bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating the maximum regret of statistical treatment rules with sample data on treatment response
Authors: Litvin Valentyn , Manski Charles F.
Published: March 2021

In this article, we present the wald_tc command, which computes the maximum regret (MR) of a user-specified statistical treatment rule that uses sample data on realized treatment response (and optionally an instrumental variable) to determine a treatment choice for a population. Because the outcomes of counterfactual treatments are not observed and treatment selection in the study population may not be random, decision makers may be able only to partially identify average treatment effects. wald_tc allows users to compute the MR of a proposed statistical treatment rule under a flexible specification of the data-generating process and determines the state that generates MR.
msreg: A command for consistent estimation of linear regression models using matched data
Authors: Hirukawa Masayuki , Liu Di , Prokhorov Artem
Published: March 2021

Economists often use matched samples, especially when dealing with earning data where some observations are missing in one sample and need to be imputed from another sample. Hirukawa and Prokhorov (2018, Journal of Econometrics 203: 344–358) show that the ordinary least-squares estimator using matched samples is inconsistent and propose two consistent estimators. We describe a new command, msreg, that implements these two consistent estimators based on two samples. The estimators attain the parametric convergence rate if the number of continuous matching variables is no greater than four.
segregsmall: A command to estimate segregation in the presence of small units
Authors: D’Haultfœuille Xavier , Girard Lucas , Rathelot Roland
Published: March 2021

Suppose that a population, composed of a minority and a majority group, is allocated into units, which can be neighborhoods, firms, classrooms, etc. Qualitatively, there is some segregation whenever allocation leads to the concentration of minority individuals in some units more than in others. Quantitative measures of segregation have struggled with the small-unit bias. When units contain few individuals, indices based on the minority shares in units are upward biased. For instance, they would point to a positive amount of segregation even when allocation is strictly random. The command segregsmall implements three recent methods correcting for such bias: the nonparametric, partial identification approach of D’Haultfœuille and Rathelot (2017, Quantitative Economics 8: 39–73); the parametric model of Rathelot (2012, Journal of Business & Economic Statistics 30: 546–553); and the linear correction of Carrington and Troske (1997, Journal of Business & Economic Statistics 15: 402–409). The package also allows for conditional analyses, namely, measures of segregation accounting for characteristics of the individuals or the units.
Beyond linearity, stability, and equilibrium: The edm package for empirical dynamic modeling and convergent cross-mapping in Stata
Authors: Li Jinjing , Zyphur Michael J. , Sugihara George , Laub Patrick J.
Published: March 2021

How can social and health researchers study complex dynamic systems that function in nonlinear and even chaotic ways? Common methods, such as experiments and equation-based models, may be ill-suited to this task. To address the limitations of existing methods and offer nonparametric tools for characterizing and testing causality in nonlinear dynamic systems, we introduce the edm command in Stata. This command implements three key empirical dynamic modeling (EDM) methods for time series and panel data: 1) simplex projection, which characterizes the dimensionality of a system and the degree to which it appears to function deterministically; 2) S-maps, which quantify the degree of nonlinearity in a system; and 3) convergent cross-mapping, which offers a nonparametric approach to modeling causal effects. We illustrate these methods using simulated data on daily Chicago temperature and crime, showing an effect of temperature on crime but not the reverse. We conclude by discussing how EDM allows checking the assumptions of traditional model-based methods, such as residual autocorrelation tests, and we advocate for EDM because it does not assume linearity, stability, or equilibrium.
Surface characteristics of sol-gel treated single jersey plated socks
Authors: Bake Ieva , Kukle Silvija , Belakova Dana
Published: March 2021

This study examines properties of the cotton/polyamide plain plated commercial socks (CO 81%/PA 19%) and pure polyamide fabric subjected to the multifunctional treatment by a sol-gel coating technique where tetraethyl-orthosilicate (TEOS) and zinc acetate dihydrate (ZAD) were used as precursors. Commercially available sock is produced on a single cylinder sock knitting machine which results in two surfaces (cotton and polyamide), with dissimilar characteristics thus leading to necessity of their separate studies. Experimental part examines surface structural clarification and compound identification using infrared spectroscopy. To assess the impact of modification such properties as air permeability must be tested and analysed. Pilot tests of antibacterial activity against Bacillus subtilis mscL 1141 and Staphylococcus aureus mscL 334 where carried out. Due to the modification consolidation treatment temperature below the destruction of material and the chemical compounds vibrational modes overlap, but in regions 1170–1650 cm−1 and 3200–3395 cm−1 show the presence of bounds corresponding to sol-gel coating presence on the surface.
Singularity avoidance for manipulators with spherical wrists using the approximate damped reciprocal algorithm
Authors: Yu Tiantian , Wang Daqing , Gao Lifu
Published: March 2021

Due to the loss of freedom, the stability and tracking ability of the manipulator around the singularity become worse. This article aims at improving the accuracy of the manipulator and ensuring the stability of the system with the damped reciprocal method. Firstly, the singularities are separated into forearm and wrist singularities to obtain the singular factors of the manipulator respectively. Secondly, a new mathematical function of the approximate damped reciprocal of the singular factor is proposed. Thirdly, the singularities are avoided by modifying the Jacobian matrixes of the manipulator with the approximate damped reciprocal algorithm. Finally, the effectiveness and the stability of the system are proved by the simulations on a manipulator with the spherical wrist. The simulation results prove that this method can largely improve the accuracy of the end-effector and can ensure the stability of the system around the singular region.
Reliability analysis method for redundancy systems based on GO methodology and the universal generation function
Authors: Cao Hui , Duan Fuhai , Jiang Xiuhong
Published: March 2021

In this study, Goal-Oriented (GO) methodology, as an important technique for reliability analysis, is used in multi-state redundancy systems. However, traditional GO operation is usually not sufficiently effective for such multi-state redundancy systems because of the complex computational problem. To solve this problem, an efficient UGF-based GO operation that combines the advantages of GO methodology and the universal generation function (UGF) is proposed. The algorithm can avoid the complex calculation process caused by the algorithm-based GO operation of traditional probability formulas, and can simplify the correction of the shared signal by regarding it as the system’s conditional probability. In addition, the further correction problem in which some dependent shared signals with a common failure are caused by other shared signals is also considered. Some application examples are presented to illustrate the proposed UGF-based GO methodology, as well as its effectiveness and practicability.
Conditional dismissal as an alternative to the traditional criminal proceedings in Israel
Authors: Shoham Efrat , Nicotra Eitan
Published: March 2021

The overloaded court system, along with the increasing recognition of the harm inflicted upon offenders by the criminal court procedure, led, in 2013, to the enactment of a new criminal-administrative procedure, termed “conditional dismissals,” which diverts minor offenses from the courts to be settled by prosecution authorities. This preliminary study examines the profile of 1750 cases of conditional dismissals concluded by district attorneys and police prosecution division between 2016 and 2018 and whether some notions of the “restorative justice” model were implemented. The findings indicate that both district attorneys and police prosecution division had initial difficulties in implementing the notion of diverting cases from the criminal court process. Over half of the cases in both agencies were for bodily injury and property offenses. There is a significant difference regarding the majority of the dismissal terms between the district attorneys and the police prosecution division. The results further indicate that 4.5% of all dismissals contained only restorative stipulations (especially in sex offenses), and one-third contained restorative stipulations along with punitive stipulations. The findings also show that the district attorneys are more inclined to use restorative terms, while the police prosecution division is more inclined to use punitive terms. The article discusses the possible explanations for these findings and the significant differences in the application of restorative practice between the police prosecution division and the district attorneys.
“Every time I tell my story I learn something new”: Voice and inclusion in research with Black women with histories of substance use and incarceration
Authors: Gunn Alana J. , Hardesty Melissa , Overstreet Nicole , Wallace Scyatta
Published: March 2021

While current ethical procedures aim to minimize risks to imprisoned individuals, there is heightened awareness of the need to protect those who participate in research post-incarceration while under community-based supervision. Formerly incarcerated women, in particular, face myriad challenges to community reintegration which also make them vulnerable participants in research. As such, this study explores how 28 formerly incarcerated Black women experience the qualitative research process. Findings revealed that women engaged in research because these contexts were viewed as therapeutic spaces for raising awareness that can help others. Moreover, the interview process allowed women to share their pasts in ways that promote their recovery from addiction. Participants also reported risks of emotional distress and fears regarding researcher stigma. The implications for trauma-informed interviewing practices underscore the need for greater considerations of the role of the researcher, research environment, and how they contribute to one’s personal recovery.
The value of imaging and clinical outcomes in a phase II clinical trial of a lysophosphatidic acid receptor antagonist in idiopathic pulmonary fibrosis
Authors: Kim Grace Hyun J. , Goldin Jonathan G. , Hayes Wendy , Oh Andrea , Soule Benjamin , Du Shuyan
Published: March 2021

Background:

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrotic lung disease characterized by worsening dyspnea and lung function and has a median survival of 2–3 years. Forced vital capacity (FVC) is the primary endpoint used most commonly in IPF clinical trials as it is the best surrogate for mortality. This study assessed quantitative scores from high-resolution computed tomography (HRCT) developed by machine learning as a secondary efficacy endpoint in a 26-week phase II study of BMS-986020 – an LPA1 receptor antagonist – in patients with IPF.

Methods:

HRCT scans from 96% (137/142) of randomized subjects were utilized. Quantitative lung fibrosis (QLF) scores were calculated from the HRCT images. QLF improvement was defined as ⩾2% reduction in QLF score from baseline to week 26.

Results:

In the placebo arm, 5% of patients demonstrated an improvement in QLF score at week 26 compared with 15% and 27% of patients in the BMS-986020 600 mg once daily (QD) and twice daily (BID) arms, respectively [ versus placebo: p = 0.08 (600 mg QD); p = 0.0098 (600 mg BID)]. Significant correlations were found between changes in QLF and changes in percent predicted FVC, diffusing capacity for carbon monoxide (DLCO), and shortness of breath at week 26 ( ρ = −0.41, ρ = −0.22, and ρ = 0.27, respectively; all p < 0.01).

Conclusions:

This study demonstrated the utility of quantitative HRCT as an efficacy endpoint for IPF in a double-blind, placebo-controlled clinical trial setting. The reviews of this paper are available via the supplemental material section.
GAD antibody-spectrum disorders: progress in clinical phenotypes, immunopathogenesis and therapeutic interventions
Authors: Tsiortou Popianna , Alexopoulos Harry , Dalakas Marinos C.
Published: March 2021

Antibodies against glutamic acid decarboxylase (GAD), originally linked to stiff person syndrome (SPS), now denote the “ GAD antibody-spectrum disorders” ( GAD-SD) that also include autoimmune epilepsy, limbic encephalitis, cerebellar ataxia and nystagmus with overlapping symptomatology highlighting autoimmune neuronal excitability disorders. The reasons for the clinical heterogeneity among GAD-antibody associated syndromes remain still unsettled, implicating variable susceptibility of GABAergic neurons to anti-GAD or other still unidentified autoantibodies. Although anti-GAD antibody titers do not correlate with clinical severity, very high serum titers, often associated with intrathecal synthesis of anti-GAD-specific IgG, point to in-situ effects of GAD or related autoantibodies within the central nervous system. It remains, however, uncertain what drives these antibodies, why they persist and whether they are disease markers or have pathogenic potential. The review, focused on these concerns, describes the widened clinical manifestations and overlapping features of all GAD-SD; addresses the importance of GAD antibody titers and potential significance of GAD epitopes; summarizes the biologic basis of autoimmune hyperexcitability; highlights the electrophysiological basis of reciprocal inhibition in muscle stiffness; and provides practical guidelines on symptomatic therapies with gamma-aminobutyric acid-enhancing drugs or various immunotherapies.
Cerebral Toxoplasmosis in Systemic Lupus Erythematosus
Authors: Ng Chen Fei , Chong Chia Yin
Published: March 2021

A 37-year-old man with underlying systemic lupus erythematosus and lupus nephritis presented with an episode of generalized tonic seizure. He complained of poor concentration and forgetfulness for 1 week. He suffered a relapse of lupus nephritis 4 months ago and received a course of intravenous methylprednisolone followed by oral prednisolone and mycophenolate mofetil. Clinically, there was no focal neurological deficit. Retroviral screening was negative. Magnetic resonance imaging (MRI) of the brain revealed eccentric and concentric signs which confirmed the diagnosis of cerebral toxoplasmosis.
Cycling-Related Injuries During COVID-19 Lockdown: A North London Experience
Authors: Mumtaz Shadaab , Cymerman James , Komath Deepak
Published: March 2021

Objectives:

There has been a notable surge in cycling injuries during the COVID-19(SARS-CoV-2 virus) pandemic. Cycling in general increased during lockdown as a leisure & fitness activity along with reduction in the use of public transport for commuting. We investigated the bicycle-related maxillofacial injuries & associations presenting through our emergency department(ED) which covers more than 1.6 million of London population.

Study Design/Methods:

A retrospective observational study was undertaken in the Barnet General Hospital (“hub”) which receives all maxillofacial referrals from 6 “spoke” hospitals & other urgent primary/community care practices in North London area between 16 March 2020 & 16 July 2020. All data corresponding to cycling injuries during the lockdown period was analyzed with the aid of trauma database/trust-wide electronic patient records.

Results:

Twenty-two patients (6.7%) with cycling-related injuries out of a total of 322 patients who attended during the 4 months study period with maxillofacial emergencies were identified. Average age of patient cohort was 35.4 years, mainly consisting of adult males (77%). Seven patients had minor head injury and 1 patient suffered traumatic brain injury. About 59% patients did not wear a protective helmet & 3 patients had heavy alcohol/recreational drug intoxication during the accidents. Four patients needed inpatient admission and treatment under general anesthesia.

Conclusions:

Based on our humble study, we advocate the need for robust road & personal safety measures with mandatory government legislations, policing of drug intoxication & encouragement of physical & mental health improvement measures during these unprecedented times & beyond.
Myocardial infarction with non-obstructive coronary arteries (MINOCA) complicating myocarditis
Authors: Raja Shariff Raja Ezman , Zainal Abidin Hafisyatul Aiza , Najme Khir Rizmy , Kasim Sazzli
Published: March 2021

Myocarditis can lead to myocardial infarction in the absence of coronary artery obstruction. We report a case of probable myocarditis, complicated by myocardial infarction with non-obstructive coronary arteries. A 19-year-old man presented with chest pain typical of myocarditis. He was a smoker but was otherwise well. Electrocardiogram revealed diffuse ST-elevation and echocardiography revealed a thin, akinetic apex. Troponin-T levels on admission were raised leading to an initial diagnosis of myocarditis being made. However, late gadolinium enhancement study on cardiac magnetic resonance imaging demonstrated transmural enhancement typical of ischaemia. Coronary angiogram was normal, leading to a likely diagnosis of myocardial infarction with non-obstructive coronary arteries. It is important to highlight that coronary assessment remains important when working up for myocarditis, as myocardial infarction with non-obstructive coronary arteries can often complicate myocarditis in cases of normal angiography. Another important lesson was on how cardiac magnetic resonance imaging provided vital evidence to support underlying ischaemia despite normal coronary angiogram, leading to a diagnosis of myocardial infarction with non-obstructive coronary arteries. Myocardial infarction with non-obstructive coronary arteries remains a broad ‘umbrella’ term and cardiac magnetic resonance imaging, as well as more invasive coronary imaging techniques during angiography, can further assist in its diagnosis. Our case provides a reminder that myocardial infarction with non-obstructive coronary arteries, although increasingly recognised, remains under-diagnosed and can often overlap with peri-myocarditis, highlighting the need to employ multi-modality imaging in guiding management.
Clinical experience of using virtual 3D modelling for pre and intraoperative guidance during robotic-assisted partial nephrectomy
Authors: Berger Lorenz , Gulamhusein Aziz , Hyde Eoin , Gibb Matt , Kuusk Teele , Neves Joana , Silva Pedro , Marchetti Marta , Barod Ravi , Tran Maxine , Patki Prasad , Bex Axel , Ourselin Sebastien , Dasgupta Prokar , Mumtaz Faiz
Published: March 2021

Objective:

Surgical planning for robotic-assisted partial nephrectomy is widely performed using two-dimensional computed tomography images. It is unclear to what extent two-dimensional images fully simulate surgical anatomy and case complexity. To overcome these limitations, software has been developed to reconstruct three-dimensional models from computed tomography data. We present the results of a feasibility study, to explore the role and practicality of virtual three-dimensional modelling (by Innersight Labs) in the context of surgical utility for preoperative and intraoperative use, as well as improving patient involvement.

Methods:

A prospective study was conducted on patients undergoing robotic-assisted partial nephrectomy at our high volume kidney cancer centre. Approval from a research ethics committee was obtained. Patient demographics and tumour characteristics were collected. Surgical outcome measures were recorded. The value of the three-dimensional model to the surgeon and patient was assessed using a survey. The prospective cohort was compared against a retrospective cohort and cases were individually matched using RENAL (radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, location relative to polar lines) scores.

Results:

This study included 22 patients. Three-dimensional modelling was found to be safe for this prospective cohort and resulted in good surgical outcome measures. The mean (standard deviation) console time was 158.6 (35) min and warm ischaemia time was 17.3 (6.3) min. The median (interquartile range) estimated blood loss was 125 (50–237.5) ml. Two procedures were converted to radical nephrectomy due to the risk of positive margins during resection. The median (interquartile range) length of stay was 2 (2–3) days. No postoperative complications were noted and all patients had negative surgical margins. Patients reported improved understanding of their procedure using the three-dimensional model.

Conclusion:

This study shows the potential benefit of three-dimensional modelling technology with positive uptake from surgeons and patients. Benefits are improved perception of vascular anatomy and resection approach, and procedure understanding by patients. A randomised controlled trial is needed to evaluate the technology further.

Level of evidence:

2b
Use of pedicled dartos flap wrap around technique in elaborarted perineal repair of complex pelvic fracture urethral distraction defect
Authors: Hardev Bhatyal , Ankur Arya , Vineet Narang
Published: March 2021

Objectives:

To describe the use of a pedicled dartos flap between the pubic bone and bulbar urethra after elaborate perineal urethroplasty in complex pelvic fracture urethral distraction defect. This is to prevent the risk of entrapment of the anastomotic area within a fibrous scar and hence prevent the risk of urethral stricture recurrence. Our objective is also to theorise the entity of bulbar urethral entrapment to describe the trapping of the bulbar urethra by fibrosis after extensive bone resection in complex cases of pelvic fracture urethral distraction defect.

Methods:

Ten patients with complex pelvic fracture urethral distraction defect underwent perineal urethroplasty at our institution from 2017 to 2019. Urethroplasty was done using the elaborated perineal approach in the standard fashion. Pedicled fibrofatty tissue along with dartos from the scrotum was used to separate the site of urethral anastomosis from the bare pubic bone and fill the dead space.

Results:

All patients are asymptomatic with no stricture recurrence in follow-up.

Conclusions:

Vascularised pedicle flap should become an important tenant in the elaborated perineal repair of complex pelvic fracture urethral distraction defect. It provides an ideal option in this scenario by decreasing the risk of urethral stricture recurrence without adding morbidity and minimum extra operative time.

Level of evidence:

Not applicable.
One-year experience of government-funded magnetic resonance imaging prior to prostate biopsy: A case for omitting biopsy in men with a negative magnetic resonance imaging
Authors: El-Khoury Hanna J , Sathianathen Niranjan J , Jiao Yuxin , Farzan Reza , Gyomber Dennis , Niall Owen , Satasivam Prassannah
Published: March 2021

Objectives:

This study aimed to characterise the accuracy of multiparametric magnetic resonance imaging (mpMRI) as an adjunct to prostate biopsy, and to assess the effect of the new Australian Medicare rebate on practice at a metropolitan public hospital.

Patients and methods:

We identified patients who underwent transrectal ultrasound (TRUS)-guided prostate biopsy at a single institution over a two-year period. Patients were placed into two groups, depending upon whether their consent was obtained before or after the introduction of the Australian Medicare rebate for mpMRI. We extracted data on mpMRI results and TRUS-guided biopsy histopathology. Descriptive statistics were used to demonstrate baseline patient characteristics as well as MRI and histopathology results.

Results:

A total of 252 patients were included for analysis, of whom 128 underwent biopsy following the introduction of the Medicare rebate for mpMRI. There was a significant association between Prostate Imaging Reporting and Data System v2 (PI-RADS) classification and the diagnosis of clinically significant prostate cancer ( p<0.01). Only one man with PI-RADS ⩽2 was found to have clinically significant prostate cancer. Four men with a PI-RADS 3 lesion were found to have clinically significant cancer. A PI-RADS 4 or 5 lesion was significantly associated with the diagnosis of clinically significant cancer on multivariable analysis.

Conclusion:

mpMRI is an important adjunct to biopsy in the diagnosis of clinically significant prostate cancer. Our findings support the safety of omitting/delaying prostate biopsy in men with negative mpMRI.

Level of evidence:

Level 3 retrospective case-control study.
An Integrative Review of Measurement Instruments Used to Assess the Stigma That Affects People Who Use Drugs
Authors: Kwakep epse Semegni Chanceline , Phetlhu Deliwe Rene , Marie Modeste Regis Rugira
Published: March 2021

This article aims to review how existing instruments to measure stigma affecting people who use drugs have been developed, which domains of stigma are measured, as well as metrics used to validate these instruments. Using the Whittemore and Knafl’s process for conducting an integrative review, six studies published between January 2002 and April 2019 were systematically analyzed. Overall, all the studies included had good methodological qualities. The results showed that the instruments measured one or more domain of stigma. However, most of these studies use already pre-validated instrument to measure stigma in mental health and adapt to fit the people who use drugs context. Based on the findings we therefore recommend that more studies exploring the experience of people who use drugs regarding stigma, and the perceptions of service provides rendering care to people who use drugs should be undertaken to develop relevant and context-specific stigma instruments.
From Instructed Writing to Free-Writing: A Study of EFL Learners
Authors: Alharthi Saleh
Published: March 2021

Writing is an intricate process that encompasses various factors and is a key skill for English as a Foreign Language (EFL) students. Thus, writing assignments are vital for any curriculum. One of the essential aspects of effective writing includes good grammar knowledge. Advocates of process writing argue that a free-writing journal is a practical approach to teaching EFL students writing. This study is intended to examine the impact of the free-writing journal on EFL learners. This study was conducted on 80 students from a writing course at the University. Thirty-five students were randomly selected to join the free-writing program—the experimental group—and 45 students were kept in their regular structured writing program—the control group. The experimental group selected topics of interest to them and was encouraged to write in English freely without concern for errors, whereas the control group followed a regular structured writing program where the topics were selected for them and they wrote following a clear guideline. Five major areas were investigated to evaluate students’ progress: the number of words written, spelling, capitalization, subject-verb agreement, and punctuation. The researcher conducted semi-structured interviews with 10 students of the experimental group to elicit their perception of the free-writing program. According to the analysis, students in the free-writing program acquired better grammar acquisition than the control group. The researcher also observed students’ perception of free-writing at the end of the study and found that free-writing improved their writing skills.
The Relationship Between Market Environment Dimensions and Availability of Malaria Pills in Uganda
Authors: Nagitta Oluka Pross , Mkansi Marcia , Kajjumba George William
Published: March 2021

Introduction

This study sought to examine the contribution of relationship building (in terms of collaboration, information sharing and supply chain interdependence) on the availability of malaria treatment pills in public hospitals in Sub-Saharan Africa using data from Uganda.

Methods

By means of a cross-sectional survey research design, the study used a questionnaire strategy to collect quantitative data. Out of the 320 questionnaires that were distributed in 40 public hospitals, 283 were answered and returned, which yielded an 88% response rate. Structural equation modelling (SEM) was used to establish the relationship between measured variables and latent constructs.

Results

Drawing on the survey results, the confirmatory factor analysist and the Structural Equation Modelling clearly demonstrate that relationship building (in terms of collaboration, information sharing and supply chain interdependence) significantly influences the availability of Artemisinin-based combination therapies in public general hospitals in Uganda.

Conclusion

Policy-makers should focus on developing cheaper information technology tools to exchange information regarding stock levels, forecasting, quantification, orders, and dispensing. This study developed a measurement model for an inter-hospital relationship, using relational view theory, and it employs dimensions in terms of information sharing and supply chain interdependence to predict and explain the availability of malaria pills in government hospitals.
Suicidal Mental Imagery: Investigating a Novel Marker of Suicide Risk
Authors: Lawrence Hannah R. , Nesi Jacqueline , Schwartz-Mette Rebecca A.
Published: March 2021

Rates of suicidal ideation and behavior are high and increasing in emerging adulthood. Research focused on suicidal ideation as a predictor of suicidal behavior has nearly exclusively conceptualized suicidal ideation as verbal thoughts about suicide. Emerging research suggests, however, that mentally imagining suicide may be even more impairing than verbal thoughts about suicide. Thirty-nine emerging adults with a lifetime history of suicidal cognitions completed self-report assessments of characteristics of their suicidal cognitions, histories of suicide plans and behavior, and the degree to which their suicidal cognitions took the form of mental imagery or verbal thought. Suicidal mental imagery predicted more intense and longer duration of suicidal cognitions, a higher likelihood of having made a suicide plan, and a higher likelihood of having made a suicide attempt over and above suicidal verbal thoughts. Thus, suicidal mental imagery could provide a novel target for suicide assessment and intervention for emerging adults.
High Emotion Differentiation Buffers Against Internalizing Symptoms Following Exposure to Stressful Life Events in Adolescence: An Intensive Longitudinal Study
Authors: Nook Erik C. , Flournoy John C. , Rodman Alexandra M. , Mair Patrick , McLaughlin Katie A.
Published: March 2021

Exposure to stressful life events is strongly associated with internalizing psychopathology, and identifying factors that reduce vulnerability to stress-related internalizing problems is critical for development of early interventions. Drawing on research from affective science, we tested whether high emotion differentiation—the ability to specifically identify one’s feelings—buffers adolescents from developing internalizing symptoms when exposed to stress. Thirty adolescents completed a laboratory measure of emotion differentiation before an intensive yearlong longitudinal study in which exposure to stress and internalizing problems were assessed at both the moment level ( n = 4,921 experience-sampling assessments) and month level ( n = 355 monthly assessments). High negative and positive emotion differentiation attenuated moment-level coupling between perceived stress and feelings of depression, and high negative emotion differentiation eliminated month-level associations between stressful life events and anxiety symptoms. These results suggest that high emotion differentiation buffers adolescents against anxiety and depression in the face of stress, perhaps by facilitating adaptive emotion regulation.
Symptoms and Their Relationship to Diagnosis: A Commentary on “Symptom Descriptions in Psychopathology: How Well Are They Working for Us?” (Wilshire et al., 2021)
Authors: Saunders John B.
Published: March 2021

Symptoms are vital representations of human disorders, are key to understanding disorders, and may be the focus of specific therapeutic efforts. Symptoms are imperfect, and there are many influences on how they are described and understood. Are they hand servants of diagnosis or important in their own right? The answer seems to be both, but diagnosis is typically the way in which communication about psychopathology occurs internationally in many clinical disciplines. Diagnosis is also the basis of knowledge of the natural history of psychopathology and its treatment and therapy. Investigations into the nature and meaning of symptoms can helpfully focus on emerging disorders, of which gaming disorder is provided as an example.
Annular Defects Impair the Mechanical Stability of the Intervertebral Disc
Authors: Chen Jun-Xin , Li Yun-He , Wen Jian , Li Zhen , Yu Bin-Sheng , Huang Yong-Can
Published: March 2021

Study Design:

A biomechanical study.

Objectives:

The purpose of this study was to investigate the effects of cruciform and square incisions of annulus fibrosus (AF) on the mechanical stability of bovine intervertebral disc (IVD) in multiple degrees of freedom.

Methods:

Eight bovine caudal IVD motion segments (bone-disc-bone) were obtained from the local abattoir. Cruciform and square incisions were made at the right side of the specimen’s annulus using a surgical scalpel. Biomechanical testing of three-dimensional 6 degrees of freedom was then performed on the bovine caudal motion segments using the mechanical testing and simulation (MTS) machine. Force, displacement, torque and angle were recorded synchronously by the MTS system. P value <.05 was considered statistically significant.

Results:

Cruciform and square incisions of the AF reduced both axial compressive and torsional stiffness of the IVD and were significantly lower than those of the intact specimens ( P < .01). Left-side axial torsional stiffness of the cruciform incision was significantly higher than a square incision ( P < .01). Neither incision methods impacted flexional-extensional stiffness or lateral-bending stiffness.

Conclusions:

The cruciform and square incisions of the AF obviously reduced axial compression and axial rotation, but they did not change the flexion-extension and lateral-bending stiffness of the bovine caudal IVD. This mechanical study will be meaningful for the development of new approaches to AF repair and the rehabilitation of the patients after receiving discectomy.
Study on proanthocyanidins crosslinked collagen membrane for guided bone tissue regeneration
Authors: Yang Hongfa , Liu Wai-Ching , Liu Xinrui , Li Yunqian , Lin Chingpo , Lin Yu-Min , Wang An-Ni , Nguyen Thu-Trang , Lin Yu-Chien , Chung Ren-Jei
Published: March 2021

The goal of this study is to understand the ability of a newly developed barrier membrane to enhance bone tissue regeneration. Here in this study we present the in vitro characterization of the barrier membrane made from type I collagen and crosslinked by oligomeric proanthocyanidins (OPCs). The effects of the membrane (P-C film) on cell cycle, proliferation, alkaline phosphatase activity, and mineralization were evaluated using the human osteoblast cell line MG-63, while the barrier ability was examined using MG-63 cells, as well as the human skin fibroblast cell line WS-1. The pore size is one of the factors that plays a key role in tissue regeneration, therefore, we evaluated the pore size of the membrane using a capillary flow porometer. Our results showed that the mean pore size of the P-C film was approximately 7–9 µm, the size known to inhibit cell migration across the membrane. The P-C film also demonstrated excellent cell viability and good biocompatibility, since the cell number increased with time, with MG-63 cells proliferating faster on the P-C film than in the cell culture flask. Furthermore, the P-C film promoted osteoblast differentiation, resulting in higher alkaline phosphatase activity and mineralization. Therefore, our results suggest that this P-C film has a great potential to be used in guided bone regeneration during periodontal regeneration and bone tissue engineering.
The effects of chitosan addition to glass ionomer cement on microhardness and surface roughness
Authors: Soygun Koray , Soygun Arzu , Dogan Muharrem Cem
Published: March 2021

Objective:

The aim of this study was to investigate the surface microhardness and roughness properties of a modified glass ionomer cement formed by adding different ratios of Chitosan, when exposed to saliva and acid erosive gastric acid cycle environments.

Methods:

Chitosan was added to conventional glass ionomer liquid at volumes of 5% and 10%. The chitosan-modified glass ionomer was used for the experimental group, and traditional glass ionomer formed the control group. All the groups were separated into two subgroups. One of these subgroups was subjected to a gastric acid erosive cycle. The other subgroup was immersed in artificial saliva. Microhardness, surface roughness with optical profilometer and AFM measurements of all the samples were taken. Qualitative surface topographic evaluations were made using a SEM. The data were analyzed by Kruskal-Wallis and Mann Whitney U-test for pairwise comparisons of the groups at the 0.05 level of significance.

Results:

The addition of chitosan to GIC had a positive effect on the microhardness values. The gastric acid erosive cycle application negatively affected the microhardness and surface roughness properties of the sample groups.

Conclusion:

The chitosan-modified glass ionomer cement samples showed clinically acceptable surface roughness values. Although the results of the addition of the biopolymer, chitosan, to GIC are promising, there is a need for further in-vivo studies.
Failed Surgery for Patellar Tendinopathy in Athletes: Midterm Results of Further Surgical Management
Authors: Maffulli Nicola , Oliva Francesco , Maffulli Gayle D. , Migliorini Filippo
Published: March 2021

Background:

Tendon injuries are commonly seen in sports medicine practice. Many elite players involved in high-impact activities develop patellar tendinopathy (PT) symptoms. Of them, a small percentage will develop refractory PT and need to undergo surgery. In some of these patients, surgery does not resolve these symptoms.

Purpose:

To report the clinical results in a cohort of athletes who underwent further surgery after failure of primary surgery for PT.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 22 athletes who had undergone revision surgery for failed surgical management of PT were enrolled in the present study. Symptom severity was assessed through the Victorian Institute of Sport Assessment Scale for Patellar Tendinopathy (VISA-P) upon admission and at the final follow-up. Time to return to training, time to return to competition, and complications were also recorded.

Results:

The mean age of the athletes was 25.4 years, and the mean symptom duration from the index intervention was 15.3 months. At a mean follow-up of 30.0 ± 4.9 months, the VISA-P score improved 27.8 points ( P < .0001). The patients returned to training within a mean of 9.2 months. Fifteen patients (68.2%) returned to competition within a mean of 11.6 months. Of these 15 patients, a further 2 had decreased their performance, and 2 more had abandoned sports participation by the final follow-up. The overall rate of complications was 18.2%. One patient (4.5%) had a further revision procedure.

Conclusion:

Revision surgery was feasible and effective in patients in whom PT symptoms persisted after previous surgery for PT, achieving a statistically significant and clinically relevant improvement of the VISA-P score as well as an acceptable rate of return to sport at a follow-up of 30 months.
Outcome of a Multi-modal CBT-based Treatment Program for Chronic School Refusal
Authors: Strömbeck Johan , Palmér Robert , Sundberg Lax Ia , Fäldt Jonas , Karlberg Martin , Bergström Martin
Published: March 2021

School refusal (SR) can have several negative consequences, but effective treatments are available. When chronic, school absence requires comprehensive treatment. This study evaluates an intervention for SR based on a Cognitive Behavioral Therapy (CBT) model, Hemmasittarprogrammet (HSP). Attendance, anxiety, depression, quality of life, and emotional and behavioral symptoms were measured at pre-treatment, post-treatment, and follow-up. The participants (n = 84; 69% male) were SR students between 10 and 17 years old and their parents. School attendance increased after treatment and at follow-up. The proportion of students totally absent from school decreased and the number of students with an acceptable level of school attendance increased. Levels of anxiety and depression were lower both post-treatment and at follow-up for the youths and their parents. HSP, a promising treatment program for school refusal, builds on the literature of CBT-based programs, which has been shown to be effective for SR treatment. However, more research about the effectiveness of the program is needed. Future studies should have a stronger research design, include a measure of fidelity, and be evaluated independent of the founders of the program under investigation.
Immunosuppression use in early systemic sclerosis may be increasing over time
Authors: Park Ryan , Nevskaya Tatiana , Baron Murray , Pope Janet E
Published: March 2021

Background:

Immunosuppression remains the main treatment for progressing skin involvement, interstitial lung disease and inflammatory joint or muscle disease in systemic sclerosis. This study investigated the pattern and trends in immunosuppressive agents used in early systemic sclerosis (diagnosed before and after 2007) to determine whether the changes in the preferred type, timing and combination of immunosuppression took place over the past decade.

Methods:

In total, 397 Canadian Scleroderma Research Group database patients (183 diffuse cutaneous systemic sclerosis and 214 limited cutaneous systemic sclerosis) who had baseline and follow-up visits within 3 years (mean: 1.8 ± 0.8) after disease onset were included: 82% females, age at diagnosis 53 ± 13 years. Bivariate, chi-square, analysis of variance and adjusted regression analyses were used.

Results:

In total, 115 diffuse cutaneous systemic sclerosis patients (63%) and 62 limited cutaneous systemic sclerosis (29%) received immunosuppressive drugs, most commonly methotrexate, followed by mycophenolate mofetil and cyclophosphamide. In diffuse cutaneous systemic sclerosis, immunosuppressants were prescribed after 2007 more often (74% vs 50%, p = 0.001), especially methotrexate ( p = 0.02) and mycophenolate mofetil ( p = 0.04), and earlier (peak at 2 years after onset). Immunosuppressive therapy was associated with male gender, interstitial lung disease, anti-Scl70 positivity, ACA negativity and inflammatory joint disease in limited cutaneous systemic sclerosis and with ACA negativity and a higher modified Rodnan skin score in diffuse cutaneous systemic sclerosis. Multivariate regression analysis showed that the use of immunosuppressants after 2007 was predicted only by ACA negativity in limited cutaneous systemic sclerosis and by younger age in diffuse cutaneous systemic sclerosis.

Conclusion:

Over the past decade, there has been a trend to prescribe immunosuppressants more often and earlier in diffuse cutaneous systemic sclerosis patients, regardless of modified Rodnan skin score. Methotrexate is being more frequently used, and mycophenolate mofetil has gained favour over cyclophosphamide. Autoantibody status was the most consistent predictor of immunosuppressive therapy.
Competitiveness, Manufacturing and Infrastructure: The Asian Paradigm
Authors: Joshi Jyotsna
Published: March 2021

Emerging Asian economies are at the cusp of marking a structural shift from being factor driven to the one driven by efficiency. This is translated into their actions towards strategising their growth drivers so as to achieve factor-based efficiency through industrial infrastructure creation, namely MSME clusters, economic corridors, economic cities, infrastructure enablers and logistics hub. While the traditional tenets of competitiveness are based on building competitive advantage in manufacturing of certain products and their integration in the global value chain, this article builds upon the concept of competitiveness as a function of its constituent pillars as defined by the World Economic Forum. The objective of this article is to present a holistic view on the constituent pillars of competitiveness that have contributed maximum to the increased per capita GDP and trade for East Asian economies. Through an examination of select countries as case studies and studying their development through time, this article presents policymakers with strategies that can be used for designing manufacturing development strategy for emerging economies.
Ultra-Widefield Imaging of Peripheral Vascular Abnormalities in Idiopathic Macular Telangiectasia Type 1
Authors: Pollmann André S. , Mishra Amit V. , Francisconi Carolina L.M.
Published: March 2021

Purpose:

This work reports unusual peripheral vascular anomalies on ultra-widefield angiography in a case of idiopathic macular telangiectasia (IMT) type 1.

Methods:

A case report is discussed.

Results:

A 51-year-old woman with a 6-year history of IMT type 1 presented with ongoing vision symptoms from persistent macular edema despite extended antivascular endothelial growth factor therapy. Examination and macular imaging findings were consistent with a diagnosis of IMT type 1, and ultra-widefield angiography additionally demonstrated nonperfusion, terminal vascular loops, and arteriovenous anastomosis without exudation or telangiectasis. The patient’s condition remained stable after she elected observation.

Conclusion:

While extrafoveal vascular anomalies are a known feature of IMT type 1, they commonly consist of peripheral telangiectasias and exudation. Describing new peripheral vascular abnormalities in IMT adds to our knowledge of this condition and could be of value for diagnosis, management, and further study.