bluuebunny/crossref_metadata_2025 huggingface dataset:
Why a dedicated section on keratoconus in the European Journal of Ophthalmology?
Authors: Barbara Adel , Barbara Ramez , Barua Ankur , Alio Jorge , Bandello Francesco
Published: June 2021

Keratoconus is emerging as a new subspecialty in ophthalmology. The literature is booming with publications on the topic as we have better understanding of the pathophysiology, treatment and prognosis of the disease over the past two decades. Advances in diagnostic tools as well as genuine increase in prevalence have shifted perspective of the disease from being a rare one. Early diagnosis is of public health interest as early treatment arrests progression. With the view to encourage research, increase awareness and to reflect the evolution of knowledge related to keratoconus, the European Journal of Ophthalmology has dedicate a special section on keratoconus in its journal.
Safety of intravitreal triamcinolone and its impact on optic nerve morphology in patients treated for diabetic macular edema
Authors: Carreira Ana Rita , Marques Nadine , Carreira Pedro , Moraes Filipe , Loureiro Tomás , Telles Freitas Paula , Cardoso João , Campos Nuno
Published: June 2021

Purpose:

To assess the impact of one intravitreal injection (IVT) of Triamcinolone Acetonide (TA) on intraocular pressure (IOP) and optic nerve structural parameters in patients treated for Diabetic Macular Edema (DME).

Methods:

This retrospective study included patients with DME that were naïve to intraocular steroids and underwent one IVT of TA of 4 mg/0.1 mL and age-matched controls with DME without criteria for IVT. Patients records were reviewed for IOP (at baseline and a month after IVT) and optic nerve parameters measured by optical coherence tomography (up to 6 months before and 6 months after IVT). Exclusion criteria included glaucoma and treatment with hypotensive agents.

Results:

Twenty-six eyes were included in the Control Group and 29 in the IVT Group, with a mean age of 65.10 ± 10.08 and 67.30 ± 4.71 years, respectively ( p = 0.06). At baseline, IOP and optic nerve measurements were equivalent between groups ( p > 0.05). One month after IVT, mean IOP measurements in IVT Group were higher than those of controls (17.84 ± 4.50 vs 11.59 ± 3.09 mmHg, p < 0.001). Ocular hypertension (OHT) developed in 17.24% of cases and reversed with topical medication. After one IVT, vertical cup/disc ratio was higher (0.57 ± 0.25 vs 0.60 ± 0.14, p = 0.04) and retinal nerve fiber layer thickness was globally lower (mean: 91.03 ± 4.25 vs 81.33 ± 19.10 µm, p = 0.001) in the IVT Group.

Conclusion:

Our results confirmed that intravitreal TA results in IOP increase. This seems to negatively affect optic nerve morphology, even in patients without OHT or adequately treated with hypotensive agents.
Working Conditions and Health Risk Assessment in Hair Salons
Authors: Senthong Pattama , Wittayasilp Sivasit
Published: June 2021

Objective:The aim of this study was to assess the chemical and physical work conditions in hair salons and to analyze health risk of exposure to VOCs for the hairdressers of hair salons. Methods: This study was carried out at 4 selected hair salons close to universities in Surat Thani province, Thailand. VOCs were collected by area sampling using charcoal tubes (9 samples per salon). The air samples were analyzed using GC/FID. The noise levels, illumination, and temperature were measured by using sound level meter, lux meter, and WBGT, respectively. Results: Toluene, cyclohexanone, xylene, and hexane were the most frequently found across the hair salons. All of the VOCs concentration was highest in the mixing area. All of hair salons had cancer risk exceeding 1 × 10−6 and HI > 1.0, indicating that indoor air pollution may affect hairdresser’s health. The average VOCs concentrations after installation of local exhaust ventilation and open the door for 30 minutes before closing the hair salon, was significantly lower than before and after installation of the local exhaust ventilation. The WBGT indoors varied within 22 to 28°C, sound pressure levels within 71 to 76 dBA, and illumination within 70 to 400 lux. The noise levels and temperature in the hair salons were satisfactory on the scale of the Ministry of Labor (Thailand). Conclusions:Installing and using proper ventilation in hair salon are recommended to eliminate health effects. Hairdresser worked in poor lighting that should be improved to appropriate levels (>1000 lux).
Successful Outcomes of Critically Ill Patients with Extreme Metabolic Acidosis Treated with Structured Approach: Case Series
Authors: Dragic Sasa , Momcicevic Danica , Zlojutro Biljana , Jandric Milka , Kovacevic Tijana , Djajic Vlado , Gajic Ognjen , Kovacevic Pedja
Published: June 2021

Introduction:

Hydrogen ion concentration which is expressed as pH value is in human blood maintained in narrow physiological range (7.36-7.44 in arterial blood). This range is crucial for normal functioning of most biochemical reactions. Extreme acidosis with pH < 6.8 is incompatible with life, unless pathophysiologic process is rapidly reversed. Timely, standardized, and structured approach to assessment and management of extreme critical illness is essential to maximize the chances of patient’s survival.

Cases:

We present a series of 3 critically ill patients admitted to Medical intensive care unit (MICU) diagnosed with extreme metabolic acidosis (pH ⩽ 6.8). Each patient was treated using Checklist for Early Recognition and Treatment of Acute Illness and INjury (CERTAIN) which is a standard decision support tool in our MICU. Causes of extreme metabolic acidosis included hemorrhagic shock, sepsis, and acute renal failure and diabetic ketoacidosis. Rapid assessment, prompt resuscitation (IV fluids, vasopressors, mechanical ventilation, and renal replacement), and application of specific causal treatment led to positive outcomes in all 3 patients.

Discussion:

Medical physiology textbooks set the lower limit of pH value at which life is possible to 6.8. However, examples from clinical practice show that if adequate resuscitation measures are taken early in the acute phase of the disease, the biochemical cascade of reactions that are considered irreversible (at pH ⩽ 6.8) may be reversed after all.

Conclusion:

Critical care approach to extreme metabolic acidosis is a prime example of applied clinical physiology where basic science and clinical practice connect. With these case series we show that timely and structured approach to critical illness shifts the boundaries of reversibility for some of the most severe physiologic derangements.
European outbound tourism expansion on the islands of Cape Verde
Authors: González-Gómez Manuel
Published: June 2021

The main objective of this article is to shed light on the determinants of international tourism demand expansion in Cape Verde. The research involves cointegration analysis to test the existence of a long-term equilibrium relationship between the variables included in tourism demand using the autoregressive distributed lag bounds testing approach. The results showed high income elasticity and price inelastic demand. Moreover, turmoil in traditional tourist destinations in non-European Mediterranean basin countries, coupled with the investments of tour operators and hotel groups who are key players in the European source markets, significantly and positively affected international tourism demand. Supply side changes associated with foreign investment were necessary to increase the number of tourists. Finally, lower level of income in European countries following the financial crisis of 2008 might have favored the shift of European tourists from more expensive destinations to Cape Verde. The concentration of tourism, economic growth, jobs creation, and population growth on two islands may have affected island communities, resources, and other aspects of inter- and intraisland relationships.
Ms. Categorized: Gender, notability, and inequality on Wikipedia
Authors: Tripodi Francesca
Published: June 2021

Gender is one of the most pervasive and insidious forms of inequality. For example, English-language Wikipedia contains more than 1.5 million biographies about notable writers, inventors, and academics, but less than 19% of these biographies are about women. To try and improve these statistics, activists host “edit-a-thons” to increase the visibility of notable women. While this strategy helps create several biographies previously inexistent, it fails to address a more inconspicuous form of gender exclusion. Drawing on ethnographic observations, interviews, and quantitative analysis of web-scraped metadata, this article demonstrates that biographies about women who meet Wikipedia’s criteria for inclusion are more frequently considered non-notable and nominated for deletion compared to men’s biographies. This disproportionate rate is another dimension of gender inequality previously unexplored by social scientists and provides broader insights into how women’s achievements are (under)valued.
Remix’s retreat? Content moderation, copyright law and mashup music
Authors: Brøvig-Hanssen Ragnhild , Jones Ellis
Published: June 2021

Many online media platforms currently utilise algorithmically driven content moderation to prevent copyright infringement. This article explores content moderation’s effect on mashup music – a form of remix which relies primarily on the unauthorised combining of pre-existing, recognisable recordings. Drawing on interviews ( n = 30) and an online survey ( n = 92) with mashup producers, we show that content moderation affects producers’ creative decisions and distribution strategies, and has a strong negative effect on their overall motivation to create mashups. The objections that producers hold to this state of affairs often strongly resonate with current copyright exceptions. However, we argue that these exceptions, which form a legal ‘grey zone’, are currently unsatisfactorily accommodated for by platforms. Platforms’ political-economic power allows them, in effect, to ‘occupy’ and control this zone. Consequently, the practical efficacy of copyright law’s exceptions in this setting is significantly reduced.
Exploring the learning potential of online gaming communities: An application of the Game Communities of Inquiry Scale
Authors: Gandolfi Enrico , Ferdig Richard E , Soyturk Ilker
Published: June 2021

Online gaming is becoming increasingly social and interconnected. Millions of players learn from each other in game-related communities on platforms like Reddit and Twitch.tv. However, few studies have been conducted to examine socially constructed learning in such environments. The purpose of this study was to explore learning in game-related communities using the Game Community of Inquiry Scale (GCoIS). GCoIS is a validated instrument inspired by the community of inquiry framework and developed for measuring constructed learning in these outlets. Over 1000 participants completed an online questionnaire that included the GCoIS and additional variables (e.g. demographics, gaming habits, and gaming metacognition) for measuring possible associations. Results pointed to gender, age, online participation, and metacognition about gaming as significant predictors of GCoIS. Findings suggest that gaming communities can serve as opportunities for meaningful learning when novice members are welcomed and assisted by experts and support is given to older and female gamers.
Facing the music: Stereotyping of and by women in US music journalism
Authors: Whipple Kelsey , Coleman Renita
Published: June 2021

This study updates and expands the application of stereotyping and professional socialization to music journalism in a way that is generalizable to the United States music journalism industry, and seeks to understand the role women journalists play in counteracting or perpetuating stereotyping of women musicians. A content analysis of 936 articles finds significant stereotyping of women musicians in major US music publications during 2016. The stories, randomly sampled from eight top US publications, were predominantly about men artists and by men authors, and were more likely to discuss women musicians’ appearance and relationships, and used more sexualized and emotional language. Improvement was found in that articles were no more likely to discuss women musicians’ age and youth than men’s. Women journalists were just as likely to stereotype women musicians as men journalists were, and more so in one category. We expand stereotyping by incorporating insights from professional socialization and applying it to the ‘soft news’ yet male-dominated field of music journalism, adding to our knowledge of hard news fields such as politics, business and sports. It also updates the few studies of music journalism from decades ago, showing little progress in the blatant stereotyping of women musicians
Experiencing multimodal rhetoric and argumentation in political advertisements: a study of how people respond to the rhetoric of multimodal communication
Authors: Kjeldsen Jens , Hess Aaron
Published: June 2021

Research into visual and multimodal rhetoric has been dominated by social scientific and textual perspectives that may not be able to provide documented understandings of how rhetorical objects are actually experienced by an audience. In this study, the authors engage in rhetorical protocol analysis through 10 in-depth interviews asking informants to make sense of selected political advertisements in the 2020 US election campaign. They examine the types of competing sensory elements found within the campaign texts and situations, which they term ‘multimodal incongruity’ and establish two types of cognitive frameworks informants use when engaging in the political rhetoric of the commercials: personal experience and cynicism. Personal experience allowed the informants to make sense of and argue against campaign messages. Cynicism often guided participants to unpack the generic conventions of political advertising, politics more generally, and opposing partisan strategies. Both interpretive frames – but the frame of cynicism, in particular – enable participants to critically distance their reading of and emotional response to the campaign commercials. This critical distancing reveals connections between rationality and emotionality through ‘deliberative embedding’, meaning that the emotional is understood in terms of and negotiated in relation to already established cognitive frameworks of information, opinions and cynical readings of the genre. The authors conclude the essay by reflecting on their methodological and theoretical insights regarding multimodal rhetoric.
Rationale and design of the randomised controlled cross-over trial: Cardiovascular effects of empaglifozin in diabetes mellitus
Authors: Thirunavukarasu Sharmaine , Brown Louise AE , Chowdhary Amrit , Jex Nicholas , Swoboda Peter , Greenwood John P , Plein Sven , Levelt Eylem
Published: June 2021

Background:

Type 2 diabetes (T2D) is associated with an increased risk of cardiovascular (CV) disease. In patients with T2D and established CV disease, selective inhibitors of sodium–glucose cotransporter 2 (SGLT2) have been shown to decrease CV and all-cause mortality, and heart failure (HF) admissions. Utilising CV magnetic resonance imaging (CMR) and continuous glucose monitoring (CGM) by FreeStyle Libre Pro Sensor, we aim to explore the mechanisms of action which give Empagliflozin, an SGLT2 inhibitor, its beneficial CV effects and compare these to the effects of dipeptidyl peptidase-4 inhibitor Sitagliptin.

Methods:

This is a single centre, open-label, cross-over trial conducted at the Leeds Teaching Hospitals NHS Trust. Participants are randomised for the order of treatment and receive 3 months therapy with Empagliflozin, and 3 months therapy with Sitagliptin sequentially. Twenty-eight eligible T2D patients with established ischaemic heart disease will be recruited. Patients undergo serial CMR scans on three visits.

Discussion:

The primary outcome measure is the myocardial perfusion reserve in remote myocardium. We hypothesise that Empaglifozin treatment is associated with improvements in myocardial blood flow and reductions in myocardial interstitial fibrosis, independent of CGM measured glycemic control in patients with T2D and established CV disease.

Trial registration:

This study has full research ethics committee approval (REC: 18/YH/0190) and data collection is anticipated to finish in December 2021. This study was retrospectively registered at https://doi.org/10.1186/ISRCTN82391603 and monitored by the University of Leeds. The study results will be submitted for publication within 6 months of completion.
Recruitment and Entrapment Pathways of Minors into Sex Trafficking in Canada and the United States: A Systematic Review
Authors: Baird Kyla , Connolly Jennifer
Published: June 2021

The domestic sex trafficking of minors is occurring across Canada and the United States. Understanding the routes into sex trafficking, including the way traffickers target, recruit and enmesh youth in the sex trade is invaluable information for service providers and law makers developing prevention and intervention initiatives. This review synthesized research on the exploitation processes and tactics employed by traffickers in the sex trafficking of domestic minors in Canada and the US. The authors comprehensively and systematically searched five electronic databases and obtained additional publications and grey literature through a backward search of the references cited in articles reviewed for inclusion.  Inclusionary criteria included: Studies published in the English language between January 1990 and June 2020 containing original research with quantitative or qualitative data on the recruitment or pathways into sex trafficking for minors trafficked within the US and Canada. The search yielded 23 eligible studies. The synthesis of the studies in the review converged on the notion of sexual exploitation occurring on a continuum comprising of three components; the recruitment context, entrapment strategies utilized by traffickers, and enmeshment tactics used to prolong exploitation. Findings highlight the significant physical, psychological and emotional hurdles faced by youth victims of sex trafficking and point to the importance of comprehensive and holistic approaches to prevention and intervention practices.
Extending the Kitagawa–Oaxaca–Blinder decomposition approach to panel data
Authors: Kröger Hannes , Hartmann Jörg
Published: June 2021

The Kitagawa–Oaxaca–Blinder decomposition approach has been widely used to attribute group-level differences in an outcome to differences in endowment, coefficients, and their interactions. The method has been implemented for Stata in the popular oaxaca command for cross-sectional analyses. In recent decades, however, research questions have been more often focused on the decomposition of group-based differences in change over time, for example, diverging income trajectories, as well as decomposition of change in differences between groups, for example, change in the gender pay gap over time. We review five existing methods for the decomposition of changes in group means and contribute an extension that takes an interventionist perspective suitable for applications with a clear before–after comparison.

These decompositions of levels and changes over time can be implemented using the xtoaxaca command, which works as a postestimation command for different regression commands in Stata. It is built to maximize flexibility in modeling and implements all decomposition techniques presented in this article.
Optimizing fire allocation in a Network Centric Warfare-type model
Authors: Nguyen Nam H , Vu My A , Ta Anh N , Bui Dinh V , Hy Manh D
Published: June 2021

In this paper, we introduce a non-linear Lanchester’s model of Network Centric Warfare type and investigate an optimization problem for this model, where only the Red force is supplied by several supply agents. Optimal fire allocation of the Blue force is sought in the form of a piece-wise constant function of time. A “threatening rate” is computed for the Red force and each of its supply agents at the beginning of each stage of the combat. These rates can be used to derive the optimal decision for the Blue force to focus its firepower to the Red force itself or one of its supply agents. This optimal fire allocation is derived and proved by considering an optimization problem of the number of Blue force troops. Numerical experiments are included to demonstrate the theoretical results.
Calculation and evaluation of industrial carbon footprint of cotton denim jacket
Authors: Cheng Yu , Liang Hui-e
Published: June 2021

Carbon footprint (CFP) reflects the greenhouse gases (GHGs) produced by human activities or products throughout the life cycle, which is an important tool for assessing and managing greenhouse gas pollution. The reduction of Carbon footprint is an important topic today, and each of us needs to minimize our CFP in order to protect our planet. In this paper, the basic cotton denim jackets was played an research object roles to exploring the impact on the environment during the process of producing cotton denim jackets. Which based on the theory of industrial carbon footprint and combing with the production process chain of denim jackets, setting the accounting boundaries and functional units, the denim jacket can be divided into cutting, sewing, and finishing the three links in industrial production of carbon footprint. With the calculation and analyzation industrial carbon footprint of the denim jacket. The results show that the carbon footprint of denim jackets exceeds 1000 kg CO2 during the cycle from cutting to sewing and finishing. The largest carbon footprint is generated in the sewing process, which are about twice as high as the cutting process. The carbon footprint emissions of each piece of denim jacket is 1.75 kg CO2. Therefore, optimizing the production line in the sewing process, adopting high energy-efficient processing equipment and clean energy can better reduce the industrial carbon footprint of denim clothing. It also provided reference and basis for the supervision and evaluation of carbon emission by clothing manufacturers
Life cycle analysis for green composites: A review of literature including considerations for local and global agricultural use
Authors: Ead Ahmed Samir , Appel Raelynn , Alex Nibin , Ayranci Cagri , Carey Jason P
Published: June 2021

Increasing concerns regarding human-driven effects on the biosphere have led to the development and adoption of environmentally friendly “green” composites. Unlike conventional synthetic composites, green composites are made of natural materials in either the matrix or the fiber reinforcement (or both). They are claimed to have lower negative environmental effects due to their sustainability and easier recyclability. To assess the environmental impacts associated with any product, a life cycle assessment (LCA) is needed. This literature review summarizes the individual steps undertaken in an LCA study and discusses their relevance within the field of green composites. Similarly, an outline of life cycle costing (LCC), a type of study which determines the economic implications of a product, is incorporated. Since some phases of a product’s life cycle can have significant environmental effects, parameters affecting the time-dependant degradation of green composites and their significance in LCA studies were also explored. Finally, criteria for choosing natural fibers and biopolymers for green composites in engineering applications were considered, and case studies of hemp and flax as candidates for fiber cultivation in Alberta, Canada are provided throughout.
Collaborative Study of Thresholds for Mutagens: Hormetic Responses in Cell Proliferation Tests Using Human and Murine Lymphoid Cells
Authors: Sutou Shizuyo , Koeda Akiko , Komatsu Kana , Shiragiku Toshiyuki , Seki Hiroshi , Kudo Toshiyuki ,   The Collaborative Study Group of Thresholds for Mutagens
Published: June 2021

Background:

We previously showed that hormetic responses can be established in cell activity tests using human and murine adherent cells. This time, we examined whether hormetic responses can be established in cell proliferation tests using suspended human and murine lymphoid cells.

Methods:

Human lymphoblastoid cells (TK6) and mouse lymphoma cells (L5178Y) were cultured in multi-well culture plates and treated with mitomycin C, ethyl methansulfonate, hygromycin B, aclarubicin or colchicine at various dose levels and the number of cells was measured at varied times using a flow cytometer.

Results:

When the ratio of the number of cells treated with a test chemical to those in the negative control was plotted, the dose-response relationship typically showed a reverse U-shaped curve, indicating the occurrence of hormesis and existence of thresholds in cell toxicity. The hormetic responses depended largely on the test chemical, dose level and exposure time. When examining responses over the course of time, a J-shaped or fallen S-shaped curve was also observed.

Conclusions:

The dose-response relationship showed a reverse U-shaped curve, a hallmark of hormesis, at least some time points for all chemicals tested here, indicating that chemical hormesis can be established in in vitro cell proliferation tests.
Constructing global missionary families: Absence, memory, and belonging before World War I
Authors: Maß Sandra
Published: June 2021

The separation of parents and children was a quite common imperial family constellation before World War I. Many children left the respective colonial or mission territories at the beginning of their seventh year. They were sent to their parents’ regions of origin in Europe to spend their childhood and youth in the households of relatives or in missionary boarding schools specially set up for them. This article examines German-speaking missionary families in the imperial context of the late nineteenth and early twentieth centuries and focuses on letter communications between parents and children as an expression of family construction at a distance. I will mainly focus on two families (Kaundinya, Nommensen) in order to examine from a micro-historical perspective, the construction of missionary families in a transimperial framework. Rooted in the pietistic milieu of German-speaking missionaries from the Basel Mission and the Rhenish Mission, these families enable us to compare the results of imperial and missionary family historiography, which has developed over the last 20 years within the British context, with empirical material from other national and imperial contexts.
Visual detection of tobacco packaging film based on apparent features
Authors: Jin Zhenxun , Zhong Fengyan , Zhang Qiang , Wang Weisong , Wang Xuanyin
Published: June 2021

The main purpose of this article is to study the detection of transparent film on the surface of tobacco packs. Tobacco production line needs an industrial robot to remove the transparent film in the process of unpacking. Therefore, after the industrial robot removes the transparent film, it is necessary to use machine vision technology to determine whether there is transparent film residue on the surface of tobacco packaging. In this article, based on the study of the optical features of semitransparent objects, an algorithm for detecting the residue of transparent film in tobacco packs based on surface features is proposed. According to the difference of surface features between tobacco and film, a probability distribution model considering highlights, saturation, and texture density is designed. Because the probability distribution model integrates many features of tobacco and film, it is more reasonable to distinguish the tobacco film regions. In this article, an appropriate foreground box with a trapezoidal mask and image segmentation algorithm GrabCut is used to segment the foreground area of tobacco pack more accurately, and the possible film area is obtained by image differential and morphological processing. Finally, on the basis of comparing the effect of various machine learning algorithms on the image classification of possible film regions, support vector machine based on color features is used to judge the possible film region. Application results of the system show that the method proposed in this article can effectively detect whether there is film residue on the surface of tobacco pack.
Enhancing foreign language teacher candidates’ oral proficiency: An international comparison
Authors: Kissau Scott , Davin Kristin J , Wang Chuang , Haudeck Helga
Published: June 2021

Despite the importance of advanced language proficiency when teaching a foreign language, little research has investigated the oral proficiency of aspiring foreign language teachers across multiple countries and what their teacher training programs do to enhance it. In response, the researchers collected and analyzed both quantitative and qualitative data from foreign language teacher candidates in Germany, China, and the United States. Results suggested that oral proficiency varies significantly both within individual teacher training programs and across nations. The teacher candidates from Germany demonstrated significantly greater oral proficiency in the target language than their Chinese counterparts, who in turn, demonstrated significantly greater oral proficiency than the US teacher candidates. Helping to explain these findings, the data suggested that foreign language teacher training programs have differing areas of focus. While the programs in Germany and China focused more attention on language development, the US program emphasized pedagogical skills. Implications for practice are discussed.
Emotion in business communication: A comparative study of attitude markers in the discourse of U.S. and mainland Chinese corporations
Authors: Lee William Wai Lam
Published: June 2021

Expressing emotion is considered essential in the U.S. business communication tradition; however, its importance is uncertain beyond the U.S., and more specifically, in Chinese business contexts. This study explores emotion in U.S. and Chinese business communication through the analyses of attitude markers in the shareholders’ letters of U.S. and mainland Chinese corporations. The analyses reveal that while emotion is embedded in the discourse of companies from both cultural models, its expression is more frequent and intense in the U.S. texts. The observed dissimilarities are discussed in terms of underlying sociocultural factors. Implications arise for the teaching and learning of business communication which are still largely defined by U.S. approaches. With the rising prominence of mainland Chinese corporations worldwide, the findings provide strong evidence for students and professionals to understand Chinese as well as U.S. rhetorical styles in business communication in order to be better prepared for the global business environment.
Tracing the politics of aesthetics: From imposing, via counter to affirmative memorials to violence
Authors: Buckley-Zistel Susanne
Published: June 2021

Memorials have become increasingly relevant in societies seeking to come to terms with the past of mass violence and there is a growing body of academic scholarship that scrutinises the politics of memory in divided societies. This article takes a different approach to the politics of memorials: it does not focus on what is remembered, that is, to what a memorial testifies, but how memory at a memorial (supposedly) takes place through the aesthetic strategies put to work. It contributes to emerging literature which explores aspects of performativity and the politics of affect. The objective is, however, to take it one step further by not only shifting attention to studying the engagement with, experience and performance at these sites but also to the politics of the aesthetics choice that promote this engagement. To do so, it differentiates between three aesthetic styles of memorials: imposing, counter and affirmative memorials that were all developed at a particular time in order to pursue particular political and social objectives. The current phenomenon, affirmative memorials, holds that there is a duty to remember and is firmly embedded in efforts to build peace, advance liberal norms and contribute to transitional justice. Pursuing this strategy is however at odds with the aesthetic style of these affirmative memorials that is derived from counter memorials and celebrates plurality and openness rather than wanting to affirm one message.
Medical treatment of pouchitis: a guide for the clinician
Authors: Rabbenou Wendy , Chang Shannon
Published: June 2021

Pouchitis is the most common complication in patients who have undergone restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). Up to 81% of IPAA patients experience pouchitis, with 40% of patients presenting within the first year of surgery. Common risk factors include genetic mutations, extensive colitis, rheumatologic disorders, and primary sclerosing cholangitis. Currently, there are no medications with approved indications for pouchitis. As such, the conventional treatment of pouchitis is entirely off-label. This paper is intended to be a practical and up-to-date review of available therapies used for the management of pouchitis. The mainstay of treatment for acute pouchitis remains antibiotics, but newer therapeutics have also shown promise in the treatment of chronic pouchitis. Common lifestyle considerations that may play a role in pouchitis are also reviewed.

Plain language summary

Medical treatment of pouchitis: a guide for the clinician The ileal pouch-anal anastomosis (“pouch”) is the most common way patients who require surgery to remove their colon are able to avoid a permanent ileostomy (“ostomy”). This pouch, created from the small intestines, serves as a reservoir to hold stool. The most common complication after pouch surgery is pouchitis. Pouchitis symptoms include more frequent bowel movements, urgency to defecate, blood in the stool, incontinence, and abdominal pain. This paper is intended to be a practical review of available therapies including medications and lifestyle changes that can be considered for the management of acute pouchitis, chronic pouchitis, and cuffitis.
Switching from Infliximab Originator to SB2 Biosimilar in Inflammatory Bowel Diseases: A Multicentric Prospective Real-Life Study
Authors: Massimi Davide , Barberio Brigida , Bertani Lorenzo , Costa Francesco , Ferronato Antonio , Facchin Sonia , Cardin Romilda , Cingolani Linda , Casadei Cesare , D’Incà Renata , Zingone Fabiana , Savarino Edoardo Vincenzo
Published: June 2021

Background:

Current literature still lacks studies evaluating the effectiveness and safety of switching from Infliximab originator to SB2 biosimilar in Inflammatory Bowel Diseases (IBDs). We aimed to verify the ability of SB2 to maintain the clinical and biochemical response induced by originator after switching. As secondary outcome, we aimed to verify safety, tolerability and immunogenicity of SB2 biosimilar compared with its IFX originator.

Methods:

We prospectively enrolled all patients who switched from originator to SB2 at three Italian IBD Units from August 2018 to April 2020. We collected clinical and biochemical data at the time of switch (T0), and at the first (T1) and the second (T2) visits after switching (mean time from switching: 135 and 329 days, respectively). In addition, data regarding therapeutic drug monitoring at T0 and T1 were recorded.

Results:

Eighty-five IBD patients (28 with Ulcerative Colitis and 57 with Crohn’s Disease) were included in the study. At T1, we observed statistically significant modifications in clinical activity of disease (70 patients were in clinical remission at baseline and 60 at T1 p = 0.02), but not at T2 (p = 0.3). Fecal calprotectin values were not different both at T1 and T2 (both p = 0.9) as well as the rate of concomitant treatment with steroids (p = 0.2 and p = 0.1) or immunosuppressants (p = 0.1 and p = 1.0). Moreover, the need for therapeutic optimization from T0 to T1 and from T1 to T2 was found significant (both p = 0.01). No anti-drug antibodies were identified at T1, and no serious adverse events were recorded.

Conclusions:

Overall, our data show that most of the patients switching from Infliximab originator to SB2 maintain the clinical and biochemical remission for at least 1 year. Further data are necessary to understand the clinical implications of these findings in the long term.
HbA1c trajectory and cardiovascular outcomes: an analysis of data from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study
Authors: Wang Jun-Sing , Liu Wei-Ju , Lee Chia-Lin
Published: June 2021

Background:

We investigated the associations between glycated hemoglobin (HbA1c) trajectories and cardiovascular outcomes using data from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study.

Methods:

We used HbA1c values within the first 2 years of treatment for modeling with a latent class growth model. Groups of HbA1c trajectories were modeled separately in the standard (group 1–group 4) and intensive (group 5–group 8) treatment arms. The primary outcome in the ACCORD study was a composite of non-fatal myocardial infarction, non-fatal stroke, or death from cardiovascular causes. Effects of HbA1c trajectories on cardiovascular outcomes were analyzed using a Cox-proportional hazard model.

Results:

Baseline HbA1c levels for the eight trajectories (group 1–group 8) were 7.8 ± 0.8, 8.2 ± 0.9, 9.3 ± 1.1, 9.6 ± 1.2, 7.8 ± 0.7, 10.1 ± 0.8, 8.3 ± 0.7, and 9.5 ± 1.1%, respectively. The respective values after 2 years of treatment were 7.0 ± 0.6, 7.7 ± 0.7, 8.5 ± 0.9, 10.3 ± 1.3, 6.2 ± 0.4, 6.5 ± 0.6, 7.2 ± 0.6, and 8.5 ± 1.1%. After a median follow-up of 4.8 years, group 5 and group 6 had similar outcomes compared with group 1 (reference group). In contrast, group 3, group 4, and group 8 had higher risks of the primary composite outcome compared with group 1.

Conclusion:

HbA1c trajectory was associated with cardiovascular outcomes in type 2 diabetes patients with high cardiovascular risk.
Aberrant cerebral blood flow in tinnitus patients with migraine: a perfusion functional MRI study
Authors: Xu Zhen-Gui , Xu Jin-Jing , Chen Yu-Chen , Hu Jinghua , Wu Yuanqing , Xue Yuan
Published: June 2021

Purpose

Migraine is often accompanied with chronic tinnitus that will affect the cerebral blood flow (CBF) and exacerbate the tinnitus distress. However, the potential relationship between migraine and tinnitus remains unclear. This study will investigate whether aberrant CBF patterns exist in migraine patients with tinnitus and examine the influence of migraine on CBF alterations in chronic tinnitus.

Materials and methods

Participants included chronic tinnitus patients (n = 45) and non-tinnitus controls (n = 50), matched for age, sex, education, and hearing thresholds. CBF images were collected and analyzed using arterial spin labeling (ASL) perfusion functional magnetic resonance imaging (fMRI). Regions with major CBF differences between tinnitus patients and non-tinnitus controls were first detected. The effects of migraine on tinnitus for CBF alterations were further examined. Correlation analyses illustrated the association between CBF values and tinnitus severity as well as between CBF and severity of migraine.

Results

Compared with non-tinnitus controls, chronic tinnitus patients without migraine exhibited decreased CBF, primarily in right superior temporal gyrus (STG), bilateral middle frontal gyrus (MFG), and left superior frontal gyrus (SFG); decreased CBF in these regions was correlated with tinnitus distress. There was a significant effect of migraine on tinnitus for CBF in right STG and MFG. Moreover, the severity of migraine correlated negatively with CBF in tinnitus patients.

Conclusions

Chronic tinnitus patients exhibited reduced CBF in the auditory and prefrontal cortex. Migraine may facilitate a CBF decrease in the setting of tinnitus, which may underlie the neuropathological mechanisms of chronic tinnitus comorbid with migraine.
The effectiveness of preliminary traction in the treatment of congenital dislocation of the hip
Authors: Farsetti Pasquale , Efremov Kristian , Caterini Alessandro , Marsiolo Martina , De Maio Fernando , Ippolito Ernesto
Published: June 2021

Background

Historical papers on the treatment of congenital dislocation of the hip suggest the use of preliminary traction to facilitate closed reduction or to decrease the risk of avascular necrosis (AVN) of the femoral head. In the 1980s, some authors questioned the role of preliminary traction and suspended its use, yielding satisfactory results. Since then, several studies called into question this method, and some authors have continued to recommend preliminary traction while other authors have discouraged its use.

Materials and methods

We reanalysed the full set of radiographs of 71 hips (52 patients) surgically treated by a medial approach after 4 weeks of preoperative longitudinal traction. The mean age at operation was 16 months. Before and after traction, the height of the dislocation was graded according to the Gage and Winter method. The hips were divided into two groups: group 1, in which the traction was effective, and group 2, in which the traction was not effective. These two groups were statistically analysed regarding the severity of the dislocation, the age of the patient at surgery and the incidence of AVN.

Results

Preliminary traction was effective in 48 hips (68%, group 1), while it was not effective in the remaining 23 (32%, group 2). The effectiveness of preliminary traction was statistically related to the height of the dislocation and to the age of the patient at surgery, with traction being less effective in more severe dislocations and in older children. The incidence of AVN was statistically lower in group 1 than in group 2.

Conclusions

In our study population, despite not having a control group, preliminary traction—when effective—seemed to reduce the incidence of AVN in patients surgically treated for congenital dislocation of the hip. The effectiveness of the traction was influenced by the severity of the dislocation and the age of the patient; it worked better for less severe dislocations and in younger children. To reduce hospital costs, traction should be applied at home.

Level of evidence

3.
RAZOR trial: analysis of 3-year follow-up: an era of robotic radical cystectomy: is it a new beginning?
Authors: Ranjan Satish Kumar
Published: June 2021

RAZOR (Randomized Open versus Robotic Cystectomy) trial is a phase 3 randomized control trial comparing robot-assisted laparoscopic radical cystectomy with open radical cystectomy for the treatment of bladder cancer published by Parekh et.al. Three-year follow-up analysis of this trial showed that there was no difference in overall survival, progression-free survival, and local or distant recurrence in both the group. The present report will discuss this landmark trial in brief in the context of the advantage and feasibility of robotic radical cystectomy in the developing world.
Isolated renal hydatid disease: varied presentations, treatments, dilemmas, and the way ahead: case report series
Authors: Misra Ankit , Mandal Swarnendu , Das Manoj , Mishra Pritinanda , Mitra Suvradeep , Nayak Prasant
Published: June 2021

Background

Hydatid disease is an infectious disease that affects several organs. Isolated renal involvement is very rare. The treatment for renal hydatid cyst ranges from minimally invasive percutaneous aspiration techniques to laparoscopic and open techniques. We describe five cases of isolated renal hydatidosis with varied presentations who were treated successfully by various methods.

Case presentation

The presenting symptoms included flank pain (n = 5), mass abdomen (n = 2), and hydaturia (n = 1). In 4 patients, the diagnosis of a hydatid cyst was known preoperatively, but one patient with a preoperative diagnosis of a simple cyst was found to harbor hydatidosis intra-operatively. Eosinophilia as a marker for the active disease was present in 60% (3/5), while echinococcal serology was positive in only 25% (1/4). Two cases were approached laparoscopically, while three required an open approach. Two patients were treated with nephrectomy due to the high bulk of the disease, while the other three underwent renal preserving cyst excision.

Conclusions

The presence of eosinophilia in the preoperative workup may indicate an infective/active hydatid disease. Echinococcal serology is representative of past hydatid infection but cannot reveal about current disease status. Cysts with varied attenuations and residence in an endemic region may support a renal hydatid cyst diagnosis. A holistic approach including clinical history, laboratory parameters, and imaging is needed for diagnosis. Surgical treatment requires cyst excision, along with precautions to prevent spilling. Nephrectomy may be preferred in cases with minimal residual function.
StrongestPath: a Cytoscape application for protein–protein interaction analysis
Authors: Mousavian Zaynab , Khodabandeh Mehran , Sharifi-Zarchi Ali , Nadafian Alireza , Mahmoudi Alireza
Published: June 2021

Background

StrongestPath is a Cytoscape 3 application that enables the analysis of interactions between two proteins or groups of proteins in a collection of protein–protein interaction (PPI) network or signaling network databases. When there are different levels of confidence over the interactions, the application is able to process them and identify the cascade of interactions with the highest total confidence score. Given a set of proteins, StrongestPath can extract a set of possible interactions between the input proteins, and expand the network by adding new proteins that have the most interactions with highest total confidence to the current network of proteins. The application can also identify any activating or inhibitory regulatory paths between two distinct sets of transcription factors and target genes. This application can be used on the built-in human and mouse PPI or signaling databases, or any user-provided database for some organism.

Results

Our results on 12 signaling pathways from the NetPath database demonstrate that the application can be used for indicating proteins which may play significant roles in a pathway by finding the strongest path(s) in the PPI or signaling network.

Conclusion

Easy access to multiple public large databases, generating output in a short time, addressing some key challenges in one platform, and providing a user-friendly graphical interface make StrongestPath an extremely useful application.