bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinician Ethical Perspectives on Extracorporeal Membrane Oxygenation in Practice
Authors: Piscitello Gina M. , Bermea Rene S. , Stokes John W. , Gannon Whitney D. , Kanelidis Anthony J. , Konopka Megan , Shappell Claire , Frye Laura K. , Lyons Patrick G. , Siegler Mark , Parker William F.
Published: August 2021

Purpose:

Extracorporeal membrane oxygenation (ECMO) is an expensive and scarce life sustaining treatment provided to certain critically ill patients. Little is known about the informed consent process for ECMO or clinician viewpoints on ethical complexities related to ECMO in practice.

Methods:

We sent a cross-sectional survey to all departments providing ECMO within 7 United States hospitals in January 2021. One clinician from each department completed the 42-item survey representing their department.

Results:

Fourteen departments within 7 hospitals responded (response rate 78%, N = 14/18). The mean time spent consenting patients or surrogate decision-makers for ECMO varied, from 7.5 minutes (95% CI 5-10) for unstable patients to 20 minutes (95% CI 15-30) for stable patients (p = 0.0001). Few clinician respondents (29%) report patients or surrogate decision-makers always possess informed consent for ECMO. Most departments (92%) have absolute exclusion criteria for ECMO such as older age (43%, cutoffs ranging from 60-75 years), active malignancy (36%), and elevated body mass index (29%). A significant minority of departments (29%) do not always offer the option to withdraw ECMO to patients or surrogate decision-makers. For patients who cannot be liberated from ECMO and are ineligible for heart or lung transplant, 36% of departments would recommend the patient be removed from ECMO and 64% would continue ECMO support.

Conclusion:

Adequate informed consent for ECMO is a major ethical challenge, and the content of these discussions varies. Use of categorical exclusion criteria and withdrawal of ECMO if a patient cannot be liberated from it differ among departments and institutions.
Calculation of the actuator system in swash plate axial piston machines by a coupled multibody and TEHL simulation
Authors: Kroneis Markus , Scheerer René , Bobach Lars , Bartel Dirk
Published: August 2021

This paper presents a method for coupling a multibody simulation for the actuator system in axial piston machines in combination with a transient, three-dimensional, thermal elastohydrodynamic contact calculation. For the tribological investigation, the oscillating piston/cylinder contact is focused, whereby a simplified model of the actuator system simulates the loads. The developed method allows the integration of a complex tribological contact simulation under mixed friction conditions into a dynamic multibody simulation based on the Newton–Euler method. It is discussed how the accuracy of the results and the calculation time can be improved by the procedure.
Language, interests and autism: A tribute to Dr. Dinah Murray (1946–2021), an autism pioneer
Authors: Lawson Wenn B
Published: August 2021

So much has changed in our understanding of how autism impacts our lives. We still have a long way to go, however, until it becomes the norm that the principle of ‘nothing about me without me’ is upheld throughout autism research and autism practice. Autistic researchers and practitioners will play a central role in delivering this vision. Currently, the autistic community is mourning the passing of one such person, a true pioneer, Dr. Dinah Murray. It is fitting that we pay a tribute to her achievements and contributions, for these have enriched our lives and over-laid the autism landscape with understanding, acceptance, action and advocacy.
Habermas, democracy and the public sphere: Theory and practice
Authors: De Angelis Gabriele
Published: August 2021

A fil rouge goes through Habermas’s decade long research. It is the idea that Reason and rationality permeate human societies and may lead human action towards emancipation, if aptly elaborated through the filter of theoretical reflection. Theory must pick up on this rational core and turn the intrinsic rational potential inherent to modern societies into a self-consciously pursued ‘project of enlightenment’. This introduction to the special issue ‘Habermas, Democracy, and the Public Sphere: Theory and Practice’ shows how Habermas’s work in different scientific domains contributes to the construction of the ‘project of modernity’ from the many angles that such a complex project requires. The public sphere is, in Habermas’s theory, the societal domain in which communicative interactions have a chance to make Reason come to bear on human societies and lead them on the path to social and political emancipation. The contributions to this special issue focus therefore on the public sphere and illustrate the evolution of the concept in Habermas’s work and its relation to democracy at national and supranational level.
Transformations of work and democratic decay
Authors: Trovik Johan Andreas
Published: August 2021

Democracies worldwide are under stress. Two distinct families of explanation can be identified by the relative emphasis they place on the cultural versus the economic. Protesting against this dichotomy, there are those who insist that economic and cultural grievances interact. A conceptual scheme which ties together the economic and the cultural through interaction, however, rests on a prior separation. In this article, a richer and more plausible account of the relationship between transformations of work and contemporary democratic decay is developed. This account is based on a social practice model of work, in which the economic and the cultural are entirely intertwined. The social practice of work is among other things a privileged site for the realisation of certain ‘goods of work’. These include self-respect, self-esteem and self-realisation. It is by altering expectations about the realisation of the goods of work that transformations of work have contributed to an environment within which democracies are under stress.
Critical Engagement: Lessons Learned and Implications for HRD About Black Male Faculty Leadership in Higher Education
Authors: Henry Sherman
Published: August 2021

The Problem

Limited discussions of the Black male as a leader has taken place in the human resource development literature. Hence, racialization, the process of constructing and attaching meaning to racial identity, is an under-studied topic. Further problematic, traditional leadership theories advance a race-neutral, universalized mainstream view of leaders, and do not consider the multiple ways that race changes the master narrative. A direct result of this shortcoming is the lack of research and theories that inform the experiences of Black males in Historical White Institutions (HWIs).

The Solution

In this article, an autoethnography approach is used to counter the master narrative that has concealed the everyday, lived experience of Black males in higher education faculty and leadership roles. Critical race theory is applied as a framework for viewing lived experience as a legitimate and appropriate source of analysis. Socio-cultural theory is used to explain how cultural competence is needed to appropriately identify racism as an enduring problem that is a product of its culture and environment.

The Stakeholders

HRD faculty, HWIs administrators, hiring committees, diversity, equity and inclusion practitioners, search committees, and Black males in faculty roles in HWIs.
The Trenches and Valleys of Corporate America: A Black Male Human Resource Leader’s Autoethnographic Account
Authors: Wicker Cory J.
Published: August 2021

The Problem

In predominantly White organizational contexts and professions, such as human resources, that are significantly occupied by non-Blacks, Black male leaders struggle with achieving career success due to a lack of organizational support. Although existing research in human resource development (HRD) and career development provides a holistic representation of minoritized groups, there is a dearth of research that addresses the professional development of Black males.

The Solution

This article is an autoethnographic exploration of my experiences as a Black male leader in a predominantly White organization and profession (human resources). This article leverages autoethnography and critical race theory (CRT) as appropriate lenses to view my experiences as a Black male leader in this organizational/professional context. I utilize a layered account approach to position and deconstruct my experiences to provide an insider perspective of power structures that impede the leadership development of Black males.

The Stakeholders

HRD scholars, practitioners, organizational leaders, and Black males who are embarking upon and/or establishing their professional careers in predominantly White organizations.
A lubrication contact pair model for simulating gear micro-pitting damage characteristics based on contour integral
Authors: Zhao Yang , Xiao Yang , Sun Hao , Huo Wenhao , Wu Chuan , Feng Song , Liao Yong
Published: August 2021

A new two-dimensional finite element model of a lubricated contact pair, based on a contour integral, is proposed to investigate the formation of micro-pitting on gear tooth surfaces. Meanwhile, the contact properties and elasto-hydrodynamic lubrication (EHL) conditions of the gears are considered in the lubricated contact pair model. Then, the stress intensity factors (SIFs) KI and KII and the propagation angle θ C at the crack tip are analyzed by ABAQUS software. Next, the equivalent SIF Kσ can be calculated according to the maximum tangential stress (MTS) criterion, which is often used as the criterion for crack propagation. Considering the effect of a moving contact, the crack more easily propagates under the load x0/ b = −0.895. Furthermore, the pit shapes and variation of stress intensity factor are determined for various combinations of initial crack length a0 and angle β. The results show that longer germinated cracks propagate in areas that are deeper below the tooth surface. And the total length of final crack increases with the initial length and germination angle. These research results provide theoretical support for contact fatigue life analysis and meshing stiffness calculations of micro-pitting gears.
Optimization of milling process parameters and prediction of abrasive wear rate increment based on cutting force experiment
Authors: Li Fei , Liu Jun
Published: August 2021

Tuning the parameters of Computerized Numerical Control (CNC) is essential for practical manufacturers. Well configured parameters ensure the efficiency of production and the accuracy of the products. However, with the abrasive wear on the flank of the milling cutter, the milling processing parameters should re-configure to adapt to the increment of the abrasive wear. This paper aims to propose a method to predict the abrasive wear rate increment on the flank of the milling cutter and optimize the processing parameters of CNC milling. Firstly, we set a cutting data acquisition system to sample the processing time and cutting force among X, Y coordinates based on the five-factor and four-level orthogonal experiments. Then, the sampled cutting force data increment is transformed into the abrasive wear rate increment by applying the incremental model. Next, five processing parameters for CNC milling are optimized by the gray relational method, which takes the limited abrasive wear rate increment of the flank face and the non-increasing processing time as the constrained conditions. We obtain the relationship between five processing parameters and abrasive wear rate increment. We also find the basic principle of selecting process parameters is to reduce the abrasive wear rate without increasing the processing time. The experimental results verify that the optimized process parameters make the gray relational degree increase by 0.02, and the abrasive wear rate increment decreases by 0.42432 × 10−10 mm3/s without affecting the production efficiency. In the prediction section, by applying the Back Propagation (BP) neural network, we obtain an accurate prediction model from measurable five factors to the abrasive wear increment on the flank of the milling cutter. The maximum error between the predicted value and the actual value is 0.0003, and the predicted value curve fits well with the actual value curve. From the perspective of abrasive wear rate increment prediction, it provides a new idea for online tool wear monitoring.
Finite element analysis of large-sized O-rings used in deep-ocean pressure chambers
Authors: Song Wentao , Cui Weicheng
Published: August 2021

A proper criterion to guide how to determine the cross-section diameter of non-standard large-sized O-rings used in deep-ocean pressure chambers (DOPCs) is absent. To design a large-sized O-ring only by scale-up could be a lack of persuasiveness, and it will probably cause the increase of cost. This paper gives a detailed study on the static sealing performance of O-rings by finite element analysis (FEA). The results show that the influence of the inside diameter of O-rings can be ignored, and the O-rings with a large cross-section diameter may not be applicable to the high-pressure DOPCs, but it can allow a larger sealing clearance to be used in the low-pressure DOPCs. The reference values of safe sealing pressure with different cross-section diameters and different sealing clearances are ascertained. An improved criterion to guide how to determine the cross-section diameter of non-standard large-sized O-rings used in DOPCs is proposed. The results obtained in this paper can provide a more convincing guideline for the O-ring sealing design not only in DOPCs but also in the similar pressure vessels.
A method for long-term on-line monitoring of temperature stress of continuously welded rail
Authors: Sun Liu-Jia , Li Zai-Wei , Zhu Wen-Fa , He Yue-Lei , Fan Guo-Peng , Fang Wen-Ping , Shao Wei
Published: August 2021

Continuously welded rail (CWR) has been widely applied in modern railway structures, and its performance is directly related to the safety of railway transportation. After the removal of the rail joints, the CWR cannot expand and contract freely. The longitudinal temperature stress within the CWR turns out to be the core structural parameter in the maintenance and repair of the track. In this study, an ultrasonic theoretical model of the rail temperature force was established, and the mechanism of the critical refracted longitudinal wave to detect the rail temperature stress was analyzed. A numerical simulation calculation was conducted with the three-dimensional finite element model, and the longitudinal wave incidence angle, frequency, and transducer spacing were calculated. The impact of critical factors on the accuracy of refracted longitudinal wave detection temperature stress was investigated. The ultrasonic acoustic propagation under the corresponding stress value of the rail was calibrated to eliminate the influence of residual stress and ensure the accuracy of ultrasonic detection of temperature stress. Finally, an online rail temperature stress monitoring system was built, and a long-term operation was carried out in the Changzhou section of the Shanghai-Nanjing high-speed rail. The monitoring data of the line in 2019 was obtained, and the temperature stress change of the line was recorded. The data showed that the ultrasonic sound obtained by real-time monitoring could accurately reflect the temperature and force changes of the rail. This proposed method is expected to provide a solution for online and remote acquisition of the temperature stress of the CWR. The accumulated long-term monitoring data is of great significance to the prevention plan for rail expansion and rail breakage.
Extensive deep vein thrombosis and pulmonary embolism as a unique clinical manifestation of COVID-19 in a young healthy patient
Authors: Llausas-Villarreal Alejandro , Mendoza-Silva Marycarmen , Gómez-Gutiérrez Oliver Antonio , Gonzalez-Urquijo Mauricio , Fabiani Mario Alejandro
Published: August 2021

Background/Objective

Deep vein thrombosis and pulmonary embolism have been described as complications in previously diagnosed COVID-19 patients, especially in those admitted in critical ill units, but, to our knowledge, there is no report of venous thromboembolism in an otherwise asymptomatic COVID-19 patient.

Methods

We report the case of a 22-year-old female, healthy patient with pulmonary embolism (Pulmonary Embolism Severity Index Score 22 points, low risk) and extensive proximal deep vein thrombosis as a unique clinical manifestation of the new coronavirus disease.

Results

The patient had no risk factors and no familial history of venous thromboembolism. All thrombophilia markers were negative. The patient was treated as first by an independent vascular team, performing vena cava filter placement and open thrombectomy. Her symptoms worsened, and after 3 weeks, she underwent US-enhanced thrombolysis and mechanical thrombectomy. She was isolated for 10 days and did not develop any other clinical manifestation of COVID-19 disease. During follow-up, she remained asymptomatic and complete patency of the venous system was achieved. Full oral anticoagulation was conducted for 6 months.

Conclusion

COVID-19 appears to be a multi-symptomatic disease, and venous thromboembolism without any other previous described COVID-19 symptom could be considered one of its diverse clinical presentations and RT-PCR for SARS-CoV-2 tests emerge to be mandatory in patients with otherwise unexpected venous thrombosis.
Evaluating Self-Presentation: Gatekeeping Recognition Work in Hiring
Authors: Keere Kobe De
Published: August 2021

This study investigates how employee gatekeepers decode cultural signals applicants send out during job selection procedures. By focusing on declarative and non-declarative cultural signals such as leisure activities and presentation style, this article examines how recruiters and hiring managers do their gatekeeping recognition work. This is done by in-depth interviewing of 40 HR managers and recruiters, from the cultural and corporate sector in the Netherlands, using a video-elicitation method. The interviews revealed (1) the importance of a fun-factor, (2) that leisure activities not only serve as status markers or indicators for competence but enter as important interactional tools, (3) that gatekeepers look for authentic self-presentation but that this varies between fields and the perceived gender of the candidate. In addition, the comparative design uncovered significant sector variations. Corporate gatekeepers are characterized by the way they decoded sport activities as a signal for a work mentality, valued self-presentation in terms of representativeness and repeatedly relied on competence as an evaluative principle. Cultural gatekeepers, on the other hand, used leisure activities more often as way of cultural matching and were more drawn to a fun-factor while displaying a clear disdain for formal presentation styles.
Dynamics of serum concentrations of antibodies to infliximab: a new approach for predicting secondary loss of response in inflammatory bowel diseases
Authors: Grasmeier Melina K. , Langmann Anna F. , Langmann Peter , Treiber Matthias , Thaler Markus A. , Luppa Peter B.
Published: August 2021

Background:

Antibodies to infliximab (ATI) in serum are associated with secondary loss of response (LOR) to infliximab (IFX) therapy in patients with inflammatory bowel disease (IBD). However, feasible ATI-related predictors of therapy success are lacking and knowledge about individual ATI dynamics is limited. Therefore, this study analyzed whether ATI dynamics are able to predict LOR to IFX therapy and compared their predictive power with known predictors of LOR to IFX.

Methods:

This was a retrospective study of patients with Crohn’s disease (CD) or ulcerative colitis (UC) on IFX maintenance therapy and proactive IFX and immunogenicity monitoring in an outpatient clinic in Germany. Slopes of ATI ( SATI) and IFX levels (dynamic parameters) and medians of ATI, IFX, C-reactive protein, and fecal calprotectin (static parameters) were calculated over a defined period of time after ATI emergence. Dynamic and static parameters were analyzed for associations with end points infliximab discontinuation due to secondary LOR and total IFX discontinuation.

Results:

In all, 500 visits from 38 IBD patients (28 CD, 10 UC) with a median IFX maintenance duration of 68.2 weeks were evaluated. Grouping by SATI (ATI-N = ATI nondetectable, ATI- ↓ = negative SATI, ATI- ↑ = positive SATI) yielded significant differences for outcomes LOR ( p = 0.004) and total IFX discontinuation ( p = 0.01). Patients in the ATI-↓ group survived significantly longer LOR-free compared with the ATI-↑ group ( p = 0.02). Cox regression confirmed SATI to be a significant risk factor for LOR ( p = 0.002). An SATI cut-off of approximately 2.0 AU mL−1 week−1 was determined to predict LOR with 83.3% sensitivity and 93.8% specificity.

Conclusion:

The ATI slope-based index SATI is a new feasible diagnostic predictor of LOR in IBD patients. SATI may facilitate quick therapeutic decisions after ATI emerge.
A novel score for evaluating cerebral aneurysms treated with flow diversion: 4F-flow diversion predictive score
Authors: Kang Huibin , Luo Bin , Liu Jian , Wang Anxin , Zhang Hongqi , Li Tianxiao , Song Donglei , Zhao Yuanli , Guan Sheng , Wang Yunyan , Feng Wenfeng , Wang Yang , Shi Huaizhang , Liu Jianmin , Yang Xinjian
Published: August 2021

Background and purpose:

Although grading scales for angiography outcomes following cerebral aneurysm treatment with flow diversion have been published, physicians have not widely adopted these scales in practice. The aim of this study is to propose and validate a novel Flow diversion Predictive Score (4F-FPS) grading scale based on previously established scales that is simple and reliable.

Methods:

We retrospectively analyzed consecutive patients who underwent endovascular treatment for cerebral aneurysms with flow diversion between January 2014 and September 2019. The included patients were randomly divided into the derivation and validation group in a 70/30 ratio, respectively. Aneurysms were classified as incomplete or complete occlusion based on final angiography outcomes. 4F-FPS was derived to predict aneurysm occlusion from multivariate logistic regression analyses in the derivation group and validated with previously published grading scales in the validation group.

Results:

Overall, 662 patients [mean age, 53.8 years; 72.5% (480/662) female] with 662 aneurysms treated with the PipelineTM flow diverter were included [69.9% (463/662) derivation group, 30.1% (199/662) validation group]. The incidence of aneurysm occlusion was 82.7%. 4F-FPS demonstrated significant discrimination in 10-fold cross validation [mean receiver operating characteristic (ROC) area, 0.862 ± 0.055] and calibration (Cox & Snell R2, 0.251; Nagelkerke R2, 0.413) in the derivation group. The ROC area of 4F-FPS score in both the derivation and validation groups is the largest compared with previously published grading scales/scores ( p < 0.05), which shows better sensitivity and specificity. The 4F-FPS score showed excellent prediction, discrimination, and calibration properties.

Conclusion:

The 4F-FPS score is a simple and reliable tool to predict angiography outcome after flow diversion treatment. If widely adopted, it may provide a common language to be used in future reporting of flow diversion results for clinical trials and daily practice.

Clinical trial registration:

http://www.clinicaltrials.gov . Unique identifier: NCT03831672
Combining CGM and an Online Peer Support Community for Hispanic Adults with T2D: A Feasibility Study
Authors: Litchman Michelle L. , Ng Ashley , Sanchez-Birkhead Ana , Allen Nancy A. , Rodriguez-Gonzales Bruno , Iacob Eli , Greenwood Deborah A.
Published: August 2021

Background:

Previous research has identified that people with type 2 diabetes (T2D) within the Hispanic community would benefit from an online peer support community (OPSC) and continuous glucose monitoring (CGM) data to facilitate diabetes self-management.

Methods:

A mixed-methods feasibility study enrolled Hispanic, Spanish-speaking adults with T2D, not on insulin. Participants were provided with CGM and access to an OPSC for 12 weeks. Feasibility was assessed by number of eligible participants who enrolled, attrition, quantity of CGM data, validated clinical measures of self-efficacy, quality of life and adverse events. Engagement in the OPSC was measured using objective metrics on the online platform. Qualitative interviews were conducted upon conclusion of the intervention to assess feasibility, acceptability, participant satisfaction, and key recommendations for improvement.

Results:

Of 46 participants screened, 39 were eligible and 26 completed the study. Participants significantly improved self-efficacy scores. Posts in the OPSC related to goal setting had the highest engagement followed by mid-week and end of week check-in posts respectively. Participant interviews described challenges accessing the OPSC platform as a barrier to engagement. Despite this, all participants were satisfied with the intervention. Key recommendations for improvement included providing greater variety of and individualized education and the use of a peer support platform that is easily accessible.

Conclusions:

The CGM + OPSC intervention tailored to the Hispanic community with T2D was feasible, acceptable and satisfactory and improved participant self-efficacy for diabetes management which may lead to improved clinical outcomes.
Choriocarcinoma metastatic to the skin: A rare occurrence associated with dismal outcome
Authors: ElKhaldi Mousa , Radi Rakan , Al-Hussaini Maysa
Published: August 2021

Germ cell tumors (GCTs) are a histologically heterogeneous group of tumors that arise from the primitive germ cell of the embryonic gonad. Choriocarcinoma is a variant of GCTs that is prone to hematogenous metastasis to the liver, lung, and brain. Cutaneous metastasis in choriocarcinoma is rarely encountered with only a few cases reported in literature. We report the case of a 28-year-old male presenting with lower back pain that, upon further work-up, was diagnosed with pure choriocarcinoma of the testes. Around 9 months after his initial presentation, he developed a cutaneous back lesion. Microscopic examination confirmed the presence of choriocarcinoma composed of mononuclear cytotrophoblasts which interweave with multinucleated syncytiotrophoblasts. The patient passed away 3 weeks after the onset of cutaneous metastasis.
The Impact of Face Masks on the Emotional Reading Abilities of Children—A Lesson From a Joint School–University Project
Authors: Carbon Claus-Christian , Serrano Martin
Published: August 2021

Wearing face masks has become a usual practice in acute infection events inducing the problem of misinterpreting the emotions of others. Empirical evidence about face masks mainly relies on adult data, neglecting, for example, school kids who firmly are dependent on effective nonverbal communication. Here we offer insights from a joint school–university project. Data indicate that emotional reading of 9 to 10 years old pupils ( N = 57) was similarly impaired as adults on an overall performance level, but that their selective performance on specific emotions was quite different. Kids showed extreme problems in reading the emotion disgust, strong effects on fear and sadness, and only mild effects on happiness, but also even better performances for emotional states anger and neutral when faces were masked. This project did gain not only relevant data about children’s perception but also made clear how fruitful seriously conducted school projects can be to encourage the interest and commitment for Science, Technology, Engineering, and Mathematics (STEM)-relevant topics.
A self-aligning end-effector robot for individual joint training of the human arm
Authors: Balasubramanian Sivakumar , Guguloth Sandeep , Mohammed Javeed Shaikh , Sujatha S
Published: August 2021

Aim: Intense training of arm movements using robotic devices can help reduce impairments in stroke. Recent evidence indicates that independent training of individual joints of the arm with robots can be as effective as coordinated multi-joint arm training. This makes a case for designing and developing robots made for training individual joints, which can be simpler and more compact than the ones for coordinate multi-joint arm training. The design of such a robot is the aim of the work presented in this paper.

Methods: An end-effector robot kinematic design was developed and the optimal robot link lengths were estimated using an optimization procedure. A simple algorithm for automatically detecting human limb parameters is proposed and its performance was evaluated through a simulation study.

Results: A six-degrees-of-freedom end-effector robot with three actuated degrees-of-freedom and three non-actuated self-aligning degrees-of-freedom for safe assisted training of the individual joints (shoulder or elbow) of the human arm was conceived. The proposed robot has relaxed constraints on the relative positioning of the human limb with respect to the robot. The optimized link lengths chosen for the robot allow it to cover about 80% of the human limb’s workspace, and possess good overall manipulability. The simple estimation procedure was demonstrated to estimate human limb parameters with low bias and variance.

Discussion: The proposed robot with three actuated and three non-actuated degrees-of-freedom has a compact structure suitable for both the left and right arms without any change to its structure. The proposed automatic estimation procedure allows the robot to safely apply forces and impose movements to the human limb, without the need for any manual measurements. Such compact robots have the highest potential for clinical translation
Bodily Changes: Castration as Cultural and Social Practice in the Space of the Forbidden City
Authors: Liu Peng , Lan Lan
Published: August 2021

This article examines the Chinese imperial body as “simultaneously part of nature and part of culture” and considers the interactions between the cultural body and physical body in sociological terms. The examination elaborates on the physical body as the manifestation of the demands of society mediated by cultural meanings. Bodily changes, such as castration, which Peng Liu argue is a trade between the physical body and cultural body in meeting the demands of Imperial Chinese society, affect the cultural embodiment of the body. This article examines the bodily actions of head eunuchs and how they interact with the emperor in the space of the Forbidden City during Imperial China. Eunuchs have undertaken an invasive physical operation to not only survive but thrive in imperial society. This reflects the constraints, struggles, and disciplining of the physically castrated and culturally embodied being.
Perioperative Factors Associated With Chronic Opioid Use After Spine Surgery
Authors: Montgomery Eric Y. , Pernik Mark N. , Johnson Zachary D. , Dosselman Luke J. , Christian Zachary K. , Deme Palvasha R. , Adeyemo Emmanuel A. , Barrie Umaru , Badejo Olatunde , Stewart Nick A. , Uttarkar Ruta , Adogwa Owoicho , Tecle Najib El , Aoun Salah G. , Bagley Carlos A.
Published: August 2021

Study Design:

Retrospective case control.

Objectives:

The purpose of the current study is to determine risk factors associated with chronic opioid use after spine surgery.

Methods:

In our single institution retrospective study, 1,299 patients undergoing elective spine surgery at a tertiary academic medical center between January 2010 and August 2017 were enrolled into a prospectively collected registry. Patients were dichotomized based on renewal of, or active opioid prescription at 3-mo and 12-mo postoperatively. The primary outcome measures were risk factors for opioid renewal 3-months and 12-months postoperatively. These primarily included demographic characteristics, operative variables, and in-hospital opioid consumption via morphine milligram equivalence (MME). At the 3-month and 12-month periods, we analyzed the aforementioned covariates with multivariate followed by bivariate regression analyses.

Results:

Multivariate and bivariate analyses revealed that script renewal at 3 months was associated with black race ( P = 0.001), preoperative narcotic ( P < 0.001) or anxiety/depression medication use ( P = 0.002), and intraoperative long lumbar ( P < 0.001) or thoracic spine surgery ( P < 0.001). Lower patient income was also a risk factor for script renewal ( P = 0.01). Script renewal at 12 months was associated with younger age ( P = 0.006), preoperative narcotics use ( P = 0.001), and ≥4 levels of lumbar fusion ( P < 0.001). Renewals at 3-mo and 12-mo had no association with MME given during the hospital stay or with the usage of PCA ( P > 0.05).

Conclusion:

The current study describes multiple patient-level factors associated with chronic opioid use. Notably, no metric of perioperative opioid utilization was directly associated with chronic opioid use after multivariate analysis.
Rare Distal Metastasis of Endometrial Adenocarcinoma Impersonating as Primary Colon Cancer
Authors: Jauregui Alexia , Gajendran Mahesh , Loganathan Priyadarshini , Padilla Angelica , Qiao Jesse , Elhanafi Sherif
Published: August 2021

An 89-year-old Caucasian female with a recent diagnosis of endometrial adenocarcinoma status post hysterectomy and acute deep vein thrombosis on anticoagulation presented with hematochezia. Colonoscopy revealed sigmoid colon stricture with the biopsy findings of metastatic endometrial adenocarcinoma based on positive immunohistochemistry staining for cytokeratin 7, paired box gene 8, and estrogen receptor. The oncologist referral was given to the patient for consideration of chemotherapy, but she decided to go with palliative care. Thus far, only 2 similar cases have been published in the literature. Our case exemplifies the potential for an unconventional pattern of metastasis of primary endometrial adenocarcinoma to the colon.
Legal and non-legal barriers to abortion in Ireland and the United Kingdom
Authors: Calkin Sydney , Berny Ella
Published: August 2021

This article compares abortion laws, regulations and access patterns in the United Kingdom and the Republic of Ireland. We focus in most detail on the Republic of Ireland, Northern Ireland and England with a shorter discussion of Scotland and Wales. We attend to the laws and legal reforms in each region but also consider the non-legal factors that restrict or facilitate abortion services in each place. In this article, we seek to illustrate the complex relationship between abortion law and abortion access, noting especially how non-legal barriers shape the way an abortion law functions for the people who live under it.
Lentiviral correction of enzymatic activity restrains macrophage inflammation in adenosine deaminase 2 deficiency
Authors: Zoccolillo Matteo , Brigida Immacolata , Barzaghi Federica , Scala Serena , Hernández Raisa Jofra , Basso-Ricci Luca , Colantuoni Mariasilvia , Pettinato Emanuela , Sergi Lucia Sergi , Milardi Giulia , Capasso Paola , Lombardo Angelo , Gregori Silvia , Sanvito Francesca , Schena Francesca , Cesaro Simone , Conti Francesca , Pession Andrea , Benedetti Fabio , Gattorno Marco , Lee Pui Y. , Naldini Luigi , Cicalese Maria Pia , Aiuti Alessandro , Mortellaro Alessandra
Published: August 2021

Adenosine deaminase 2 deficiency (DADA2) is a rare inherited disorder that is caused by autosomal recessive mutations in the ADA2 gene. Clinical manifestations include early-onset lacunar strokes, vasculitis/vasculopathy, systemic inflammation, immunodeficiency, and hematologic defects. Anti–tumor necrosis factor therapy reduces strokes and systemic inflammation. Allogeneic hematopoietic stem/progenitor cell (HSPC) transplantation can ameliorate most disease manifestations, but patients are at risk for complications. Autologous HSPC gene therapy may be an alternative curative option for patients with DADA2. We designed a lentiviral vector encoding ADA2 (LV-ADA2) to genetically correct HSPCs. Lentiviral transduction allowed efficient delivery of the functional ADA2 enzyme into HSPCs from healthy donors. Supranormal ADA2 expression in human and mouse HSPCs did not affect their multipotency and engraftment potential in vivo. The LV-ADA2 induced stable ADA2 expression and corrected the enzymatic defect in HSPCs derived from DADA2 patients. Patients’ HSPCs re-expressing ADA2 retained their potential to differentiate into erythroid and myeloid cells. Delivery of ADA2 enzymatic activity in patients’ macrophages led to a complete rescue of the exaggerated inflammatory cytokine production. Our data indicate that HSPCs ectopically expressing ADA2 retain their multipotent differentiation ability, leading to functional correction of macrophage defects. Altogether, these findings support the implementation of HSPC gene therapy for DADA2.
CeTF: an R/Bioconductor package for transcription factor co-expression networks using regulatory impact factors (RIF) and partial correlation and information (PCIT) analysis
Authors: Oliveira de Biagi Carlos Alberto , Nociti Ricardo Perecin , Brotto Danielle Barbosa , Funicheli Breno Osvaldo , Cássia Ruy Patrícia de , Bianchi Ximenez João Paulo , Alves Figueiredo David Livingstone , Araújo Silva Wilson
Published: August 2021

Background

Finding meaningful gene-gene interaction and the main Transcription Factors (TFs) in co-expression networks is one of the most important challenges in gene expression data mining.

Results

Here, we developed the R package “CeTF” that integrates the Partial Correlation with Information Theory (PCIT) and Regulatory Impact Factors (RIF) algorithms applied to gene expression data from microarray, RNA-seq, or single-cell RNA-seq platforms. This approach allows identifying the transcription factors most likely to regulate a given network in different biological systems — for example, regulation of gene pathways in tumor stromal cells and tumor cells of the same tumor. This pipeline can be easily integrated into the high-throughput analysis. To demonstrate the CeTF package application, we analyzed gastric cancer RNA-seq data obtained from TCGA (The Cancer Genome Atlas) and found the HOXB3 gene as the second most relevant TFs with a high regulatory impact (TFs-HRi) regulating gene pathways in the cell cycle.

Conclusion

This preliminary finding shows the potential of CeTF to list master regulators of gene networks. CeTF was designed as a user-friendly tool that provides many highly automated functions without requiring the user to perform many complicated processes. It is available on Bioconductor (http://bioconductor.org/packages/CeTF) and GitHub (http://github.com/cbiagii/CeTF).
Transcriptomics of different tissues of blueberry and diversity analysis of rhizosphere fungi under cadmium stress
Authors: Chen Shaopeng , Zhuang QianQian , Chu XiaoLei , Ju ZhiXin , Dong Tao , Ma Yuan
Published: August 2021

Blueberry (Vaccinium ssp.) is a perennial shrub belonging to the family Ericaceae, which is highly tolerant of acid soils and heavy metal pollution. In the present study, blueberry was subjected to cadmium (Cd) stress in simulated pot culture. The transcriptomics and rhizosphere fungal diversity of blueberry were analyzed, and the iron (Fe), manganese (Mn), copper (Cu), zinc (Zn) and cadmium (Cd) content of blueberry tissues, soil and DGT was determined. A correlation analysis was also performed. A total of 84 374 annotated genes were identified in the root, stem, leaf and fruit tissue of blueberry, of which 3370 were DEGs, and in stem tissue, of which 2521 were DEGs. The annotation data showed that these DEGs were mainly concentrated in a series of metabolic pathways related to signal transduction, defense and the plant–pathogen response. Blueberry transferred excess Cd from the root to the stem for storage, and the highest levels of Cd were found in stem tissue, consistent with the results of transcriptome analysis, while the lowest Cd concentration occurred in the fruit, Cd also inhibited the absorption of other metal elements by blueberry. A series of genes related to Cd regulation were screened by analyzing the correlation between heavy metal content and transcriptome results. The roots of blueberry rely on mycorrhiza to absorb nutrients from the soil. The presence of Cd has a significant effect on the microbial community composition of the blueberry rhizosphere. The fungal family Coniochaetaceae, which is extremely extremelytolerant, has gradually become the dominant population. The results of this study increase our understanding of the plant regulation mechanism for heavy metals, and suggest potential methods of soil remediation using blueberry.
Derived woodiness and annual habit evolved in African umbellifers as alternative solutions for coping with drought
Authors: Frankiewicz Kamil E. , Banasiak Łukasz , Oskolski Alexei A. , Magee Anthony R. , Alsarraf Mohammad , Trzeciak Paulina , Spalik Krzysztof
Published: August 2021

Background

One of the major trends in angiosperm evolution was the shift from woody to herbaceous habit. However, reversals known as derived woodiness have also been reported in numerous, distantly related clades. Among theories evoked to explain the factors promoting the evolution of derived woodiness are moderate climate theory and cavitation theory. The first assumes that woody habit evolves in response to mild climate allowing for prolonged life span, which in turn leads to bigger and woodier bodies. The second sees woodiness as a result of natural selection for higher cavitation resistance in seasonally dry environments. Here, we compare climatic niches of woody and herbaceous, mostly southern African, umbellifers from theLefebvreaclade to assess whether woody taxa in fact occur in markedly drier habitats. We also calibrate their phylogeny to estimate when derived woodiness evolved. Finally, we describe the wood anatomy of selected woody and herbaceous taxa to see if life forms are linked to any particular wood traits.

Results

The evolution of derived woodiness in chamaephytes and phanerophytes as well as the shifts to short-lived annual therophytes in theLefebvreaclade took place at roughly the same time: in the Late Miocene during a trend of global climate aridification. Climatic niches of woody and herbaceous genera from the Cape Floristic Region overlap. There are only two genera with distinctly different climatic preferences: they are herbaceous and occur outside of the Cape Floristic Region. Therefore, studied herbs have an overall climatic niche wider than their woody cousins. Woody and herbaceous species do not differ in qualitative wood anatomy, which is more affected by stem architecture and, probably, reproductive strategy than by habit.

Conclusions

Palaeodrought was likely a stimulus for the evolution of derived woodiness in theLefebvreaclade, supporting the cavitation theory. The concurrent evolution of short-lived annuals withering before summer exemplifies an alternative solution to the same problem of drought-induced cavitation. Changes of the life form were most likely neither spurred nor precluded by any qualitative wood traits, which in turn are more affected by internode length and probably also reproductive strategy.
Gender differences in the risk of depressive disorders following the loss of a young child: a nationwide population-based longitudinal study
Authors: Chen Hsin-Hung , Wang I-An , Fang Shao-You , Chou Yiing-Jenq , Chen Chuan-Yu
Published: August 2021

Background

Losing a child to death is one of the most stressful life events experienced in adulthood. The aim of the current study is to investigate parental risk of seeking treatment for major depression disorders (MDD) after a child’s death and to explore whether such connection may operate differentially by parents’ prior medical condition.

Methods

We studied a retrospective cohort of 7245 parents (2987 mothers and 4258 fathers) identified in the National Health Insurance Research Database of Taiwan (NHIRD) who had lost a child with age between 1 and 12 years. For comparison, the parents of 1:4 birth year- and gender-matched non-deceased children were retrieved (16,512 mothers and 17,753 fathers). Gender-specific Cox regression analyses were performed to estimate risk.

Results

Nearly 5.0% and 2.4% of bereaved mothers and fathers sought treatment for MDD within three years after a child’s death, significantly higher than 0.8% and 0.5% in the non-bereaved parents. With covariate adjustment, the hazard ratio (HR) for maternal and paternal seeking treatment for MDD was estimated 4.71 (95% confidence interval [CI]: 3.35–6.64) and 1.93 (95% CI: 1.27–2.95), respectively. The increased risk of MDD varied by prior disease history; specifically, the increased risk of seeking treatment for MDD was especially prominent for those without chronic physical condition (CPC) (e.g., mothers with CPC: aHR = 2.38, 95% CI: 1.56–3.65 vs. no CPC: aHR = 9.55, 95% CI: 6.17–14.79).

Conclusions

After the death of a child, parental elevated risk of MDD was especially prominent for the women and those without prior medical condition. Effective strategies addressing bereavement may require family-based, integrated physical and mental healthcare and even extended counseling service.
Descriptive study of cases of schizophrenia in the Malian population
Authors: Coulibaly Souleymane dit Papa , Ba Baba , Mounkoro Pakuy Pierre , Diakite Brehima , Kassogue Yaya , Maiga Mamoudou , Dara Aperou Eloi , Traoré Joseph , Kamaté Zoua , Traoré Kadiatou , Koné Mahamadou , Maiga Boubacar , Diarra Zoumana , Coulibaly Souleymane , Togora Arouna , Maiga Youssoufa , Koumaré Baba
Published: August 2021

Background

Schizophrenia is a relatively common disease worldwide with a point prevalence of around 5/1000 in the population. The aim of this present work was to assess the demographic, clinical, familial, and environmental factors associated with schizophrenia in Mali.

Methods

This was a prospective descriptive study on a series of 164 patients aged at least 12 years who came for a follow-up consultation at the psychiatry department of the University Hospital Center (CHU) Point G in Mali between February 2019 and January 2020 for schizophrenia spectrum disorder as defined by DSM-5 diagnostic criteria.

Results

Our results revealed that the male sex was predominant (80.5%). The 25–34 age group was more represented with 44.5%. The place of birth for the majority of our patients was the urban area (52.4%), which also represented the place of the first year of life for the majority of our patients (56.1%). We noted that the unemployed and single people accounted for 56.1 and 61% respectively. More than half of our patients 58.5% reported having reached secondary school level. With the exception of education level, there was a statistically significant difference in the distribution of demographic parameters. Familial schizophrenia cases accounted for 51.7% versus 49.3% for non-familial cases. The different clinical forms were represented by the paranoid form, followed by the undifferentiated form, and the hebephrenic form with respectively 34, 28 and 17.1%. We noted that almost half (48.8%) of patients were born during the cold season. Cannabis use history was not observed in 68.7% of the patients. The proportions of patients with an out-of-school father or an out-of-school mother were 51.2 and 64.2%, respectively.

Conclusion

The onset of schizophrenia in the Malian population has been associated with socio-demographic, clinical, genetic and environmental characteristics.