bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of Early Stage Tonsil Cancer in the Age of Human Papillomavirus–Associated Malignancies
Authors: Patel Evan J. , Zhu Angela W. , Oliver Jamie R. , Cornwell MacIntosh , Jacobson Adam S. , Hu Kenneth S. , Tam Moses , Vaezi Alec , Morris Luc G. T. , Givi Babak
Published: December 2020

Objective

To investigate the patterns of care and outcomes of treatment of early stage tonsil cancers, controlling for human papillomavirus (HPV) status.

Study Design

Historical cohort study.

Setting

National Cancer Database (NCDB).

Methods

Review of the NCDB between 2010 and 2017 for all T1‐2N0M0 tonsillar squamous cell carcinoma (SCC). Demographics, clinical characteristics, HPV status, treatment regimens, and survival were analyzed.

Results

A total of 4720 patients were identified with early stage SCC of the tonsil. Most were tested for HPV (2759 [58.5%]). Among tested patients, 1758 (63.7%) were positive for HPV and 1001 (36.3%) were negative for HPV. HPV‐positive patients had higher 3‐year survival compared to HPV‐negative patients (93.2% vs 77.8%, P <. 001). Among HPV‐positive patients, there was no significant difference in survival between treatment cohorts. However, in the HPV‐negative cohort, 3‐year survival was higher in both bimodality surgical‐based settings (tonsillectomy + neck dissection + radiotherapy, 86.0% vs chemoradiotherapy, 69.6%, P =. 01) and for all surgical‐based treatments when compared to nonsurgical management (84.6% vs 69.3%, P <. 001). This difference was maintained in multivariable regression controlling for age, sex, comorbidities, clinical T stage, and treatments. In a subpopulation of HPV‐negative patients propensity score matched by all factors significant in multivariable analysis, 3‐year survival remained higher in the surgically treated group compared to the nonsurgically treated cohort (84.9% vs 67.1%, P <. 001).

Conclusions

Surgical‐ or radiation‐based treatment resulted in similar survival in early stage HPV‐positive tonsil cancer. Surgical‐based treatments were associated with longer survival in HPV‐negative cancers. These findings should be further investigated in a randomized prospective trial.
Clinical Characteristics and Surgical Outcomes of Sinonasal Lesions Associated With Tumor‐Induced Osteomalacia
Authors: Zhu Zhenzhen , Xia Weibo , Qi Fang , Wang Weiqing , Wang Xiaowei , Zha Yang , Li Fang , Jing Hongli , Wang Peipei , Lv Wei
Published: December 2020

Objective

To investigate the clinical characteristics and surgical outcomes of sinonasal tumors associated with tumor‐induced osteomalacia (TIO).

Study Design

Retrospective case series.

Setting

Single tertiary center.

Methods

We studied the clinical characteristics and surgical outcomes of 43 patients (22 male, 21 female) who had lesions in the nasal cavity and paranasal sinus associated with TIO and underwent surgery between August 2006 and November 2019.

Results

The mean ± SD duration between the onset of symptoms and surgery was 3.9 ± 2.6 years. The most common tumor site was the ethmoid sinus (76.7%), and the skull base was involved in 12 cases. Phosphaturic mesenchymal tumors were diagnosed in 41 patients, among whom there was 1 multifocal case. Another 2 cases involved odontogenic fibroma and hemangiofibroma, respectively. Serum phosphorus normalized in 39 cases within 4.4 ± 2.3 days, and serum fibroblastic growth factor 23 normalized within 1 day; clinical symptoms, however, gradually improved within several months after the first operation. There was no significant difference in the recovery rate between endoscopic and open surgery (P = 0.639). Two patients with recurrent cases and 2 with nonremission cases recovered after a sinonasal reoperation. The patient with a multifocal case recovered after the resection of the tumors in the ethmoid sinus and mandible. The overall recovery rate was 97.7%.

Conclusion

Most sinonasal tumors associated with TIO are located in the ethmoid sinus, and the skull base is involved in some cases. Complete excision of the tumor leads to recovery, and endoscopic surgery could achieve recovery rates similar to those of open surgery.
Comparative Evaluation and Management of Dysphonia Between Adults <65 and ≥65 Years of Age
Authors: Jacks Amy , Kavookjian Hannah , Kraft Shannon
Published: December 2020

Objective

To compare presenting symptoms, etiology, and treatment outcomes among dysphonic adults <65 and ≥65 years of age.

Study Design

Retrospective cohort study.

Setting

Tertiary care voice center between January 2011 and June 2016.

Methods

A total of 755 patients presenting for dysphonia were included in the study: 513 adults <65 years of age and 242 adults ≥65. Data collected included demographics, referral information, prior diagnoses, prior treatments, clinical examination findings, diagnosis, coexisting symptoms, treatments, and pre‐ and postintervention Voice Handicap Index scores. Statistical analysis was performed with SPSS to determine significant relationships between variables of interest.

Results

The most common etiologies of dysphonia were vocal cord atrophy (44.8%) in the ≥65 cohort and benign vocal cord lesions (17.8%) in the <65 cohort. When compared with adults <65 years old, patients ≥65 had a higher incidence of neurologic dysphonia (P =. 006) and vocal cord atrophy (P <. 001) but were less likely to have laryngopharyngeal reflux (P =. 001), benign vocal cord lesions (P <. 001), or muscle tension dysphonia (P <. 001). Overall, 139 patients had surgery, 251 received medical therapy, and 156 underwent voice therapy. The ≥65 cohort demonstrated improvement in Voice Handicap Index scores after surgery (P =. 001) and voice therapy (P =. 034), as did the <65 cohort (surgery, P <. 001; voice therapy, P =. 015). Adult surgical patients <65 reported greater improvements than patients ≥65 (P =. 021).

Conclusions

There are notable differences in the pathophysiology of dysphonia between patients aged ≥65 and <65 years. Although adults <65 reported slightly better outcomes with surgery, patients ≥65 obtained significant benefit from surgery and voice therapy.
The role of self-control and sociosexual orientation in partner selection: A speed-dating study
Authors: Pronk Tila M. , Karremans Johan C. , Demetriou Andrew , van der Meij Leander , Denissen Jaap J. A.
Published: December 2020

Self-control is a crucial factor in maintaining an established romantic relationship, but its role in relationship formation is understudied. The current study tested whether trait self-control is related to a more selective approach toward romantic partners. Over 4 years, we organized 11 speed-date events at which a total of 342 single, heterosexual participants met potential partners. Our results indicated that there was no main effect of self-control on selectivity. However, there was an interaction between self-control and sociosexual orientation (SOI) in predicting selectivity. Specifically, self-control was positively related to selectivity for people with a restricted SOI (i.e., interested in a long-term, stable relationship). For people with an unrestricted SOI (i.e., interested in a short-term, sexual relationship), however, self-control was related to lower selectivity. Our findings point to the flexibility of self-control in facilitating goal progress, stimulating people to refrain from—or act on—their impulses, depending on their own personal mating goals.
Effects of individualized antiplatelet therapy, based on CYP2C19 genotyping, on platelet function in patients underwent percutaneous coronary intervention
Authors: Zhang Min , Wang Jiangrong , Zhang Yong , Zhang Pei , Chao Yangyang , Gao Mei , Hou Yinglong
Published: December 2020

Objective:

To evaluate the effect of individualized antiplatelet therapy, based on CYP2C19 genotyping, on platelet function in patients underwent PCI and to compare this treatment with conventional antiplatelet therapy.

Methods:

All patients were treated with 100 mg aspirin once a day. Additionally, the CA group received 75 mg clopidogrel once a day. The IA group was divided into extensive metabolizers (EMs, no loss-of-function, i.e. LOF allele, 75 mg clopidogrel once a day), intermediate metabolizers (IMs, carrying one LOF alleles, 75 mg clopidogrel twice daily), and poor metabolizers group (PMs, carrying two LOF alleles, 90 mg ticagrelor twice daily). After taking these antiplatelet medications for ⩾5 days, we assessed platelet function by thromboelastography, and recorded the MAADP (maximum amplitude produced by adenosine diphosphate) value. MAADP > 47 mm was defined as residual HPR, indicating a high risk of thrombosis. MAADP ≤ 31 mm indicated a high risk of bleeding.

Results:

The proportion of patients with MAADP > 47 mm was significantly lower in the IA group (29.6%) than the CA group (38.1%). The proportion of patients with MAADP ≤ 31 mm was significantly higher in the IA group (31.0%) than the CA group (21.3%). No significant differences were found in the proportions of patients with MAADP > 47 mm or MAADP ≤31 mm when compared between the EMs and IMs group.

Conclusion:

Individualized antiplatelet therapy, based on CYP2C19 genotyping, can reduce the incidence of HPR in ACS patients after PCI compared to conventional therapy. By taking a double dose of clopidogrel, patients with a CYP2C19 LOF allele can therefore overcome the reduced efficacy of clopidogrel associated with LOF alleles without increasing the risk of bleeding, which is of guiding significance for the management of antiplatelet therapy on ACS patients after PCI especially considering the CYP2C19 LOF alleles that carry an important predictor for the ischemic events.

Clinical trial registration number:

chiCTR-INC-17011550.
Hsa_circ_0001445 inhibits ox-LDL-induced HUVECs inflammation, oxidative stress and apoptosis by regulating miRNA-640
Authors: Cai Yinlian , Xu Ling , Xu Chaoxiang , Wang Yaoguo , Fan Chenghui
Published: December 2020

The role of Hsa_circ_0001445 in oxidation Low Lipoprotein (ox-LDL) induced HUVEC inflammatory damage remains poorly characterized. The present study investigated the performance of the circRNA Hsa_circ_0001445 on ox-LDL-induced HUVEC inflammatory damage. ox-LDL was employed to treat HUVECs and the expression of Hsa_circ_0001445 in cells were detected by qRT-PCR. Then, the overexpression plasmid of circ_0001445 was transfected into HUVECs. The Cell Counting Kit-8 assay was performed to detect cell viability, and the expression of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β and IL-6 in treatment cells were measured using ELISAs. Furthermore, the oxidative stress kit was used to detect the levels of malondialdehyde, superoxide dismutase and glutathione peroxidase in treatment cells. Flow cytometry assay was applied to measure cell apoptosis, and the expressions of apoptosis-related protein were measured by western blot. The luciferase reporter assay was applied to confirm the target binding between Hsa_circ_0001445 and micro-RNA-640 (miRNA-640). Next, miRNA-640 mimic was transfected into ox-LDL-induced HUVECs, and then cell proliferation, expression level of inflammatory factors, oxidative stress and apoptosis level in treatment cells were assessed, with the expression of related proteins measured. The results revealed that the expression of Hsa_circ_0001445 was obviously downregulated in ox-LDL-induced HUVECs. Overexpression of Hsa_circ_0001445 promoted cell proliferation, inhibited ox-LDL-induced HUVEC inflammatory response, downregulate the expression of TNF-α, IL-1β and IL-16, overexpression of Hsa_circ_0001445 inhibited cell apoptosis. miRNA-640 was confirmed as a direct target of Hsa_circ_0001445, and miRNA-640 mimic reversed the effects of Hsa_circ_0001445 overexpression on ox-LDL-induced HUVECs. Our findings concluded that Hsa_circ_0001445 inhibits ox-LDL-induced HUVEC inflammation, oxidative stress and apoptosis by regulating miRNA-640.
Surgical outcomes and complications of bedside tracheostomy in the ICU for patients on ECMO
Authors: Smith Michael C , Evans Parker T , Prendergast Katherine M , Schneeberger Steven J , Henson C Patrick , McGrane Stuart , Kopp Eugene B , Collins Nina E , Guillamondegui Oscar D , Dennis Bradley M
Published: December 2020

Objective:

Extracorporeal membrane oxygenation (ECMO) is increasingly employed in the management of patients with severe cardiac and pulmonary dysfunction. Patients commonly require tracheostomy for ventilator liberation. Though bedside percutaneous tracheostomy is commonly performed, it has the potential for increased complications, both surgical and with the ECMO circuit. We examined surgical outcomes of bedside percutaneous tracheostomy in the ECMO population.

Methods:

Patients were identified from an institutional database for bedside procedures. Demographics and data on complications were recorded. Descriptive statistics were calculated.

Results:

37 patients on ECMO at the time of tracheostomy were identified. Median age and BMI were 43.2 and 28.0, respectively. 33 patients (89%) were on VV ECMO, and 4 (11%) were on VA ECMO. All were on anticoagulation prior to tracheostomy, which was held for 4 h before and after the procedure in all cases. There were no procedure-related deaths or airway losses. No patients experienced periprocedural clotting events of their ECMO circuit or oxygenator within 24 h. 3 patients (8%) required reintervention (re-exploration or bronchoscopy) for bleeding. Four other patients (10%) had minor bleeding controlled with packing. One patient had pneumomediastinum which resolved without intervention, and one had an occlusion of their tracheostomy which was treated with tracheostomy exchange.

Conclusions:

Bedside percutaneous tracheostomy is feasible for patients on ECMO. Further study is needed to determine specific risk factors for complications and means to mitigate these. Bedside percutaneous tracheostomy may be considered as part of the management of patients on ECMO to help facilitate liberation from mechanical support.
Increased deep vein thrombosis cases during the COVID-19 quarantine
Authors: Karaali Evren , Çiloğlu Osman , Demirtürk Orhan Saim , Keklikçioğlu Burak , Akçay İsmail , Ekiz Timur
Published: December 2020

Objective

The aim of this study was to compare the number of deep vein thrombosis (DVT) cases during the quarantine period for COVID-19 to that of the last year.

Methods

This study was conducted as a single-center and retrospective study. All hospital admissions during April 2020 and May 2020 were screened from the hospital records, and DVT cases were recorded. Likewise, all hospital admissions during April 2019 and May 2019 were screened, and DVT cases were noted. DVT cases of both years were compared.

Results

Among 480931 patients admitted to our hospital in April 2019 and May 2019, DVT was detected in 82 patients (0.017%) (47 males, 35 females) with a mean age of 56.99 ± 9.1 years (ranges 39 to 79 years). Besides, among 145101 patients admitted to our hospital in April 2020 and May 2020, DVT was detected in 123 patients (0.084%) (51 males, 72 females) with a mean age of 58.64 ± 8.9 years (ranges 40 to 83 years). Despite the decrease in the total number of patients admitted to the hospital, there was a significant increase in the number of DVT patients. Interestingly, there were only two symptomatic pulmonary-embolism cases in the 2019 period, whereas there were seven symptomatic pulmonary embolisms secondary to DVT in the 2020 period. Unfortunately, one patient died due to pulmonary embolism secondary to DVT in 2020. The previous history of DVT was remarkable in patients admitted during the COVID-19 confinement.

Conclusion

In conclusion, COVID-19 confinement seems to be associated with increased rates of DVT. Strict preventive measures such as exercise training or prophylactic drug use should be considered to prevent immobility-related DVT during the COVID-19 quarantine.
Inclusion of palliative care in health care policy for older people: A directed documentary analysis in 13 of the most rapidly ageing countries worldwide
Authors: Pivodic Lara , Smets Tinne , Gott Merryn , Sleeman Katherine E , Arrue Borja , Cardenas Turanzas Marylou , Pechova Karolina , Kodba Čeh Hana , Lo Tong Jen , Nakanishi Miharu , Rhee YongJoo , ten Koppel Maud , Wilson Donna M , Van den Block Lieve
Published: December 2020

Background:

Palliative care is insufficiently integrated in the continuum of care for older people. It is unclear to what extent healthcare policy for older people includes elements of palliative care and thus supports its integration.

Aim:

(1) To develop a reference framework for identifying palliative care contents in policy documents; (2) to determine inclusion of palliative care in public policy documents on healthcare for older people in 13 rapidly ageing countries.

Design:

Directed documentary analysis of public policy documents (legislation, policies/strategies, guidelines, white papers) on healthcare for older people. Using existing literature, we developed a reference framework and data extraction form assessing 10 criteria of palliative care inclusion. Country experts identified documents and extracted data.

Setting:

Austria, Belgium, Canada, Czech Republic, England, Japan, Mexico, Netherlands, New Zealand, Singapore, Slovenia, South Korea, Spain.

Results:

Of 139 identified documents, 50 met inclusion criteria. The most frequently addressed palliative care elements were coordination and continuity of care (12 countries), communication and care planning, care for family, and ethical and legal aspects (11 countries). Documents in 10 countries explicitly mentioned palliative care, nine addressed symptom management, eight mentioned end-of-life care, and five referred to existing palliative care strategies (out of nine that had them).

Conclusions:

Health care policies for older people need revising to include reference to end-of-life care and dying and ensure linkage to existing national or regional palliative care strategies. The strong policy focus on care coordination and continuity in policies for older people is an opportunity window for palliative care advocacy.
Empathy, Social Responsibility, and Civic Behavior Among Irish Adolescents: A Socio-Contextual Approach
Authors: Silke Charlotte , Brady Bernadine , Boylan Ciara , Dolan Pat
Published: December 2020

Research suggests that empathy and positive social values are important drivers of youth prosocial and civic action. However, theory and research indicate that young people’s civic behaviors are also shaped by their socio-contextual experiences. Drawing on a sample of 533 adolescents from public secondary schools in the Republic of Ireland, this research employed structural equation modeling to examine whether youth’s (cognitive and affective) empathy and social responsibility values mediated the relationship between youth’s social (parents, peers, school, and community) contexts and their civic behavior. Results suggest that youth’s cognitive empathy and social responsibility values appear to mediate the relationship between a number of social-contextual experiences and youth’s civic behavior. Overall, the findings from this research have important implications for research and practice.
Reciprocal Relationships Between Exposure to Community Violence and Sleep Problems Across Adolescence
Authors: Mrug Sylvie , Orihuela Catheryn A. , Veerasammy Alex
Published: December 2020

Urban adolescents experience high rates of exposure to community violence, which is associated with sleep problems. However, less is known about the prospective relationships between community violence exposure and sleep problems across adolescence. This study investigated reciprocal relationships between community violence exposure and sleep problems across early, middle, and late adolescence. Participants included 84 urban adolescents (50% females, 95% African Americans) who reported on their community violence exposure and sleep problems at mean ages 13, 16, and 17. Results from an autoregressive latent trajectory model with structured residuals showed that exposure to community violence at age 13 predicted more sleep problems at age 16, but violence exposure at age 16 did not predict sleep problems at age 17. Sleep problems did not predict community violence exposure over time. These results point to early adolescence as a vulnerable period for the development of sleep problems in youth exposed to community violence.
Feasibility of Rapidly Developing and Widely Disseminating Patient Decision Aids to Respond to Urgent Decisional Needs due to the COVID-19 Pandemic
Authors: Stacey Dawn , Ludwig Claire , Archambault Patrick , Babulic Kevin , Edwards Nancy , Lavoie Josée , Sinha Samir , O’Connor Annette M.
Published: December 2020

To meet urgent decisional needs of retirement/nursing home residents and their families, our interdisciplinary stakeholder team rapidly developed and disseminated patient decision aids (PtDAs) regarding leaving one’s residence during the COVID-19 pandemic. The development steps were as follows: identify urgent decisional needs, develop PtDAs using the Ottawa Decision Support Framework template and minimal International PtDA Standards, obtain stakeholder feedback, broadly disseminate, and incorporate user feedback. Within 2 wk, we developed 2 PtDAs for retirement and nursing home living environments that were informed by decisional needs (identified from public responses to related media reports), current pandemic regulations/guidance, and recent systematic reviews. Within 3 wk of their dissemination (websites, international PtDA inventory, Twitter, Facebook, media interviews), the PtDAs were downloaded 10,000 times, and user feedback was positive. Our expert team showed feasible rapid development and wide dissemination of PtDAs to respond to urgent decisional needs. Development efficiencies included access to a well-tested theory-based PtDA template, recent evidence syntheses, and values-based public responses to media reports. Future research includes methods for rapidly collecting user feedback, facilitating implementation, and measuring use and outcomes.
Expression and clinical significance of PTPN12 in clear cell renal cell carcinoma
Authors: Jin Yi , Wang Tian-xi , Li Hao , Guo Peng , Wang Qing-qing
Published: December 2020

Background

Clear cell renal cell carcinoma (ccRCC) is a common urological disease. Expression of the protein tyrosine phosphatase 12 gene ( PTPN12) is decreased in many cancers; however, the relationship between PTPN12 gene function and renal cancer remains unclear.

Methods

We detected PTPN12 protein expression in ccRCC and corresponding normal tissues from 64 patients with ccRCC by immunohistochemistry, and relative PTPN12 mRNA levels by real-time quantitative polymerase chain reaction. The relationships between the relative expression levels of PTPN12 mRNA and the patients’ clinical data were analyzed.

Results

PTPN12 protein and mRNA expression levels were significantly lower in ccRCC compared with the corresponding normal tissues. The mRNA expression levels in the ccRCC and corresponding normal tissues from the 64 patients with ccRCC were 0.459±0.445 and 1.001±0.128, respectively, compared with the control (glyceraldehyde 3-phosphate dehydrogenase). There was a significant correlation between relative expression of PTPN12 mRNA in ccRCC tissues and tumor diameter and clinical stage.

Conclusion

The expression levels of PTPN12 protein and mRNA were significantly lower in ccRCC tissues compared with normal tissues. The role of PTPN12 may provide new insights and evidence to aid the diagnosis and targeted therapy of ccRCC.
Development and validation of a novel prognostic model for long-term overall survival in liposarcoma patients: a population-based study
Authors: Cao Shuai , Li Jie , Yang Kai , Zhang Jun , Xu Jiawei , Feng Chaoshuai , Li Haopeng
Published: December 2020

Objective

To construct and validate a clinically accurate and histology-specific nomogram to predict overall survival (OS) among liposarcoma (LPS) patients.

Methods

We retrospectively screened eligible patients with LPS diagnosed between 2004 and 2015 from the Surveillance, Epidemiology, and End Results database. We screened independent predictors for the nomogram using univariate and multivariate analyses. We then evaluated the prognostic accuracy of the nomogram by receiver operating characteristic (ROC) curve analysis and Harrell’s concordance index. The prognostic performances of the nomogram and the American Joint Committee on Cancer (AJCC) seventh edition staging system were compared using integrated discrimination improvement (IDI), net reclassification improvement (NRI), and decision curve analyses (DCA).

Results

A novel nomogram was developed using independent prognostic variables, which exhibited excellent predictive performances for 3- and 5-year OS according to ROC curves. The C-index proved that the proposed nomogram had better prognostic accuracy for LPS than the traditional AJCC system, while the NRI, IDI, and DCA of the nomogram indicated better clinical net benefit.

Conclusions

The proposed nomogram can predict 3- and 5-year OS of LPS patients with reliable accuracy and may thus help clinicians to develop appropriate clinical therapies and counseling strategies to prolong the life expectancy of these patients.
Relationship between enuresis and obstructive sleep apnea–hypopnea syndrome in children
Authors: Sun Chen , Xu Yingpeng , Luo Chenxi , Li Qi
Published: December 2020

Objective

We explored the relationship between enuresis and obstructive sleep apnea–hypopnea syndrome (OSAHS) in children and influencing factors of enuresis with OSAHS.

Methods

We recruited 196 children ≥5 years old from the otolaryngology outpatient department, who experienced snoring and underwent nasopharynx lateral radiography and in-laboratory polysomnography. We analyzed correlations between the apnea–hypopnea index (AHI) and lowest oxygen saturation (L-SaO2) with age, body mass index (BMI), tonsil size, and adenoidal–nasopharyngeal (A/N) ratio using the Pearson correlation test. Differences in severe OSAHS prevalence, age, AHI, L-SaO2, tonsil size, and A/N ratio between children with and without enuresis were assessed using the chi-square test and t-test. Risk factors of enuresis were analyzed using logistic regression. Follow-up was conducted to assess remission in children with enuresis after adenotonsillectomy.

Results

BMI, tonsil size, and A/N ratio were correlated with AHI and L-SaO2. Severe OSAHS prevalence, AHI, tonsil size, and A/N ratio were higher and L-SaO2 were lower in children with enuresis. Logistic regression showed that BMI, AHI, tonsil size, and sleep apnea were risk factors for enuresis.

Conclusions

Our study findings showed that enuresis was associated with OSAHS in children. Adenotonsillectomy may improve the symptoms of enuresis.
Lessons learned from COVID-19 for clinical research operations in Italy: what have we learned and what can we apply in the future?
Authors: Cagnazzo Celeste , Besse Marie-Georges , Manfellotto Dario , Minghetti Paola , Cazzaniga Sara , Cottini Lorenzo , Fontanella Andrea , Maruti Ilaria , Stabile Stefano , Testoni Sara , Trogu Paola , Sinno Valentina , Gussoni Gualberto
Published: December 2020

The coronavirus disease 2019 (COVID-19) pandemic has stressed the importance of health research as never before. In the specific domain of clinical research, the effort to rapidly find responses to health challenges and therapeutic hypotheses has highlighted the need for efficient, timely, ethically correct research. The guidelines published by the Agenzia Italiana del Farmaco have shown that some useful changes are feasible: simple and rapid methods have been implemented to conduct clinical research in the emergency conditions of the pandemic, maintaining high levels of quality. In this perspective, four Italian scientific associations operating in clinical research have worked together to evaluate which measures, among the ones implemented during the pandemic, have been particularly significant and potentially effective under normal conditions or in case of emergencies, and that therefore will be useful in the future as well.
Sheep-Associated Malignant Catarrhal Fever: Role of Latent Virus and Macrophages in Vasculitis
Authors: Saura-Martinez Helena , Al-Saadi Mohammed , Stewart James P. , Kipar Anja
Published: December 2020

Malignant catarrhal fever (MCF) is a sporadic, generally fatal disease caused by gammaherpesviruses in susceptible dead-end hosts. A key pathological process is systemic vasculitis in which productively infected cytotoxic T cells play a major role. Nonetheless, the pathogenesis of MCF vasculitis is not yet clear. We hypothesized that it develops due to an interaction between virus-infected cells and immune cells, and we undertook a retrospective in situ study on the rete mirabile arteries of confirmed ovine gammaherpesvirus-2 (OvHV-2)-associated MCF cases in cattle, buffalo, and bison. Our results suggest that the arteritis develops from an adventitial infiltration of inflammatory cells from the vasa vasorum, and recruitment of leukocytes from the arterial lumen that leads to a superimposed infiltration of the intima and media that can result in chronic changes including neointimal proliferation. We found macrophages and T cells to be the dominant infiltrating cells, and both could proliferate locally. Using RNA in situ hybridization and immunohistology, we showed that the process is accompanied by widespread viral infection, not only in infiltrating leukocytes but also in vascular endothelial cells, medial smooth muscle cells, and adventitial fibroblasts. Our results suggest that OvHV-2-infected T cells, monocytes, and locally proliferating macrophages contribute to the vasculitis in MCF. The initial trigger or insult that leads to leukocyte recruitment and activation is not yet known, but there is evidence that latently infected, activated endothelial cells play a role in this. Activated macrophages might then release the necessary pro-inflammatory mediators and, eventually, induce the characteristic vascular changes.
On proper applications of Galërkin’s approach in structural mechanics courses
Authors: Ruta G , Elishakoff I
Published: December 2020

An incautious use of the well-known Galërkin’s technique to find approximate solutions of a differential problem may lead to apparently wrong results. Examples are based on an inverse approach to investigate buckling of compressed axisymmetric circular plates, a subject that is common in courses on mechanics of structures and stability of structural elements. We discuss how the mistake may originate and show how it is possible to recover the expected results, thus providing a means for the students to cross-check their outputs.
The public university and the retreat from globalisation: An economic geography perspective on managing local-global tensions in international higher education
Authors: Knight Eric , Jones Andrew , Gertler Meric S
Published: December 2020

As a growing backlash against globalisation gathers momentum, internationally oriented public universities face a period of great unrest. In particular, they find themselves caught between the narrowing local agendas of their public funders and the global outlook of their researchers and students. We suggest that an economic geography lens provides a powerful perspective for how universities might navigate these tensions. Specifically, we show how local-global tensions can be managed through strategies engaged at the city and regional level. Our contribution seeks to inform current debates in the higher education sector and bring economic geography more centrally into public discourse on this topic.
A rusting gold standard: Failures in an Indonesian RCT, and the implications for poverty reduction
Authors: Tyagi Vikram , Webber Sophie
Published: December 2020

Randomised Control Trials (RCT) are both widely used in development, reaching hundreds of millions through RCT informed policy, and highly regarded, receiving a Nobel Prize in Economics. Proponents, largely academic economists, position RCTs as a scientific and ideologically neutral way to get to the heart of ‘what works’ in development. However, this new and radical micro-experimental approach to poverty reduction has sat uneasily within the broader development sphere, including critical geographers. We contribute to this debate by empirically examining the practical manifestation of the methodology within ‘PNPM Generasi’ – an innovative Indonesian cash transfer program evaluated through the largest RCT to date. Drawing primarily on field interviews, our examination finds three departures from the gold standard proclamations of the RCT methodology in practice. First, we find that randomising aid delivery breached ethical guidelines and compromised the effectiveness of the program being studied, largely as a result of RCTs being run in secret from local communities and politicians. Second, we find applying the RCT methodology on the ground was technically complex and financially costly, requiring not only an excessive use of scarce program funds, but also undermining the validity of the evaluation results. Finally, we find RCT results were not widely used in practice. We demonstrate these findings are not restricted to our specific case, but rather, reflect systemic deficiencies with RCT evaluations. Our results suggest that RCTs may have value if applied judiciously, and as part of multi-pronged approaches, but we caution against their growing monopoly influence on poverty reduction.
Supportive practices: perceptions of interventions targeting parents whose children are placed in out-of-home care
Authors: Shanks Emelie , Weitz Ylva Spånberger
Published: December 2020

Knowledge regarding the needs of parents whose children are placed in out-of-home care is still limited and studies focusing on interventions targeting this group are scarce. This article explores birth parents’ views on their needs and perceptions of support delivered by two different interventions: one offering support to individuals and the other providing a parental group. The methodology comprised a thematic analysis of 14 qualitative interviews. Parents’ expressed needs revolved around five issues: participation and influence in the relations with child welfare services; their emotional needs; their social needs; their relationship with their child; and practical and financial arrangements. The results revealed that the two interventions had overlapping as well as specific supportive functions and that these met some of the identified needs. Both programmes provided an opportunity for parents to speak openly about their grief and experiences of stigma and to receive help to cope with it, thus functioning as empowering and stigma-relieving practices that provide emotional support. The intervention that offered individual support contributed to a reduction in parents’ feelings of powerlessness when negotiating with child welfare services and functioned as an equalising practice by facilitating participation and influence. The parental group succeeded in reducing parents’ social isolation, providing social support and functioning as a normalising practice. However, neither intervention was explicitly perceived as helpful for improving parent–child relationships or practical and financial arrangements. The study highlights how the parents benefitted from receiving different types of support and contributes to knowledge about a group that has been neglected in practice and research.
Effects of initial stress state on the subsurface stress distribution after ultrasonic impact treatment on thick specimens
Authors: Liu Chuan , Shen Jiabin , Lin Changhua , Wang Jianfei , Wang Jianxin
Published: December 2020

Thick welded specimens with different initial stress states were prepared and treated with the ultrasonic impact treatment (UIT). The subsurface stresses before and after UIT were measured by the X-ray diffraction (XRD) method combined with layer removal. The measured results were corrected based on the finite element correction method. The effects of initial high tensile stress and low compressive stress on the in-depth after-UIT stress distributions were investigated. The results show that initial stress has no effects on the stresses induced by the UIT within 1 mm depth and within that depth, UIT can induce almost the same longitudinal and transverse stress curves beneath the surface with a peak compressive stress close to the material yield strength at the depth of near 0.6 mm and 0.8 mm. UIT induces almost the same longitudinal and transverse stresses along with the measured depth under initial low compressive stress state. While under the initial high tensile stress state, the initial stress dominates the final stress distribution over 1 mm depth. Initial high tensile stress (welding residual stress) can reduce the depth of the after-UIT compressive stresses to 62.5% to 75% of that under the initial low-compressive stress state.
A numerical study on nonlinear bending performance of transversely loaded composite singly curved stiffened surfaces
Authors: Bakshi Kaustav
Published: December 2020

The review of recent literature shows that the bending performances of transversely loaded laminated composite singly curved stiffened surfaces are not studied in detail using the geometrically nonlinear strains. The present paper aims to fill that void and proposes an isoparametric C° finite element formulation combining von-Karman nonlinearity and Sanders’ first approximation theory. The curved surfaces are simulated using nonlinear strains. The stiffeners are formulated using geometrically linear and nonlinear strains. The correctness of the proposed approach is confirmed through solution of benchmark problems. The relative performances of stiffened curved surfaces in terms of maximum transverse displacements are studied for industrially important parametric variations like boundary conditions, laminations, stacking sequences, and number, orientations, eccentricities, and depth of stiffeners. The results are critically discussed and it is concluded that the clamped 0°/90°/0° shell with curved stiffeners ( y-stiffener) located below the mid-surface shows the greatest bending stiffness. The nonlinear approach is essential for both shell and stiffener for correct prediction of the transverse displacements. The relatively simpler linear approach can be considered for single x-stiffener only.
A non-obstetric exposure to chloroform for Queen Victoria
Authors: Wilkinson David J
Published: December 2020

The administration of chloroform by John Snow to Queen Victoria to provide analgesia for the delivery of her children was a pivotal moment in the development of anaesthesia. It has long been thought that this was the only occasion she had experienced anaesthesia but examination of her diaries shows this to be untrue.
Robotic assisted laparoscopic radical prostatectomy following open trans-vesical adenomectomy: A single centre experience and review of the literature
Authors: Georgiades Fanourios , Konstantinou Kostas , Kouriefs Chryssanthos
Published: December 2020

Introduction:

Robotic assisted laparoscopic radical prostatectomy (RALRP) following endoscopic resection of the prostate is known to be feasible with good outcomes. However, the literature evidence is limited on the feasibility and outcomes of RALRP following open prostatic surgery. In this study, our aim was to report our experience with RALRP in patients who had undergone trans-vesical adenomectomy of the prostate in the past.

Patients and methods:

We reviewed our prospectively maintained database of men treated with RALRP at our institution to identify patients with previous history of open suprapubic trans-vesical adenomectomy, between 2016 and 2020. Data were collected on demographic information, interventions, oncological outcomes and follow-up.

Results:

Out of 362 patients, four individuals were identified that had previous open suprapubic trans-vesical adenomectomy. The mean age was 71 years with a mean pre-operative prostate specific antigen (PSA) of 11.35 ng/ml, and an average of 10 years after their trans-vesical adenomectomy. The mean console time was 119 min with an average estimated blood loss of 137.5 ml and 75% underwent lymphadenectomy. Post-operatively, all patients were discharged after 1 day with their urinary catheters removed at 7 days post-op. For one of the patients, a urine leak was identified, and his pelvic drain was removed at 5 days instead of 1 day as for the other three patients. No other complications were noted within 30 days. The average prostate weight was 54.7 g with all specimens being T3a R0. At 6 weeks follow-up, PSA was undetectable, three patients reported full continence and 1 was using two pads/day.

Conclusion:

RALRP following previous open trans-vesical prostatectomy is feasible and safe with excellent oncological outcomes. They are, however, more challenging and cumbersome with increased console time.
Epidemiological study of granulomatous prostatitis in a tertiary hospital: Associated risk factors and relationship with prostate cancer
Authors: Coello Torà Iris , de la Cruz Ruiz Marta , Carrillo García Paula , Carmelo Pieras Ayala Enrique
Published: December 2020

Objective:

The primary objective was to estimate the incidence of granulomatous prostatitis (GP) in Son Espases University Hospital, a tertiary care hospital, in Palma de Mallorca (Spain). As secondary objectives, presence of concomitant PCa in the biopsy was analyzed, as well as the history of previous BCG instillations, biopsy origin, urinary symptoms, and cardiovascular risk (CV) factors.

Methods:

A descriptive retrospective study of GP and the aforedescribed variables were carried out from 2010 to 2017.

Results:

A total of 3651 histopathological prostate specimens were analyzed, 39 of which were diagnosed with GP (incidence of 1.06%). Lower urinary tract symptoms (LUTS) were present in a 48.7% and previous history of bladder tumor resection (TURBT) was present in 35.9% of the cases. Also, urinary tract infections were equally present. All cases with prior TURBT had intravesical instillations with BCG, although 5 (12.8%) and 4 (10.3%) cases had abnormal rectal examination and elevated PSA levels after instillations, respectively. Finally, in 14 cases (35.9%) there was also a diagnosis of concomitant PCa. The most common CV risk factor in these patients was smoking (79.5%) followed by hypertension (64.8%).

Conclusions:

The estimated incidence of GP in our center (1.06%)g is close to that described by other authors. About 14 cases were diagnosed with PCa (35.9%), a higher value than previously described in the literature, and most of these were found incidentally, especially in cystoprostatectomies. This high percentage of concomitant GP and PCa could be due to a rise in Transrectal Prostate biopsies (TRPB), as in recent years there has been a tendency to increase the use of PSA in routine clinical practice.
The antinomies of the modern imaginary and the double dialectic of control
Authors: Browne Craig
Published: December 2020

Cornelius Castoriadis made a significant and distinctive contribution to the development of the notion of the dialectic of control. In the first instance, Castoriadis formulated an important reconceptualization and restatement of the Marxist conception of the central contradiction of capitalism. He argued that capitalism depended on the creativity of workers while excluding them from effective control. Similarly, Castoriadis sought to extend the Marxist analysis of those tendencies present within the structuration of the labour process that may prefigure a socialist reorganization of production. Castoriadis’s analyses of capitalism during the phase of his involvement with Socialism or Barbarism are likewise informed by his assessment of state socialist regimes. In particular, this assessment provided important insights into the modalities of control in modern society and the complications of transcending forms of institutional domination in modernity. It will be argued that some of the distinctive intentions of Castoriadis’s later elucidation of the social imaginary can be traced to his interpretation of bureaucratic capitalism and that this is evident in his subsequent accounts of the capitalist imaginary. In his later theory, Castoriadis interprets the problem of the dialectic of control in terms of the relationship between instituting and instituted society. Castoriadis’s analysis of capitalism during the period of Socialism or Barbarism will be situated in the wider debates over capitalism at that time. Similarly, Castoriadis’s departure from some of the philosophical sources that influenced the development of the notion of the dialectic of control will be explored.
Sixty years of Sartre’s Critique: Revisiting The Critique of Dialectical Reason today
Authors: Boncardo Robert
Published: December 2020

Despite being the work of one of the 20th-century’s most famous philosophers, Jean-Paul Sartre’s Critique of Dialectical Reason has never been fully integrated into our collective philosophical consciousness. None of the book’s key concepts, from seriality to the group, have come to play an important role in other philosophers’, sociologists’, or political theorists’ work. Amongst Sartre scholars, while work on the Critique has increased steadily in recent years, in particular in France and Belgium, no critical consensus exists about the book’s overall meaning or value. On the occasion of the Critique’s 60th birthday, in this article I provide a summary of its main aims and concepts with a view to establishing a new basis for reading and discussing the book. I will argue that the Critique is a coherent and unique work of social theory that speaks to a world suffering an overwhelming wave of what Sartre calls ‘counter-finality’ in the form of climate change.
Evaluation of Students’ Flow State in an E-learning Environment Through Activity and Performance Using Deep Learning Techniques
Authors: Semerci Yusuf Can , Goularas Dionysis
Published: December 2020

Estimating the flow state of students in a course allows evaluating their sentimental state and the challenges they are facing. In e-learning platforms, the evaluation of flow state is a complex task because it depends on the ability to extract the parameters that better reflect the activity and effort of students. In this scope, the current study proposes a method based on flow theory aiming to provide information about the students' flow state in a course that is taught in an e-learning environment. First, the interaction of students with an e-learning platform that comprises classical e-learning pages and a timeline tool is analyzed, using activity heatmaps and deep neural networks. Then, by taking also in account their grades, the flow state of students is calculated. The resulted data are validated with a statistical analysis that also utilizes student surveys. In order to guarantee that this method is applicable to various profiles, students from different faculties participated in this study. In a period where education is rapidly adapting to online lectures and e-learning platforms, the estimation of student's flow state in e-learning environments can provide useful feedback and data to students and educators.