bluuebunny/crossref_metadata_2025 huggingface dataset:
Public Perceptions of Police Agency Fairness and the Willingness to Call Police
Authors: Socia Kelly M. , Morabito Melissa S. , Bond Brenda J. , Nader Elias S.
Published: April 2021

Police leaders strive to improve interactions and practices relating to residents’ perceptions of police fairness and their willingness to report crimes. Research suggests that strengthening community perceptions of police fairness may increase residents’ willingness to contact the police for help. This study uses a nationally representative public opinion survey to examine the factors that influence perceptions of police fairness and the willingness to call police for help. In doing so, we examine a variety of demographic factors, prior experiences with the police, and perceptions about whether the local police agency is racially representative of the community. We find that very few factors influence both perceptions of police fairness and the willingness to call police for help. Specifically, perceptions of police fairness depend on age, education, and political leanings, whereas willingness to call police for help depends on perceptions of police fairness, political leanings, perceptions of police representativeness, and prior proactive police contact. Notably, we found no differences in perceptions of fairness based on respondent race after controlling for other demographics, perceptions, and experiences. These results indicate that symbolic representation in police departments is not enough on its own to support positive perceptions of police fairness and willingness to call the police for help.
Realising the potential of general population research to reconceptualise the study of “delusions”: From normalising “psychosis” to defamiliarising “normality”
Authors: Harper David J.
Published: April 2021

Over recent decades a research programme involving nonclinical samples has provided a justification for the use of normalising practices within cognitive behaviour therapy for psychosis. These studies have found that, contrary to mainstream psychiatric assumptions, beliefs considered delusional are neither rare in the general population nor qualitatively different from “nondelusional” beliefs, whilst theories from a “normal” rather than “abnormal” psychology have shown them to be intelligible rather than un-understandable. Yet the programme’s inherent limitations have meant that the potential of nonclinical research has not been fully realised. An alternative research programme is proposed which could elucidate the diversity of belief in the general population by examining the role of social norms and lived belief narratives in unconventional belief communities. This could address the limitations of the normalising programme, provide a necessary corrective to the “clinician’s illusion” bias, and prompt a more fundamental reconceptualisation of beliefs considered delusional.
Clinical and Radiological Outcomes of Operative Therapy in Insertional Achilles Tendinopathy With Debridement and Double-Row Refixation
Authors: Greiner Fabian , Trnka Hans-Jörg , Chraim Michel , Neunteufel Elena , Bock Peter
Published: April 2021

Background:

Insertional Achilles tendinopathy (IAT) is a painful pathology in which the strongest and thickest tendon of the human body is affected. Different conservative and operative treatments have been described to address this pathology. This study aimed to evaluate the medium-term clinical and radiological outcomes of patients who underwent a surgical therapy via a longitudinal tendon-splitting approach with debridement and double-row refixation.

Methods:

All patients were assessed pre- and postoperatively using a visual analog scale (VAS), the American Orthopaedic Foot & Ankle Society (AOFAS) Hindfoot Score, the Foot and Ankle Outcome Score (FAOS), and the Foot Function Index (FFI). Additionally, a lateral radiograph of the foot was performed to assess the postoperative result. Forty-two patients with confirmed IAT who underwent surgery between 2013 and 2017 with a longitudinal tendon-splitting approach and tendon refixation using a double-row refixation system were evaluated. The average follow-up was 32.8 (range, 18-52) months. We included 26 female and 16 male patients with an average age of 56.8 (range, 27-73) years.

Results:

The mean VAS improved from 8.91 ± 1.0 preoperatively to 1.47 ± 2.5 postoperatively ( P < .01). AOFAS scores improved significantly from 51.0 ± 12.5 preoperatively to 91.3 ± 14.3 postoperatively ( P < .01). All total and subscores of the FFI and FAOS saw a significant improvement at follow-up ( P < .01). Lateral radiographs showed recurrent calcification in 30 patients (71.4%).

Conclusion:

We found that, at an average of 33 months posttreatment, insertional Achilles tendinopathy via a longitudinal tendon-splitting approach resulted in good outcomes for patients after failure of initial conservative therapy. Recurrent calcification seems to be very common but shows no association with inferior outcomes or the return of symptoms.

Level of Evidence:

Level IV, retrospective case series.
Concordance and Prognostic Relevance of Angiographic and Clinical Definitions of Myocardial Infarction Type
Authors: Hoang Truong H. , Lazarev Pavel V. , Maiskov Victor V. , Merai Imad A. , Kobalava Zhanna D.
Published: April 2021

Background:

Atherothrombosis is the principal mechanism of type 1 (T1) myocardial infarction (MI), while type 2 (T2) MI is typically diagnosed in the presence of triggers (anemia, arrhythmia, etc.). We aimed to evaluate the proportions of T1 vs. T2 MI based on angiographic and clinical definitions, their concordance and prognosis.

Methods:

Consecutive MI patients [n = 712, 61% male; age 64.6 ± 12.3 years] undergoing coronary angiography were classified according to the presence of atherothrombosis and identifiable triggers. Association of angiographic and clinical MI type criteria with adverse outcomes (Time follow-up was 1.5 years) was evaluated. Predictive ability of GRACE risk score for all-cause mortality was then assessed.

Results:

Atherothrombosis and clinical triggers were identified in 397 (55.6%) and 324 (45.5%) subjects, respectively. Only 247 (34.7%) patients had “true” T1MI (atherothrombosis+ / triggers−); 174 (24.4%) were diagnosed with “true” T2MI (atherothrombosis− / triggers+), while 291 (40.9%) had discordant clinical and angiographic characteristics. All-cause mortality in T2MI (20.1%) patients was higher than in T1MI (9.3%), P = 0.002. Presence of triggers [odds ratio (OR) 2.4, 95% CI 1.5-3.6, P < 0.0001] but not atherothrombosis [OR 0.8, 95% confidence interval (CI) 0.5-1.3, P = 0.26] was associated with worse prognosis. GRACE score is a better predictor of death in T1MI vs. T2MI: area under curve 0.893 (95% CI 0.830-0.956) vs 0.748 (95% CI 0.652-0.843), P = 0.013

Conclusion:

Angiographic and clinical definitions of MI type are discordant in a substantial proportion of patients. Clinical triggers are associated with all-cause mortality. Predictive performance of GRACE score is worse in T2MI patients.
Death and Disposal Locations of Serial Homicides: The Effect on Recovery Timeframes
Authors: Chapman Brendan , Raymer Cody , Keatley David A.
Published: April 2021

Many factors affect the solvability of homicides, including body disposal location and time between death and recovery. The aim of this exploratory study was to probe a number of spatiotemporal variables for trends across a subset of solved homicide case data from 54 North American serial killers, active between 1920 and 2016 (125 solved cases) to identify areas for further research. We investigated murder site and body disposal site as location variables with eight subcategories across eight discrete time series, seeking insight into how these factors may affect the early stages of an investigation and (therefore by inference) solvability. The findings showed that bodies recovered after 48 hours are more likely discovered outdoor while those discovered within 24 hours, within the victim’s residence. This has implications for the ability to recover forensic evidence when bodes are located after a prolonged time since death as well as in more hostile environments.
Response to Adamson et al. (2020): ‘Cognitive behavioural therapy for chronic fatigue and chronic fatigue syndrome: Outcomes from a specialist clinic in the UK’
Authors: Hughes Brian M , Tuller David
Published: April 2021

In a paper published in the Journal of the Royal Society of Medicine, Adamson et al. (2020) interpret data as showing that cognitive behavioural therapy leads to improvement in patients with chronic fatigue syndrome and chronic fatigue. Their research is undermined by several methodological limitations, including: (a) sampling ambiguity; (b) weak measurement; (c) survivor bias; (d) missing data and (e) lack of a control group. Unacknowledged sample attrition renders statements in the published Abstract misleading with regard to points of fact. That the paper was approved by peer reviewers and editors illustrates how non-rigorous editorial processes contribute to systematic publication bias.
Animal fiber imagery classification using a combination of random forest and deep learning methods
Authors: Zhu Yaolin , Duan Jiameng , Wu Tong
Published: April 2021

Feature extraction is a key step in animal fiber microscopic images recognition that plays an important role in the wool industry and textile industry. To improve the accuracy of wool and cashmere microscopic images classification, a hybrid model based on Convolutional Neural Network (CNN) and Random Forest (RF) is proposed for automatic feature extraction and classification of animal fiber microscopic images. First, use CNN to learn the representative high-level features from animal fiber images, then add dropout layers to avoid over-fitting. And the backward propagation algorithm are used to optimize the CNN structure. Random forest, which is robust and has strong generalization ability, is introduced for the classification of animal fiber microscopic images to obtain the final results. The study shows that, the proposed method has better generalization performance and higher classification accuracy than other classification methods.
Building an ‘Industrial Engineering Mindset’ among Indian Healthcare Executives: Toward Management of Healthcare Facilities at an Industrial Scale post the COVID-19 Pandemic
Authors: Bhattacharyya Som Sekhar , Chandwani Rajesh
Published: April 2021

The COVID-19 pandemic highlighted the necessity of good quality and adequate quantity of healthcare infrastructure facilities. Healthcare facilities were provided for COVID-19 facilities with improvisation and supplementary lateral infrastructure from other sectors. However, the main point of contemplation going into the future was regarding how to quickly develop healthcare facilities. The subject domain of ‘industrial engineering’ (IE) and its associated perspectives could provide some key insights regarding this. The authors undertook a conceptual literature review and provided theoretical argumentation toward this. The findings provided insights regarding the application of industrial engineering concepts in healthcare facilities and services.
Identification and evolution analysis of the JAZ gene family in maize
Authors: Han Yang , Luthe Dawn
Published: April 2021

Background

Jasmonates (JAs) are important for plants to coordinate growth, reproduction, and defense responses. In JA signaling, jasmonate ZIM-domain (JAZ) proteins serve as master regulators at the initial stage of herbivores attacks. Although discovered in many plant species, little in-depth characterization of JAZ gene expression has been reported in the agronomically important crop, maize (Zea maysL.).

Results

In this study 16 JAZ genes from the maize genome were identified and classified. Phylogenetic analyses were performed from maize, rice, sorghum, Brachypodium, and Arabidopsis using deduced protein sequences, total six clades were proposed and conservation was observed in each group, such as similar gene exon/intron structures. Synteny analysis across four monocots indicated these JAZ gene families had a common ancestor, and duplication events in maize genome may drive the expansion of JAZ gene family, including genome-wide duplication (GWD), transposon, and/or tandem duplication. Strong purifying selection acted on all JAZ genes except those in group 4, which were under neutral selection. Further, we cloned three paralogous JAZ gene pairs from two maize inbreds differing in JA levels and insect resistance, and gene polymorphisms were observed between two inbreds.

Conclusions

Here we analyzed the composition and evolution of JAZ genes in maize with three other monocot plants. Extensive phylogenetic and synteny analysis revealed the expansion and selection fate of maize JAZ. This is the first study comparing the difference between two inbreds, and we propose genotype-specific JAZ gene expression might be present in maize plants. Since genetic redundancy in JAZ gene family hampers our understanding of their role in response to specific elicitors, we hope this research could be pertinent to elucidating the defensive responses in plants.
Cross-talk between transcriptome, phytohormone and HD-ZIP gene family analysis illuminates the molecular mechanism underlying fruitlet abscission in sweet cherry (Prunus avium L)
Authors: Qiu Zhilang , Wen Zhuang , Hou Qiandong , Qiao Guang , Yang Kun , Hong Yi , Wen Xiaopeng
Published: April 2021

Background

The shedding of premature sweet cherry (Prunus avium L) fruitlet has significantly impacted production, which in turn has a consequential effect on economic benefits.

Result

To better understand the molecular mechanism of sweet cherry fruitlet abscission, pollen viability and structure had been observed from the pollination trees. Subsequently, the morphological characters of the shedding fruitlet, the plant hormone titers of dropping carpopodium, the transcriptome of the abscising carpopodium, as well as the HD-ZIP gene family were investigated. These findings showed that the pollens giving rise to heavy fruitlet abscission were malformed in structure, and their viability was lower than the average level. The abscising fruitlet and carpopodium were characterized in red color, and embryos of abscising fruitlet were aborted, which was highly ascribed to the low pollen viability and malformation. Transcriptome analysis showed 6462 were significantly differentially expressed, of which 2456 genes were up-regulated and 4006 down-regulated in the abscising carpopodium. Among these genes, the auxin biosynthesis and signal transduction genes (α-Trp, AUX1), were down-regulated, while the 1-aminocyclopropane-1-carboxylate oxidase gene (ACO) affected in ethylene biosynthesis, was up-regulated in abscising carpopodium. About genes related to cell wall remodeling (CEL, PAL, PG EXP, XTH), were up-regulated in carpopodium abscission, which reflecting the key roles in regulating the abscission process. The results of transcriptome analysis considerably conformed with those of proteome analysis as documented previously. In comparison with those of the retention fruitlet, the auxin contents in abscising carpopodium were significantly low, which presumably increased the ethylene sensitivity of the abscission zone, conversely, the abscisic acid (ABA) accumulation was considerably higher in abscising carpopodium. Furthermore, the ratio of (TZ + IAA + GA3) / ABA also obviously lower in abscising carpopodium. Besides, the HD-ZIP gene family analysis showed that PavHB16 and PavHB18 were up-regulated in abscising organs.

Conclusion

Our findings combine morphology, cytology and transcriptional regulation to reveal the molecular mechanism of sweet cherry fruitlet abscission. It provides a new perspective for further study of plant organ shedding.
Artisan versus Artiflex phakic intraocular lens implantation in the treatment of moderate to high myopia: meta-analysis
Authors: Hou Chenting , Li Hui , Li Jiangfeng , Li Jinjian , Peng Hui , Wang Qing
Published: April 2021

Background

To compare the postoperative safety, efficacy, predictability, visual quality and biomechanics after implantation of Artisan vs. Artiflex phakic intraocular lenses (PIOLs).

Methods

Pubmed, Embase, Cochrane Library were conducted up from January 2000 to February 2020. Comparative clinical studies reporting in accordance with the eligibility criteria were included in this meta-analysis. The pooled weighted mean differences (WMDs) and odds ratios (ORs) with corresponding 95% confidence intervals were calculated.

Results

Comparative trials with myopia patients were selected in this review. The pooled WMD and OR estimates statistical significance in terms of postoperative best corrected visual acuity (BCVA), efficacy, postoperative spherical equivalence (SE), predictability, contrast sensitivity and mean intraocular higher-order aberrations (HOA) (mm) for a 6-mm pupil, manifesting that Artiflex PIOL showed evident beneficial effect for correcting myopia compared to Artisan PIOL. There was no significant difference in the incidence of complications between the two groups.

Conclusion

Both of two techniques were safe and effective for myopia and compared to Artisan PIOL, Artiflex PIOL had significant improvement in efficacy, predictability, contrast sensitivityand HOA, except safety and complications in the treatment of moderate to high myopia.
A new indolocarbazole derivative in melanoma and carcinoma lung in vivo treatment
Authors: Lantsova Anna , Golubeva Irina , Borisova Larisa , Nikolaeva Lyudmila , Ektova Lydia , Dmitrieva Maria , Orlova Olga
Published: April 2021

Objective

The current scientific research direction is development of drugs with a targeted effect on malignant tumors. One of the promising groups is indolocarbazoles and their derivatives, which can initiate various tumor cell death pathways. Russian scientists from N. N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of Russian Federation has developed a new experimental drug form of the original compound LCS 1269 with cytotoxic and antiangiogenic properties, blocking vasculogenic mimicry in tumor. The study aim is the experimental drug form LCS 1269 antitumor activity on models of transplantable mouse tumors B-16 melanoma and Lewis epidermoid lung carcinoma (LLC) with different routes and modes of administration.

Material and methods

Female F1 hybrid mice (C57Bl/6 x DBA/2) and male and female linear mice C57BL/6 were used for management of tumor strains. Mice were obtained from N. N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of Russian Federation vivarium. The antitumor effect was assessed by tumor growth inhibition (TGI) and increase of treated animal’s life span (ILS) compared to the control.

Results

The experimental drug form showed high antitumor activity when administered intravenously once at doses of 100 and 120 mg/kg (TGI = 98–82% and TGI = 95–77%, respectively, ILS = 24%, p < 0.05) on melanoma B-16 mice. On LLC mice, the experimental drug form showed that the intravenous administration route was effective in the range of doses from 60 to 80 mg/kg with a 5 day administration regimen with an interval of 24 h. A dose of 70 mg/kg had maximum effect at the level of TGI = 96–77% (p < 0.05) with its retention for 20 days after the end of treatment.

Conclusion

The studies have shown that the new compound LCS 1269 in the original drug form, has a pronounced antitumor activity and significantly reduces the volume of tumor mass both on melanoma B-16 and on LLC. It allows us to recommend continue the search for sensitivity of animal transplantable tumors to LCS 1269.
Effects of supplementation with main coffee components including caffeine and/or chlorogenic acid on hepatic, metabolic, and inflammatory indices in patients with non-alcoholic fatty liver disease and type 2 diabetes: a randomized, double-blind, placebo-controlled, clinical trial
Authors: Mansour Asieh , Mohajeri-Tehrani Mohammad Reza , Samadi Majid , Qorbani Mostafa , Merat Shahin , Adibi Hossein , Poustchi Hossein , Hekmatdoost Azita
Published: April 2021

Background

Non-alcoholic fatty liver disease (NAFLD) is much more frequent and more severe, including cirrhosis, hepatocellular carcinoma in patients with type 2 diabetes. Coffee is a complex beverage with hundreds of compounds whereas caffeine and chlorogenic acid are the most abundant bioactive compounds. The published epidemiological data demonstrating beneficial associations between all categories of coffee exposure and ranges of liver outcomes are rapidly growing; however, the main contributors and cause-effect relationships have not yet been elucidated. To address existing knowledge gaps, we sought to determine the efficacy and safety of 6 months chlorogenic acid and/or caffeine supplementation in patients with type 2 diabetes affected by NAFLD.

Methods

This trial was carried out at two Diabetes Centers to assess the effects of supplementation with daily doses of 200 mg chlorogenic acid, 200 mg caffeine, 200 mg chlorogenic acid plus 200 mg caffeine or placebo (starch) in patients with type 2 diabetes and NAFLD. The primary endpoint was reduction of hepatic fat and stiffness measured by FibroScan, and changes in serum hepatic enzymes and cytokeratin − 18 (CK-18) levels. Secondary endpoints were improvements in metabolic (including fasting glucose, homeostasis model assessment-estimated insulin resistance (HOMA-IR), hemoglobin A1c (HBA1C), C-peptide, insulin and lipid profiles) and inflammatory (including nuclear factor k-B (NF-KB), tumor necrosis factor (TNF-α), high sensitive- C reactive protein(hs-CRP)) parameters from baseline to the end of treatment.

Results

Neither chlorogenic acid nor caffeine was superior to placebo in attenuation of the hepatic fat and stiffness and other hepatic outcomes in patients with diabetes and NAFLD. Except for the lower level of total cholesterol in caffeine group (p = 0.04), and higher level of insulin in chlorogenic acid plus caffeine group (p = 0.01) compared with placebo, there were no significant differences among the treatment groups.

Conclusion

These findings do not recommend caffeine and/or chlorogenic acid to treat NAFLD in type 2 diabetes patients.

Trial registration

IRCT201707024010N21. Registered 14 September 2017.
Gender intentional approaches to enhance health social enterprises in Africa: a qualitative study of constraints and strategies
Authors: McKague Kevin , Harrison Sarah , Musoke Jenipher
Published: April 2021

Background

Health social enterprises are experimenting with community health worker (CHW) models that allow for various income-generating opportunities to motivate and incentivize CHWs. Although evidence shows that improving gender equality contributes to the achievement of health outcomes, gender-based constraints faced by CHWs working with social enterprises in Africa have not yet been empirically studied. This study is the first of its kind to address this important gap in knowledge.

Methods

We conducted 36 key informant interviews and 21 focus group discussions between 2016 and 2019 (for a total of 175 individuals: 106 women and 69 men) with four health social enterprises in Uganda and Kenya and other related key stakeholders and domain experts. Interview and focus group transcripts were coded according to gender-based constraints and strategies for enhanced performance as well as key sites for intervention.

Results

We found that CHW programs can be more gender responsive. We introduce theGender Integration Continuum for Health Social Enterprisesas a tool that can help guide gender equality efforts. Data revealed female CHWs face seven unique gender-based constraints (compared to male CHWs): 1) higher time burden and lack of economic empowerment; 2) risks to personal safety; 3) lack of career advancement and leadership opportunities; 4) lack of access to needed equipment, medicines and transport; 5) lack of access to capital; 6) lack of access to social support and networking opportunities; and 7) insufficient financial and non-financial incentives. Data also revealed four key areas of intervention: 1) the health social enterprise; 2) the CHW; 3) the CHW’s partner; and 4) the CHW’s patients. In each of the four areas, gender responsive strategies were identified to overcome constraints and contribute to improved gender equality and community health outcomes.

Conclusions

This is the first study of its kind to identify the key gender-based constraints and gender responsive strategies for health social enterprises in Africa using CHWs. Findings can assist organizations working with CHWs in Africa (social enterprises, governments or non-governmental organizations) to develop gender responsive strategies that increase the gender and health outcomes while improving gender equality for CHWs, their families, and their communities.
Predictors of death at home among cancer patients in Israel: a population-based study
Authors: Rottenberg Yakir , Goldzweig Gil , Shaulov Adir
Published: April 2021

Background

Most cancer patients prefer to die at home; however, many die in hospital. The aim of the current study is to elucidate the association between dying at home and various personal factors in the Israeli population of cancer patients.

Methods

Data on cancer incidence (2008–2015) and death (2008–2017) was provided by the Israeli Central Bureau of Statistics and the Israel National Cancer Registry. Binary logistic regression analyses were performed to assess odds ratios for death at home following cancer diagnosis while controlling for age, sex, ethnicity, years of education, residential socioeconomic score, and time from diagnosis. We also assessed the relation between place of death and specific cancer sites, as well as the time trend from 2008 to 2017.

Results

About one quarter (26.7%) of the study population died at home. Death at home was most frequent among patients diagnosed with brain tumors (37.0%), while it was the lowest among patients with hematologic malignancies (lymphoma and leukemia, 20.3 and 20.0%, respectively). Rates of dying at home among patients with residential socioeconomic scores of 1, 2–9, and 10 were about 15, 30, and 42.9%, respectively. In patients from the 4th to the 7th decades of life, rates of death at home increased at a linear rate that increased exponentially from the 8th decade onwards. After controlling for potential confounders, predictive variables for death at home included age (OR = 1.020 per year, 95% CI 1.017–1.024), male sex (OR = 1.18, 95% CI 1.077–1.294), years of education (OR = 1.029 per year, 95% CI 1.018–1.040), and time from diagnosis (OR = 1.003 per month, 95% CI 1.001–1.005 allp < 0.001). No trend was seen from 2008 to 2013, while from 2014 to 2017 a slight increase in the rate of death at home was seen each year.

Conclusions

These results indicate wide variability in death at home exists among patients of different ages, sex, education, socioeconomic status and time from diagnosis. These findings stress the importance of delivering quality palliative care at home, mainly for patients with hematologic malignancies, younger patients, and patients of very low socioeconomic status. Understanding the complex mechanisms whereby patient preferences and the above variables may determine the preferred place of death remains an important research priority.
Feasibility of modified radical mastectomy with nipple-areola preservation combined with stage I prosthesis implantation using air cavity-free suspension hook in patients with breast cancer
Authors: Liu Jiaqi , Yu Heshan , He Yuxiao , Yan Ting , Ding Yu , Chu Jun , Gao Ning , Lin Xiaona , Xu Yanbin , He Guijin
Published: April 2021

Background

Mastoscopic surgery is proven to have lower incidence of postoperative complications and better postoperative recovery than traditional breast cancer surgery. This study aimed to examine the feasibility of mastoscopic modified radical mastectomy (MRM) with skin nipple-areola preservation under air cavity-free suspension hook and stage I silicone prosthesis implantation (SMALND) compared with routine MRM.

Methods

This was a retrospective study of patients who underwent MRM for breast cancer at the Shengjing Hospital Affiliated to China Medical University between January 1, 2019, and June 30, 2019. Surgical outcomes, complications, satisfaction, and quality of life (Functional Assessment of Cancer Therapy-Breast [FACT-B] [Chinese version]) were compared between the two groups.

Results

A total of 87 patients were enrolled, with 30 underwent SMALND and 57 underwent routine MRM. The intraoperative blood loss in the SMALND group was lower than in the control group (165.3±44.1 vs. 201.4±52.7 ml, P=0.001), the operation time was longer (220.5±23.9 vs. 155.6±9.2 min, P<0.001), daily axillary drainage volume was smaller (20.2±3.6 vs. 24.1±3.0 ml, P<0.001), daily subcutaneous drainage volume was smaller (15.5±2.3 vs. 19.3±3.5 ml, P<0.001), the discharge time was shorter (7.5±1.6 vs. 9.0±1.8 days, P<0.001), and FACT-B scores were higher (83.8±5.6 vs. 72.1±4.6, P<0.001). The overall satisfaction was higher in the SMALND group than in the controls (76.7% vs. 54.4%, P=0.041). Compared with the controls, the occurrence rates of nipple and flap necrosis, upper limb edema, and paraesthesia in the SMALND group were lower within 6 months (all P<0.05).

Conclusions

Compared with traditional MRM, SMALND had better surgical outcomes, higher satisfaction, higher quality of life, and lower complication rates.
Impact of frailty on 5-year survival in patients older than 70 years undergoing colorectal surgery for cancer
Authors: Artiles-Armas Manuel , Roque-Castellano Cristina , Fariña-Castro Roberto , Conde-Martel Alicia , Acosta-Mérida María Asunción , Marchena-Gómez Joaquín
Published: April 2021

Background

Frailty has been shown to be a good predictor of post-operative complications and death in patients undergoing gastrointestinal surgery. The aim of this study was to analyze the differences between frail and non-frail patients undergoing colorectal cancer surgery, as well as the impact of frailty on long-term survival in these patients.

Methods

A cohort of 149 patients aged 70 years and older who underwent elective surgery for colorectal cancer was followed-up for at least 5 years. The sample was divided into two groups: frail and non-frail patients. The Canadian Study of Health and Aging-Clinical Frailty Scale (CSHA-CFS) was used to detect frailty. The two groups were compared with regard to demographic data, comorbidities, functional and cognitive statuses, surgical risk, surgical variables, tumor extent, and post-operative outcomes, which were mortality at 30 days, 90 days, and 1 year after the procedure. Univariate and multivariate analyses were also performed to determine which of the predictive variables were related to 5-year survival.

Results

Out of the 149 patients, 96 (64.4%) were men and 53 (35.6%) were women, with a median age of 75 years (IQR 72–80). According to the CSHA-CFS scale, 59 (39.6%) patients were frail, and 90 (60.4%) patients were not frail. Frail patients were significantly older and had more impaired cognitive status, worse functional status, more comorbidities, more operative mortality, and more serious complications than non-frail patients. Comorbidities, as measured by the Charlson Comorbidity Index (p = 0.001); the Lawton-Brody Index (p = 0.011); failure to perform an anastomosis (p = 0.024); nodal involvement (p = 0.005); distant metastases (p < 0.001); high TNM stage (p = 0.004); and anastomosis dehiscence (p = 0.013) were significant univariate predictors of a poor prognosis on univariate analysis. Multivariate analysis of long-term survival, with adjustment for age, frailty, comorbidities and TNM stage, showed that comorbidities (p = 0.002; HR 1.30; 95% CI 1.10–1.54) and TNM stage (p = 0.014; HR 2.06; 95% CI 1.16–3.67) were the only independent risk factors for survival at 5 years.

Conclusions

Frailty is associated with poor short-term post-operative outcomes, but it does not seem to affect long-term survival in older patients with colorectal cancer. Instead, comorbidities and tumor stage are good predictors of long-term survival.
Accounting for all territorial emissions and sinks is important for development of climate mitigation policies
Authors: Lindroth Anders , Tranvik Lars
Published: April 2021

The Paris agreement identifies the importance of the conservation, or better, increase of the land carbon sink. In this respect, the mitigation policies of many forest rich countries rely heavily on products from forests as well as on the land sink. Here we demonstrate that Sweden’s land sink, which is critical in order to achieve zero net emissions by 2045 and negative emissions thereafter, is reduced to less than half when accounting for emissions from wetlands, lakes and running waters. This should have implications for the development of Sweden’s mitigation policy. National as well as the emerging global inventory of sources and sinks need to consider the entire territory to allow accurate guidance of future mitigation of climate change.
Healthcare governance during humanitarian responses: a survey of current practice among international humanitarian actors
Authors: Jarrett Prudence , Fozdar Yasin , Abdelmagid Nada , Checchi Francesco
Published: April 2021

Background

Large international humanitarian actors support and directly deliver health services for millions of people in crises annually, and wield considerable power to decide which health services to provide, how and to whom, across a vast spectrum of health areas. Despite decades of reform aiming to improve accountability in the sector, public health practice among humanitarian actors is not heavily scrutinized in either the countries where they are headquartered or those where they provide healthcare. We surveyed current healthcare governance practice among large international humanitarian actors to better understand what organisations are doing to ensure oversight and accountability for health services in humanitarian responses.

Methods

The term ‘healthcare governance’ was defined and categorised into seven domains: implementation of health management information systems (HMIS) and use of resulting data; professional development of health sector staff; audits of health service performance; management of clinical incidents; evidence-based practice; pharmaceutical supply; and beneficiary engagement. Senior health professionals at 32 leading international actors providing humanitarian health services were contacted between July and August 2019 to complete a 109-question online survey about their organisation’s practice in these domains.

Results

Respondents from 13 organisations completed the questionnaire. Healthcare governance practices were undertaken to varying degrees by all organisations but were often driven by donor requirements and external factors rather than improvement of programme performance. Common strengths were the inclusion of governance in organisational policies, high availability of technical guidelines, and close monitoring of pharmaceutical services. Recurring weaknesses were poor beneficiary engagement, inconsistent use of health information for decision making, unsystematic implementation of healthcare audits, inconsistent management of clinical incidents, and lack of training and professional development opportunities.

Conclusions

To our knowledge, this is the first study to describe healthcare governance practice among humanitarian actors. Leading international humanitarian healthcare providers are already implementing many healthcare governance activities; however, these are inconsistently applied and generally not reflective of systematic policies or earmarked organisational resources. There is a need for sector-wide consensus on how the humanitarian sector defines healthcare governance, the domains that constitute it, which actors in the humanitarian system are implicated, and how malpractice should be systematically addressed.
Dehydrodiisoeugenol inhibits colorectal cancer growth by endoplasmic reticulum stress-induced autophagic pathways
Authors: Li Changhong , Zhang Kui , Pan Guangzhao , Ji Haoyan , Li Chongyang , Wang Xiaowen , Hu Xin , Liu Ruochen , Deng Longfei , Wang Yi , Yang Liqun , Cui Hongjuan
Published: April 2021

Background

Dehydrodiisoeugenol (DEH), a novel lignan component extracted from nutmeg, which is the seed of Myristica fragrans Houtt, displays noticeable anti-inflammatory and anti-allergic effects in digestive system diseases. However, the mechanism of its anticancer activity in gastrointestinal cancer remains to be investigated.

Methods

In this study, the anticancer effect of DEH on human colorectal cancer and its underlying mechanism were evaluated. Assays including MTT, EdU, Plate clone formation, Soft agar, Flow cytometry, Electron microscopy, Immunofluorescence and Western blotting were used in vitro. The CDX and PDX tumor xenograft models were used in vivo.

Results

Our findings indicated that treatment with DEH arrested the cell cycle of colorectal cancer cells at the G1/S phase, leading to significant inhibition in cell growth. Moreover, DEH induced strong cellular autophagy, which could be inhibited through autophagic inhibitors, with a rction in the DEH-induced inhibition of cell growth in colorectal cancer cells. Further analysis indicated that DEH also induced endoplasmic reticulum (ER) stress and subsequently stimulated autophagy through the activation of PERK/eIF2α and IRE1α/XBP-1 s/CHOP pathways. Knockdown of PERK or IRE1α significantly decreased DEH-induced autophagy and retrieved cell viability in cells treated with DEH. Furthermore, DEH also exhibited significant anticancer activities in the CDX- and PDX-models.

Conclusions

Collectively, our studies strongly suggest that DEH might be a potential anticancer agent against colorectal cancer by activating ER stress-induced inhibition of autophagy.
New Horizons—Addressing Healthcare Disparities in Endocrine Disease: Bias, Science, and Patient Care
Authors: Chin Marshall H
Published: April 2021

Unacceptable healthcare disparities in endocrine disease have persisted for decades, and 2021 presents a difficult evolving environment. The COVID-19 pandemic has highlighted the gross structural inequities that drive health disparities, and antiracism demonstrations remind us that the struggle for human rights continues. Increased public awareness and discussion of disparities present an urgent opportunity to advance health equity. However, it is more complicated to change the behavior of individuals and reform systems because societies are polarized into different factions that increasingly believe, accept, and live different realities.

To reduce health disparities, clinicians must (1) truly commit to advancing health equity and intentionally act to reduce health disparities; (2) create a culture of equity by looking inwards for personal bias and outwards for the systemic biases built into their everyday work processes; (3) implement practical individual, organizational, and community interventions that address the root causes of the disparities; and (4) consider their roles in addressing social determinants of health and influencing healthcare payment policy to advance health equity.

To care for diverse populations in 2021, clinicians must have self-insight and true understanding of heterogeneous patients, knowledge of evidence-based interventions, ability to adapt messaging and approaches, and facility with systems change and advocacy. Advancing health equity requires both science and art; evidence-based roadmaps and stories that guide the journey to better outcomes, judgment that informs how to change the behavior of patients, providers, communities, organizations, and policymakers, and passion and a moral mission to serve humanity.
Separated Families and Epistolary Assistance
Authors: Roseau Katherine
Published: April 2021

This article focuses on clandestine letters between Jews in French internment camps and their loved ones. It offers an examination of these letters, which were hidden in packages or thrown from cattle cars on their way to Auschwitz. These letters are astonishingly abundant today largely thanks to three types of aid: creative self-help, mutual aid among internees, and aid from non-Jewish helpers. At the intersection of three areas of scholarship—the material letter, internment camps, and aid to Jews during the Holocaust—this article explores how internees could write with limited resources, send letters without using the official postal service, and participate in mutual aid inside the camps. The article argues that the internment-camp letter was at once the result of aid and itself an avenue of aid, parallel to the more organized humanitarian organizations.

Cet article porte sur la correspondance clandestine entre les Juifs dans les camps d'internement en France et leurs proches. Il présente une analyse de ces lettres que l'on a cachées dans des colis ou que l'on a jetées des wagons à bestiaux destinés à Auschwitz. Une correspondance d'une abondance étonnante existe aujourd'hui en grande partie grâce à trois types d'aide : la débrouillardise individuelle, l'entraide parmi les internés et l'aide des non-Juifs. A la croisée de trois champs de recherche (la matérialité de la lettre, les camps d'internement et l'aide aux Juifs pendant la Shoah), cet article explore comment les internés ont pu écrire avec un matériau limité, envoyer des lettres sans la poste, et s'entraider à l'intérieur des camps. L'article suggère que la lettre du camp d'internement soit à la fois le résultat et l'agent de cette aide, œuvrant en parallèle des organisations humanitaires plus officielles.
Les lettres d’admiratrices et admirateurs reçues par l’acteur René Navarre au début du vingtième siècle
Authors: Monnier Solène
Published: April 2021

Précis

Entre 1912 et 1939, l'acteur René Navarre, célèbre pour son rôle de Fantômas (1913–14), reçut un nombre important de lettres d'admiratrices et admirateurs. Ces derniers adoptent de multiples stratégies afin de tisser un lien plus fort que celui qui les maintient au statut d'adorateur auprès de leur idole. A la frontière de l'individuel et du social, la lettre offre de riches informations à celui qui s'y intéresse. Cet article s'efforce d'analyser certains de ces courriers en interrogeant les nombreuses formes de « distance »—spatio-temporelle, sociale, culturelle, émotionnelle—auxquelles ils se confrontent.

Between 1912 and 1939, actor René Navarre, a.k.a. Fantômas in the homonymous serial of 1913–14, received much fan mail from his many admirers. In their letters, Navarre's admirers adopted a variety of strategies to establish personalized connections with their idol, moving beyond mere worship. This article explores this surprising epistolary corpus, probing the boundary between public and private spheres to interrogate the many forms of “distance”—spatiotemporal, social, cultural, emotional—that these letters confronted.
Evidence, objectivity and welfare reform: a qualitative study of disability benefit assessments
Authors: Porter Tom , Pearson Charlotte , Watson Nick
Published: April 2021

Background:

Anti-welfare narratives depict welfare systems as overly-permissive, open to fraud, and fundamentally unfair. Countering these supposed ills have been political appeals to evidence and reforms made to disability benefit assessments under the banner of objectivity. But objectivity is a complex construct, which entails philosophical and political choices that tend to oppress, exclude and symbolically disqualify alternative perspectives.

Aims and objectives:

To examine reforms made to UK disability benefits assessments in the name of objectivity.

Methods:

Thematic analysis of 50 in-depth qualitative interviews with UK disability benefit claimants.

Findings:

Reforms made in pursuit of procedural objectivity reproduce existing social order, meaning claimants without personal, social and economic resources are less likely to succeed. Data reveal an increasingly detached and impersonal assessment process, set against a broader welfare landscape in which advocacy and support have been retrenched. In this context, attaining a valid and reliable assessment was, for many, contingent upon personal, social and economic resources.

Discussion and conclusions:

Political appeals to evidence helped establish an impetus and a legitimising logic for welfare reform. Procedural objectivity offers superficially plausible, but ultimately specious, remedies to longstanding anti-welfare tropes. Despite connotations of methodological neutrality, procedural objectivity is not a politically neutral epistemological standpoint. To know disability in a genuinely valid and reliable way, knowledge-making practices must respect dignity and proactively counter exclusory social order. These latter principles promise outcomes that are more trustworthy by virtue of their being more just.
Emotional warfare? Track two diplomacy and the emotionalisation of the Cold War
Authors: Matza Tomas
Published: April 2021

This article discusses a series of US citizen exchanges to the USSR that were termed track two, or citizen, diplomacy. The track two model was meant to address the freeze in high-level diplomatic engagements at a time of heightening tensions between rivals. Intriguingly, track two diplomacy was explicitly emotionalised – that is, linked to a psychologically informed approach to conflict resolution and contact. I focus on two sets of diplomatic delegations – those co-organised by the Esalen Institute and the Association for Humanistic Psychology, as well as grassroots citizen exchanges. Of particular interest is the famous visit by Carl Rogers to the USSR in 1986 where he held a set of workshops that were part of the AHP Soviet Exchange Project. I show the various central roles that discourses on emotions (psychological theories), emotional discourses (the expression of emotions) and emotion-evocation played in these US endeavours. What is particularly interesting to see is how, as the Cold War began to wane, the United States’ emotionalised exchanges became more unidirectional and interventionist in nature. I term this form of emotionalisation ‘emotional warfare’ and conclude that, as pedagogies, techniques and informal contacts, they should be read not only through the prism of friendly exchange, but also through those of geopolitical agonism, as well as the neoliberalisation of both empires in the post-Cold War period. In focusing on these exchanges in the 1980s, the article also makes a contribution to contemporary studies of emotion culture in the post-Soviet context by describing some of the prehistory of Russia’s ‘psychological turn’.
Virtual hematoxylin and eosin histopathology using simultaneous photoacoustic remote sensing and scattering microscopy
Authors: Restall Brendon S. , Haven Nathaniel J. M. , Kedarisetti Pradyumna , Martell Matthew T. , Cikaluk Brendyn D. , Silverman Sveta , Peiris Lashan , Deschenes Jean , Zemp Roger J.
Published: April 2021

Hematoxylin and eosin (H&E) staining is the gold standard for most histopathological diagnostics but requires lengthy processing times not suitable for point-of-care diagnosis. Here we demonstrate a 266-nm excitation ultraviolet photoacoustic remote sensing (UV-PARS) and 1310-nm microscopy system capable of virtual H&E 3D imaging of tissues. Virtual hematoxylin staining of nuclei is achieved with UV-PARS, while virtual eosin staining is achieved using the already implemented interrogation laser from UV-PARS for scattering contrast. We demonstrate the capabilities of this dual-contrast system for en-face planar and depth-resolved imaging of human tissue samples exhibiting high concordance with H&E staining procedures and confocal fluorescence microscopy. To our knowledge, this is the first microscopy approach capable of depth-resolved imaging of unstained thick tissues with virtual H&E contrast.