bluuebunny/crossref_metadata_2025 huggingface dataset:
The positive side of negative identity: Stigma and deviance in backlash movements
Authors: Terman Rochelle
Published: September 2020

Backlash movements often engage in extraordinary acts of deviance and taboo-breaking. Yet violating mainstream norms is costly, as it provokes public condemnation and stigma. Why do backlash movements transgress mainstream norms? In this essay, I argue that deviance and stigma are central elements of backlash politics and serve important functions for backlash movements. Building off insights from Sociology, I show how ‘secondary deviance’ is commonly embraced in groups that experience status deprivation. I apply these insights to backlash movements in order to illuminate why transgression is so often a part of their repertoire. Violating dominant norms – and provoking mainstream stigma and rebuke – advances the goals of backlash movements by allowing them to cultivate a distinct group identity, instil collective sentiments of status deprivation, and validate the movement’s political claims in popular discourse. In brief, backlash movements engage in certain behaviours not in spite of their deviant status, but because of this status.
A political anthropology of finance: Studying the distribution of money in the financial industry as a political process
Authors: Ortiz Horacio
Published: September 2020

This article proposes an analytics to study the financial industry as a global political institution, based on its role in the production of global hierarchies, by the way it collects, produces and distributes money worldwide. I propose to do this by combining three analytic angles. First, I propose to situate the financial industry in a global space, where it contributes to produce multiple social hierarchies, which connect to the history of colonialism, the World Wars, the Cold War and its aftermath. These hierarchies cannot be subsumed under a single logic, but must be studied as intersecting and mutually constitutive. The second angle concerns the rules of monetary distribution applied by financial professionals, mobilizing, among others, the concepts of investor, market efficiency, risk and value, with their partly contradictory character and their technical, moral and political meanings. These rules are institutionalized in state regulation, labour and commercial contracts, giving the financial industry a certain institutional cohesion worldwide. The last analytic angle then concerns the way in which financial professionals make sense of their place in the global hierarchies they contribute to produce. They tend to use repertoires of meritocracy to connect their role in global monetary distribution to the social elites they tend to belong to, with conflicts that vary across the multiple forms of social identification present in the financial industry worldwide. Combining these three analytic angles allows for mobilizing fieldwork done in the offices of the financial industry to develop a critical account of its global political role.
Empowerment theory and prison-based dog training programs
Authors: Han Tyler M , Gandenberger Jaci , Flynn Erin , Sharma Jyoti , Morris Kevin N
Published: September 2020

Though a growing body of evidence supports the efficacy of prison-based dog training programs, research on the process of change or the underlying mechanisms of change for incarcerated individuals who participate in these programs is limited. This qualitative study used interviews with 21 dog program staff to examine the utility of empowerment theory as a theoretical framework for understanding mechanisms of change for participants in prison-based dog training programs.

Findings

Thematic analysis of interviews with program staff indicated that outcomes of prison-based dog training programs are consistent with constructs of empowerment theory. Reported outcomes were more aligned with individual-level empowerment; however, participation in these programs addressed some structural issues of power within the correctional institution. Analysis resulted in six themes: (1) finding purpose and meaning, (2) enhanced self-concept, (3) skill development, (4) greater perceived control, (5) increased community engagement, and (6) positive post-release outcomes.

Applications

The alignment of prison-based dog training program outcomes with constructs of empowerment theory suggests that positive outcomes may be related to empowering handlers, though human–animal interactions and positive reinforcement training were often mentioned by staff. Consequently, programs may benefit from using empowerment theory as a guiding framework in program design and training of program staff. Prison-based dog training programs may be of particular interest to social workers in correctional settings, as program features align with core social work values of social justice, dignity and worth of the person, and the importance of human relationships.
Satisfaction, utilization, and feasibility of a telehealth intervention for in-home dementia care support: A mixed methods study
Authors: Williams Kristine N , Shaw Clarissa A , Perkhounkova Yelena , Hein Maria , Coleman Carissa K
Published: September 2020

Background

Technology can enhance support for families caring for persons living with dementia but must be acceptable to be adopted. The FamTechCare clinical trial engaged caregivers in video recording care encounters that were reviewed by an expert panel who provided tailored feedback. The intervention reduced caregiver depression and improved caregiver competence. This mixed methods study reports on caregiver satisfaction and utilization of the intervention and expert panel evaluation of the intervention.

Methods

A convergent parallel mixed methods design was used to evaluate the satisfaction, usability, and feasibility of the FamTechCare intervention. In the multisite randomized controlled trial, caregiver-person living with dementia dyads were randomized to the FamTechCare video support or attention control telephone support groups. Caregivers completed a satisfaction survey at the completion of the 3-month trial. Utilization was evaluated using the number and duration of videos submitted and calls received by caregivers. Relationships between participant characteristics and their satisfaction and utilization were evaluated. Feasibility of the intervention was assessed through content analysis of interviews with the expert panel.

Results

The majority of caregivers in both groups reported benefits from participation. More FamTechCare caregivers found the interventionist support to be helpful ( p = 0.001) and effective ( p = 0.020) compared to attention control caregivers. FamTechCare caregivers of persons with more severe dementia were more likely to report that video recording intruded on their privacy ( p = 0.050). Caregiver age, gender, education, dyad relationship, rural status, and type and severity of dementia were not associated with ratings of acceptability, ease of use, or intervention utilization. The expert panel described the FamTechCare intervention as useful and identified adaptations to enhance feasibility.

Conclusion

Regardless of age, gender, and relationship, caregivers found the intervention acceptable and easy to use and rated the expert feedback as effective in addressing care challenges. Further adaptation may be needed for FamTechCare to be readily implemented.
The symptom experience of early and late treatment seekers before an atrial fibrillation diagnosis
Authors: Wilson Ryan E , Rush Kathy L , Reid R Colin , Laberge Carol G
Published: September 2020

Background

Atrial fibrillation is a complex condition associated with a broad spectrum of symptoms, coupled with variability in the frequency, duration and severity of symptoms. Early treatment seeking is important to reduce the risk of stroke, heart failure and dementia. Despite the increasing prevalence, there remains a limited understanding of the symptom experience prior to an atrial fibrillation diagnosis, and how these experiences influence treatment-related decisions and time frames.

Aims

This qualitative study aimed to explore the symptom experiences of patients receiving an early diagnosis of less than 48 hours and a late diagnosis of 48 hours or more after symptom awareness.

Methods

Twenty-six adults were interviewed guided by the symptom experience model. The symptom checklist was used to probe patient’s symptoms further. Data were analysed using a two-step approach to thematic analysis utilising concepts from the symptom experience model.

Results

The two groups differed in their perception, evaluation and response to symptoms. The early diagnosis group (n = 6) experienced traumatic, severe and persistent symptoms, evoking concern and urgent treatment seeking. Conversely, the late diagnosis group (n = 20) reported more vague, paroxysmal symptoms that were readily ignored, self-theorised as non-illness related, and engaged in non-treatment strategies. Healthy self-perceptions, past experiences, atrial fibrillation knowledge and healthcare provider interactions influenced early or late treatment seeking.

Conclusion

For many, the atrial fibrillation pre-diagnosis was a tumultuous period, requiring prolonged periods to recognise symptoms and formulate treatment-seeking responses. This study may promote future research and strategies aimed at facilitating the early identification and response to symptoms among atrial fibrillation patients.
Endovascular treatment of pediatric ischemic stroke: A single center experience and review of the literature
Authors: Fragata Isabel , Morais Teresa , Silva Rita , Nunes Ana Paiva , Loureiro Petra , Diogo Martins José , Pamplona Jaime , Carvalho Rui , Baptista Mariana , Reis João
Published: September 2020

Introduction

Mechanical thrombectomy is standard treatment for large vessel occlusion (LVO) in adults. There are no randomized controlled trials for the pediatric population. We report our single-center experience with thrombectomy of LVO in a series of pediatric patients, and perform a review of the literature.

Methods

Retrospective review of consecutive pediatric thrombectomy cases between 2011 and 2018. Demographic variables, imaging data, technical aspects and clinical outcome were recorded.

Results

In a period of 7 years, 7 children were treated for LVO at our center. Median age was 13 (2–17), and median Ped-NIHSS was 15 (3–24), and the median ASPECTS was 8 (2–10). Five patients had cardiac disease, and 2 of them were under external cardiac assistance. Median time from onset of symptoms to beginning of treatment was 7h06m (2h58m–21h38m). Five patients had middle cerebral artery occlusions. Thrombectomy was performed using a stentriever in 3 patients, aspiration in 3 patients, and combined technique in 1 patient. Six patients had good recanalization (TICI 2 b/3). There were no immediate periprocedural complications. At 3 months, 4 patients (57%) were independent (mRS score <3). Two patients died, one after haemorrhagic transformation of an extensive MCA infarct, and one due to extensive brainstem ischemia in the setting of varicella vasculitis.

Discussion

Selected pediatric patients with LVO may be treated with mechanical thrombectomy safely. In patients under external cardiac assistance and under anticoagulation, thrombectomy is the only alternative for treatment of LVO. A multidisciplinary approach in specialized pediatric stroke centers with trained neurointerventionalists are essential for good results.
Sheet thinning prediction method based on localized friction effect in deep-drawing
Authors: Preedawiphat Pavaret , Koowattanasuchat Pramote , Mahayotsanun Numpon , Mahabunphachai Sasawat
Published: September 2020

The paper investigated the effect of localized friction on sheet thinning under lubricated conditions in the deep-drawing process. The Finite Element Analysis (FEA) was used to evaluate the sheet thinning of the AISI 304 sheet under six segmented blank-sheet interfaces. Different values of variable coefficient of friction (VCOF) in each segmented area were investigated, and the sheet thickness values at the considered areas were measured. The regression analysis models (Linear Regression, Response Surface Method, and Polynomial Regression) was used to determine the relationships between VCOF and sheet thinning. The results showed that the Linear Regression showed the best fit. The significant factor analysis was also carried out to determine how the localized friction affected the sheet thinning. The contributions of VCOF from at least two segmented areas affected the sheet thinning at any particular location. The obtained relationships of the VCOF and sheet thinning could be beneficial for the localized friction control for highly complex shapes.
Research on operating domain optimization of power split hybrid electric vehicle based on global bifurcation and chaos threshold
Authors: Lei Dou , Yingfeng Cai , Long Chen , Dehua Shi , Donghai Hu , Zhen Zhu , Jiajia Wang
Published: September 2020

The power-split hybrid electric vehicle (PS-HEV) has multiple working modes to maintain high operation efficiency according to different conditions. The main modes involved in the vehicle driving process are pure electric mode and the hybrid driving mode. Because the electromechanical coupling problem is involved in the above two working modes, the transmission system exhibits strong non-linear characteristics. If the operation range of the engine and motor are unreasonable, the rotor system will vibrate and become instability. In this paper, the non-linear dynamic equations of the electromechanical coupling of the transmission system are established for electric driving mode and hybrid driving mode. The closed-homoclinic phase trajectory equation at the center point of the disturbance-free Hamilton system is determined. The chaotic thresholds for the pure electric and hybrid driving modes are derived through the Melnikov’s method to obtain the optimal working domain of the engine and motor. Finally, numerical simulation analysis is conducted to verify the feasibility of the work domain optimization scheme. Simulation results show that the proposed engine and motor working area optimization scheme can effectively avoid the homoclinic bifurcation in the PS-HEV during the driving process and prevent the vehicle from entering the chaotic state.
Perception, Planning and Control for Self-Driving System Based on On-board Sensors
Authors: Dai Yanyan , Lee Suk-Gyu
Published: September 2020

The autonomous vehicle can recognize and understand environment, self-control, and achieve the driving level of the human driver. To create this kind of system, the following work was carried out: (a) a real time lane detection system is proposed, based on vision system functions, using webcam camera; (b) In order to detect curve lanes, deep learning is applied for lane detection, based on fully Convolutional Neural Network (CNN); (c) The cubic spline interpolation method is used for path generation, based on Global Positioning System (GPS) data, where distance between two adjacent path generation points is same. Compared with the connection method of the cubic polynomial fitting algorithm, the curve fitted path by the cubic spline interpolation method is smoother and more satisfied with the vehicle motion pattern; (d) Based on frenet coordinate frame, optimize trajectory planning method is used to plan safe, easy and comfort trajectory. Compared to the Cartesian coordinate frame, frenet coordinate frame simplifies the solution of road curve fitting problems, especially in the case of complex road environment; (e) Fuzzy sliding mode control method is proposed for vehicle steering control. Finally, the simulation and experiment results are used to prove the effectiveness of the proposed methods.
Optimized design and performance analysis of a magnetic-field modulated brushless dual-mechanical port motor with Halbach array permanent magnets
Authors: He Ren , Li Junmin
Published: September 2020

In order to develop an electrical continuously variable transmission (E-CVT) to replace mechanical power coupling equipment applied in series-parallel hybrid electric vehicle (HEV), this paper proposes a magnetic-field modulated brushless dual-mechanical port motor with Halbach array permanent magnets, which has a more compact structure. The operating characteristics are analyzed by the lever analogy. It is concluded that the motor can realize the speed and torque decoupling between the engine and the wheel, which meet multi-mode operation requirements for HEV. To realize the multi-objective design of torque output, torque ripple and usage amount of permanent magnets, an optimization scheme combined parameter sensitivity with response surface methodology is adopted. The trade-offs among the optimization objectives are considered, then the key structural parameters and its optimal values are efficiently determined. Based on a two-dimensional model, the electromagnetic performances are simulated and analyzed. The results show that, after the parameters optimization, the no-load back electromotive force (EMF) has better sinusoidal characteristic, and the torque ripples and cogging torque peaks of the motor have been significantly reduced. Furthermore, a prototype motor is tested. The experimental results are consistent with the simulation results, which demonstrates the validity of the proposed structure and parameter optimization method.
Comparison of drug-coated balloon angioplasty versus uncoated balloon angioplasty in treatment of total occlusions with severe femoropopliteal lesions: An additional analysis from the AcoArt I study
Authors: Sun Guoyi , Liu Jie , Jia Senhao , Zhang Jiwei , Zhuang Baixi , Jia Xin , Fu Weiguo , Wu Danming , Wang Feng , Zhao Yu , Guo Pingfan , Bi Wei , Wang Shenming , Guo Wei ,   for the AcoArt I Trial Investigators
Published: September 2020

Objectives

Femoropopliteal chronic total occlusions are challenging to treat, and evidence of the effectiveness of drug-coated balloon angioplasty for long femoropopliteal chronic total occlusion lesions is limited. We compared the midterm outcomes of drug-coated balloon angioplasty versus plain old balloon angioplasty (POBA) for femoropopliteal chronic total occlusions.

Methods

In total, 95 patients from the AcoArt I trial (ClinicalTrials.gov identifier NCT01850056) with ≥5-cm femoropopliteal chronic total occlusion lesions were enrolled in this post-hoc subset analysis (drug-coated balloon, n = 50; POBA, n = 45). The primary endpoints were primary patency and clinically driven target lesion revascularization (CD-TLR) at 24 months. The secondary endpoints were late lumen loss at six months and binary restenosis, major adverse events (composite of death and target limb amputation), change in the Rutherford class, and the ankle-brachial index at 24 months.

Results

Demographic, clinical, and lesion characteristics were matched (mean lesion length, 20 cm). The six-month late-lumen loss rate was lower in the drug-coated balloon than POBA group (0.18 ± 0.81 vs. 1.34 ± 0.94 mm, respectively; P < 0.001). The 24-month primary patency rate was significantly higher in the drug-coated balloon than POBA group (53.85% vs. 17.50%, respectively; P < 0.001). The CD-TLR rate in the drug-coated balloon and POBA groups was 12.77 and 45.24%, respectively ( P = 0.002). The 24-month overall mortality rate in the drug-coated balloon and POBA groups was 12.77% and 6.98%, respectively ( P = 0.360), with no device- or procedure-related deaths. One major amputation had occurred in each group by the 24-month follow-up.

Conclusion

The paclitaxel drug-coated balloon shows better primary patency and freedom from target lesion revascularization than POBA at 24month after treatment of femoropopliteal chronic total occlusions (≥5 cm) lesion.
Lost in Translation, Recovered in Conversation? Introducing Leadership's Social Media Profile
Authors: Tomkins Leah
Published: September 2020

‘Twitter is not a technology, it’s a conversation. And it’s happening with or without you.’ 1

As Leadership takes its first steps into the realm of social media, we should think about why we are doing this and what we might hope to achieve. Far from being merely a decision about which platforms and tools to use to advertise our work, the establishment of a social media presence is a spur to reflect on the qualities of our relationships both within and beyond our community of authors, readers, reviewers and editors. In this essay, I link our approach to social media to broader concerns about the state of our discipline, our alienation from practice, and our responsibilities as both scholars and practitioners of leadership. Although framed in relation to social media, I hope these reflections have resonance for our involvement in social, political and institutional commentary more generally, even amongst those who have no interest in Twitter per se!
A single-arm study to evaluate the transfer of drospirenone to breast milk after reaching steady state, following oral administration of 4 mg drospirenone in healthy lactating female volunteers
Authors: Melka Dace , Kask Kalev , Colli Enrico , Regidor Pedro-Antonio
Published: September 2020

Objective:

The primary objective of this trial was to assess the transfer of drospirenone to breast milk after daily administration of an oral test preparation containing 4 mg of drospirenone at the steady state. The secondary objective of the trial was to assess safety based on clinical and laboratory measurements and reporting of adverse events and/or adverse drug reactions.

Patients and Methods:

This was an open label, non-comparative single-center study. Drospirenone 4 mg per day was the first postpartum contraceptive for the study participants who were no longer breastfeeding yet were still lactating. It was administered for 7 days to achieve steady-state concentration. All participants were volunteers who planned to use oral contraceptives as their family planning method in the future.

Results:

Twelve volunteers completed the trial according to the protocol, and the samples of all 12 study completers were analyzed. The average concentration–time curve of drospirenone in plasma 24 h after the administration of the last dose (area under the curve (0–24 h)) was 635.33 ng h/mL and 120 h after the single repeated dose administration (area under the curve (0–120 h)) was 1180.57 ng h/mL, respectively. The average Cmax was 48.64 ng/mL. The average concentration–time curve of drospirenone in milk 24 h after the administration of the last dose (area under the curve (0–24 h)) was 134.35 ng h/mL and 120 h after the single repeated dose administration (area under the curve (0–120 h)) was 227.17 ng h/mL, respectively. The average Cmax was 10.34 ng/mL.

Conclusion:

On average, 18.13% of plasma drospirenone made it to breast milk and the highest concentration of drospirenone in breast milk was 17.55% of that in plasma. The total quantity of drospirenone passing to breast milk is on average 4478 ng during a 24-h period representing 0.11% of the maternal daily dose. Thus, at the recommended doses, no effects on breastfed newborns/infants are anticipated with drospirenone 4 mg.
Congenital peripheral nerve hypoplasia: a report of seven cases
Authors: Tian Xiaofei , Lam Wee Leon , Guo Wen , Chen Tao , Chen Shanlin
Published: September 2020

We report the clinical findings of congenital peripheral nerve hypoplasia in seven patients. All seven children presented with unilateral ulnar or median nerve palsy or both. They were assessed clinically, and nerve diameters were assessed with ultrasonography and compared with the contralateral limb. Nerve conduction studies were performed in five children, and the nerves were explored in the four children who presented with accompanying constriction bands. By ultrasonography, the mean diameter of the ulnar nerve was 63% and 29% when compared with the normal arm and forearm, respectively, and the mean diameter of the median nerve was 63% and 46%. Hypoplasia in the nerve was not confined to constriction points but occurred in the entire upper limb in all seven cases. These patients were followed for an average of 12 months (range 6 to 30). Despite neurolysis and surgical decompression in four patients, none of the nerve palsies had recovered. The clinical findings suggest that this condition cannot be explained by simple mechanical compression, and more extensive pathological changes in the involved upper limb are evident in this rare disease.

Level of evidence: IV
Immune response and blood–brain barrier dysfunction during viral neuroinvasion
Authors: Chen Zhuangzhuang , Li Guozhong
Published: September 2020

The blood-brain barrier (BBB), which protects the CNS from pathogens, is composed of specialized brain microvascular endothelial cells (BMECs) joined by tight junctions and ensheathed by pericytes and astrocyte endfeet. The stability of the BBB structure and function is of great significance for the maintenance of brain homeostasis. When a neurotropic virus invades the CNS via a hematogenous or non-hematogenous route, it may cause structural and functional disorders of the BBB, and also activate the BBB anti-inflammatory or pro-inflammatory innate immune response. This article focuses on the structural and functional changes that occur in the three main components of the BBB (endothelial cells, astrocytes, and pericytes) in response to infection with neurotropic viruses transmitted by hematogenous routes, and also briefly describes the supportive effect of three cells on the BBB under normal physiological conditions. For example, all three types of cells express several PRRs, which can quickly sense the virus and make corresponding immune responses. The pro-inflammatory immune response will exacerbate the destruction of the BBB, while the anti-inflammatory immune response, based on type I IFN, consolidates the stability of the BBB. Exploring the details of the interaction between the host and the pathogen at the BBB during neurotropic virus infection will help to propose new treatments for viral encephalitis. Enhancing the defense function of the BBB, maintaining the integrity of the BBB, and suppressing the pro-inflammatory immune response of the BBB provide more ideas for limiting the neuroinvasion of neurotropic viruses. In the future, these new treatments are expected to cooperate with traditional antiviral methods to improve the therapeutic effect of viral encephalitis.
Effectiveness of a mailed fecal immunochemical test outreach: a Medicare Advantage pilot study
Authors: Issaka Rachel B. , Akinsoto Nkem O. , Strait Erica , Chaudhari Van , Flum David R. , Inadomi John M.
Published: September 2020

Background:

Mailed fecal immunochemical test (FIT) outreach effectively increases colorectal cancer (CRC) screening but is underutilized. This pilot aimed to determine the use of FIT for CRC screening among Medicare Advantage enrollees when offered via mailed outreach and the factors associated with FIT return.

Methods:

Our pilot study included Medicare Advantage enrollees who were 50–75-years old, not up to date with CRC screening, and had a billable primary care encounter in the prior 3 years. Eligible patients received a letter containing information about CRC screening and a FIT kit, screening status by FIT was then assessed using the electronic health record.

Results:

Of the 1142 patients identified, 945 were eligible for outreach. On 12-month follow up, 29% of patients ( n = 276) completed CRC screening via FIT, with a median return time of 140 days [interquartile range (IQR) 52–257]; 6% ( n = 17) of the completed tests were positive, and 53% ( n = 9) of patients have completed a diagnostic colonoscopy. Patients with primary encounter <12 months prior to mailed outreach were most likely to complete a FIT. Over the 12-month study period, CRC screening rates increased by 5% (63–68%).

Conclusions:

Mailed FIT outreach in a Medicare Advantage population was feasible and led to a 5% increase in CRC screening completion. Our pilot revealed rare incorrect patient addresses and high lab discard rate; both important factors that were addressed prior to larger-scale implementation of a mailed FIT program. Further research is needed to understand the potential impact of multilevel interventions on CRC screening in this healthcare system.
More Focus is Needed to Reduce Adverse Events for Diabetes Devices
Authors: Krouwer Jan S.
Published: September 2020

Advances in devices for people with diabetes have demonstrated many improvements; yet, the number of adverse events has almost doubled from 2018 to 2019. It is a challenge to examine these events due to a difficult query tool on the FDA website. There are several possible reasons why effort is not devoted to decreasing the number of adverse events including the fact that user error is a common cause. This commentary serves to raise awareness of the adverse event problem.
Redefining Pregnancy-Induced Rhinitis
Authors: Baudoin Tomislav , Šimunjak Tena , Bacan Nikolina , Jelavić Boris , Kuna Krunoslav , Košec Andro
Published: September 2020

Background

Pregnancy-induced rhinitis (PIR) is a form of chronic non-allergic rhinitis not present before pregnancy that manifests itself during pregnancy with complete resolution of symptoms after delivery.

Objective

The objective of this ambidirectional longitudinal cohort study is to evaluate the prevalence of PIR and to investigate the appearance and character of its symptoms, and its impact on the quality of life. Methodology: Six hundred eighty-one (681) women were recruited in the study. They completed questionnaires about nasal symptoms a day after delivery and each woman with nasal symptoms was interviewed 30 days later and data on symptom duration and quality were recorded.

Results

The prevalence of PIR was 31.86% (N = 217), 47.14% (N = 321) women had no nasal symptoms and 21% (N = 143) of participants had prior sinonasal disease. The clinical presentation of pregnancy rhinitis included nasal obstruction as the most common symptom, followed by rhinorrhea, postnasal secretion, nose itching, sneezing, and hyposmia. The median duration of PIR was 4 months with their complete resolution of symptoms between 2th and 16th day after delivery in the majority of respondents. PIR was diagnosed significantly more often if the women carried a female child. PIR affected their quality of life during pregnancy in 53,9% women (N = 117), with an average VAS score of 8. It seems that pregnancy may affect the course of previously present sinonasal disease (allergic rhinitis, chronic rhinosinusitis, nonallergic rhinitis, or non-infectious rhinitis prior to the pregnancy).

Conclusions

PIR is a common clinical entity with a wide range of symptoms with a direct impact on the quality of life in pregnancy. We propose a new definition of pregnancy-induced rhinitis.
Hybrid Fixation Restores Tibiofibular Kinematics for Early Weightbearing After Syndesmotic Injury
Authors: Patel Neel K. , Chan Calvin , Murphy Conor I. , Debski Richard E. , Musahl Volker , Hogan MaCalus V.
Published: September 2020

Background:

Disruption of the anterior inferior tibiofibular ligament (AITFL), posterior inferior tibiofibular ligament (PITFL), and interosseous membrane (IOM) is a predictive measure of residual symptoms after an ankle injury. Controversy remains regarding the ideal fixation technique for early return to sport, which requires restoration of tibiofibular kinematics with early weightbearing.

Purpose:

To quantify tibiofibular kinematics after syndesmotic fixation with different tricortical screw and suture button constructs during simulated weightbearing.

Study Design:

Controlled laboratory study.

Methods:

A 6 degrees of freedom robotic testing system was used to test 9 fresh-frozen human cadaveric specimens (mean age, 65.1 ± 17.3 years). A 200-N compressive load was applied to the ankle, while a 5-N·m external rotation and a 5-N·m inversion moment were applied independently to the ankle at 0° of flexion, 15° and 30° of plantarflexion, and 10° of dorsiflexion. Fibular medial-lateral translation, anterior-posterior translation, and internal-external rotation relative to the tibia were tracked by use of an optical tracking system in the following states: (1) intact ankle; (2) AITFL, PITFL, and IOM transected ankle; (3) single-screw fixation; (4) double-screw fixation; (5) hybrid fixation; (6) single suture button fixation; and (7) divergent suture button fixation. Repeated-measures analysis of variance with Bonferroni correction was performed for statistical analysis.

Results:

In response to the external rotation moment and axial compression, single tricortical screw fixation resulted in significantly higher lateral translation of the fibula compared with that of the intact ankle at 10° of dorsiflexion ( P < .05). Suture button fixation resulted in significantly higher posterior translation of the fibula at 0° of flexion and 10° of dorsiflexion, whereas divergent suture button fixation resulted in higher posterior translation at only 0° of flexion ( P < .05). In response to the inversion moment and axial compression, single tricortical screw and hybrid fixation significantly decreased lateral translation in plantarflexion, whereas double tricortical screw fixation and hybrid fixation significantly decreased external rotation of the fibula compared with that of the intact ankle at 15° of plantarflexion ( P < .05).

Conclusion:

Based on the data in this study, hybrid fixation with 1 suture button and 1 tricortical screw may most appropriately restore tibiofibular kinematics for early weightbearing. However, overconstraint of motion during inversion may occur, which has unknown clinical significance.

Clinical Relevance:

Surgeons may consider this data when deciding on the best algorithm for syndesmosis repair and postoperative rehabilitation.
Living With a Trifecta of Pain and Cancer With Personal Reflections of COVID-19
Authors: Hovey Richard B
Published: September 2020

The purpose of preparing this Feature Article was to explore and share my lived experience of living with multiple layers of chronic pain, with a diagnosis of advanced, aggressive and metastasized prostate cancer, and COVID-19. My exploration begins with the manifestations of chronic pain from a bicycling accident, psoriatic arthritis, with cancer treatments and the pain it creates during a panademic has added to the challenges of social distancing, isolation, and medical treatments. As with many patient experiences, we the person as patient outside of health care sometimes struggle to find the right words, the proper sentence structure and as Tamas writes about the expectation of others to provide, “Clean and reasonable scholarship about messy, unreasonable experiences is an exercise in alienation.” I write this while living with extreme chronic pain, continue cancer treatments while the threat and additional anxiety of COVID-19 looms over me. This is my story.
Sensory hypersensitivities in those with persistent post-traumatic headache versus migraine
Authors: Hanna Jeffery J , Chong Catherine D , Dumkrieger Gina M , Ross Katherine B , Schwedt Todd J
Published: September 2020

Background and Objective:

Symptoms of persistent post-traumatic headache (PPTH) most often resemble those of migraine, including the presence of photo-, phono-, and cutaneous hypersensitivities. The severity of these hypersensitivity symptoms in those with PPTH compared to those with migraine has yet to be fully elucidated. The objective of this study was to compare symptoms of sensory hypersensitivities between PPTH, migraine, and healthy controls (HCs). Further defining characteristics of PPTH and its similarities to migraine might assist with developing future diagnostic criteria for PPTH and provide insights into PPTH mechanisms.

Methods:

This analysis included 56 individuals with PPTH attributed to mild traumatic brain injury, 30 with migraine, and 36 HCs. To assess sensory hypersensitivities, all subjects completed the Allodynia Symptom Checklist-12, the Photosensitivity Assessment Questionnaire, and the Hyperacusis Questionnaire. Differences among groups were assessed using Fisher’s exact test, Kruskal–Wallis, or Mann–Whitney U test.

Results:

PPTH and migraine groups had greater severity of cutaneous, photo-, and phono-hypersensitivity symptoms compared to HCs. There were no statistically significant differences between the PPTH and migraine groups for cutaneous allodynia (median [first quartile, third quartile]; PPTH: 4.0 [2.0, 7.0]; migraine: 5.0 [3.0, 8.0]; p = 0.54) or photosensitivity severity (PPTH: 5.0 [2.0, 7.0]; migraine: 5.0 [2.0, 6.0]; p = 0.53). Those with PPTH had higher hyperacusis scores compared to those with migraine (PPTH: 23.0 [17.0, 31.0]; migraine: 13.5 [9.0, 24.0]; p = 0.001).

Conclusion:

Sensory hypersensitivity symptoms among individuals with PPTH are at least as severe as those experienced by people with migraine. Results further confirm symptom similarities between PPTH and migraine and could suggest that PPTH and migraine have a partially shared underlying pathophysiology.
Retinoic acid–responsive CD8 effector T cells are selectively increased in IL-23–rich tissue in gastrointestinal GVHD
Authors: Ball Jennifer A. , Clear Andrew , Aries James , Charrot Sarah , Besley Caroline , Mee Matt , Stagg Andrew , Lindsay James O. , Cavenagh Jamie , Calaminci Maria , Gribben John G. , Davies Jeff
Published: September 2020

Gastrointestinal (GI) graft-versus-host disease (GVHD) is a major barrier in allogeneic hematopoietic stem cell transplantation (allo-HSCT). The metabolite retinoic acid (RA) potentiates GI-GVHD in mice via alloreactive T cells expressing the RA receptor-α (RARα), but the role of RA-responsive cells in human GI-GVHD remains undefined. Therefore, we used conventional and novel sequential immunostaining and flow cytometry to scrutinize RA-responsive T cells in tissues and blood of patients who had received allo-HSCT and to characterize the impact of RA on human T-cell alloresponses. Expression of RARα by human mononuclear cells was increased after exposure to RA. RARαhi mononuclear cells were increased in GI-GVHD tissue, contained more cellular RA-binding proteins, localized with tissue damage, and correlated with GVHD severity and mortality. By using a targeted candidate protein approach, we predicted the phenotype of RA-responsive T cells in the context of increased microenvironmental interleukin-23 (IL-23). Sequential immunostaining confirmed the presence of a population of RARαhi CD8 T cells with the predicted phenotype that coexpressed the effector T-cell transcription factor T-bet and the IL-23–specific receptor (IL-23R). These cells were increased in GI- but not skin-GVHD tissues and were also selectively expanded in the blood of patients with GI-GVHD. Finally, functional approaches demonstrated that RA predominantly increased alloreactive GI-tropic RARαhi CD8 effector T cells, including cells with the phenotype identified in vivo. IL-23–rich conditions potentiated this effect by selectively increasing β7 integrin expression on CD8 effector T cells and reducing CD4 T cells with a regulatory cell phenotype. In summary, we have identified a population of RA-responsive effector T cells with a distinctive phenotype that is selectively expanded in human GI-GVHD and that represents a potential new therapeutic target.
Seismic geomorphology and overpressure variation in the shallow-water-flow-prone sand units in the north-central Gulf of Mexico
Authors: Berger William J. , Ul-Hadi Shams , Keenan James , Metz Zachary , Nguyen Thien
Published: September 2020

The north-central Gulf of Mexico area received rapid deposition of a basin-floor fan system consisting of interbedded muds, silts, and sandy turbidite deposits during the Pleistocene. Overpressure occurs at shallow depths when burial rates exceed the dewatering rates of sediment pore fluids. Two stratigraphic sequences in the region contain significant overpressure with elevated shallow-water flow risk within these units. We have used publicly available seismic and well data to identify the geomorphology and overpressure variation of these units. The previously described “Blue Unit” and its lateral extent, thickness, depth below sea level (BSL), and overpressure gradient have been revised. The Blue Unit extends from the northern portion of the Mississippi Canyon (MC) protraction area to as far south as the Atwater Valley (AT) protraction area. For the first time, the Green Unit’s lateral extent, thickness, depth BSL, and pore pressure are defined. The “Green Unit” was found to extend further south than the Blue Unit into the AT protraction area and further east in the Desoto Canyon protraction area. The tops of both units are highly incised by postdepositional erosional systems, whereas the base of each unit is well preserved. The top of the Blue Unit below the mud line (BML) varies from <70 m (<230 ft) in the north to as deep as 701 m (2300 ft) in the south, whereas the top of the Green Unit is as shallow as 300 m (985 ft) in the north to 901 m (2956 ft) in the south. Overpressure in the MC area has been reported just BML. The pore pressure gradient ranges from 0.47 to 0.52 psi/ft at the base of the Blue Unit and increases to 0.60 psi/ft within the Green Unit.
Mass transport deposit or complex channel system? A case study of the 3D Nimitz seismic survey, Taranaki Basin, New Zealand
Authors: Clairmont Roberto , Bedle Heather
Published: September 2020

The Taranaki Basin is well known for studies examining the seismic stratigraphy, depositional and erosional features, and tectonic frameworks linked to the New Zealand (NZ) continent. We have examined a “funny looking thing” (FLT) that we associate to be consistent with that of a braided channelized system. We observe this feature within the 3D Nimitz survey, located in the northern Taranaki Basin, off the western continental coast of North Island, NZ. The FLT occurs within Quaternary deposits of the Whenuakura Formation, which are interpreted to reflect shelfal topset sediments. It is underlain by the Giant Foresets Formation of Pliocene to Pleistocene age, which are described as large-scale progradational and aggradational continental successions that migrated west to northwest in a basinward direction. It comprises a shelf-to-slope succession of claystone to siltstone with argillaceous sandstone intervals defining an overall coarsening-upward succession. The FLT within the Whenuakura Formation is characterized by chaotic facies in cross section, which shares characteristics with potential mass-wasting events. However, further analysis using seismic attributes improved the spatial and stratigraphic architecture of the FLT, which favored a complex channelized system interpretation over a mass transport deposit complex.

Geological feature: Braided channel system Seismic appearance: Splayed structurally controlled feature, with internally abundant, continuously lineated patterns on horizon slice Alternative interpretations: Erosional scour Features with similar appearance: Mass transport deposit Formation: Whenuakura Age: Pleistocene–Recent Location: Offshore Taranaki Basin, North Island, New Zealand Seismic data: Nimitz 3D seismic survey; obtained by Origin Energy Ltd. Analysis tools: Variance and curvature attributes
Fitness Landscape of Clonal Hematopoiesis Under Selective Pressure of Immune Checkpoint Blockade
Authors: Miller Peter G. , Gibson Christopher J. , Mehta Arnav , Sperling Adam S. , Frederick Dennie T. , Manos Michael P. , Miao Benchun , Hacohen Nir , Hodi F. Stephen , Boland Genevieve M. , Ebert Benjamin L.
Published: September 2020

PURPOSE

Conventional cytotoxic therapies increase the risk of clonal hematopoiesis and select for TP53-mutant clones, which carry a high risk for transformation to therapy-related myelodysplastic neoplasms. In contrast, the effect of immune checkpoint blockade (ICB) on clonal hematopoiesis is unknown.

METHODS

Paired peripheral-blood samples taken before and after treatment with ICB were obtained for 91 patients with either cutaneous melanoma or basal cell carcinoma. Error-corrected sequencing of a targeted panel of genes recurrently mutated in clonal hematopoiesis was performed on peripheral-blood genomic DNA.

RESULTS

The average interval between acquisition of the paired samples was 180 days. Forty-one percent of the patients had clonal hematopoiesis at a variant allele frequency (VAF) > 0.01 in the pretreatment sample. There was near-complete agreement in the distribution and burden of clonal hematopoiesis mutations in the paired blood samples, with 87 of 88 mutations identified across the cohort present in paired samples, regardless of the duration between sample collection. The VAF in the paired samples also showed a high correlation, with an R2 = 0.95 ( P < .0001). In contrast to cytotoxic therapy, exposure to ICB did not lead to selection of TP53- or PPM1D-mutant clones. However, consistent with the known effects of DNA-damaging therapy, we identified one patient who had eight unique TP53 mutations in the posttreatment blood sample after receiving two courses of radiation therapy.

CONCLUSION

There was no expansion of hematopoietic clones or selection for clones at high risk for malignant transformation in patients who received ICB, observations that warrant further validation in larger cohorts. These findings highlight an important difference between ICB and conventional cytotoxic therapies and their respective impacts on premalignant genetic lesions.
The Fgf8 subfamily (Fgf8, Fgf17 and Fgf18) is required for closure of the embryonic ventral body wall
Authors: Boylan Michael , Anderson Matthew J. , Ornitz David M. , Lewandoski Mark
Published: September 2020

The closure of the embryonic ventral body wall in amniotes is an important morphogenetic event and is essential for life. Defects in human ventral wall closure are a major class of birth defect and a significant health burden. Despite this, very little is understood about how the ventral body wall is formed. Here we show that fibroblast growth factor (FGF) ligands FGF8, FGF17 and FGF18 are essential for this process. Conditional mutants for these genes display subtle migratory defects in the abdominal muscles of the ventral body wall and an enlarged umbilical ring, through which the internal organs are extruded. By refining where and when these genes are required using different Cre lines, we show that Fgf8 and Fgf17 are required in the presomitic mesoderm while Fgf18 is required in the somites. These studies identify complex and multifactorial origins of ventral wall defects and has important implications for understanding their origins during embryonic development.
The transcriptional repressor Bcl6 promotes pre-TCR induced differentiation to CD4+CD8+ thymocyte and attenuates Notch1 activation
Authors: Solanki Anisha , Yánez Diana C. , Lau Ching-In , Rowell Jasmine , Barbarulo Alessandro , Ross Susan , Sahni Hemant , Crompton Tessa
Published: September 2020

Pre-TCR signal transduction is required for developing thymocytes to differentiate from CD4-CD8- double negative (DN) to CD4+CD8+ double positive (DP) cell. Notch signalling is required for T-cell fate specification and must be maintained throughout β-selection, but inappropriate Notch activation in DN4 and DP cells is oncogenic. Here, we show that pre-TCR signalling leads to increased expression of the transcriptional repressor Bcl6 and that Bcl6 is required for differentiation to DP. Conditional deletion of Bcl6 from thymocytes reduced pre-TCR-induced differentiation to DP cell, disrupted expansion and enrichment of icTCRβ+ cells within the DN population and increased DN4 cell death. It also increased Notch1 activation and Notch-mediated transcription in the DP population. Thus, Bcl6 is required in thymocyte development for efficient differentiation from DN3 to DP cell and to attenuate Notch1 activation in DP cells. Given the importance of inappropriate NOTCH1 signalling in T-ALL, and the involvement of Bcl6 in other types of leukaemia, this study is important to our understanding of T-ALL.