bluuebunny/crossref_metadata_2025 huggingface dataset:
Revision total hip arthroplasty is associated with significantly higher opioid consumption as compared to primary total hip arthroplasty in the acute postoperative period
Authors: Bernstein Jenna A , Feng James , Mahure Siddharth A , Schwarzkopf Ran , Long William J
Published: September 2020

Background:

There are currently a lack of investigations that characterised narcotic utilisation following revision total hip arthroplasty (THA). We sought to determine if immediate post-surgical opioid use was different between revision THA and primary THA.

Methods:

A single institution total joint arthroplasty database was used to identify adult patients who underwent revision THA or primary THA from 2016 to 2019. Morphine milligram equivalents (MME) were calculated for different time periods.

Results:

6977 patients were identified, 89.72% primary THA and 10.28% revision THA. Aggregate opioid consumption was higher for revision THA patients (317.40 MME vs. 93.01 MME), as was opioid consumption in the first 24 hour and second 24-hour periods. Visual analogue pain (VAS) scores were significantly higher in the 0–12 hour postoperative and the 12–24 hours postoperative periods in the revision THA group.

Conclusions:

Patients undergoing revision THA had significantly higher narcotic utilisation than those undergoing primary THA, particularly in the first 24 hours postoperatively.
Cinematic itineraries and identities: Studying Bollywood tourism among the Hindustanis in the Netherlands
Authors: Nanjangud Apoorva , Reijnders Stijn
Published: September 2020

For decades, the ‘make-believe’ world of Bollywood has created elaborate imaginaries of India. A sizable part of its audience consists of diasporic communities, who not only consume Bollywood movies for entertainment but also as a way to stay connected with their Indian heritage. This study closely looks at one such diasporic community, namely the Dutch Hindustanis, investigating how Bollywood cinema affects their image of India, and how influential Bollywood cinema is in influencing their travel decisions to India. In-depth interviews indicate that Bollywood is a dominant cultural source for defining the respondents’ relationship with India. Moreover, the repeated consumption of Bollywood cinema stirs the desire to actually travel to India, seldom in search of ‘home’, but to visit sites associated with multiple Bollywood movies. Bollywood cinema being from their ‘distant homeland’ also incentivizes their travels to India thereby making it a meaningful experience. This study contributes to film (and) tourism research by introducing the concept of ‘cinematic itinerary’ to refer to these comprehensive film tourism practices.
Black cultural studies is intersectionality
Authors: Johnson Marcus , Joseph Ralina L
Published: September 2020

This article argues that Black cultural studies must be understood as an intersectional intervention of praxis. Grounding our field in the past, speaking from the present, and projecting to the future, we examine the transformational influence that Black feminist theory has had on cultural studies, from Kimberlé Williams Crenshaw’s defense of 2 Live Crew, to the #SayHerName and Protect Black Women rally and marches.
Theorising backlash politics: Conclusion to a special issue on backlash politics in comparison
Authors: Alter Karen J , Zürn Michael
Published: September 2020

This conclusion to a special issue on backlash politics develops a proto-theory of backlash politics. The special issue’s introduction defined backlash politics as a particular form of political contestation with a retrograde objective as well as extraordinary goals or tactics that has reached the threshold level of entering mainstream public discourse. While a sub-category of contentious politics, we argue that backlash politics is distinct and should not be understood as ‘regressive contentious politics’. Drawing from the contributions to this special issue, we discuss the causes of backlash politics, yet we argue that the greatest theoretical advances may come from studying backlash dynamics and how these dynamics contribute to different outcomes. We develop a proto-theory of backlash politics that considers causes for the rise of backlash movements, how frequent companions to backlash politics – emotive politics, nostalgia, taboo breaking, and institution reshaping – intensify backlash dynamics and make it more likely that backlash politics generate consequential outcomes.
A study of the bond behavior of FRP bars in MPC seawater concrete
Authors: Sun Wen , Zheng Yu , Zhou Linzhu , Song Jiapeng , Bai Yun
Published: September 2020

Using magnesium potassium phosphate cement (MPC) and fiber-reinforced polymer (FRP) bar to produce reinforced concrete can overcome the durability problems facing conventional steel reinforced PC concrete. In addition, FRP bar reinforced MPC concrete can also mitigate the CO2 emission issues caused by Portland cement (PC) production and the shortage of natural resources such as virgin aggregates and freshwater. This paper, therefore, is aimed at investigating the bond behavior of the FRP bars in MPC seawater concrete. The direct pullout tests were conducted with a steel bar, BFRP bar, and GFRP bar embedded into different concretes. The effects of reinforcing bars, type of concrete and mixing water on the bond behavior of FRP and steel bars were investigated and discussed. The results showed that the MPC concrete increases the bond strength of BFRP and GFRP bars by 51.06% and 24.42%, respectively, compared with that in PC concrete. Using seawater in MPC concrete can enhance the bond strength of GFRP bar by 13.75%. The damage interface of the FRP bar -MPC is more severe than that of PC with a complete rupture of the FRP ribs and peeling-off of the resin compared to that in steel reinforced MPC specimens. Moreover, the bond stress-slip models were developed to describe the bond behavior of MPC-FRP specimen, and the analytical results match well with the experimental data. In conclusion, the FRP bars showed better bond behavior in the MPC seawater concrete than that in the PC counterparts.
The social meaning of snitching in Chinese drug detention centers
Authors: Cheng Vincent S , Lapto Florence K
Published: September 2020

Snitching is the act of providing information to the authorities in exchange for rewards. Although snitching is, strictly speaking, a taboo among street offenders and prison inmates worldwide, offenders regard some types of snitching as relatively more acceptable than others. Studies regarding the social meaning of snitching have mostly been conducted with reference to American and European contexts, while the situation in the Asian or Chinese context has not been thoroughly explored. This paper helps to fill a research gap by examining the characteristics of the social meaning of snitching in a severely under-researched context—the inmate culture within Chinese drug detention centers. Our discussion is based on data collected from semi-structured interviews with 28 former inmates of drug detention centers, and it endeavors to explore how offenders conceptualize snitching and why they perceive snitching in the way they do. Our findings show that, while inmates in Chinese drug detention centers generally despise snitching, they see some specific forms of snitching as normal or even necessary. We analyze how inmates rationalize snitching behavior in these specific cases, and argue that this process is shaped by the collective control system implemented in the detention centers: (1) the collective merit system that connects each person’s well-being to the collective well-being, and (2) the informant mechanism that divides inmates into competing factions. Finally, theoretical implications are provided.
Migration After Endovasclar Aneurysm Sealing in Conjunction With Chimney Grafts
Authors: Zoethout Aleksandra C. , Sheriff Arshad , Zeebregts Clark J. , Reijnen Michel M. P. J. , Hill Andrew , Holden Andrew
Published: September 2020

Purpose

To assess the incidence of migration after endovascular aneurysm sealing (EVAS) in conjunction with chimney grafts (chEVAS) for repair of abdominal aortic aneurysms (AAAs).

Materials and Methods

A retrospective, observational cohort study was conducted of 31 patients (mean age 75.7 years; 27 men) treated for juxtarenal AAA between April 2013 and December 2018 at single centers in New Zealand and the Netherlands. The majority of patients received >1 chimney graft (13 single, 13 double, and 5 triple) during chEVAS. Six patients had only the first postoperative scan, so the migration analysis was based on 25 patients.

Results

Median seal length assessed on the first postoperative computed tomography scan was 36.5 mm. The assisted technical success rate was 93.5% with 2 technical failures. Median time to final imaging follow-up was 17 months in 25 patients. At the latest follow-up, there were no cases of caudal migration >10 mm. Freedom from caudal movement of 5 to 9 mm was estimated as 86.1% at 1 year and 73.9% at 2 years; freedom from clinically relevant migration (movement requiring reintervention) was 100% at both time intervals. However, at 3 years there were 2 cases of caudal movement of 5 to 9 mm and a type Ia endoleak warranting reintervention. No correlation between migration and aneurysm growth (p=0.851), endoleak (p=0.562), or the number of chimney grafts (p=0.728) was found. During follow-up, 2 patients (7%) had aneurysm rupture and 10 (33%) had reinterventions. Eight patients (27%) died; 2 were aneurysm-related (7%) and due to the consequences of a reintervention.

Conclusion

In the 2 years following chEVAS, there was no caudal migration >10 mm, but nearly a quarter of patients had caudal movement of 5 to 9 mm. A trend was observed toward ongoing migration that required intervention at 3-year follow-up. chEVAS is technically challenging and should be considered only for patients with no viable alternative treatment option.
Comparison of Clinical Outcomes in Patients Selected for Infra-Popliteal Bypass or Plain Balloon Angioplasty for Chronic Limb Threatening Ischemia Between 2009 and 2013
Authors: Popplewell Matthew A. , Davies Huw O. B. , Meecham Lewis , Bate Gareth , Bradbury Andrew W.
Published: September 2020

Introduction:

A published subgroup analysis of the Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL)-1 trial suggests that, in patients with chronic limb threatening ischemia (CLTI) due to infra-popliteal (IP) disease, clinical outcomes are better following vein bypass surgery (BS) than after plain balloon angioplasty (PBA). The aim of the present study is to determine if clinical outcomes following IP revascularization in our unit are concordant with those found in BASIL-1.

Methods:

We analyzed prospectively gathered data pertaining to 137 consecutive CLTI patients undergoing IP PBA or BS between 2009 and 2013. We compared 30-day morbidity and mortality, days in hospital (index admission and out to 12-months), amputation free survival (AFS), overall survival (OS), limb salvage (LS), and freedom from arterial re-intervention (FFR). Patient outcomes were censored on 1 February 2017, providing a minimum 3 years follow-up.

Results:

Patients undergoing BS (73/137, 47%) tended to be younger, have less comorbidity, and were more likely to be on best medical therapy (BMT). BS patients spent more days in hospital during the index admission (median 9 vs 5, p = .003), but not out to 12 months (median 15 vs 13, NS). BS patients suffered more 30-day morbidity (36% vs 10%, p < .001), mainly due to infective complications, but not mortality (3.1% vs 6.8%, NS). AFS (p = .001) and OS (p < .001), but not LS or FFR, were better after BS.

Conclusions:

CLTI patients selected for revascularization by means of IP BS had better long-term outcomes in terms of AFS and OS, but not FFR or LS. Although we await the results of the BASIL-2 trial, current data support the BASIL-1 sub-group analysis which suggests that patients requiring revascularization for IP disease should have BS where possible and that PBA should usually be reserved for patients who are not suitable for BS.
‘You are Okay’: Effects of a support and educational program for children with mild intellectual disability and their parents with mental health concerns
Authors: Riemersma Ivon , Van Santvoort F , Van Doesum KTM , Hosman CMH , Janssens JMAM , Van der Zanden RAP , Otten R
Published: September 2020

Background:

Children with mild intellectual disabilities and emotional and behavioural problems whose parents have mental health concerns are at an increased risk of developing problems themselves. This study analysed the effectiveness of the ‘You are Okay’-program aimed to support these children and parents and to reduce the risk of problem development in children.

Method:

A quasi-experimental design was used to compare the experimental group (‘care as usual’ and ‘You are Okay’) with the control group (‘care as usual’) on the main outcome of emotional and behavioural problems and proposed intermediate outcomes.

Results:

Children in the experimental group reported a significant medium to large decrease in emotional and behavioural problems compared to the control group. The effects on the intermediate outcomes were non-significant.

Conclusions:

This specific study population comprising a vulnerable group of children seems to benefit from this specially adapted ‘You are Okay’-program. More research is necessary to draw further conclusions.
Use the Environment to Prevent and Control COVID-19 in Senior-Living Facilities: An Analysis of the Guidelines Used in China
Authors: Wang Zhe
Published: September 2020

Objective:

To identify the environmental factors essential for infection control in senior-living facilities.

Background:

In the COVID-19 pandemic, older adults are more likely to be infected and develop serious outcomes than young people. Worldwide, senior-living facilities face a battle to protect their residents. Compared with age-related declines, the built environment is more modifiable and can be used for infection control.

Methods:

This research conducted content analysis of the guidelines on COVID-19 control issued by the State Council of China in February 2020 for senior-living facilities. Six senior-living facility managers in China were interviewed and shared their experiences using these guidelines. Quantitative and qualitative analyses were conducted to identify the essential environmental factors for infection control.

Results:

Environmental factors suggested in the guidelines were analyzed for three groups of infection-control strategies: keep COVID-19 from entering the facility, prevent COVID-19 spread in the facility, and manage infection and illness. Key topics of experience using the guidelines were identified, including residents’ needs for social interaction and the difficulties of providing dedicated air-conditioning and circulation systems. Based on these analyses, from the perspective of environmental design, environmental factors essential for COVID-19 control in senior-living facilities were summarized at the site, building, and room levels.

Conclusion:

Proper planning and design of the built environment promote strategies for infection control in senior-living facilities. Findings can be used to guide the new design, renovation, and modification of senior-living facilities for COVID-19 control and future public health emergencies.
Transient Global Amnesia as a Possible First Manifestation of COVID-19
Authors: Hussein Haitham M.
Published: September 2020

Evidence of involvement of the nervous system in COVID-19 disease is accumulating. We describe a case of a 53-year-old man presented with classic syndrome of transient global amnesia with symptoms lasting less than 24 hours and mild transient unexplained fever. Workup including brain MRI, electroencephalogram, and chest X ray was negative and the patient was discharged. The day after discharge, the patient started to experience the classic respiratory and systemic COVID-19 illness and was eventually readmitted with hypoxic respiratory failure and positive COVID-19 test a week after the first hospital discharge. The case highlights the importance of neurological syndromes as presenting prodrome to the respiratory illness of COVID-19.
Application of non-mydriatic fundus examination and artificial intelligence to promote the screening of diabetic retinopathy in the endocrine clinic: an observational study of T2DM patients in Tianjin, China
Authors: Hao Zhaohu , Cui Shanshan , Zhu Yanjuan , Shao Hailin , Huang Xiao , Jiang Xia , Xu Rong , Chang Baocheng , Li Huanming
Published: September 2020

Background:

We aimed to determine the role of non-mydriatic fundus examination and artificial intelligence (AI) in screening diabetic retinopathy (DR) in patients with diabetes in the Metabolic Disease Management Center (MMC) in Tianjin, China.

Methods:

Adult patients with type 2 diabetes mellitus who were first treated by MMC in Tianjin First Central Hospital and Tianjin 4th Center Hospital were divided into two groups according to the time that MMC was equipped with the non-mydriatic ophthalmoscope and AI system and could complete fundus examination independently (the former was the control group, the latter was the observation group). The observation indices were as follows: the incidence of DR, the fundus screening rate of the two groups, and fundus screening of diabetic patients with different course of disease.

Results:

A total of 5039 patients were enrolled in this study. The incidence rate of DR was 18.6%, 29.8%, and 49.6% in patients with diabetes duration of ⩽1 year, 1–5 years, and >5 years, respectively. The screening rate of fundus in the observation group was significantly higher compared with the control group (81.3% versus 28.4%, χ2 = 1430.918, p < 0.001). The DR screening rate of the observation group was also significantly higher compared with the control group in patients with diabetes duration of ⩽1 year (77.3% versus 20.6%; χ2 = 797.534, p < 0.001), 1–5 years (82.5% versus 31.0%; χ2 = 197.124, p < 0.001) and ⩾5 years (86.9% versus 37.1%; χ2 = 475.609, p < 0.001).

Conclusions:

In the case of limited medical resources, MMC can carry out one-stop examination, treatment, and management of DR through non-mydratic fundus examination and AI assistance, thus incorporating the DR screening process into the endocrine clinic, so as to facilitate early diagnosis.
Rates and correlates of pharmacotherapy-related problems among psychiatric inpatients: a representative Danish study
Authors: Kibsdal Karina Porsborg , Andersen Sabina , Gazerani Parisa , Plet Hanne
Published: September 2020

Background:

Drug related problems (DRPs) occur frequently among psychiatric patients due to common prescribing errors and complex treatment schedules. Clinical pharmacists (CPs) are thought to play an important role in preventing DRPs and, consequently, to increasing the quality of inpatient care. There is, however, limited information available on DRPs within the psychiatric field in Denmark. The aim of this study was to identify rates and correlates of pharmacotherapy-related problems among psychiatric inpatients in a Danish psychiatric hospital.

Methods:

A retrospective descriptive study was conducted by two CPs and data were obtained from the medical records available in two psychiatric wards. Chart-reviews were conducted for the period of June 2015 to February 2017. The analyses focussed on the prevalence of DRP categories, implementation and acceptance rates, and drugs associated with the DRPs. Extracted data were discussed with the wards’ physicians and registered in a DRP-database.

Results:

In total, 607 medical records were reviewed and, on average, 2.5 DRPs per medication review were found. There was a positive correlation between the number prescribed drugs and the average number of DRPs. The most frequent categories of DRPs were ‘drug dosage’, ‘inappropriate drug’ and ‘interactions’. The drugs represented most frequently in DRPs were olanzapine, quetiapine and pantoprazole. The overall acceptance rate was 49% with 33% of those implemented clinically.

Conclusion:

DRPs were commonly observed among psychiatric patients, particularly in those with multiple prescriptions, in relation to drugs dosage, inappropriate prescriptions and drug interactions. Particular attention must be paid to olanzapine, quetiapine and pantoprazole. Strategies to minimise DRPs among psychiatric patients are warranted and CPs can play an important role.
Neurological manifestations in COVID-19: A narrative review
Authors: Rahman Asma , Niloofa Roshan , De Zoysa Ishan M , Cooray Akila D , Kariyawasam Jayani , Seneviratne Suranjith L
Published: September 2020

COVID-19, a respiratory viral infection, has affected more than 10 million individuals worldwide. Common symptoms include fever, dry cough, fatigue and shortness of breath. Some patients show neurological manifestations such as headache, dizziness, cerebrovascular disease, peripheral nerve and muscle symptoms and smell and taste impairment. In previous studies, SARS-CoV-1 and MERS-CoV were found to affect the nervous system. Given the high similarity between SARS-CoV-1 and SARS-CoV-2, effects on the nervous system by SARS-CoV-2 are a possibility. We have outlined the common neurological manifestations in COVID-19 (information are up-to-date as of June 2020) and discussed the possible pathogenetic mechanisms and management options.
Pained publics
Authors: Conley Donovan , Burroughs Benjamin
Published: September 2020

In her contribution to the Quarterly Journal of Speech’s centennial issue, “Pathologia,” Jenny Rice suggests, “pathology does not only or always reveal something broken. Rather, the experience of pathology also reminds us that rhetoric’s sensorium is working—really working” (p. 35). Yes, and in a time of pandemic turbulence, we are reminded that the sensorium of civic life works in ways that shape, even threaten, our collective modes of engagement and relationality. Rice offers “the wound” as a response to pathological publicness, noting, “I propose that we begin to theorize the wound itself as the beginning of dialogue. Only the wound can stand as pathology’s counterpart” (p. 40). Wounds focalize and materialize the pathogenic, opening up possibilities for redress while also remediating their own contaminants. Accordingly, our special issue aims to grapple with the ways contemporary publicness affects, and is affected by, civic wounds: how they are discursively produced, and productively discursive. What emergent forms of expression or composition do wounds make possible or foreclose? And, how might critical communication scholarship ad/dress the pathogenic constitution of civic wounds? Each of the essays in “Ad/Dressing Civic Wounds” thus situates particular ways in which wounds are “really working” to produce the conditions that open or foreclose possibilities in the never-finished work of finding shared grounds of togetherness we might call civic life.
Adapting Premedical Post-Baccalaureate Approaches to Support US-style Medical Education in the United Arab Emirates
Authors: Shaya Janah , Vukusic Sulafudin , Hassan Asli , Muhammad Abdus Sabur , Tay Guan , Al Safar Habiba , Corridon Peter R.
Published: September 2020

A recent academic paradigm shift in the United Arab Emirates (UAE) introduced US-style medical education to meet the nation’s growing need for medical practitioners. This newly established Doctor of Medicine (MD) program at Khalifa University of Science and Technology (KU) left gaps in student preparedness. To address this problem, KU simultaneously developed a post-bachelor’s premedical program, commonly known as a pre-medicine post-baccalaureate (PMPB) program, that prepared students for entry into the UAE’s first MD program. The authors adapted US-style post-baccalaureate approaches to create KU’s PMPB program that gave students unique opportunities to take coursework that filled gaps in previous knowledge and prepare for the Medical College Admission Test (MCAT) exam. The 1-year bridging program harnessed academic strengths from the Association of American Medical Colleges (AAMC) post-baccalaureate premedical programs network and Kaplan, Inc. Overall, 19 (12 Emirati and 7 international) students achieved admissible MCAT scores (group’s minimum score = 485, average score = 492, and maximum score = 509) and gained research experiences that supported their entry into KU’s medical school. The PMPB program supplied two-thirds of the medical schools’ fall 2019 inaugural class, increased local awareness and interest in medicine and created a novel platform to help students pursue a career in medicine in the UAE.
The Time-lag Effect of R&D Investment on the Value of Listed Companies in China: A Cross-industry Analysis
Authors: Xie Hongming , Yang Jie , Yu Wei , Yang Yingnan , Wu Wenshi
Published: September 2020

Innovation plays an increasingly important role in economic growth, and R&D investment has become a key component of innovation initiatives. In this study, we performed analyses of 58 listed automobile manufacturers and 52 listed Internet companies in China. The empirical analysis is carried out by using STATA15.0 to preliminarily explore the mechanism of the time-lag effect of R&D investment on the value of these companies over the years of time-lag as well as conduct comparison analyses across industries. The results show that R&D investment has a positive effect on corporate value and this effect has a long-term time-lag effect. The mechanism of time-lag effect of R&D investment on the corporate value over the lag years has significant differences across industries. The time-lag effect of R&D investment on the value of the listed automobile manufacturer presents an inverted U shape, while the time-lag effect of R&D investment on the value of the listed Internet companies decreases gradually. The study helps local government better understand the different mechanisms of the time-lag effect of R&D investment on the value of the listed companies and also serves as a reference for local government to make decisions on subsidies and other supportive policies for innovation initiatives of the listed companies.
Loving one’s job: A matter of choice or subjection?
Authors: da Costa Lemos Ana Heloísa , de Carvalho Silva Marcelo Almeida , Serra Carlos Henrique Aguiar
Published: September 2020

The idea that it is through discourse that subjective adherence to the capitalist order is renewed motivated our interest in analysing the modern-day terms applied to this adherence, as manifested in the discourse that stresses the importance of ‘loving one’s job’. In order to better understand this discourse, we chose to analyse its presence within a specific business medium, using the Fairclough three-dimensional model as analytical tool. Using Foucauldian and Deleuzian perspectives in our analysis, we argue that the ‘love of one’s job’ discourse, subtle and seductive in nature and often almost invisible, has numerous effects on labour, such as discipline and control. This discourse can constitute a modality of neo- normative control, in that it appeals to the sentiments of the workers in order to increase their dedication to work.
Recruiting digital talent: The strategic role of recruitment in organisations’ digital transformation
Authors: Gilch Phyllis Messalina , Sieweke Jost
Published: September 2020

Recruitment plays a central role during digital transformation because companies in many industries need to hire employees who possess IT-related knowledge, skills and abilities to digitalise their products, services and processes. However, extant research so far mainly has focussed on the use of digital technology in recruiting processes and its outcomes, whereas strategic aspects have received little attention. Based on 26 interviews with recruiters in 22 organisations, this study examines the interplay between recruitment and digital transformation beyond the use of digital technology in recruitment, focussing on more strategic aspects. The study examines recruitment’s role in organisations’ digital transformation. We found that the recruitment of digital talent as a new target group triggers change within the company, and does so in three ways: First, recruiters have realised the necessity to adapt their measures and processes to the new target group. Second, recruiters have developed a new self-understanding. Third, recruiters have recognised the need to support the organisation’s digital transformation by taking on a bridging function. Our study makes two contributions: First, we identified two new roles for recruitment during digital transformation: It acts as a ‘sensory organ’ that enhances the organisation’s absorptive capacity; and it takes on the role of a ‘mediator’ between external and internal groups. Second, this study builds on the human resources (HR) literature by analysing the strategic implications that digital transformation imposes on recruitment, highlighting recruitment’s part in renewing an organisation’s human resource base, which is crucial for its digital transformation.
The Mesoarchean Amikoq Layered Complex of SW Greenland: Part 1. Constraints on theP–Tevolution from igneous, metasomatic and metamorphic amphiboles
Authors: Aarestrup Emil , Jørgensen Taus R. C. , Armitage Paul E.B. , Nutman Allen P. , Christiansen Ole , Szilas Kristoffer
Published: September 2020

The metamorphic history of the Mesoarchean Amikoq Layered Complex within the Akia terrane of SW Greenland was characterised by electron microprobe mineral data and detailed petrography on 12 representative samples, integrated with zircon U–Pb geochronology and petrology. The complex intruded into a >3004 Ma supracrustal association now consisting of granoblastic metabasites with subordinate quartz-rich gneiss. Supracrustal host rocks contain a relict high-temperature assemblage of orthopyroxene–clinopyroxene (± pigeonite exsolution lamellae, exsolved at ~975–1010°C), which is interpreted to pre-date the Amikoq intrusion. Cumulate to granoblastic-textured rocks of the main Amikoq Layered Complex range modally from leuconorite to melanorite, orthopyroxenite to harzburgite/dunite and rare hornblende melagabbro. Observed mineralogy of main complex noritic lithologies is essentially relict igneous with orthopyroxene–biotite and hornblende–plagioclase thermometers yielding temperatures of ~800–1070°C. An anatectic zircon megacryst from a patchy quartzo–feldspathic leucosome hosted in an orthopyroxene-dominated Amikoq rock reflects local anatexis at peak metamorphicP–Tconditions and yields an intrusion minimum age of 3004 ± 9 Ma. Field observations indicate local anatexis of orthopyroxene-dominated lithologies, possibly indicating a post-intrusion peak temperature of >900°C. The last preserved stages of retrogression are recorded in paragneiss plagioclase–garnet, biotite–garnet and host rock ilmenite–magnetite pairs (≤3 kbar and ~380–560°C).

The Amikoq Complex intruded a MORB-like crustal section and the former remained relatively undisturbed in terms of modal mineralogy. Preservation of igneous textures and mineralogy are related to an anhydrous, high-grade metamorphic history that essentially mimics igneous crystallisation conditions, whereas local high-strain zones acted as fluid pathways resulting in hydrous breakdown of igneous minerals. There is no evidence of equilibration of the intrusion at sub-amphibolite-facies conditions.
COVID-19 and pneumothorax: a multicentre retrospective case series
Authors: Martinelli Anthony W. , Ingle Tejas , Newman Joseph , Nadeem Iftikhar , Jackson Karl , Lane Nicholas D. , Melhorn James , Davies Helen E. , Rostron Anthony J. , Adeni Aldrin , Conroy Kevin , Woznitza Nick , Matson Matthew , Brill Simon E. , Murray James , Shah Amar , Naran Revati , Hare Samanjit S. , Collas Oliver , Bigham Sarah , Spiro Michael , Huang Margaret M. , Iqbal Beenish , Trenfield Sarah , Ledot Stephane , Desai Sujal , Standing Lewis , Babar Judith , Mahroof Razeen , Smith Ian , Lee Kai , Tchrakian Nairi , Uys Stephanie , Ricketts William , Patel Anant R.C. , Aujayeb Avinash , Kokosi Maria , Wilkinson Alexander J.K. , Marciniak Stefan J.
Published: September 2020

Introduction

Pneumothorax and pneumomediastinum have both been noted to complicate cases of coronavirus disease 2019 (COVID-19) requiring hospital admission. We report the largest case series yet described of patients with both these pathologies (including nonventilated patients).

Methods

Cases were collected retrospectively from UK hospitals with inclusion criteria limited to a diagnosis of COVID-19 and the presence of either pneumothorax or pneumomediastinum. Patients included in the study presented between March and June 2020. Details obtained from the medical record included demographics, radiology, laboratory investigations, clinical management and survival.

Results

71 patients from 16 centres were included in the study, of whom 60 had pneumothoraces (six with pneumomediastinum in addition) and 11 had pneumomediastinum alone. Two of these patients had two distinct episodes of pneumothorax, occurring bilaterally in sequential fashion, bringing the total number of pneumothoraces included to 62. Clinical scenarios included patients who had presented to hospital with pneumothorax, patients who had developed pneumothorax or pneumomediastinum during their inpatient admission with COVID-19 and patients who developed their complication while intubated and ventilated, either with or without concurrent extracorporeal membrane oxygenation. Survival at 28 days was not significantly different following pneumothorax (63.1±6.5%) or isolated pneumomediastinum (53.0±18.7%; p=0.854). The incidence of pneumothorax was higher in males. 28-day survival was not different between the sexes (males 62.5±7.7%versusfemales 68.4±10.7%; p=0.619). Patients aged ≥70 years had a significantly lower 28-day survival than younger individuals (≥70 years 41.7±13.5% survivalversus<70 years 70.9±6.8% survival; p=0.018 log-rank).

Conclusion

These cases suggest that pneumothorax is a complication of COVID-19. Pneumothorax does not seem to be an independent marker of poor prognosis and we encourage continuation of active treatment where clinically possible.
Design of Vegetable Pot Seedling Pick-up Mechanism with Planetary Gear Train
Authors: Tong Zhipeng , Yu Gaohong , Zhao Xiong , Liu Pengfei , Ye Bingliang
Published: September 2020

It has been challenging to design seedling pick-up mechanism based on given key points and trajectories, because it involves dimensional synthesis and rod length optimization. In this paper, the dimensional synthesis of seedling pick-up mechanism with planetary gear train was studied based on the data of given key points and the trajectory of the endpoint of seedling pick-up mechanism. Given the positions and orientations requirements of the five key points, the study first conducted a dimensional synthesis of the linkage size and center of rotation. The next steps were to select a reasonable solution and optimize the data values based on the ideal seedling trajectory. The link motion was driven by the planetary gear train of the two-stage gear. Four pitch curves of noncircular gears were obtained by calculating and distributing the transmission ratio according to the data. For the pitch curve with two convex points, the tooth profile design method of incomplete noncircular gear was applied. The seedling pick-up mechanism was tested by a virtual prototype and a physical prototype designed with the obtained parameter values. The results were consistent with the theoretical design requirements, confirming that the mechanism meets the expected requirements for picking seedlings up. This paper presents a new design method of vegetable pot seedling pick-up mechanism for an automatic vegetable transplanter.
Who’s related to whom? Use published phylogenies and make customized tree-thinking assessments
Authors: Blacquiere Luke D. , Fawaz Allia , Hoese William J.
Published: September 2020

A phylogeny depicts the hypothesized evolutionary relationships among taxa as a nested hierarchical branching diagram. Interpreting the relationships among taxa on a phylogeny is part of a set of skills called tree-thinking. Because published phylogenies are not constructed for the purpose of tree-thinking pedagogy, the information can be difficult for students to interpret and explicit instruction is required for mastery of the tree-thinking skill-set. We present a process to construct customizable assessment questions using published phylogenies, to assess a key tree-thinking skill, determining relatedness among taxa on a phylogeny. We detail how to construct two types of forced-choice questions: binary-choice and four-choice. In both question types, students are presented with a phylogeny and are instructed to determine which taxon from a list of taxa is most closely related to a focal taxon. The list of taxa includes distracters as possible responses explicitly selected based on common alternative strategies (similarity,proximity,node counting), in addition to the correct response. Instructors can select taxa of their own choosing in order to customize assessments. These assessment questions can be utilized during instruction as a formative assessment to enhance learning or in a summative assessment.
Bayesian gamma-negative binomial modeling of single-cell RNA sequencing data
Authors: Dadaneh Siamak Zamani , de Figueiredo Paul , Sze Sing-Hoi , Zhou Mingyuan , Qian Xiaoning
Published: September 2020

Background

Single-cell RNA sequencing (scRNA-seq) is a powerful profiling technique at the single-cell resolution. Appropriate analysis of scRNA-seq data can characterize molecular heterogeneity and shed light into the underlying cellular process to better understand development and disease mechanisms. The unique analytic challenge is to appropriately model highly over-dispersed scRNA-seq count data with prevalent dropouts (zero counts), making zero-inflated dimensionality reduction techniques popular for scRNA-seq data analyses. Employing zero-inflated distributions, however, may place extra emphasis on zero counts, leading to potential bias when identifying the latent structure of the data.

Results

In this paper, we propose a fully generative hierarchical gamma-negative binomial (hGNB) model of scRNA-seq data, obviating the need for explicitly modeling zero inflation. At the same time, hGNB can naturally account for covariate effects at both the gene and cell levels to identify complex latent representations of scRNA-seq data, without the need for commonly adopted pre-processing steps such as normalization. Efficient Bayesian model inference is derived by exploiting conditional conjugacy via novel data augmentation techniques.

Conclusion

Experimental results on both simulated data and several real-world scRNA-seq datasets suggest that hGNB is a powerful tool for cell cluster discovery as well as cell lineage inference.
First insights on value-based healthcare of elders using ICHOM older person standard set reporting
Authors: Lee Wei-Ju , Peng Li-Ning , Lin Chi-Hung , Lin Shinn-Zong , Loh Ching-Hui , Kao Sheng-Lun , Hung Tzu-Shing , Chang Chia-Yun , Huang Chun-Feng , Tang Ting-Ching , Chen Liang-Kung
Published: September 2020

Background

Clinical guidelines for specific conditions fragment care provision for elders. The International Consortium for Health Outcomes Measurement (ICHOM) has developed a global standard set of outcome measures for comprehensive assessment of older persons. The goal of this study was to report value-based health metrics in Taiwan using this ICHOM toolset.

Methods

The cross-sectional study of baseline data excerpted from a prospective longitudinal cohort, which recruited people ≥65 years old with ≥3 chronic medical conditions between July and December 2018. All participants received measurements of physical performance, anthropometric characteristics, health-related behaviors, Charlson Comorbidity Index, and Montreal Cognitive Assessment. The ICHOM toolset comprises three tiers: 1 includes frailty and having chosen a preferred place of death; 2 includes polypharmacy, falls, and participation in decision-making; and 3 includes loneliness, activities of daily living, pain, depression, and walking speed. These items were converted into a 0–10 point value-based healthcare score, with high value-based health status defined as ≥8/10 points.

Results

Frequencies of individual ICHOM indicators were: frail 11.7%, chose preferred place of death 14.4%, polypharmacy 31.5%, fell 17.1%, participated in decision-making 81.6%, loneliness 26.8%, limited activities of daily living 22.4%, pain 10.4%, depressed mood 13.0%, and slowness 38.5%. People with high disease burden (OR 0.40, 95% CI 0.21–0.76, p = 0.005) or cognitive impairment (OR 0.49, 95%CI 0.27–0.87, p = 0.014) were less likely to have high value-based healthcare status.

Conclusions

The ICHOM Standard Set Older Person health outcome measures provide an opportunity to shift from a disease-centric medical paradigm to whole person-focused goals. This study identified advanced age, chronic disease burden and cognitive impairment as important barriers to achieving high value-based healthcare status.
Do multiple community-based interventions on health promotion tackle health inequalities?
Authors: Nickel Stefan , von dem Knesebeck Olaf
Published: September 2020

Background

Previous systematic reviews of the impact of multi-component community-based health promotion interventions on reducing health inequalities by socio-economic status (SES) were restricted to physical activity and smoking behavior, and revealed limited and rather disillusioning evidence. Therefore, we conducted a comprehensive review worldwide to close this gap, including a wide range of health outcomes.

Methods

The Pubmed and PsycINFO databases were screened for relevant articles published between January 1999 and August 2019, revealing 87 potentially eligible publications out of 2876 hits. In addition, three studies out of a prior review on the effectiveness of community-based interventions were reanalyzed under the new research question. After a systematic review process, 23 papers met the inclusion criteria and were included in the synthesis.

Results

More than half (56.5%) of the studies reported improvements of socially disadvantaged communities overall (i.e. reduced inequalities at the area level) in at least one health behavior and/or health status outcome. Amongst the remaining studies we found some beneficial effects in the most deprived sub-groups of residents (8.2%) and studies with no differences between intervention and control areas (34.8%). There was no evidence that any program under review resulted in an increase in health disparity.

Conclusions

Our results confirm that community-based interventions may be reducing absolute health inequalities of deprived and disadvantaged populations, but their potential so far is not fully realized. For the future, greater attention should be paid to inequalities between sub-groups within communities when analyzing changes in health inequality over time.
Is insulin resistance a predictor for complete response in breast cancer patients who underwent neoadjuvant treatment?
Authors: Alan Ozkan , Akin Telli Tugba , Aktas Bilge , Koca Sinan , Ökten Ilker Nihat , Hasanov Rahib , Basoglu Tugba , Arikan Rukiye , Demircan Nazim Can , Ercelep Ozlem , Kaya Serap , Ugurlu Mustafa Umit , Kaya Handan , Akgul Babacan Nalan , Dane Faysal , Yumuk Perran Fulden
Published: September 2020

Purpose

Neoadjuvant chemotherapy is the standard front-line treatment modality in locally advanced breast cancer. Achieving pathological complete response (pCR) is a significant prognostic factor for prolonged disease-free and overall survival. Insulin resistance is defined as a pathological condition in which insulin effect is impaired in peripheral target tissues such as the skeletal muscle, liver, and adipose tissue. The relationship between breast cancer and insulin resistance is controversial. In this study, our aim is to evaluate the role of insulin resistance, body mass index (BMI), metabolic syndrome, and inflammation markers to predict complete response in breast cancer patients who underwent neoadjuvant treatment.

Methods

Data from 55 locally advanced non-diabetic breast cancer patients, treated with neoadjuvant chemotherapy between 2015 and 2017, were retrospectively evaluated. Homeostatic model assessment, IR = insulin resistance (HOMA-IR) was calculated by using the obtained insulin and fasting blood glucose values before neoadjuvant chemotherapy (fasting insulin × fasting glucose/405). We considered a cut-off of 2.5 for insulin resistance. The systemic inflammatory index (SII), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) were calculated.

Results

Twenty-five patients had no insulin resistance. The most common pathologic subtype (56%) was hormone receptor (HR) positive and human epidermal growth factor receptor-2 (Her-2)-negative invasive ductal carcinoma. Sixteen (29%) patients had a pathological complete response (pCR). We found that the probability of pCR in patients with insulin resistance was 4.7 times lower than that in patients without insulin resistance [OR: 4.7 (95%CI 1.7–17.2), p = 0.01].

Conclusion

Our results revealed that insulin resistance may have a negative effect on pathological complete response (pCR) following neoadjuvant therapy particularly with hormone-positive and Her-2-negative cases of non-diabetic breast cancer.
Association of the MTHFR 677C>T and 1298A>C polymorphisms and male infertility risk: a meta-analysis
Authors: Aliakbari Fereshteh , Pouresmaeili Farkhondeh , Eshghifar Nahal , Zolghadr Zahra , Azizi Faezeh
Published: September 2020

Background and objectives

One of the possible male sterility risk factors are polymorphisms of Methylenetetrahydrofolate reductase (MTHFR). However, the epidemiologic investigations described inconsistent results regarding MTHFR polymorphism and the risk of male infertility. For that reason, we carried out a meta-analysis of published case-control studies to re-examine the controversy.

Methods

Electronic searches of Cochrane, EMBASE, Google Scholar, and PubMed were conducted to select eligible studies for this meta-analysis (updated to May 2019). According to our exclusion and inclusion criteria, only high-quality studies that remarked the association between MTHFR polymorphisms and male infertility risk were included. The Crude odds ratio (OR) with a confidence interval of 95% (CI) was used to assess the relationship between MTHFR polymorphism and male infertility risk.

Results

Thirty-four case-control studies with 9662 cases and 9154 controls concerning 677C/T polymorphism and 22 case-control studies with 5893 cases and 6303 controls concerning 1298A/C polymorphism were recruited. Both MTHFR polymorphisms had significant associations with male infertility risk (CT + TT vs. CC: OR = 1.37, 95% CI: 1.21–1.55, P = 0.00, I2 = 41.9%); (CC vs. CA + AA: OR = 0.82, 95% CI: 0.52–1.30, P = 0.04, I2 = 50.1%). Further, when stratified by ethnicity, the significant association results were observed in Asians and Caucasians for 677C/T and just Asians for 1298A/C.

Conclusions

Some of MTHFR polymorphisms like MTHFR 677C > T are associated with an elevated male infertility risk. To confirm our conclusion and to provide more accurate and complete gene-environment communication with male infertility risk, more analytical studies are needed.