bluuebunny/crossref_metadata_2025 huggingface dataset:
Is There Even a Standard of Review at the icc?
Authors: Gray Kevin W.
Published: December 2020

Most practitioners of icl thought that that the Appeals Chamber employed three putatively distinct standards of review with respect to questions of facts, law, and the exercise of discretion: respectively correctness, reasonableness, and abuse of discretion. However, the Bemba Appeals Decision turned this all on its head. The Appeals Chamber found (by the narrowest 3–2 vote) that while correctness remained the standard of review with respect to errors of law, errors of fact would no longer be reviewed on a purely reasonableness standard. Although the Bemba decision provoked immediate outrage, this article argues that the jurisprudence of the icc was never clear on the standard of view – pace the view of many scholars. Analysing the decisions of the Appeals Chamber, it shows that the debate between correctness and reasonableness had never been fully resolved. It concludes with a proposal for how the court might simplify its approach.
Cinema-going at the Antwerp Zoo (1915–1936): A Cinema-concert Program Database
Authors: Engelen Leen , Crombez Thomas , Winkel Roel Vande
Published: December 2020

This paper outlines the genesis of the cinema-concert program database of the Belgian movie theatre Cinema Zoologie (1915–1936) deposited in the dans repository. First, it provides a detailed account of the historical sources and the data collection process. Second, it explains the structure of the database and the coding that was used to enter the data. Finally, the strengths and weaknesses of the database are discussed and its potential for future research is highlighted.
A tale of two genera: the revival of Hoplodoris (Nudibranchia: Discodorididae) with the description of new species of Hoplodoris and Asteronotus
Authors: DONOHOO SAMANTHA A. , GOSLINER TERRENCE M.
Published: December 2020

Nudibranchs in the family Discodorididae are generally medium (~30mm) to large (> 50mm) in size, sometimes cryptic, and are found in almost every marine ecosystem around the world. The diversity and systematics of the genera within Discodorididae are poorly understood and have led to numerous taxonomic changes. Hoplodoris Bergh, 1880 has recently been considered a synonym of Asteronotus Ehrenberg, 1831; however, morphological and molecular phylogenetic analyses reveal a distinct separation between these two genera. Here we provide a re-description of the type species Hoplodoris desmoparypha as well as descriptions of four undescribed species of Asteronotus and Hoplodoris. Bayesian inference and maximum likelihood analyses of two mitochondrial and two nuclear genes were used to evaluate the phylogenetic positions of the new species and clarify the relationships between Asteronotus and Hoplodoris to the rest of the Discodorididae. Based on our results, Hoplodoris is removed from synonymy with Asteronotus. Descriptions for Asteronotus markaensis sp. nov., and Asteronotus namuro sp. nov. from the Red Sea, as well as Hoplodoris balbon sp. nov. and Hoplodoris rosans sp. nov. from the western Pacific are provided.
Morphology of testate amoeba Difflugia australis (Playfair, 1918) Gautier-Lièvre et Thomas, 1958 from a subtropical reservoir (southeast China)
Authors: NDAYISHIMIYE JEAN CLAUDE , NYIRABUHORO PASCALINE , WANG WENPING , MAZEI YURI , YANG JUN
Published: December 2020

Difflugia australis, first described by Playfair (1918), has a unique morphotype. However, in the absence of morphometric data, it has not yet been reliably classified within the largest testate amoeba genus Difflugia. In this study D. australis collected from a subtropical reservoir in southeast China was investigated by means of light and scanning electron microscopy. Basing on biometrical data, we provide an improved diagnosis of this little known species. Difflugia australis is different from other similar congeners (i.e., D. bacillariarum Perty, 1849 and D. elegans Penard, 1890) mainly by the combination of the following features: the shell is broadly ovate, with rounded dome and convex sides converging down to a very short distance from the aperture and diverging suddenly into a short rim (collar). It is usually more or less asymmetrical, with one side being more dilated than the other. The shell surface is slightly smooth, composed of flat siliceous plates of irregular shape and size, mixed with fine grains; microbial spores of comparable forms are spread on the shell surface; particles are often interspersed with a network of organic cement with unique mesh pattern; one (sometimes two) slanting spine-like posterior end of the shell is variable in form; collar is mainly formed by small plates of equal size. The dimensions of the shell are: total shell length 88–106 µm; shell width 53–88 µm; aperture diameter 19–28 µm; collar height 3–6 µm; spine length 3‒23 μm. The size frequency distributions of both total shell length and shell width indicate that it is a size-monomorphic species with low variability.
Identifying Periods of Forecast Model Confidence for Improved Subseasonal Prediction of Precipitation
Authors: Richardson Doug , Black Amanda S. , Monselesan Didier P. , Moore II Thomas S. , Risbey James S. , Schepen Andrew , Squire Dougal T. , Tozer Carly R.
Published: December 2020

Subseasonal forecast skill is not homogeneous in time, and prior assessment of the likely forecast skill would be valuable for end-users. We propose a method for identifying periods of high forecast confidence using atmospheric circulation patterns, with an application to southern Australia precipitation. In particular, we use archetypal analysis to derive six patterns, called archetypes, of daily 500-hPa geopotential height (Z500) fields over Australia. We assign Z500 reanalysis fields to the closest-matching archetype and subsequently link the archetypes to precipitation for three key regions in the Australian agriculture and energy sectors: the Murray Basin, southwest Western Australia, and western Tasmania. Using a 20-yr hindcast dataset from the European Centre for Medium-Range Weather Forecasts subseasonal-to-seasonal prediction system, we identify periods of high confidence as when hindcast Z500 fields closely match an archetype according to a distance criterion. We compare the precipitation hindcast accuracy during these confident periods compared to normal. Considering all archetypes, we show that there is greater skill during confident periods for lead times of less than 10 days in the Murray Basin and western Tasmania, and for greater than 6 days in southwest Western Australia, although these conclusions are subject to substantial uncertainty. By breaking down the skill results for each archetype individually, we highlight how skill tends to be greater than normal for those archetypes associated with drier-than-average conditions.
Internal Tide Structure and Temporal Variability on the Reflective Continental Slope of Southeastern Tasmania
Authors: Marques Olavo B. , Alford Matthew H. , Pinkel Robert , MacKinnon Jennifer A. , Klymak Jody M. , Nash Jonathan D. , Waterhouse Amy F. , Kelly Samuel M. , Simmons Harper L. , Braznikov Dmitry
Published: December 2020

Mode-1 internal tides can propagate far away from their generation sites, but how and where their energy is dissipated is not well understood. One example is the semidiurnal internal tide generated south of New Zealand, which propagates over a thousand kilometers before impinging on the continental slope of Tasmania. In situ observations and model results from a recent process-study experiment are used to characterize the spatial and temporal variability of the internal tide on the southeastern Tasman slope, where previous studies have quantified large reflectivity. As expected, a standing wave pattern broadly explains the cross-slope and vertical structure of the observed internal tide. However, model and observations highlight several additional features of the internal tide on the continental slope. The standing wave pattern on the sloping bottom as well as small-scale bathymetric corrugations lead to bottom-enhanced tidal energy. Over the corrugations, larger tidal currents and isopycnal displacements are observed along the trough as opposed to the crest. Despite the long-range propagation of the internal tide, most of the variability in energy density on the slope is accounted by the spring–neap cycle. However, the timing of the semidiurnal spring tides is not consistent with a single remote wave and is instead explained by the complex interference between remote and local tides on the Tasman slope. These observations suggest that identifying the multiple waves in an interference pattern and their interaction with small-scale topography is an important step in modeling internal energy and dissipation.
Wave Anomaly Detection in Wave Measurements
Authors: Voermans Joey J. , Babanin Alexander V. , Kirezci Cagil , Carvalho Jonas T. , Santini Marcelo F. , Pavani Bruna F. , Pezzi Luciano P.
Published: December 2020

Quality control measures for ocean waves observations are necessary to give confidence of their accuracy. It is common practice to detect anomalies or outliers in surface displacement observations by applying a standard deviation threshold. Besides being a purely statistical method, this quality control procedure is likely to flag extreme wave events erroneously, thereby impacting higher-order descriptions of the wave field. In this paper we extend the use of the statistical phase-space threshold, an established outlier detection method in the field of turbulence, to detect anomalies in a wave record. We show that a wave record in phase space (here defined as a diagram of displacement against acceleration) can be enclosed by a predictable ellipse where the major and minor axes are defined by the spectral properties of the wave field. By using the parameterized ellipse in phase space as a threshold to identify wave anomalies, this is a semiphysical filtering method. Wave buoy data obtained from a mooring deployed near King George Island, Antarctica [as part of the Antarctic Modeling Observation System (ATMOS)], and laser altimeter data obtained at the Northwest Shelf of Australia were used to demonstrate the functioning of the filtering methodology in identifying wave anomalies. Synthetic data obtained using a high-order spectral model are used to identify how extreme waves are positioned in phase space.
Judaism and Catholicism: The Common Ground of Social Justice
Authors: Klug Brian
Published: December 2020

This article is about the relationship between Judaism and Catholicism. Rather than proceeding on the plane of theology – comparing Catholicism and Judaism in terms of their conceptions of the divine – the author approaches the subject ‘from the ground up’, considering their convergence at the level of social action. Taking his cue from Margaret Archer, who has spoken about ‘the Church as a social movement’, he presents Judaism in a similar light, drawing on resources within Judaism that conduce towards promoting human rights and social justice. Moreover, writing as a Jewish Fellow at a Catholic Oxford college (St Benet’s Hall), he recounts certain experiences that illustrate how Jews and Catholics can come together on common ground.
Comparison of Pregaming Alcohol Use and Consequences by Season Status and Sex in College Student Athletes
Authors: Williams Callon M. , Reynolds Linda M. , Mastroleo Nadine R.
Published: December 2020

As student athletes exhibit unique alcohol use patterns based on being in- versus out-of-season and biological sex, we aimed to explore student athlete ( N = 442) alcohol use, pregaming behaviors, and associated negative outcomes. Results suggest being out-of-season and male are positively associated with negative alcohol-related consequences, and male athletes report greater numbers of pregame specific alcohol-related consequences than female athletes ( p <  .05). Female athletes indicated significantly higher estimated blood alcohol concentrations than male athletes on pregaming nights. No differences emerged between in- and out-of-season athletes on pregame consequences. Results suggest that further emphasis on the role season status and sex has on pregaming behaviors and experiencing negative outcomes may be an important next step toward enhancing prevention and intervention approaches.
Molecular adsorbent recirculating system (MARS) and continuous veno-venous hemodiafiltration (CVVHDF) for diltiazem removal: An in vitro study
Authors: Fabresse Nicolas , Larabi Islam Amine , Lamy Elodie , Mégarbane Bruno , Alvarez Jean-Claude
Published: December 2020

The objective of the present study was to evaluate the efficacy of the molecular adsorbent recirculating system (MARS) vs continuous veno-venous hemodiafiltration (CVVHDF). Diltiazem poisoning was simulated in a central compartment consisting in a 5L dialysis solute spiked with diltiazem at two different toxic concentrations: 750 and 5000 µg/L. For CVVHDF, mean extraction coefficients (EC = (in concentration − out concentration)/in concentration) were concentration-dependent with a decrease all along the dialysis. At the end of the sessions the mean amounts remaining in the central compartment were 8% and 7% of the initial dose at 750 and 5000 µg/L, respectively. The mean cumulative amounts found in the effluent were 60% and 75% of the initial dose, respectively. The missing amounts accounted for 32% and 18% of the initial dose, respectively, corresponding to an adsorption to the dialysis membrane. In contrast, the different compartments of the MARS resulted in undetectable output concentration earlier that the end of the session. The mean concentrations of diltiazem remaining in the central compartment were <1 µg/L at the end of the sessions. Global ECs were around 50% all along the experiment at both concentrations, and the average charcoal cartridge ECs was 80% throughout the experiments.

CVVHDF system in the developed model was efficient for diltiazem removal, mainly by diffusion, convection and to a lesser extent by adsorption to the dialysis membrane. In MARS system, resin cartridge and hemodialysis components are ineffective, charcoal cartridge is responsible for almost all drug removal.
Predicting Posttraumatic Stress Disorder Among Survivors of Recent Interpersonal Violence
Authors: Morris Matthew C. , Sanchez-Sáez Francisco , Bailey Brooklynn , Hellman Natalie , Williams Amber , Schumacher Julie A. , Rao Uma
Published: December 2020

A substantial minority of women who experience interpersonal violence will develop posttraumatic stress disorder (PTSD). One critical challenge for preventing PTSD is predicting whose acute posttraumatic stress symptoms will worsen to a clinically significant degree. This 6-month longitudinal study adopted multilevel modeling and exploratory machine learning (ML) methods to predict PTSD onset in 58 young women, ages 18 to 30, who experienced an incident of physical and/or sexual assault in the three months prior to baseline assessment. Women completed baseline assessments of theory-driven cognitive and neurobiological predictors and interview-based measures of PTSD diagnostic status and symptom severity at 1-, 3-, and 6-month follow-ups. Higher levels of self-blame, generalized anxiety disorder severity, childhood trauma exposure, and impairment across multiple domains were associated with a pattern of high and stable posttraumatic stress symptom severity over time. Predictive performance for PTSD onset was similarly strong for a gradient boosting machine learning model including all predictors and a logistic regression model including only baseline posttraumatic stress symptom severity. The present findings provide directions for future work on PTSD prediction among interpersonal violence survivors that could enhance early risk detection and potentially inform targeted prevention programs.
Uneven Effects of Adverse Weather Conditions on Participation in Leisure-Time Physical Activities Across Income Levels
Authors: Shi Jingye , Wang Yuting
Published: December 2020

Purpose:

To examine how the effect of adverse weather on participation in leisure-time physical activities (LTPA) varies with income.

Design:

Cross-sectional study.

Subjects:

14,394 individuals from 56 Canadian cities, surveyed in 1992, 1998, and 2005.

Measures:

The adverseness level of daily weather is measured by the number of hours with precipitation or strong winds (wind speeds in excess of 38 km/hour) between 6 am and 11 pm.

Analysis:

Probit and multinomial logit models are used to examine the variation in weather-LTPA correlations across income levels.

Results:

At the mean income level, when the weather quality deteriorated from all-day nice weather to all-day adverse weather, the probability of participating in LTPA decreased by 24.54% (from 0.2424 to 0.1829, P < 0.01). As income increased by $10,000, the same deterioration in weather quality led to a 17.06% decrease in LTPA (from 0.2508 to 0.2080, P < 0.01). The smaller decrease is mainly because the $10,000 increase in income is associated with a 14.49% increase in indoor LTPA, which partly offsets the decrease in outdoor LTPA.

Conclusion:

Interventions and policies that increase indoor physical activity options, such as providing easier access to indoor facilities and offering subsidies for purchasing or renting home exercise equipment, are promising for effectively promoting LTPA, especially for individuals in lower-income groups or from regions that frequently experience adverse weather.
Gender-Based Violence, Twin Pandemic to COVID-19
Authors: Dlamini Nobuhle Judy
Published: December 2020

The COVID-19 pandemic exposed and exacerbated existing inequalities within countries and across geographies. It reminded us how the world and its people are interconnected. Gender-based violence (GBV), which is an expression of gender inequality and toxic masculinity, is another pandemic that exists in all societies at varying degrees of prevalence and severity.1 It requires the same effort and attention that governments globally have given to COVID-19. With half the world under lockdown as governments’ response to COVID-19, GBV increased significantly (UN Women, 2020a). The increase was a reminder of the need to have contingent mitigating mechanism to protect the marginalized, women and girls, against a co-existing pandemic, GBV. The intersection of marginalization and discrimination made certain groups of women more susceptible to GBV and COVID-19 pandemics. These intersecting social identities of vulnerability need equal attention in order to eradicate inequality (Simonovic, 2020).
Expansive soil-biochar-root-water-bacteria interaction: Investigation on crack development, water management and plant growth in green infrastructure
Authors: Wang Hao , Zhang Kexin , Gan Lin , Liu Jiaqin , Mei Guoxiong
Published: December 2020

The objectives of the study are to explore fundamental mechanism of expansive soil-biochar-root-water-bacteria interaction, and investigate crack development and hydraulic properties of biochar amended soils aiming at green infrastructures. The physical, chemical and biological effects of biochar on expansive soil have been comprehensively explored. Crack development is investigated quantificationally, and mechanism of soil damage evolution is briefly discussed base on micro-chemical analyses. During outdoor vegetation period, photosynthesis light response curves were measured to evaluate plant growth. After period of vegetation, hydraulic properties of root-soil composites and unplanted soils were compared. The study reveals that soil crack intensity factor decreases by 33.5%, 48.5% and 47.3% due to 5%, 10% and 15% biochar introduction respectively after 5 wetting-drying cycles. 15% biochar amendment helps to restrain both initiation and propagation of soil cracks. Biochar amendment of up to 5% contributes well to residual water content and plant growth (i.e., light saturation point and light compensation point). Excessive biochar addition would restrain roots elongation, and increase saturated water content. Spatial root distribution is changed due to biochar addition, which further influences hydraulic properties and crack development. Hydraulic conductivity and soil dry density share negative correlations, 5% biochar enhances hydraulic conductivity remarkably at relatively loose condition. Biochar amendment also contributes to preventing nitrogen loss and forming more complex bacterial community in soils. The study adds to our knowledge of physio-chemical interactions of biochar with expansive clay, vegetation, water and microorganism.
After Marriage: The Assimilation, Representation, and Diversification of LGBTQ Lives on Irish Television
Authors: Kerrigan Páraic
Published: December 2020

Since Ireland’s 2015 Marriage Equality referendum, emerging trends, variances and understandings of LGBTQ identities have begun to emerge on Irish television. At the crux of this post-marriage equality queer visibility lies a friction between the assimilation of queerness to an acceptable homonormative alternative to monogamous heteronormativity versus broader representations of indeterminate variety and fluidity. In exploring the dynamic between assimilation and representation, the article makes a two-pronged argument. On the one hand, post-marriage equality television becomes a site of containment, performing a regulatory function configuring queer visibility through a homonormative paradigm, reflecting the mainstreaming evident in the marriage equality campaign. On the other, post-marriage equality Irish television has enabled cultural scripts to emerge pertaining to the challenges still remaining for the gay community in response to more intersectional, complex understandings of diverse LGBTQ experiences.
The Subconscious Effect of Subtle Media Bias on Perceptions of Terrorism
Authors: Feick Lukas , Donnay Karsten , McCabe Katherine T.
Published: December 2020

Media outlets strategically frame news about violent events using sensationalist labels such as “terrorist” or “Islamist” but also more subtle wording choices that affect the overall article tone. We argue theoretically and show empirically using a conjoint experiment that, contrary to existing studies, the effect of these two framing devices on readers’ perceptions of terrorist events should be carefully separated. Even though article tone transports no factual information, in our experiment negative and sensational wording choices carried a greater impact on threat perceptions than the explicit “terrorist” and “Islamist” labels. In a realistic news article setting, which varied other salient context cues such as proximity or event size, subtle shifts in article tone still subconsciously influenced threat perceptions. This highlights the potential dangers of media coverage fueling otherwise unjustified fears by injecting unnecessary editorial tone.
Brand-Evoked Mental Imagery: The Role of Brands in Eliciting Mental Imagery
Authors: Gavilan Diana , Avello Maria
Published: December 2020

This research provides evidence of the role played by a brand in the stimulation of mental imagery. We anticipate that a familiar (vs. unfamiliar) brand will evoke higher levels of visual mental imagery in the consumer. In addition, if the consumer exhibits favorability toward the brand, the visual mental imagery evoked will be enhanced. Therefore, we provide evidence of the moderating role of brand favorability in the relationship between brand familiarity and visual mental imagery. Our findings suggest that brands are evocative and are able to enhance (or reduce) information processing and, thus, the generation of visual mental images that we name “brand-evoked mental imagery.” The results contribute to the literature on branding and mental imagery and have several practical implications for marketers.
Unusual type of scleromyxedema with multiple subcutaneous nodules, IgM-λ paraproteinemia, and scleroderma-like microangiopathy
Authors: Awaji Kentaro , Asano Yoshihide , Takaoka Mariko , Oka Tomonori , Miyake Tomomi , Suga Hiraku , Sato Shinichi
Published: December 2020

Scleromyxedema is a mysterious cutaneous mucinosis of unknown etiology. Various types of scleromyxedema variant have been reported, which often give us a clue to understand the key aspects of this disease. Here, we describe a woman with highly unusual type of scleromyxedema. In addition to the rare manifestations of multiple subcutaneous nodules and IgM-λ paraproteinemia, our patient showed several characteristic symptoms of scleroderma such as shortened nails and fingertips, sclerodactyly, and bone resorption of fingertips and mandibles as a result of peripheral circulatory insufficiency, although this disease is known to be pathophysiologically different from scleroderma. A skin biopsy revealed cutaneous microvascular stenosis and occlusion due to intravascular mucin deposition and fibrotic changes, suggesting that scleromyxedema potentially develops peripheral circulatory disorders and other vascular involvement. The subcutaneous nodules were responsive to high-dose intravenous immunoglobulin. Scleromyxedema can represent a wide variety of systemic involvement, and therefore, we should pay attention to those symptoms as well as skin lesions.
Correction of Severe Frontal Bossing with Coronal Brow Lift and Osteoplastic Frontal Sinus Setback Aided by Virtual Surgical Planning: A Case Report
Authors: Kumbla Pallavi A. , Thorburn Ashley Q. , de la Torre Jorge I. , Myers René P.
Published: December 2020

Objective:

An 18 year old male with a hypoplastic midface, low anterior hairline, heavy brows and marked frontal bossing presented for evaluation. Laboratory evaluation for acromegaly was negative. He did have impairment of his bilateral visual fields as confirmed by visual field testing by ophthalmology. His nasal radix was also of particular concern to him as it formed a significantly depressed crease between his nasal bridge and his brow. He requested surgical correction of these deformities from both a functional and aesthetic standpoint.

Methods:

We performed thin-cut CT maxillofacial scanning with 3D reformats and submitted this for virtual surgical planning (VSP). We were able to create a template with which to remove the anterior table of the frontal sinus safely, confidently, and without the aid of a craniotomy. The operation was performed through a preexisting bicoronal incision. The anterior table of the frontal sinus was removed in one piece. His forehead and superior orbits were contoured with a burr. After contouring, the anterior table was fixated in a more recessed position. Nasal radix augmentation was also performed using bone grafting. A coronal brow lift was then performed.

Results:

The patient’s post-operative course was uneventful. He noted marked improvement in his superior visual fields. He had complete resolution of his nasal radix deformity and his frontal bossing. This was confirmed by thin-cut CT maxillofacial scanning postoperatively. His frontal branches were functionally intact and his hairline was raised to a more appropriate position.

Conclusions:

Virtual surgical planning allowed us to perform an osteoplastic forehead reduction safely and without older methods such as Caldwell x-rays with coin reference, transillumination, or the bayonet forcep technique. It also allowed us to avoid the use of surgical navigation which can be time consuming and cumbersome. This VSP-based access to the frontal sinus has applications in many aspects of reconstructive cranial surgery as well as aesthetic forehead reductions for patients that do not require a craniotomy.
Impact of a financial incentive on the completion of educational metrics
Authors: Pugh Andrew , Ford Tabitha , Madsen Troy , Carlson Christine , Doyle Gerard , Stephen Robert , Stroud Susan , Fix Megan
Published: December 2020

Background

The Accreditation Council for Graduate Medical Education (ACGME) requires all emergency medicine (EM) training programs to evaluate resident performance and also requires core faculty to attend didactic conference. Assuring faculty participation in these activities can be challenging. Previously, our institution did not have a formal tracking program nor financial incentive for participation in these activities. In 2017, we initiated an educational dashboard which tracked and published all full-time university faculty conference attendance and participation in resident evaluations and other educational activities.

Objectives

We sought to determine if the implementation of a financially-incentivized educational dashboard would lead to an increase in faculty conference attendance and the number of completed resident evaluations.

Methods

We conducted a pre- and post-intervention observational study at our EM residency training program between July 2017 and July 2019. Participants were 17 full-time EM attendings at one training site. We compared the number of completed online resident evaluations (MedHub) and number of conference days attended (call-in verification) before and after the introduction of our financial incentive in June 2018. The incentive required 100% completion of resident evaluations and at least 25% attendance at eligible didactic conference days. We calculated pre- and post-intervention averages, and comparisons were made using a chi-square test.

Results

Prior to implementation of the intervention, the 90-day resident evaluation completion rate was 71.8%. This increased to 100% after implementation (p < 0.001). Conference attendance prior to implementation was 43.8%, which remained unchanged at 41.3% after implementation of the financial incentive (p = 0.920).

Conclusions

Attaching a financial incentive to a tracked educational dashboard increased faculty participation in resident evaluations but did not change conference attendance. This difference likely reflects the minimum thresholds required to obtain the financial incentive.
Differential distribution of manifest lesions in diabetic retinopathy by fundus fluorescein angiography and fundus photography
Authors: Li Xiaoli , Xie Jie , Zhang Liang , Cui Ying , Zhang Guanrong , Wang Jun , Zhang Aiping , Chen Xiangting , Huang Tian , Meng Qianli
Published: December 2020

Background

To analyze the distribution of manifest lesions of diabetic retinopathy (DR) by fundus fluorescein angiography (FFA) and color fundus photography (FP).

Methods

A total of 566 eyes of 324 Chinese patients diagnosed with DR were included in this retrospective study. DR severity was graded by the international grading criterion. The distributions of microaneurysms (MA), intraretinal hemorrhages/exudates (He/Ex), intraretinal microvascular abnormality (IRMA), capillary nonperfusion areas (NPA), and neovascularization (NV) were estimated by multiple logistic regression analyse based on nine-field FFA and FP images.

Results

In mild nonproliferative diabetic retinopathy (NPDR), the highest frequency of MA was found in the posterior pole (67.7%), followed by the inferior nasal (59.4%), and the nasal (55.4%) fields. In moderate NPDR, MA frequently distributed in the posterior pole (98.0%), nasal (97.0%), superior (96.0%), inferior nasal (94.9%), and inferior (92.9%) fields, whereas He/Ex were most prevalent in the posterior pole (69.7%). In severe NPDR and proliferative DR, IRMA, NPA, and NV were more frequent in the nasal field, particularly in the inferior nasal field (60.3, 38.7, and 76.0%, respectively). All lesions were more observed in the combined posterior pole, nasal, and inferior nasal fields than in the posterior pole or combined two fields in the early and severe stages of DR (P < 0.05).

Conclusions

The manifest lesions of DR were common in the nasal field besides the posterior pole in Chinese patients. A combined examination of the posterior pole, nasal, and inferior nasal mid-peripheral retina would help to detect different retinal lesions of DR.

Trial registration

ClinicalTrial. gov, NCT03528720. Registered 18 May 2018 - Retrospectively registered.
Thrombocytopenia and thrombosis in hospitalized patients with COVID-19
Authors: Mei Heng , Luo Lili , Hu Yu
Published: December 2020

As our understanding on coronavirus disease 2019 (COVID-19) deepens, it is increasingly recognized that COVID-19 is more than a respiratory condition. Thrombocytopenia and thromboembolic complications are a composite factor associated with critical COVID-19 and increased mortality. Immune-inflammation-mediated destruction, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection per se and increased consumption are proposed to be responsible for thrombocytopenia. Multiple concomitant conditions or results caused by SARS-CoV-2 infection are high risk factors for thrombosis. Recently, platelet activation and platelet-mediated immune inflammation induced by SARS-CoV-2 infection were also found to be the contributors to the thrombosis in COVID-19 patients. In addition to thrombus scoring system, D-dimer is an excellent indicator for monitoring thrombosis. COVID-19 patients with high risk for thrombosis should be subjected to early thromboprophylaxis, and prolonged activated partial-thromboplastin time should not be a barrier to the use of anticoagulation therapies in the control of thrombosis in COVID-19 patients.
Should ice application be replaced with neurocryostimulation for the treatment of acute lateral ankle sprains? A randomized clinical trial
Authors: Tittley Jean , Hébert Luc J. , Roy Jean‐Sébastien
Published: December 2020

Study design

Single‐blind parallel group randomized clinical trial.

Objectives

To compare the effects of neurocryostimulation (NCS) with those of traditional ice application on functional recovery, pain, edema and ankle dorsiflexion range of motion (ROM) in individuals receiving physiotherapy treatments for acute lateral ankle sprains (LAS).

Background

Ankle sprain is a very common injury and its management is often costly, with important short‐ and long‐term impacts on individuals and society. As new methods of therapy using cold (cryotherapy) are emerging for the treatment of musculoskeletal conditions, little evidence exists to support their use. NCS, which provokes a rapid cooling of the skin with the liberation of pressured CO2, is a method believed to accelerate the resorption of edema and recovery in the case of traumatic injuries.

Methods

Forty‐one participants with acute LAS were randomly assigned either to a group that received in‐clinic physiotherapy treatments and NCS (experimental NCS group, n = 20), or to a group that received the same in‐clinic physiotherapy treatments and traditional ice application (comparison ice group, n = 21). Primary (Lower Extremity Functional Scale ‐ LEFS) and secondary (visual analog scale for pain intensity at rest and during usual activities in the last 48 h, Figure of Eight measurement of edema, and weight bearing lunge for ankle dorsiflexion range of motion) outcomes were evaluated at baseline (T0), after one week (T1), two weeks (T2), four weeks (T4) and finally, after six weeks (T6). The effects of interventions were assessed using two‐way ANOVA‐type Nonparametric Analysis for Longitudinal Data (nparLD).

Results

No significant group‐time interaction or group effect was observed for all outcomes (0.995 ≥ p ≥ 0.057) following the intervention. Large time effects were however observed for all outcomes (p <  0.0001).

Conclusion

Results suggest that neurocryostimulation is no more effective than traditional ice application in improving functional recovery, pain, edema, and ankle dorsiflexion ROM during the first six weeks of physiotherapy treatments in individuals with acute LAS.

Level of evidence

Therapy, level 1b.

Trial registration

ClinicalTrials.gov, NCT02945618. Registered 23 October 2016 ‐ Retrospectively registered (25 participants recruited prior to registration, 17 participants after).
Circ6401, a novel circular RNA, is implicated in repair of the damaged endometrium by Wharton’s jelly-derived mesenchymal stem cells through regulation of the miR-29b-1-5p/RAP1B axis
Authors: Shi Qin , Sun Baolan , Wang Di , Zhu Yi , Zhao Xinxin , Yang Xiaoqing , Zhang Yuquan
Published: December 2020

Background

Accumulating evidence indicates that mesenchymal stem cells (MSCs) exert tissue repair effects and therapeutic angiogenesis through their noncoding RNAs (ncRNAs). Our previous studies showed that MSCs derived from Wharton’s jelly (WJ-MSCs) can ameliorate damaged human endometrium by promoting angiogenesis. There is limited information on the functions and mechanism of ncRNAs in MSC-induced endometrial repair, and additional studies are needed for more insights.

Methods

Here, WJ-MSCs were cocultured with or without endometrial stromal cells (ESCs) damaged by mifepristone (cocultured group versus non-cocultured group). TUNEL staining assays, EdU proliferation assays, flow cytometry apoptosis assays, and western blot assays were performed to observe the reparative effect of WJ-MSCs on damaged ESCs. Subsequently, circular RNA (circRNA) and microRNA microarrays were performed between the two groups. A subset of top upregulated circRNAs was validated by qRT-PCR. The functions of circ6401 (hsa_circ_0006401) in WJ-MSCs were investigated using lentivirus-mediated circRNA overexpression assays. The subcellular localization of circ6401 and miR-29b-1-5p in WJ-MSCs was identified by double RNA fluorescence in situ hybridization. Dual-luciferase reporter assays and western blot assays were performed to elucidate the regulatory mechanisms among circ6401, miR-29b-1-5p, and RAP1B.

Results

WJ-MSCs significantly improved ESC proliferation and upregulated the expression of vascular angiogenesis markers. Circ6401 was upregulated in WJ-MSCs cocultured with damaged ESCs, while miR-29b-1-5p was significantly downregulated. Furthermore, circ6401 was found to bind to miR-29b-1-5p and prevent it from decreasing the level of RAP1B, a crucial protein involved in the VEGF signaling pathway, which promoted angiogenesis and stimulated the proliferation of ESCs.

Conclusions

Our results showed the abundance and regulation profiles of ncRNAs of WJ-MSCs during repair of damaged ESCs and, for the first time, clarified the underlying mechanism by which circ6401 promotes endometrial repair by WJ-MSCs; thus, demonstrating that circ6401 may serve as a potential therapeutic target.
Effects of corn steep liquor on β-poly(l-malic acid) production in Aureobasidium melanogenum
Authors: Wang Genan , Shi Bingyi , Zhang Pan , Zhao Tingbin , Yin Haisong , Qiao Changsheng
Published: December 2020

β-poly(l-malic acid) (PMLA) is a water-soluble biopolymer used in medicine, food, and other industries. However, the low level of PMLA biosynthesis in microorganisms limits its further application in the biotechnological industry. In this study, corn steep liquor (CSL), which processes high nutritional value and low-cost characteristics, was selected as a growth factor to increase the PMLA production in strain, Aureobasidium melanogenum, and its metabolomics change under the CSL addition was investigated. The results indicated that, with 3 g/L CSL, PMLA production, cell growth, and yield (Yp/x) were increased by 32.76%, 41.82%, and 47.43%, respectively. The intracellular metabolites of A. melanogenum, such as amino acids, organic acids, and key intermediates in the TCA cycle, increased after the addition of CSL, and the enrichment analysis showed that tyrosine may play a major role in the PMLA biosynthesis. The results presented in this study demonstrated that the addition of CSL would be an efficient approach to improve PMLA production.
Neighborhood variation in unsolved homicides: a retrospective cohort study in Indianapolis, Indiana, 2007–2017
Authors: Magee Lauren A. , Fortenberry J. Dennis , Tu Wanzhu , Wiehe Sarah E.
Published: December 2020

Background

Homicide is a widely acknowledged public health problem in the United States. The majority of homicides are committed with a firearm and have long-term health consequences for family members and entire communities. When left unsolved, violence may be perpetuated due to the retaliatory nature of homicides. Improving homicide clearance rates may help prevent future violence, however, we know little about the community-level social dynamics associated with unsolved homicides.

Methods

This study examines the individual-and-community-level social processes associated with low homicide clearance rates in Indianapolis, Indiana between 2007 and 2017. Homicide clearance is the primary outcome, defined as if a perpetrator was arrested for that homicide case between 2007 and 2017. Individual-level variables include the victim’s race/ethnicity, sex, and age. Community-level (i.e., census tracts) variables include the number of resident complaints against the police, resident complains of community disorder, income inequality, number of police interactions, and proportion of African American residents.

Results

In Indianapolis over a 11-year period, the homicide clearance rate decreased to a low of 38% in 2017, compared to a national clearance rate of 60%. Homicide case clearance was less likely for minority (OR 0.566; 95% CI, 0.407–0.787;p < 0.01) and male (OR 0.576; 95% CI, 0.411–0.807;p < 0.01) victims. Resident complaints of community disorder were associated with a decreased odds of case clearance (OR 0.687; 95% CI, 0.485–0.973;p < .01)., African American victim’s cases were less likely to be cleared in 2014–2017 (OR 0.640; 95% CI, 0.437–0.938;p < 0.05), compared to 2007.

Conclusions

Our study identified differences in neighborhood social processes associated with homicide clearance, indicating existing measures on these community factors are complex. Programs aimed at improving signs of community disorder and building community engagement may improve neighborhood clearance rates, lower violence, and improve the health of these communities.
Hepatitis C: milestones from discovery to clinical cure
Authors: Hu Wei , Zhang Chao , Shi Ji-Jing , Zhang Ji-Yuan , Wang Fu-Sheng
Published: December 2020

On October 5th, 2020, Drs. Harvey J. Alter, Michael Houghton and Charles M. Rice were rewarded with Nobel Prize in Physiology or Medicine for “the discovery of hepatitis C virus (HCV)”. During the past 50 years, remarkable achievements have been made in treatment of HCV infection: it has changed from being a life-threatening chronic disease to being curable. In this commentary, we briefly summarized the milestone events in the “scientific journey” from the first report of non-A, non-B hepatitis and discovery of the pathogen (HCV) to final identification of efficacious direct-acting antivirals. Further, we address the challenges and unmet issues in this field.
Successful conversion surgery of distal pancreatectomy with celiac axis resection (DP-CAR) with double arterial reconstruction using saphenous vein grafting for locally advanced pancreatic cancer: a case report
Authors: Murase Yoshiki , Ban Daisuke , Maekawa Aya , Watanabe Shuichi , Ishikawa Yoshiya , Akahoshi Keiichi , Ogawa Kosuke , Ono Hiroaki , Kudo Atsushi , Kudo Toshifumi , Tanaka Shinji , Tanabe Minoru
Published: December 2020

Background

Pancreatic cancer is a disease with a poor prognosis, requiring multidisciplinary treatment combining chemotherapy and surgery for effective management. Distal pancreatectomy with celiac axis resection (DP-CAR) is a surgical intervention performed for locally advanced pancreatic cancer, but the benefit of arterial reconstruction in DP-CAR is unclear.

Case presentation

A 49-year-old man with pancreatic cancer was referred to our hospital. Imaging revealed a 54-mm tumor mainly in the pancreatic body, but with arterial infiltration including into the celiac, common hepatic, left gastric, splenic and gastroduodenal arteries. Distant metastases were not detected. The patient was diagnosed with unresectable locally advanced pancreatic cancer and chemoradiotherapy was planned. Three cycles of gemcitabine (1000 mg/m2) plus nab-paclitaxel (125 mg/m2) every 4 weeks were followed by irradiation (2 Gy/day, total 50 Gy over 25 days) together with S-1 administration (80 mg/m2/day). A partial response (PR) according to Response Evaluation Criteria in Solid Tumors (RECIST) was achieved, so surgical intervention was considered. Because the tumor had invaded the root of the gastroduodenal artery, we performed DP-CAR with resection of the gastroduodenal artery, followed by arterial reconstruction of the proper hepatic and left gastric arteries, anastomosed with the abdominal aorta using a great saphenous vein graft in the shape of a “Y”. Histopathology showed that 60% of tumor cells were destroyed by the chemoradiotherapy, defined as grade IIb in the Evans classification. No malignancy was detected at the surgical margin, including the celiac artery, gastroduodenal artery or pancreatic stump; thus R0 surgery was successful. S-1 (80 mg/day) was administered as adjuvant chemotherapy for 6 months. The patient is now doing well without recurrence for > 2 years after the initial treatment (more than 16 months after surgery).

Conclusion

For locally advanced pancreatic cancer, multidisciplinary treatment combining gemcitabine/nab-paclitaxel-based chemoradiotherapy and then DP-CAR surgery with gastroduodenal artery resection and arterial reconstruction using saphenous vein grafting enabled R0 resection in this patient and led to a favorable long-term prognosis.
Lung cancer screening by low-dose computed tomography: a cost-effectiveness analysis of alternative programmes in the UK using a newly developed natural history-based economic model
Authors: Griffin Edward , Hyde Chris , Long Linda , Varley-Campbell Jo , Coelho Helen , Robinson Sophie , Snowsill Tristan
Published: December 2020

Background

A systematic review of economic evaluations for lung cancer identified no economic models of the UK setting based on disease natural history. We first sought to develop a new model of natural history for population screening, then sought to explore the cost-effectiveness of multiple alternative potential programmes.

Methods

An individual patient model (ENaBL) was constructed in MS Excel® and calibrated against data from the US National Lung Screening Trial. Costs were taken from the UK Lung Cancer Screening Trial and took the perspective of the NHS and PSS. Simulants were current or former smokers aged between 55 and 80 years and so at a higher risk of lung cancer relative to the general population. Subgroups were defined by further restricting age and risk of lung cancer as predicted by patient self-questionnaire. Programme designs were single, triple, annual and biennial arrangements of LDCT screens, thereby examining number and interval length. Forty-eight distinct screening strategies were compared to the current practice of no screening. The primary outcome was incremental cost-effectiveness of strategies (additional cost per QALY gained).

Results

LDCT screening is predicted to bring forward the stage distribution at diagnosis and reduce lung cancer mortality, with decreases versus no screening ranging from 4.2 to 7.7% depending on screen frequency. Overall healthcare costs are predicted to increase; treatment cost savings from earlier detection are outweighed by the costs of over-diagnosis. Single-screen programmes for people 55–75 or 60–75 years with ≥ 3% predicted lung cancer risk may be cost-effective at the £30,000 per QALY threshold (respective ICERs of £28,784 and £28,169 per QALY gained). Annual and biennial screening programmes were not predicted to be cost-effective at any cost-effectiveness threshold.

Limitations

LDCT performance was unaffected by lung cancer type, stage or location and the impact of a national screening programme of smoking behaviour was not included.

Conclusion

Lung cancer screening may not be cost-effective at the threshold of £20,000 per QALY commonly used in the UK but may be cost-effective at the higher threshold of £30,000 per QALY.