bluuebunny/crossref_metadata_2025 huggingface dataset:
Availability, Affect, and Decisions to Seek Information about Cancer Risks
Authors: McDowell Michelle , Pachur Thorsten
Published: September 2020

How do people decide which risks they want to get informed about? The present study examines the role of the availability and affect heuristics on these decisions. Participants ( N = 100, aged 19–72 years) selected for which of 23 cancers they would like to receive an information brochure, reported the number of occurrences of each type of cancer in their social circle (availability), and rated their dread reaction to each type of cancer (affect); they also made relative judgments about which of 2 cancers was more common in Germany (judged risk). Participants tended to choose information brochures for those cancers for which they indicated a higher availability within their social networks as well as for cancers they dreaded. Mediation analyses suggested that the influence of availability and affect on information choice was only partly mediated by judged risk. The results demonstrate the operation of 2 key judgment heuristics (availability and affect), previously studied in risk perception, also in decisions about information choice. We discuss how our findings can be used to identify which risks are likely to fall from people’s radar.
Experimental studies of hydrothermal liquefaction of kitchen waste with H+, OH− and Fe3+ additives for bio-oil upgrading
Authors: Wang Lixian , Chi Yong , Shu Di , Weiss-Hortala Elsa , Nzihou Ange , Choi Sangmin
Published: September 2020

Kitchen waste (KW) has gradually become a prominent problem in municipal solid waste treatment. Hydrothermal liquefaction (HTL) is a promising method used to make fuel oil from food and KW. However, the upgrading of bio-oil is particularly important for the sake of industrial reuse. In this study, the KW from university restaurants was subjected to HTL experiments in order to study theoretical feasibility. With the change of conversion temperature and residence time, the optimal conversion working conditions in this study were determined according to the quality and yield of the bio-oil. Moreover, the bio-oil upgrading effects of different additives (hydrogen chloride, sodium hydroxide, and iron(III) chloride) on the HTL of KW were studied. Alkaline additives have an inhibitory effect on the bio-oil yield and positive effect on coke yield. Acidic additives and iron (Fe)-containing additives can promote bio-oil yield. As an important aspect of upgrading, the effect on the nitrogen content of bio-oil with additives was revealed. The alkaline and Fe-containing additives have little effect on reducing the viscosity of the bio-oil while with the appropriate ratio (2.5 mol•kg−1) of acidic additives to the raw material, the static and dynamic fluidity of the oil phase products are reduced to about 0.1 Pa•s.
Psychometric Properties and Factor Analysis of a Short Form of the Multidimensional Measure of Emotional Abuse
Authors: Maldonado Ana I. , Farzan-Kashani Julian , Sun Shuyan , Pitts Steven C. , Lorenzo Jennifer M. , Barry Robin A. , Murphy* Christopher M.
Published: September 2020

The 28-item Multidimensional Measure of Emotional Abuse (MMEA) assesses four common forms of emotional abuse in intimate relationships and has been used extensively to study the development of intimate partner violence (IPV), the consequences of emotional abuse, and the outcomes of IPV interventions. The current study provides psychometric analyses of a shortened version of the MMEA using self-report data from a sample of men receiving treatment at a community-based relationship violence intervention program (RVIP; N = 467) and reports from their relationship partners ( N = 252), and data from a sample of undergraduate students ( N = 194) who reported on their own and their partners’ abusive behavior. Theoretical and statistical considerations, including internal consistency after item deletion, were used to select items for the shortened version. In the clinic sample (for self- and partner reports) and in the undergraduate sample (for self-report only), the 16-item MMEA-Short Form (MMEA-SF) retains the 4-factor structure of the 28-item MMEA. In both samples and across reporting methods (self and partner), the 16-item MMEA-SF has good internal consistency, good concurrent validity with the Revised Conflict Tactics Scales (CTS2) psychological aggression subscale, and similar correlations with CTS2 physical assault subscale as the original 28-item MMEA version. The MMEA-SF can reduce assessment burden while maintaining good domain coverage and strong psychometric properties and will be an asset to researchers and practitioners who need a brief, multifaceted measure of emotional relationship abuse in both clinic and undergraduate samples.
External Democracy Promotion in Time of Democratic Crisis: Linkage, Leverage, and Domestic Actors’ Diversionary Behaviours
Authors: Castaldo Antonino
Published: September 2020

Since the 1990s, the literature on External Democracy Promotion (EDP) expanded exponentially. Despite widely supported conclusions on EDP (in)effectiveness in fostering democratization and preventing democratic backsliding are still lacking, the literature has generated sophisticated explanations of these processes. Among them, Levitsky and Way’s (L&W’s) linkage and leverage theory stands out as one of the most influential. According to Tolstrup, however, their underestimation of domestic agency constitutes a crucial lacuna, which he proposes to fill through the concept of “Gatekeeping Elite” that underlines a significant impact of local actors on the linkage dimension and, consequently, on EDP (in)effectiveness. I believe that Tolstrup’s intuition can be further developed, expanding even more the explanatory power of L&W’s theory. I claim that domestic actors may exert a crucial influence also on the leverage dimension, thanks to “diversionary behaviours” that local elites may use to change external actors’ interests and preferences, persuading them to limit their democratizing pressures and thus reduce their own vulnerability to EDP processes. To assess the plausibility of this claim, I perform a congruence analysis on the recent and crucial case of autocratization in Serbia (EU candidate country), which is not fully explained by the aforementioned models.
The Travels of a Set of Numbers: The Multiple Networks Enabled by the Colombian ‘Estrato’ System
Authors: Arboleda Fernando León Tamayo , Valverde Mariana
Published: September 2020

This article documents how a Constitutionally grounded effort to institute ‘cross subsidies’ for public utility payments gave rise to a set of numbers that never achieved the goal of cross-class solidarity. This legal based system lived on, in large part because the numbers were quickly adopted both in popular speech and by multiple institutions, in an uncoordinated manner. Scalar tensions are key to the story: the Colombian ‘estrato’ system for classifying residential properties (initially for differential utility payment purposes) has at its core a set of numbers that was designed as nationally valid: but the work of labelling all residences with one of the six numbers to produce zoning-like ‘estrato’ maps incites qualitative micro-local knowledge. Overall, we show that local knowledges of socioeconomic difference constantly clash with and undermine not only the initial ambitious plan to render cross-class ‘solidarity’ technical but also the subsequent efforts to propose more rational alternatives.
Dynamics modeling, simulation, and optimization of vibration characteristics of the tracked vehicle system
Authors: Miao Yunfei , Wang Guoping , Rui Xiaoting
Published: September 2020

In this study, the transfer matrix method for multibody systems is used to study the vibration characteristics of a tracked vehicle system. The transfer matrix method has the advantages of not needing the global dynamics equations of the system, low order of system matrices, and fast dynamics computation speed. According to the solution process of vibration characteristics, a detailed dynamics model considering the rigid–flexible coupling effect is developed to describe the structural relationship of the tracked vehicle system. Then, a topology figure for representing the transfer direction of the dynamics model is proposed to derive the overall transfer equation of the system. Dynamics equations governing the motion of the system and rocket are given. Next, through comparisons of the simulation and relevant experiments, the validity and correctness of the proposed method are verified. Based on this, the coupling dynamics responses of the system with different firing orders and firing intervals are simulated and analyzed, which shows that the firing order and interval have great influences on the vibration of the system. In this case, with the adaptive genetic algorithm, a multivariable optimization method is proposed. The optimization results show that the vibration is greatly reduced by using the optimized scheme.
Psychoanalytic Perspectives on Moral Injury in Nurses on the Frontlines of the COVID-19 Pandemic
Authors: Lesley Marsha
Published: September 2020

OBJECTIVE: To raise awareness of the potential for moral injury in nurses working on the frontlines of COVID-19 patient care and to present aspects of mental functioning that may increase the likelihood of psychological distress. Approaches that draw on psychoanalytic thinking to support frontline nurses’ mental health are explained. METHOD: This article draws on recent work that is available from multiple sources, including published journal articles on moral injury, recent reports from news services highlighting the crisis state of the pandemic and effects on nurses, established literature on the structural model of the mind, and recent webinars and online lectures addressing mental health crisis interventions. The author draws on expertise from years of training in the Adult Psychoanalytic Training Program at the Michigan Psychoanalytic Institute and graduation as an academic analyst. RESULTS: How nurses navigate moral hazards inherent in the current state of frontline health care may depend on their existing ego strengths and levels of self-blame and guilt from a harsh superego. CONCLUSIONS: Mental health professionals need to be aware of the mental minefields that frontline nurses must navigate when providing care that, due to circumstances beyond their control, may be morally ambiguous. Educating nurses about the meaning of their own emotional and psychic responses amid the realities in the field may help to decrease the damaging effects of moral injury.
Executive Function Training for Preschool Children With ADHD: A Randomized Controlled Trial
Authors: Shuai Lan , Wang Yuanyuan , Li Wei , Wilson Amanda , Wang Shanshan , Chen Runsen , Zhang Jinsong
Published: September 2020

Objective:

This randomized controlled study explored the efficacy, feasibility, and acceptability of executive function training (EFT) for preschool children with ADHD.

Method:

The current study design was an 8 week randomized parallel groups, single-blinded trial, using EFT-P. A total of 96 children with an ADHD diagnosis at age 4 to 5 years old were randomized into the intervention group and waitlist group. In the intervention group, 46 out of 50 participants completed the 8-week program, compared with 39 out of 46 in the waiting group. The level of ADHD symptoms and the executive function (EF) were evaluated by both neuropsychological tests from NEPSY Second Edition (NEPSY-II) and Behavior Rating Inventory of Executive Function Preschool version (BRIEF-P).

Results:

The EFT is feasible to administer and is acceptable for preschool children, with a 93% retention rate. Results showed that following the intervention, the visual-motor precision ( p = .024), ADHD diagnostic state ( p = .01), and oppositional defiant symptoms ( p = .023) improved significantly in preschool children. However, the symptoms of ADHD and other EF evaluations were found to be insignificant.

Conclusion:

The EFT is feasible, acceptable, and potentially effective to reduce symptoms and improve EF for preschool children with ADHD. The next step is to extend the program time and provide more frequent practice of activities between the children and the therapist and/or parent, to improve the effectiveness.
Effects of Photographic Reviews on Recollections of the Personal Past: A New Perspective on Benefits and Costs
Authors: Foley Mary Ann
Published: September 2020

Empirical studies of the power of photographs on recollections of the personal past have produced a complicated set of results, with reports of both costs and benefits on recollection accuracy. The purpose of the selective review offered in the current paper is to cast in new light this complicated pattern of findings by calling for close attention to the acts of looking, including the timing of the looking in relation to acts of remembering. Incorporating a broad range of scholarly perspectives, the current article’s interdisciplinary component points to specific features of photograph-looking experiences that warrant further study. The current review provides an overview of benefits in memory for event and event details, indexed by enhancements in recall and recognition measures. The overview of costs includes reductions in the amount remembered as well as changes in belief about event occurrences. Reconstruction accounts of the basis for these effects follows the analysis of benefits and costs. The new perspective in the current review leads to intriguing directions for future research involving content of photographs, the ways they are obtained, and aspects of the photograph review experience.
Naked loan selfies: Becoming collateral, becoming pornography
Authors: Liu Jessie , Keane Helen
Published: September 2020

Naked loan selfies are a Chinese Internet phenomenon in which naked selfies taken by young women are used as a form of collateral in peer-to-peer loaning systems. Despite being the subject of sensationalised media coverage in China, naked loan selfies have so far received only very limited academic attention. Drawing on the new materialist ontologies of Karen Barad and Annemarie Mol, this article investigates naked loan selfies as techno-social entities that are enacted through specific online networks and practices. The article uses text-based research and online walkthroughs to trace the way naked loan selfies are constituted first as collateral, and second as pornography. As well as providing insight into an under-researched online phenomenon, this article contributes to the growing body of work on selfies as networked, lively and agentic.
Speaking up or staying silent? Examining the influences of censorship and behavioral contagion on opinion (non-) expression in China
Authors: Zhu Yuner , Fu King-wa
Published: September 2020

Despite being designed to go unnoticed, censorship apparatus would occasionally manifest itself under various circumstances. In this study, we formulate four layers of censorship exposure where individual users can come across censorship. We investigate how different layers of censorship exposure influence users’ opinion expressions. Results show that people tend to stay silent when the censorship in the global environment is intensive, whereas they tend to “rebel” against censorship by voicing their opinions, when they experience censorship themselves or witness censorship occurring to their friends or reference persons. We also find community acts as a critical buffer against the influences of censorship. Outspoken crowd could shield individuals from the fear of punishment and outspoken friends could mitigate individuals’ anger against censorship. In either case, individuals can be liberated from their overconcern with censorship and be empowered to act for themselves.
Ultrasonic monitoring of pipe wall interior surface temperature
Authors: Zhang Yifeng , Cegla Frederic , Corcoran Joseph
Published: September 2020

Accurate temperature measurement is a crucial aspect of structural health monitoring and prognosis. Conventional temperature measurement devices are either incapable of measuring subsurface temperatures in solids or need to be invasively installed. This study investigates the use of an ultrasonic technique for non-invasive measurement of subsurface temperatures in steel components; the temperature of a point on an inaccessible surface is inferred using a time-of-flight measurement from a transducer placed on an opposing accessible surface. Two different inversion approaches are presented, one named the assumed distribution method and the other named the inverse thermal modelling method. The robustness and accuracy of the two ultrasonic temperature inversion methods are quantitatively assessed via simulations and controlled experiments. It was found that both the assumed distribution and inverse thermal modelling methods demonstrate short thermal response times and are able to track the temperature evolution of inaccessible surfaces. A series of experimental studies show that in the presence of a 15°C difference between the accessible and inaccessible surfaces, the inaccessible surface temperature is typically measured to within better than 2°C with respect to a resistance temperature detector reference measurement. Additionally, the article compares the measurement performance achieved using a deployable electromagnetic acoustic transducer and a permanently installed piezo-electric PZT transducer. The time-of-flight measurements taken using the electromagnetic acoustic transducer system had higher random noise than the PZT system (standard deviations of 0.42 and 0.016 ns, respectively), subsequently leading to higher random noise in the temperature estimates.
Creating Space for Youth Voice: Implications of Youth Disclosure Experiences for Youth-Centered Research
Authors: Woodgate Roberta Lynn , Tennent Pauline , Barriage Sarah
Published: September 2020

This paper examines youth’s disclosure experiences within the context of chronic illness, drawing on examples from IN•GAUGE, an on-going research program led by Dr. Roberta L. Woodgate. Youth’s descriptions of their disclosure experiences provide valuable insights into the ways in which they use their voice in everyday life. This examination of the disclosure experiences of youth offers a lens through which the concept of youth voice in the research process can be understood and youth’s agency foregrounded. We present implications for researchers, ethics boards, funding agencies, and others who engage in youth-centered research, and offer alternative terminology to use in characterizing the elicitation and dissemination of youth voice in the research process. We contend that conceptualizing such efforts as giving youth voice has the potential to discredit the significant agency and autonomy that youth demonstrate in sharing their stories, perspectives, and opinions within the research context. We advocate for the adoption of the phrase of providing or creating space for youth voice, as one alternative to the phrase giving youth voice
Accuracy of a 14-Day Factory-Calibrated Continuous Glucose Monitoring System With Advanced Algorithm in Pediatric and Adult Population With Diabetes
Authors: Alva Shridhara , Bailey Timothy , Brazg Ronald , Budiman Erwin S. , Castorino Kristin , Christiansen Mark P. , Forlenza Gregory , Kipnes Mark , Liljenquist David R. , Liu Hanqing
Published: September 2020

Background:

In this study, we evaluated the analytical performance of the second-generation factory-calibrated FreeStyle Libre Flash Glucose Monitoring (FreeStyle Libre 2) System compared to plasma venous blood glucose reference, Yellow Springs Instrument 2300 (YSI).

Methods:

The study enrolled participants aged four and above with type 1 or type 2 diabetes at seven sites in the United States. Adult participants (18+ years) participated in three in-clinic sessions and pediatric participants (4-17 years) participated in up to two in-clinic sessions stratified to provide data for days 1, 2, 3, 7, 8, 9, 12, 13, or 14 of sensor wear. Participants aged 11+ underwent supervised glycemic manipulation during in-clinic sessions to achieve glucose levels across the measurement range of the System. Performance evaluation included accuracy measures such as the proportion of continuous glucose monitoring (CGM) values that were within ±20% or ±20 mg/dL of reference glucose values, and bias measures such as the mean absolute relative difference (MARD) between CGM and reference values.

Results:

Data from the 144 adults and 129 pediatric participants were analyzed. Percent of sensor results within ±20%/20 mg/dL of YSI reference were 93.2% and 92.1%, and MARD was 9.2% and 9.7% for the adults and pediatric participants, respectively. The System performed well in the hypoglycemic range, with 94.3% of the results for the adult population and 96.1% of the data for pediatric population being within 15 mg/dL of the YSI reference. The time lag was 2.4 ± 4.6 minutes for adults and 2.1 ± 5.0 minutes for pediatrics.

Conclusions:

The System demonstrated improved analytical accuracy performance across the dynamic range during the 14-day sensor wear period as compared to the previous-generation device. NCT#: NCT03607448 and NCT03820050
Sex-Specific Associations between Cartilage Structure and Metabolism at Rest and Acutely Following Walking and Drop-Landing
Authors: Harkey Matthew S. , Blackburn J. Troy , Hackney Anthony C. , Lewek Michael D. , Schmitz Randy J. , Pietrosimone Brian
Published: September 2020

Objective

Cartilage health is thought to be dependent on the relationship between mechanics, structure, and metabolism, rather than these individual components in isolation. Due to sex differences in cartilage health, there is need to determine if the relationships between these cartilage components separately for males and females. Therefore, we sought to determine the sex-specific associations between cartilage structure and metabolism at rest and their acute response following walking and drop-landing in healthy individuals.

Design

A cartilage ultrasound assessment and an ante-cubital blood draw were performed before and after walking and drop-landing conditions in 20 males and 20 females. Cartilage structure was assessed via medial and lateral femoral cartilage cross-sectional area. Cartilage metabolism was quantified with serum cartilage oligomeric matrix protein (COMP) concentration. Percent change scores from pre- to postloading were used to calculate acute alterations in cross-sectional area and COMP. Correlational analyses were used to assess the association between cartilage structure and metabolism measures separately for males and females.

Results

In females, greater resting COMP concentration was associated with less cartilage cross-sectional area in the medial(ρ = −0.50, P = 0.03) and lateral (ρ = −0.69, P = 0.001) femur. Resting cartilage measures were not associated among males. Following walking and drop-landing, percent change scores in cartilage structure and metabolism were not associated.

Conclusions

This study highlights that, in females, thinner anterior femoral cartilage is associated with greater resting serum COMP concentrations, a biomarker often linked to cartilage breakdown. Future studies into the relationships between various cartilage components should consider sex-specific analyses as these relationships are sex dependent.
Gynecomastia in a Patient Taking Meloxicam—A Case Report
Authors: Rosas Steven L. , Deyo-Svendsen Mark E. , Oldfather Rachel Z. , Phillips Michael R. , Israel T. Andrew , Weisenbeck Emily R.
Published: September 2020

Gynecomastia is benign enlargement of glandular tissue in the male breast. It occurs due to an imbalance of estrogen and testosterone. It may be unilateral or bilateral. Physiologic gynecomastia commonly occurs in infants and during puberty and is self-limited. Gynecomastia may affect up to 50% of adult men over age 50 years old and can be related to underlying medical illness or caused by certain medications. Known causative agents include anti-androgenic and estrogenic drugs. Probable agents include alcohol and anti-ulcer, psychoactive, and antiretroviral medications. Non-steroidal anti-inflammatory drugs (NSAIDs) are not commonly associated with the development of gynecomastia. This case presents an instance in which the NSAID, meloxicam, was the only identified variable in a patient who developed unilateral gynecomastia. His breast tenderness and abnormal exam resolved spontaneously within 4 weeks of cessation of meloxicam therapy.
“Determining a Health-promoting Lifestyle among Afghan Immigrants Women in Iran”
Authors: Ahmadi Zahra , Amini Leila , Haghani Hamid
Published: September 2020

Background

Health-promoting lifestyle is an effective strategy for maintaining and controlling health, especially in immigrant women as a vulnerable group. Regarding this, the present study was conducted to determine the health promoting lifestyle and its associated factors in Afghan migrant women in Iran.

Method

This was a population based cross-sectional study in which 255 Afghan women of reproductive age. The study population was selected using the continuous sampling method from all Afghan women who referred to health centers of southwest of Tehran in 2018. The data were collected through the socio-demographic and Health Promoting Lifestyle Profile-II (HPLP-II) questionnaire.

Results

The total HPLP-II mean score of women was (124.05 ± 17.28). The lowest score was related to physical activity dimension (14.70 ± 3.78) and the highest score was related to spiritual growth (24.56 ± 5.06). Although some factors such as age, duration of education, income level, ability to speak Persian, education level of husband, and number of children significantly related factors to participant’s lifestyle ( P <.05), but multiple regression model showed that income level and ability to speak Persian are final statistically related factors to Afghan women health promoting lifestyle in Iran.

Conclusion

Familiarization of the individual with the Persian language and the promotion of employment status should be considered due to the low socio-economic level and the fact that most women participating in the study are housewives.
Integrating Multiple Informants’ Reports: How Conceptual and Measurement Models May Address Long-Standing Problems in Clinical Decision-Making
Authors: Makol Bridget A. , Youngstrom Eric A. , Racz Sarah J. , Qasmieh Noor , Glenn Lara E. , De Los Reyes Andres
Published: September 2020

Assessing youth psychopathology involves collecting multiple informants’ reports. Yet multi-informant reports often disagree, which necessitates integrative strategies that optimize predictive power. The trait-score approach leverages principal components analysis to account for the context and perspective from which informants provide reports. This approach may boost the predictive power of multi-informant reports and thus warrants rigorous testing. We tested the trait score approach using multi-informant reports of adolescent social anxiety in a mixed clinical and community sample of adolescents ( N = 127). The trait score incrementally predicted observed social anxiety (βs = 0.47–0.67) and referral status (odds ratios = 2.66–6.53) above and beyond individual informants’ reports and a composite of informants’ reports. The trait score predicted observed behavior at magnitudes well above those typically observed for individual informants’ reports of internalizing psychopathology (i.e., rs = .01–.15). Findings demonstrate the ability of the trait score to improve prediction of clinical indices and potentially transform widely used practices in multi-informant assessments.
A nomogram based on glycomic biomarkers in serum and clinicopathological characteristics for evaluating the risk of peritoneal metastasis in gastric cancer
Authors: Zhao Junjie , Qin Ruihuan , Chen Hao , Yang Yupeng , Qin Wenjun , Han Jing , Wang Xuefei , Ren Shifang , Sun Yihong , Gu Jianxin
Published: September 2020

Background

Peritoneal metastasis (PM) in gastric cancer (GC) remains an untreatable disease, and is difficult to diagnose preoperatively. Here, we aim to establish a novel prediction model.

Methods

The clinicopathologic characteristics of a cohort that included 86 non-metastatic GC patients and 43 PMGC patients from Zhongshan Hospital were retrospectively analysed to identify PM associated variables. Additionally, mass spectrometry and glycomic analysis were applied in the same cohort to find glycomic biomarkers in serum for the diagnosis of PM. A nomogram was established based on the associations between potential risk variables and PM.

Results

Overexpression of 4 N-glycans (H6N5L1E1: m/z 2620.93; H5N5F1E2: m/z 2650.98; H6N5E2, m/z 2666.96; H6N5L1E2, m/z 2940.08); weight loss ≥ 5 kg; tumour size ≥ 3 cm; signet ring cell or mucinous adenocarcinoma histology type; poor differentiation; diffuse or mixed Lauren classification; increased CA19-9, CA125, and CA724 levels; decreased lymphocyte count, haemoglobin, albumin, and pre-albumin levels were identified to be associated with PM. A nomogram that integrated with five independent risk factors (weight loss ≥ 5 kg, CA19-9 ≥ 37 U/mL, CA125 ≥ 35 U/mL, lymphocyte count < 2.0 * 10 ~ 9/L, and H5N5F1E2 expression ≥ 0.0017) achieved a good performance for diagnosis (AUC: 0.892, 95% CI 0.829–0.954). When 160 was set as the cut-off threshold value, the proposed nomogram represented a perfectly discriminating power for both sensitivity (0.97) and specificity (0.88).

Conclusions

The nomogram achieved an individualized assessment of the risk of PM in GC patients; thus, the nomogram could be used to assist clinical decision-making before surgery.
Modeling the synergistic effects of toxicant mixtures
Authors: Liess Matthias , Henz Sebastian , Shahid Naeem
Published: September 2020

Background

Toxicants often occur simultaneously. Some combinations show synergistic combined effects that go far beyond what is predicted with current effect models. Up until now, only the combined additive effects of similar acting chemicals have been assessed accurately, whereas the combined effects of dissimilar acting chemicals have been greatly underestimated in many cases.

Results

Here, we use the individual tri-phasic concentration–response relationship of two toxicants with different modes of action to model their combined synergistic effect on Daphnia magna. The novel stress addition approach (SA) predicted the combined effects (LC50) of different esfenvalerate and prochloraz combinations with an uncertainty factor of 2.8 at most, while the traditional effect addition (EA) and concentration addition (CA) approaches underestimated the combined effect by a factor of up to 150 and 660, respectively. Data of the single substance concentration–response relationships and on their combined effects enable to determine the degree of synergism. For the evaluation of the combined toxicant effect, we provide the approach as R package and as Indicate model (http://www.systemecology.eu/indicate/).

Conclusion

Adding stressors arithmetically, considering non-monotonic cause–effect relationships, is a decisive component in predicting the combined effects of multiple stressors within test systems. However, the extent of the synergistic effects that multiple stressors exert on populations within the ecosystem context is still highly controversial. Various processes are relevant at the ecosystem level, which are not considered in laboratory studies. However, the present work serves as a building block for understanding the effects of multiple stressors in the field.
Alemtuzumab-associated diffuse alveolar damage – a case report
Authors: Bayas Antonios , Menacher Martina , Schwaiblmair Martin , Märkl Bruno , Naumann Markus
Published: September 2020

Background

Identifying causes of alemtuzumab induced respiratory symptoms in Multiple Sclerosis (MS) patients is crucial.

Case presentation

We report a case of diffuse alveolar damage (DAD) in a patient with MS after the first course of alemtuzumab treatment. A 42-year-old female developed progressive non-productive cough and exertional dyspnea 2 months after alemtuzumab treatment. DAD was diagnosed histopathologically by lung biopsy. The patient recovered completely, alemtuzumab was not continued.

Conclusions

Our case highlights another pathomechanism for non-infective lung-disorders in alemtuzumab treated MS patients. DAD is a potential, albeit rare side effect of alemtuzumab, broadening the spectrum of non-infective lung disorders that should be considered in the diagnostic work-up.
A donor twin discordant with Peters anomaly in a twin–twin transfusion syndrome case: a case report
Authors: Chang Yao-Lung , Chao An-Shine , Chou Ching-Yu , Chang Shuenn-Dyh , Chiang Ming-Chou , Lee Yung-Sung
Published: September 2020

Background

Peters anomaly is a rare form of anterior segment ocular dysgenesis, the antenatal image of Peters anomaly had not been reported. We herein showcased a discordant finding of Peters anomaly in a monozygotic twin complicated with twin-twin transfusion syndrome (TTTS) and exhibited its antenatal sonographic images,

Case presentation

A 38-year-old gravida 2 para 1 pregnant woman visited our clinic at the gestational age of 18 weeks where TTTS stage III was diagnosed and the following laser therapy was done successfully. Ten days after the surgery, the follow-up ultrasound detected the opacity of both fetal eyeballs in the donor twin and thus congenital cataract was suspected initially. Then magnetic resonance imaging (MRI) examination was arranged at the gestational age of 23 weeks, and no central nervous system or other anomaly was found. At the 29 weeks of gestation, the opacity of both fetal eyeballs of the donor twin did not clear. The pregnancy resulted in cesarean section at the gestational age of 37 weeks indicated by malpresentation where two male live births were born. Examination under anesthesia was arranged for donor twin after delivery and Peters anomaly was diagnosed based on central corneal opacity with iridocorneal and corneolenticular adhesions.

Conclusions

The prenatal image of Peters anomaly may present as the opacity of the fetal eyeballs similar to congenital cataract. Some cases of the Peters anomaly had been reported with a genetic abnormality, but since our case presented discordant presentation in monozygotic twin pregnancy where both twins are supposed to share the same genetic make-up, therefore other factors that are epigenetic may be held accountable. Nevertheless, a genetic origin of the anomaly in our case cannot be excluded.
High platelet-to-lymphocyte ratio is associated with poor prognosis in patients with unresectable intrahepatic cholangiocarcinoma receiving gemcitabine plus cisplatin
Authors: Huh Gunn , Ryu Ji Kon , Chun Jung Won , Kim Joo Seong , Park Namyoung , Cho In Rae , Paik Woo Hyun , Lee Sang Hyub , Kim Yong-Tae
Published: September 2020

Background

Several systemic inflammatory response (SIR) markers, including platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and albumin-to-globulin ratio (AGR), have emerged as prognostic markers in various cancers. The aim of this study was to explore the impact of SIR markers on the survival outcomes of unresectable intrahepatic cholangiocarcinoma (IHC) patients.

Methods

Patients with histologically confirmed, unresectable IHC treated with gemcitabine plus cisplatin (GP) chemotherapy in a single tertiary hospital from 2012 to 2016 were retrospectively reviewed. Progression-free survival (PFS) and overall survival (OS) were determined using unadjusted Kaplan-Meier and adjusted Cox-proportional-hazards analysis. Time-dependent receiver operating characteristic (ROC) analysis was performed to compare the performance of the SIR markers in predicting OS.

Results

A total of 137 patients received a median of six cycles (interquartile range [IQR], 3–11) of GP chemotherapy with a median observation time of 9.9 months (range, 1.8–54.7 months). The median PFS and OS of all patients were 7.8 months and 9.9 months, respectively. Among the SIR markers, high PLR (> 148) and high NLR (> 5) were associated with a short PFS (Hazard ratio [HR] 1.828,P = 0.006; HR 1.738,P = 0.030, respectively) and short OS (HR 2.332,P < 0.001; HR 2.273,P < 0.001, respectively). Low LMR (< 3.5) and low AGR (< 1.2) were associated with a short OS (HR 2.423,P < 0.001; HR 1.768,P = 0.002, respectively). In multivariable cox-regression analysis, high PLR (HR 1.766,P = 0.009) and distant lymph node (LN) metastasis (HR 2.085,P = 0.001) were associated with a short PFS. High PLR (HR 1.856,P = 0.002) was an independent predictor of a short OS, along with distant LN metastasis (HR 1.929;P < 0.001), low LMR (HR 1.691;P = 0.041), and low level of serum albumin (< 3.5 g/dL) (HR 1.632;P = 0.043). Time-dependent ROC analysis revealed that the area under the curve of PLR for predicting overall survival was greater than that of NLR, LMR, and AGR at most time points.

Conclusions

High PLR was an independent prognostic factor of a short PFS and OS in patients with unresectable IHC receiving GP chemotherapy.
The role of CD28 in the prognosis of young lung adenocarcinoma patients
Authors: Sun Dantong , Tian Lu , Bian Tiantian , Zhao Han , Tao Junyan , Feng Lizong , Liu Qiaoling , Hou Helei
Published: September 2020

Background

The prognosis of lung cancer was found to be associated with a series of biomarkers related to the tumor immune microenvironment (TIME), which can modulate the biological behaviors and consequent outcomes of lung cancer. Therefore, establishing a prognostic model based on the TIME for lung cancer patients, especially young patients with lung adenocarcinoma (LUAD), is urgently needed.

Methods

In all, 809 lung cancer patients from the TCGA database and 71 young patients with LUAD in our center were involved in this study. Univariate and multivariate analysis based on clinical characteristics and TIME-related expression patterns (as evaluated by IHC) were performed to estimate prognosis and were verified by prognostic nomograms.

Results

Both LUAD and lung cancer patients with high CD28 expression had shorter disease-free survival (DFS) (P = 0.0011; P = 0.0001) but longer overall survival (OS) (P = 0.0001; P = 0.0282). TIME-related molecules combined with clinical information and genomic signatures could predict the prognosis of young patients with LUAD with robust efficiency and could be verified by the established nomogram based on the Cox regression model. In addition, CD28 expression was correlated with an abundance of lymphocytes and could modulate the TIME. Higher CD28 levels were observed in primary tumors than in metastatic tissues.

Conclusion

TIME-related molecules were identified as compelling biomarkers for predicting the prognosis of lung cancer, especially in a cohort of young patients. Furthermore, CD28, which is associated with poor DFS but long OS, might participate in the modulation of the TIME and has a different role in the prognosis of young patients with LUAD.
Tobacco exposure as a major modifier of oncologic outcomes in human papillomavirus (HPV) associated oropharyngeal squamous cell carcinoma
Authors: Elhalawani Hesham , Mohamed Abdallah S. R. , Elgohari Baher , Lin Timothy A. , Sikora Andrew G. , Lai Stephen Y. , Abusaif Abdelrahman , Phan Jack , Morrison William H. , Gunn G. Brandon , Rosenthal David I. , Garden Adam S. , Fuller Clifton D. , Sandulache Vlad C.
Published: September 2020

Background

The incidence of oropharyngeal squamous cell carcinoma (OPSCC) in the US is rapidly increasing, driven largely by the epidemic of human papillomavirus (HPV)-mediated OPSCC. Although survival for patients with HPV mediated OPSCC (HPV+ OPSCC) is generally better than that of patients with non-virally mediated OPSCC, this effect is not uniform. We hypothesized that tobacco exposure remains a critical modifier of survival for HPV+ OPSCC patients.

Methods

We conducted a retrospective analysis of 611 OPSCC patients with concordant p16 and HPV testing treated at a single institute (2002–2013). Survival analysis was performed using Kaplan-Meier analysis and Cox regression. Recursive partitioning analysis (RPA) was used to define tobacco exposure associated with survival (p < 0.05).

Results

Tobacco exposure impacted overall survival (OS) for HPV+ patients on univariate and multivariate analysis (p = 0.002, p = 0.003 respectively). RPA identified 30 pack-years (PY) as a threshold at which survival became significantly worse in HPV+ patients. OS and disease-free survival (DFS) for HPV+ > 30 PY patients didn’t differ significantly from HPV- patients (p = 0.72, p = 0.27, respectively). HPV+ > 30 PY patients had substantially lower 5-year OS when compared to their ≤30 PYs counterparts: 78.4% vs 91.6%; p = 0.03, 76% vs 88.3%; p = 0.07, and 52.3% vs 74%; p = 0.05, for stages I, II, and III (AJCC 8th Edition Manual), respectively.

Conclusions

Tobacco exposure can eliminate the survival benefit associated with HPV+ status in OPSCC patients. Until this effect can be clearly quantified using prospective datasets, de-escalation of treatment for HPV + OPSCC smokers should be avoided.
Systemic TNFα correlates with residual β-cell function in children and adolescents newly diagnosed with type 1 diabetes
Authors: Overgaard Anne Julie , Madsen Jens Otto Broby , Pociot Flemming , Johannesen Jesper , Størling Joachim
Published: September 2020

Background

Type 1 diabetes (T1D) is caused by immune-mediated destruction of the β-cells. After initiation of insulin therapy many patients experience a period of improved residual β-cell function leading to partial disease remission. Cytokines are important immune-modulatory molecules and contribute to β-cell damage in T1D. The patterns of systemic circulating cytokines during T1D remission are not clear but may constitute biomarkers of disease status and progression. In this study, we investigated if the plasma levels of various pro- and anti-inflammatory cytokines around time of diagnosis were predictors of remission and residual β-cell function in children with T1D followed for one year after disease onset.

Methods

In a cohort of 63 newly diagnosed children (33% females) with T1D with a mean age of 11.3 years (3.3–17.7), ten cytokines were measured of which eight were detectable in plasma samples by Mesoscale Discovery multiplex technology at study start and after 6 and 12 months. Linear regression models were used to evaluate association of cytokines with stimulated C-peptide.

Results

Systemic levels of tumor necrosis factor (TNF)-α, interleukin (IL)-2 and IL-6 inversely correlated with stimulated C-peptide levels over the entire study (P < 0.05). The concentrations of TNFα and IL-10 at study start predicted stimulated C-peptide level at 6 months (P = 0.011 and P = 0.043, respectively, adjusted for sex, age, HbA1c and stage of puberty).

Conclusions

In recent-onset T1D, systemic cytokine levels, and in particular that of TNFα, correlate with residual β-cell function and may serve as prognostic biomarkers of disease remission and progression to optimize treatment strategies.

Trial Registration

The study was performed according to the criteria of the Helsinki II Declaration and was approved by the Danish Capital Region Ethics Committee on Biomedical Research Ethics (journal number H-3-2014-052). The parents of all participants gave written consent.
COVID-19 pandemic- knowledge, perception, anxiety and depression among frontline doctors of Pakistan
Authors: Amin Faridah , Sharif Salman , Saeed Rabeeya , Durrani Noureen , Jilani Daniyal
Published: September 2020

Background

COVID-19 is a global pandemic and has become a major public health burden worldwide. With already fragile healthcare systems it can have long lasting effects in developing countries. Outbreaks especially a pandemic situation evokes fear related behaviors among healthcare professionals and there is always an increased risk of mental health disorders. Therefore, this study aims to determine knowledge and perception about this pandemic, prevalence and factors associated with anxiety/depression among frontline physicians of Pakistan.

Methods

Data were collected through an online survey released in the last week of March-2020. 389 frontline physicians from all four provinces and 65 cities of Pakistan participated. Survey questionnaire consisted of 4 parts including informed consent section, demographic section, knowledge and perception about COVID-19 pandemic and assessment of depression through World Health Organization Self-reporting questionnaire (SRQ-20). A score of 8 or above on SRQ-20 was used as cut-off to label the participant as depressed. Data was analyzed using SPSS version22.

Results

A 43% prevalence of anxiety/depression among frontline physicians of Pakistan was reported. Almost all the doctors had moderate to high knowledge score. Majority of participants marked N-95 mask as “essential” during aerosol generating procedures, assessing patients with respiratory symptoms, in COVID patient-care area, ER triage and direct care of COVID-19 patient. Only 12% of the doctors were fully satisfied with the provision of PPEs and almost 94% felt unprotected.

In multivariable model, assessing more than five COVID suspects/day (aOR = 2.73, 95% CI: 1.65–4.52), working 20 h/week or less (aOR = 2.11, 1.27–3.49), having children among household members (aOR = 1.58, 95% CI: 1.00–2.50) and moderate to low knowledge of the infection (aOR = 2.69, 95% CI: 1.68–4.31) were found to be independent predictors of anxiety/depression among physicians.

Conclusion

Anxiety/depression among more than a third of frontline doctors of Pakistan warrants the need to address mental health of doctors caring for patients during this pandemic; control modifiable factors associated with it and explore the effectiveness of interventions to promote psychological well-being of physicians.
The segment IV approach: a useful method for achieving the critical view of safety during laparoscopic cholecystectomy in patients with anomalous bile duct
Authors: Fujioka Shuichi , Nakashima Keigo , Kitamura Hiroaki , Takano Yuki , Misawa Takeyuki , Kumagai Yu , Hata Taigo , Akiba Tadashi , Ikegami Toru , Yanaga Katsuhiko
Published: September 2020

Background

The critical view of safety (CVS) method can be achieved by avoiding vasculo-biliary injury resulting from misidentification during laparoscopic cholecystectomy (LC). Although achieving the CVS has become popular worldwide, there is no established standardized technique to achieve the CVS in patients with an anomalous bile duct (ABD). We recently reported our original approach for securing the CVS using a new landmark, the diagonal line of the segment IV of the liver (D-line). The D-line is an imaginary line that lies on the right border of the hilar plate. The cystic structure can be securely isolated along the D-line without any misidentification, regardless of the existence of an ABD. We named this approach the segment IV approach in LC.

Methods

In this study, we adopted the segment IV approach in patients with an ABD.

Results

From October 2015 to June 2020, 209 patients underwent LC using the segment IV approach. Among them, three (1.4%) were preoperatively diagnosed with an ABD. The branching point of the cystic duct was the posterior sectional duct, anterior sectional duct, or left hepatic duct in each patient. The CVS was achieved in all cases without any complications.

Conclusion

It is a promising technique, especially even for patients with an ABD during LC.