respiratory rate. However, perception of timdis produced an increase in HR higher than dissonance ( p < .05) and the timbre condition had a higher frequency of SCR than dissonance ( p < .05). In addition, participants only detected 59.3% of dissonances but they were aware of 90% of notes in-key ( original melody). Finally, there was no significant correlation between percentage of detection and frequency of SCR. Results are discussed based on the prediction error mechanism, a theoretical model of expectation.
Navigating gender stereotypes as educational leaders: An ecological approach
Authors: Shah Sahar
Published: June 2021

This paper employs the feminist educational leadership perspective to analyse the ecological context and its influence on the leadership experiences of school head teachers within a patriarchal cultural setting. Methodology: This paper forms part of a mixed methods study that included a quantitative random survey during the first research phase to determine the leadership styles of 350 secondary school head teachers across nine districts in the Punjab province of Pakistan using the Multifactor Leadership Questionnaire. This paper is based on the second research phase that analyses empirical data from semi structured interviews of a purposive-stratified sample of 14 head teachers, selected from among the 264 survey respondents, comprising of seven males and seven females. Bronfenbrenner’s ecological development theory is employed as an analytical framework for thematic analysis. Findings: The study reveals that females must navigate gender stereotypes in a society where they have to fight to establish authority, encounter misogynistic attitudes, rely upon familial support to begin their career, gain spiritual support from a higher power, face work-family conflicts all while practicing educational leadership with high motivation. On the other hand, males assume themselves to be natural leaders and appear to be spared from ecological challenges that impede their leadership journeys. Implications: The findings confirm the prevalence of gender stereotypes that position leadership within the masculine domain in a patriarchal context. The study proposes a complete restructuring of the socio-cultural framework to create a gender neutral society that provides equal educational and professional opportunities to all social members in order to maximize human capital development that is crucial for a country’s economic progress. The findings reflect several subtle and non-subtle socio-cultural challenges faced by female leaders around the world. Originality – This study contributes to enhancing the literature on gender and educational leadership in a patriarchal cultural context.
Community-Based Pharmacy Travel Health Service Pilot Impact on Participant Understanding and Satisfaction
Authors: Wilkinson Erica A. , Newell Bradley J. , Melton Brittany L. , Robertson Amy D.
Published: June 2021

Background:

Increased rates of international travel have led to a higher demand for healthcare professionals to provide travel health services. Community-based pharmacists are capable of meeting this need.

Objective:

This study evaluates the impact of pharmacists providing travel health services in a community-based pharmacy on participant understanding and satisfaction of travel education and preparation.

Method:

A trained pharmacist met with participants to review their medical history, travel itinerary, and provide education. Indicated immunizations were administered and the participant’s primary care provider was contacted if prescription medications were warranted. A questionnaire was administered before and after the travel health consultation assessing participants perceived understanding of travel health information, satisfaction, and perceived monetary value of the service. Data were collected by 5-point Likert-scale responses, with 5 equivalent to strongly agree. Wilcoxon signed-rank test and descriptive statistics were used for evaluation. Participants were included if they had international travel planned within 12 weeks of the consultation.

Results:

A total of 12 participants were included. Participant understanding significantly increased for all 5 survey items relating to travel health information with a p value < 0.05 for each item. The largest change was for how to find medical help during international travel (medians and IQR were 3(2-3), and 5(5-5) for pre-and post-consultation, respectively, p = 0.003). Participant satisfaction questions received a median response of 5. Participants’ perceived monetary value of the service was a median of $50 (IQR $50-50).

Conclusion:

Pharmacist-led travel health consultations improved participant understanding of travel health information and was of perceived value.
Black Men’s Experiences With Health care: Individuals’ Accounts of Challenges, Suggestions for Change, and the Potential Utility of Virtual Agent Technology to Assist Black Men With Health Management
Authors: Kramer Justin , Yinusa-Nyahkoon Leanne , Olafsson Stefan , Penti Brian , Woodhams Elisabeth , Bickmore Timothy , Jack Brian W
Published: June 2021

Black men have the highest age-adjusted death rate of any major race-gender group in America. Understanding their perceived barriers to accessing health care may benefit future interventions working to increase Black men’s health care engagement. Data collected from focus groups of Black men( N = 67), key informant interviews( N = 12), and interviews( N = 5) with participants who pilot tested an online health education system (called “Gabe”) were analyzed to explore their health care experiences and how computer-based health programs might better assist Black men. Concerns pertaining to health care systems’ failure to recognize the diversity among Black men, and physicians’ lack of sociocultural awareness about the challenges they regularly face, were most salient. Building trust with providers was cited as being central to engagement, with Gabe users perceiving the system to be both trustworthy and accessible. Participants reported an openness to technology assisting with health management and provided suggestions of how online systems can meet the needs of Black men.
Impact of Prior-to-Admission Methicillin-Resistant Staphylococcus aureus Nares Screening in Critically Ill Adults With Pneumonia
Authors: Mallidi Mariana G. , Slocum Giles W. , Peksa Gary D. , DeMott Joshua M.
Published: June 2021

Background

The high negative predictive value (NPV) of a negative nasal methicillin-resistant Staphylococcus aureus (MRSA) result in suspected MRSA pneumonia is well established; however, data are limited on the NPV of samples collected prior to hospital admission for critically ill patients.

Objective

To evaluate the predictive characteristics of MRSA nares screening performed prior to hospital admission in critically ill adult patients diagnosed with pneumonia.

Methods

A retrospective analysis was conducted in critically ill patients with pneumonia and MRSA nares screening within 60 days of respiratory culture. The primary outcome was NPV of MRSA nares for MRSA pneumonia using samples within 60 days compared to in-hospital respiratory cultures. A sensitivity analysis was performed for samples within 30 days. Secondary outcomes were prevalence, positive predictive value (PPV), sensitivity, specificity, and MRSA pneumonia risk factors.

Results

The NPV for MRSA nares screening collected prior to hospital admission was high at 98% (95% CI = 96%-99%) for samples collected within 60 days (n = 243) and 99% (95% CI: 94%-99.9%) for samples within 30 days (n = 119). Specificity for MRSA nares collected 60 days prior to admission (96%, 95% CI: 93-98) and 30 days (96%, 95% CI: 91%-99%) were both high. PPV and sensitivity were lower. Risk factors for MRSA pneumonia were similar.

Conclusion and Relevance

MRSA nares screening within 60 days of intensive care unit admission has a high NPV and specificity for MRSA pneumonia in critically ill patients and may be a powerful stewardship tool for avoidance of empirical anti-MRSA therapy.
Clinical and Radiographic Results of Ankle Joint Preservation Surgery in Posterior Ankle Arthritis
Authors: Kim Jaeyoung , Kim Ji-Beom , Lee Woo-Chun
Published: June 2021

Background:

Little information is available about how to manage ankles with eccentric arthritis in the sagittal plane. This study aimed to report clinical and radiographic outcomes following joint preservation surgery for ankles with eccentric arthritis at the posterior tibiotalar joint and a plantarflexed talus in the sagittal plane, which we named posterior ankle arthritis.

Methods:

Ten ankles with posterior ankle arthritis were treated with realignment surgery between 2017 and 2018. Posterior ankle arthritis was defined as having both (1) eccentric narrowing of the joint space at the posterior aspect of the tibiotalar joint on weightbearing lateral radiographs and (2) coronal talar tilt angle less than 4 degrees on weightbearing anteroposterior radiographs. Flatfoot reconstruction with a hindfoot arthrodesis procedure was performed in all patients (subtalar arthrodesis, n = 9; triple arthrodesis, n = 1), and a supramalleolar osteotomy was added in patients with varus distal tibial alignment (n = 6). Pain, functional outcome (foot function index [FFI]), radiographic arthritis stage (stage I to IV), and 9 radiographic parameters, including lateral talar center migration (LTCM), were evaluated on pre- and postoperative weightbearing radiographs. All patients completed a minimum 2-year follow-up.

Results:

Preoperative radiographic evaluation demonstrated that ankles with posterior arthritis had a lower medial longitudinal arch, forefoot abduction, and valgus hindfoot alignment. Postoperatively, sagittal tibiotalar alignment was restored, as evidenced by an improved median LTCM from −3.3 to −0.3 mm ( P < .001). The radiographic arthritis stage improved in 7 (70%) patients, whereas 3 (30%) remain unchanged in the same stage. The median score for pain (visual analog scale) decreased significantly from 8 to 2, and the median FFI improved significantly from 67.8 to 23.4 ( P < .001). None of the patients underwent conversion to joint-sacrificing procedures at the latest follow-up.

Conclusion:

The study results suggest a possible relationship between posterior ankle arthritis and the plantarflexion of the talus, which can be seen in the setting of a flatfoot deformity. Reconstruction of the flatfoot deformity using subtalar arthrodesis restored the tibiotalar relationship in the sagittal plane and resulted in clinical improvements at an average 2.3-year follow-up in this 10-ankle case series.

Level of Evidence:

Level IV, case series.
A Comparison of Two Five-Factor Model Operationalizations of the Triarchic Model of Psychopathy in a Clinical Sample
Authors: Ruchensky Jared R. , Donnellan M. Brent , Hopwood Christopher J. , Edens John F. , Skodol Andrew E. , Morey Leslie C.
Published: June 2021

Structural models of personality traits, particularly the five-factor model (FFM), continue to inform ongoing debates regarding what personality attributes and trait domains are central to psychopathy. A growing body of literature has linked the constructs of the triarchic model of psychopathy (boldness, meanness, disinhibition) to the FFM. Recently, researchers developed both item and regression-based measures of the triarchic model of psychopathy using the NEO Personality Inventory–Revised—a popular measure of the FFM. The current study examines the correlates of these two FFM-derived operationalizations of the triarchic model using data from the Collaborative Longitudinal Personality Disorders Study. The two approaches had strong convergent validity coefficients and similar patterns of criterion-related validity coefficients. Meanness related to greater personality pathology characterized by exploitation of others and poor attachment, whereas disinhibition related to indicators of greater negative affect and poor behavioral constraint. Boldness related to reduced negative affect and greater narcissistic personality traits. Although the item and regression-based approaches showed similar patterns of associations with criterion-variables, the item-based approach has some practical and psychometric advantages over the regression-based approach given strong correlations between the meanness and disinhibition scores from the regression approach.