bluuebunny/crossref_metadata_2025 huggingface dataset:
The Relationship Between Childhood Circumstances and Late Life Physical and Mental Health: The Role of Adult Socioeconomic Status
Authors: Hempel Megan , Breheny Mary , Yeung Polly , Stevenson Brendan , Alpass Fiona
Published: September 2020

Objectives:

Socioeconomic status and health in childhood are linked to health outcomes in later life. Health outcomes may also be shaped by socioeconomic circumstances in adulthood and later life. This paper examined the relationship between childhood conditions and later life health and tested whether this relationship was mediated by later life economic living standards.

Methods:

Data from a longitudinal study of aging was combined with retrospective life history data from 787 participants from the New Zealand Health, Work and Retirement Study.

Results:

Significant relationships were found between childhood conditions and later life health. These relationships were mediated by economic living standards in older age, but the partial direct effect of childhood conditions on health found in early older age became fully meditated 10 years later.

Conclusion:

While childhood circumstances are part of this complex relationship, socioeconomic conditions in later life are vital to ensuring ongoing health into older age.
Polysomnographic Outcomes After Observation for Mild Obstructive Sleep Apnea in Children Younger Than 3 Years
Authors: Sarber Kathleen M. , von Allmen Douglas C. , Tikhtman Raisa , Howard Javier , Simakajornboon Narong , Yu Wenwen , Smith David F. , Ishman Stacey L.
Published: September 2020

Objective

Mild obstructive sleep apnea (OSA), particularly in young children, is often treated with observation. However, there is little evidence regarding the outcomes with this approach. Our aim was to assess the impact of observation on sleep for children aged <3 years with mild OSA.

Study Design

Case‐control study.

Setting

Pediatric tertiary care center.

Methods

We reviewed cases of children (<3 years old) diagnosed with mild OSA (obstructive apnea‐hypopnea index, 1‐5 events/h) who were treated with observation between 2012 and 2017 and had at least 2 polysomnograms performed 3 to 12 months apart. Demographic data and comorbid diagnoses were collected.

Results

Twenty‐six children met inclusion criteria; their median age was 7.2 months (95% CI, 1.2‐22.8). Nine (35%) were female and 24 (92%) were White. Their median body mass index percentile was 39 (95% CI, 1‐76). Comorbidities included cardiac disease (42.3%), laryngomalacia (42.3%), allergies (34.6%), reactive airway disease (23.1%), and prematurity (7.7%). The obstructive apnea‐hypopnea index significantly decreased from 2.7 events/h (95% CI, 1‐4.5) to 1.3 (95% CI, 0‐4.5; P =. 013). There was no significant improvement in median saturation nadir (baseline, 86%; P =. 76) or median time with end‐tidal carbon dioxide >50 mm Hg (baseline, 0 minutes; P =. 34). OSA resolved in 8 patients (31%) and worsened in 1 (3.8%). Only race was a significant predictor of resolution per regression analysis; however, only 2 non‐White children were included.

Conclusion

In our cohort, resolution of mild OSA occurred in 31% of patients treated with 3 to 12 months of observation. The presence of laryngomalacia, asthma, and allergies did not affect resolution. Larger studies are needed to better identify factors (including race) associated with persistent OSA and optimal timing of intervention for these children.

Level of Evidence

4.
Pediatric Basilar Skull Fracture Mechanisms and Trends From 2007 to 2018
Authors: Magit Anthony , Stramiello Joshua A. , Good Raquel , Nation Javan
Published: September 2020

Objectives

To evaluate the specific mechanism and trend of injury resulting in pediatric basilar skull fractures.

Study Design

Retrospective chart review of a trauma database.

Setting

Tertiary care children’s hospital.

Methods

Patients ≤18 years old with basilar skull fractures were identified via the trauma database for admissions from 2007 to 2018. Patients were identified with ICD‐9 codes (801.0, 801.1, 801.2, 801.3 or 801.4) and ICD‐10 codes (S02.1, S02.10, S02.11, S02.19) for skull base fractures (International Classification of Diseases, Ninth Revision and Tenth Revision).

Results

A total of 729 patients were included: 251 females and 478 males. The 2 most common mechanisms of injury are multilevel falls and unhelmeted rider falls. Multilevel falls occur more in the toddler age group (average age, 4 years), and unhelmeted rider falls are seen in the older age group (average age, 11.2 years). Helmeted rider and motor vehicle accident basilar skull injuries are relatively uncommon. There was a spike in television/entertainment center mechanisms of injury in toddlers from 2007 to 2011 but has since decreased.

Conclusion

Pediatric basilar skull fractures are costly to the health care system, as patients spent more time in intensive care unit beds with a charge limited to hospital rooms between $1.7 and $2.7 million per year. The protective effect of helmets is demonstrated by unhelmeted rider injuries being the second‐most common mechanism of basilar skull fractures and by helmeted rider injuries being rare. The small proportion of basilar skull fractures from motor vehicle accidents is an example of policy and behavioral changes resulting in decreased injury.
Financial Bailout Spending Would Have Almost Paid for Thirty Years of Global Green New Deal Climate: Triage, Regeneration, and Mitigation
Authors: Baiman Ron
Published: September 2020

Human-induced climate crisis is destroying the capacity of our planet to support our species and other life at an unprecedented rate. The most urgent of climate crisis tipping points is Arctic warming and sea ice loss. It is estimated that Arctic summer sea ice loss, that could—based on current trends—occur in one or two decades, would cause an abrupt 0.5 Watts per square meter increase in global warming above preindustrial levels that would be roughly equivalent to the effect of more than seventeen years of greenhouse gas (GHG) emissions if it occurred today. A Global Green New Deal (GGND) will require at least three phases and three funding sources. The three overlapping phases are (a) short-run climate restoration or triage, (b) medium-term soil carbon sponge and water cycle adaptation or regeneration, and (c) long-run GHG drawdown or mitigation. The three funding sources are (a) utilizing the sovereign of the US government and Federal Reserve to create dollars, (b) taxing GHG emissions, and (c) taxing wealthy and high-income individuals with a particular focus on rentiers. The ex-nihilo financial support offered by the Fed to bail out the global financial system from 2008 to 2011 would have been almost sufficient to fund a 2020–2050 comprehensive GGND that includes all of the components above.
Being the rope in a tug of war: Márkus and Rorty as readers of Hegel in the ’70s, ’80s and ’90s
Authors: Redding Paul
Published: September 2020

This paper gives a brief sketch of György Márkus’s philosophical style as manifest in the context of his role within the revival of Hegelian philosophy in Sydney in the last decades of the 20th century. Written from the perspective of one of his students, this style is sharpened by the contrast with that of another philosopher who was influential in the Hegel revival around that time, Richard Rorty. It is suggested that the stark antithesis between Márkusian and Rortarian philosophical and interpretative styles reflects tensions within Hegel’s own attitude to what it might mean to reanimate a philosophy from the past within a radically changed cultural context.
Epidemiology of Demyelinating Diseases in Korean Pediatric Patients
Authors: Yoon Hye Hyun , Park Ji Young , Kim Su Yeong , Lee Na Mi , Yi Dae Yong , Yun Sin Weon , Lim In Seok , Chae Soo Ahn
Published: September 2020

The epidemiology of demyelinating diseases in the Korean pediatric population has not been reported to date. This study aimed to identify the epidemiology of demyelinating diseases in Korean children by using big data. The subjects were children (0-17 years old) diagnosed with acute-disseminated encephalomyelitis, multiple sclerosis, neuromyelitis optica, and Guillain-Barré syndrome enrolled in the Korean Health Insurance Review and Assessment Service (HIRA) from January 2010 to December 2017.

Of 1722 enrolled children, 553 (32.1%) had acute-disseminated encephalomyelitis, 170 (9.9%) had multiple sclerosis, 68 (3.9%) had neuromyelitis optica, and 931 (54.1%) had Guillain-Barré syndrome. The male-female ratios were 1.47:1 in acute-disseminated encephalomyelitis, 1.43:1 in Guillain-Barré syndrome, 1:1.66 in multiple sclerosis, and 1:1.62 in neuromyelitis optica. Demyelinating diseases were most prevalent in summer. The prevalence differed by region, with 545 (31.6%) in Seoul and 298 (17.3%) in Gyeonggi. This study is the first to identify the incidence of demyelinating diseases in South Korea.
Interpersonal Trauma and Sexual Function and Satisfaction: The Mediating Role of Negative Affect Among Survivors of Military Sexual Trauma
Authors: K. Blais Rebecca , K. Zalta Alyson , S. Livingston Whitney
Published: September 2020

Healthy sexual function among women service members/veterans (SM/Vs) is associated with higher quality of life, lower incidence and severity of mental health diagnoses, higher relationship satisfaction, and less frequent suicidal ideation. Although trauma exposure has been established as a predictor of poor sexual function and satisfaction in women SM/Vs, no study to date has examined whether specific trauma types, such as military sexual trauma (MST), increase risk for sexual issues. Moreover, the possible mechanisms of this association have not been explored. The current study examined whether posttraumatic stress disorder (PTSD) and depression symptom clusters mediated the association of trauma type and sexual function and satisfaction in 426 trauma-exposed women SM/Vs. Two hundred seventy participants (63.4%) identified MST as their index trauma. Path analyses demonstrated that MST was related to poorer sexual function and lower satisfaction relative to the other traumas ( χ2[28, N = 426] = 43.3, p = 0.03, CFI = 1.00, TLI = 0.99, and RMSEA = 0.04), and this association was mediated by higher non-somatic depressive symptoms and PTSD symptom clusters of anhedonia and negative alterations in cognition and mood (NACM). Causality cannot be inferred due to the cross-sectional nature of the data. However, our findings suggest that interventions aimed at decreasing sexual issues among female SM/Vs with MST should target depressogenic symptoms, whether the origin is depression or PTSD. Longitudinal research exploring the etiological processes that contribute to sexual dysfunction among those with MST is needed.
Simulation of the round insert face milling process of AISI 316LN stainless steel with machining-based plastic behavior modeling
Authors: Kim Do Young , Kim Dong Min , Kwon OBum , Park Hyung Wook
Published: September 2020

A proper plastic behavioral model is required to simulate metal cutting. Here, we model the plastic behavior of AISI 316LN stainless steel during face milling. We used a numerical approach to derive a plasticity model appropriate for machining; a two-dimensional cutting force prediction and a genetic algorithm were conducted for that. The force prediction was performed considering a geometrical relationship between the work material and cutting tool. We used the Johnson-Cook (JC) constitutive material model, and initial model parameters were obtained via tension testing at low strain rates (0.001–1 s−1). The genetic algorithm optimized the model parameters; the predictive accuracy with respect to cutting force was high in the model with optimized parameters. We used the optimized JC model for finite element analysis and simulated face milling with a round insert. We measured the cutting forces to validate our modeling approach; the simulated and measured principal forces were in good agreement (error rate ≤ 3.9% under all machining conditions). Our model improved the accuracy of plastic behavior prediction by 93.0% versus the original model. The high accuracy was retained even when the machining environment changed.
Safety distance model for longitudinal collision avoidance of logistics vehicles considering slope and road adhesion coefficient
Authors: Guo Chen , Wang Xiaolan , Su Lili , Wang Yansong
Published: September 2020

With the acceleration of urbanization process, the country’s strong support for the healthy development of the logistics industry has made urban logistics become a hot topic in recent years. With the increase in the number of logistics vehicles, traffic accidents have become more frequent. Intelligent vehicle collision avoidance system is an important part of advanced safety technology. To increase veracity and practicability of logistics vehicle safety collision avoidance, this paper presents a safety distance model for longitudinal collision avoidance of logistics vehicles considering road slope and road adhesion coefficient. Based on the vehicle kinetic theory, the information of surrounding environment for the vehicle is obtained using environment sensing system adequately, a method is designed to estimate the road slope and road adhesion coefficient. Combined with vehicle dynamics and tire normal force variation, the road slope was estimated. Based on the relationship between slip rate and adhesion coefficient, the Least Square Method is used for multivariate fitting to obtain the relationship between rolling resistance coefficient and road adhesion coefficient, estimate the road adhesion coefficient, and the maximum deceleration of vehicle braking is modified. Therefore, the safety distance model is established. In order to verify the accuracy and effectiveness of the model, three cases are designed for verification: case I is verification of the safety distance model considering the slope factor; case II is verification of the safety distance model considering the road adhesion factor; case III is the safety distance verification considering both the factors of slope and road adhesion coefficient. The result shows that it is necessary to take the factors of road slope and adhesion coefficient into the safety distance model to improve the accuracy of the model.
Fabrication, characterization, and in vivo biocompatibility evaluation of titanium-niobium implants
Authors: Yolun Abdurrahman , Şimşek Murat , Kaya Mehmet , Annaç Ebru Elibol , Köm Mustafa , Çakmak Ömer
Published: September 2020

In this study, biocompatible titanium-niobium (Ti-Nb) alloys were fabricated by using powder metallurgy methods. Physical, morphological, thermal, and mechanical analyses were performed and their in vivo compatibility was evaluated. Besides α, β, and α″ martensitic phases, α+β Widmanstätten phase due to increasing sintering temperature was seen in the microstructure of the alloys. Phase transformation temperatures of the samples decreased as Nb content increased. The ratio of Nb in the samples affected their mechanical properties. No toxic effect was observed on implanted sites. This study shows that Ti-Nb alloys can be potentially used for orthopedic applications without any toxic effects.
What will ‘taking back control’ mean for social policy in the UK? Brexit, public services and social rights
Authors: Stewart Kitty , Cooper Kerris , Shutes Isabel
Published: September 2020

While social policy falls predominantly under national rather than European Union (EU) jurisdiction, there are nonetheless multiple ways in which social policy and social outcomes in EU member states have been affected by EU membership. This paper draws on existing evidence and analysis to review the consequences for UK social policy of the decision to leave the EU. We focus predominantly on the implications of the British government’s pledge to ‘take back control’ of money, borders and laws. Our conclusion is that Brexit is likely to have negative effects on the quality of public services and, for some groups in particular, social rights, and that these effects are likely to be greater the more distant are the future trading and wider relationships between the UK and the EU27.
The museum and temporalization
Authors: Hartog François
Published: September 2020

More than any other institution, the museum is preoccupied with time, perpetually creating, contesting, and regaining it. From the collections of ancient art amassed in mid-14th-century Italy to the contemporary galleries without their own collections, the museum has always been a leading force in shaping Western civilization’s perceptions of time. After a survey of the history of Europe’s museums, the article traces the configurations of temporality that have arisen in different periods. Beginning in the 15th century, museums exhibited recent art alongside classical masterpieces, highlighting the cleavage between new and old. Three and a half centuries later, however, the art of the present was proclaimed a contemporary of the art of the past and the future, a notion upheld in spite of the outpourings of revolutionary pathos. It was in the second half of the 20th century that this synchronizing tendency yielded to the domination of the one and only present, which remains in force today. This new and challenging situation could be a starting point for the reassessment of contemporary museums’ role in influencing and realizing social temporality.
Comprehensive Analysis of the Expression and Prognosis for SFRPs in Breast Carcinoma
Authors: Wu Zeng-Hong , Zhang You-jing , Yue Jian-Xin , Zhou Tao
Published: September 2020

Secreted frizzled-related proteins ( SFRPs) are a group of five secreted glycoproteins— SFRP1, SFRP2, SFRP3 (frizzled related protein , FRZB), SFRP4, and SFRP5—which contain a frizzled-related cysteine-rich domain and a netrin module. We analyzed SFRPs’ expression levels, mutations, regulation, functional networks, and correlation with immune infiltration in breast cancer (BC) patients using data from multiple open databases. SFRP1/3/4/5 were downregulated and SFRP2 was upregulated in BC patients compared to healthy controls. Furthermore, higher levels of SFRP1/3/4 were significantly associated with favorable prognosis. In addition, the prognostic significance of the infiltrating B cells was correlated to the SFRPs. Based on these findings, we hypothesize that SFRPs play a synergistic role in BC progression, and are, therefore, promising prognostic biomarkers as well as therapeutic targets.
Are the Enclaves on the Same Boat? An Investigation on the Development Indicators of Dahagram–Angarpota of Bangladesh
Authors: Misu Farjana , Khatun Mst. Asma , Islam Mohammad Amirul
Published: September 2020

Enclaves are the most distressed areas in the world where the ray of development hardly reaches. This study aims to evaluate the progress in the development in Dahagram–Angarpota enclave of Bangladesh after the initiation of 24-h open corridor access through the Indian territory in 2011. The study reveals that after 24-h open access through the corridor, the enclave achieved substantial positive changes in all the five indicators, namely, economic, social and infrastructural, technological, health and demographic indicators. However, the achievement in the four influential factors of development such as income, wealth, poverty and food security are still below the national level. Binary logistic regression model identified a positive change in income–wealth index of households through the changes in corridor access, education, electricity supply, number of livestock and involvement with micro credit. In the process of raising income–wealth, achieving food security and alleviating poverty, this study has suggested some policy recommendations that would guide different development programmes in the area.
Book review: Dev Nath Pathak, Living & Dying Meanings in Maithili Folklore
Authors: Dutta Dr Piyashi
Published: September 2020

Dev Nath Pathak, Living & Dying Meanings in Maithili Folklore. New Delhi: Primus Books, 2018, vii+ 239 pp., ₹3,651.00 (hardback). ISBN: 978-93-5290-215-6.
Effect of Non-tariff Barriers on Maize Production and Marketing by Smallholder Farmers in Tanzania
Authors: Maziku Petro , Mashenene Robert
Published: September 2020

This study assessed the effect of non-tariff barriers (NTBs) on the production and marketing of maize for smallholder farmers in Mbozi and Momba Districts located in Songwe region in Tanzania. A cross-sectional design was employed in gathering primary data. A two-stage stratified sampling procedure was used in the selection of 400 smallholder farmers, who were surveyed using standardized questionnaires. In estimating the effect of NTBs on maize production and supply, the duality model was employed. The results indicate that NTBs have a depressive effect on the quantity of maize produced and marketed. The findings further show that a unit increase in transaction costs attributed to NTBs could reduce the quantity of maize produced by 16 per cent in the two districts. Based on these findings, it is concluded that the quantity of maize produced and supplied by farmers in the two districts decreases with an increase in the NTB costs. The study recommends the reduction and/or removal of the NTBs, which impede maize production and marketing among smallholder farmers. This would help the government to achieve its goals of creating high prices in the surplus districts and attain low consumer prices in the deficit urban centers, thus reducing poverty.
India–ASEAN Trade Relations: Examining the Trends and Identifying the Potential
Authors: Banik Nilanjan , Kim Misu
Published: September 2020

The Association of South East Asian Nations (ASEAN) is an important trading partner for India. Through its Act East Policy, India seeks deeper economic integration with ASEAN. In this article, we investigate the pattern of trade between India and ASEAN, using comparative advantage by country (CAC) and market comparative advantage (MCA) as criteria, which are more appropriate measures for showing comparative advantage in a specific market. These measures indicate some major Indian exports to ASEAN are not competitive. When domestic industries are not competitive, governments protect them through tariffs and non-tariff barriers, which act counter to deeper economic integration. We also identify the sectors in which India has the potential to become competitive but is not because of distortionary domestic policy measures. These domestic constraints prohibit Indian firms from participating in the ASEAN supply chain network, an important factor in developing deeper economic integration. Two such sectors—namely aluminium automotive components and the ready-made garment industry—are examined as case studies. Notwithstanding these distortionary policy measures, India still offers a bigger market to do business. The ability to supply lower cost chemicals and affordable pharmaceutical products at the time of COVID-19 is an added plus.
Potential Substitution Between Accrual Earnings Management and Real Earnings Management Among Pakistani Listed Firms
Authors: Shah Syed Farhan , Rashid Abdul , Malik Wasim Shahid
Published: September 2020

This article empirically explores the association between accrual earnings management (AEM) and real earnings management (REM) using a sample of 150 non-financial listed firms for the period 2008–2017. The AEM is measured through the original Jones model (1991) and Dechow et al. (1995) model, whereas REM is measured through Roychowdhury’s (2006) model. For empirical analysis, the study estimates simultaneous equations by using ordinary least square (OLS) and the two-stage least square techniques (2SLS). The result of the analysis indicates that there is a negative and significant relationship between AEM and REM, suggesting that Pakistani listed firms employ AEM and REM as a substitute to achieve earnings targets. The results of the study are valuable for auditors and regulators to contemplate, govern and legalize suitable guidelines to enhance the transparency in the financial reporting quality.
Evaluation of the Symmetry of the Levator Veli Palatini Muscle and Velopharyngeal Closure Among a Noncleft Adult Population
Authors: Tahmasebifard Neda , Ellis Charles , Rothermich Kathrin , Fang Xiangming , Perry Jamie L.
Published: September 2020

Purpose:

The goal of this study is to determine the typical range of asymmetry between the length and thickness of the levator veli palatini muscle and to explore the impact of the observed asymmetry on velopharyngeal closure. A second objective is to report normative length and thickness of the levator veli palatini muscle among adults with typical velopharyngeal anatomy.

Method:

Magnetic resonance imaging (MRI) data and Amira 5.5 Visualization software were used to evaluate the levator veli palatini muscle among 89 participants with typical velopharyngeal anatomy. Flexible nasopharyngoscopy was used to determine the function of velopharyngeal closure among 39 of the 89 participants with typical velopharyngeal anatomy to examine the functional impact of observed asymmetry.

Results:

Matched paired t tests demonstrated a nonsignificant difference between the length and thickness of the right and left levator muscle. The mean difference between the right and left length of the levator muscle was 2.28 mm but ranged from 0.09 mm to 10.37 mm. In all cases where individuals displayed asymmetry in the levator muscle through MRI, there was no observed impact on the symmetry of velopharyngeal closure.

Discussion:

This study suggest that differences in the right and left levator veli palatini muscle are not significant among individuals without cleft palate. However, among individual cases where asymmetry was sizeable, there was no direct impact on the closure pattern. This may suggest there are multiple factors that contribute to asymmetrical velopharyngeal closure that are beyond the level of the levator veli palatini muscle.
A practical approach to the management of colorectal cancer during the COVID-19 crisis in the reference cancer treatment center in Tunisia
Authors: Letaief Feriel , Gharbi Imen , Hamdi Adel , Yahyaoui Yosra , Ayadi Mona , Blousa Imen , Mezlini Amel
Published: September 2020

COVID-19 is an exceptional public healthcare emergency that affected all countries. The corona virus pandemic has made the treatment of all cancers difficult. This international phenomenon represents an outbreak in medicine and this situation is a major issue for all patients, whether they are infected with the virus or not. Colorectal cancer is one of the most common malignant tumors of the digestive tract which needs special multidisciplinary care. Treatment modalities including chemotherapy and targeted therapies can weaken the immune system and then cause serious or lethal coronavirus infections. This document gives an idea about how we dealt to protect patients with colorectal cancer at Salah Azaiez Institute during COVID 19 pandemic.
Laser Doppler imaging evaluation of nitroglycerin patch application in systemic sclerosis patients
Authors: Pintea Bentea Georgiana , Wauters Aurélien , Wautrecht Jean-Claude , Cogan Elie
Published: September 2020

Recent studies suggest the use of topical nitroglycerin (NTG) application in systemic sclerosis (SSc)-associated Raynaud phenomenon (RP). With the current study, we aimed to characterize for the first time the microvascular response to a NTG patch (Trinipatch® 5 mg/24 h) applied to the hand dorsum in patients with SSc using Laser Doppler imaging (LDI) at baseline and following a cold challenge. The study included 21 patients with SSc and 13 controls. Blood flow was evaluated by LDI at the level of the fingertips and metacarpus. Microvascular morphology was evaluated by nailfold capillaroscopy (NC). LDI revealed decreased fingertip baseline perfusion and a stronger vasoconstrictor response to a cold challenge in patients with SSc versus control. Metacarpal application of a NTG patch led to an increase in blood flow and hand temperature in patients with SSc. Furthermore, NTG administration led to a faster reperfusion after cold challenge. Correlation analyses revealed that the magnitude of the vasodilatory response was inversely related to baseline fingertip perfusion and hand temperature, but unrelated to the number of capillaries/mm assessed using NC. In conclusion, we provide evidence of a vasodilatory reaction following NTG patch application in patients with SSc using LDI and a protective effect against cold challenge. The magnitude of the response to NTG was related to functional, but not structural features. Our results support a further evaluation of the NTG patch as a possible therapeutic agent in SSc-associated RP.
Patient-Reported Long-Term Outcome is Superior After Treatment with Self-Expanding Metallic Stents in Esophageal Perforations
Authors: Waltersten M. , Sundbom M.
Published: September 2020

Background and aims:

Esophageal perforations are life threatening. Since the 1990s, placing of covered esophageal stents has become an alternative to surgery. Theoretically, this minimally invasive approach has several benefits; however, little data are available on long-term outcome in these patients. We aimed to evaluate how patient-reported outcome differed between full surgery and placement of self-expanding metallic stents when treating primary benign esophageal perforations.

Material and methods:

Of 48 patients treated at our hospital in 2000–2015, 23 were alive and asked to answer three questionnaires. We used a short clinical questionnaire, the QLQ-OG25 from the European Organization for Research and Treatment of Cancer and a simplified quality-of-life instrument, the Check Your Health. Non-parametric statistics were used to evaluate differences between the two groups.

Results:

In all, 20 (87%) individuals (13 men, 64 years of age) responded. At survey, surgical patients had lost 13 kg of initial weight, compared to no weight loss in the self-expanding metallic stents group (p = 0.01). This involuntary weight loss worried patients according to the QLQ-OG25; otherwise patient-experience measures did not differ between groups. For quality of life, surgical patients scored significantly lower physical health, emotional well-being, social functioning, and overall quality of life after treatment, but after stenting no differences were seen.

Conclusions:

In contrast to stenting, surgical treatment was associated with involuntary, and worrisome, weight loss as well as reduced quality of life. We therefore believe that self-expanding metallic stents should be used when possible in treating benign esophageal perforations.
The use of branding strategies to increase the uptake of modern contraception among Kenyan youth
Authors: Leyton Alejandra , Hutchinson Paul , Mirzoyants Anastasia
Published: September 2020

Building brand equity is a strategic process that can boost normative and behavior change campaigns. However, the use of brand equity within the social and health sciences remains an under-researched field in lower income countries. This work examines Shujaaz, a multi-channel communication platform that uses branding strategies to create positive associations with safe sexual and reproductive health (SRH) practices among Kenyan youth. This study has the following three goals: (1) define and measure Shujaaz brand equity and its components (i.e., loyalty, awareness, perceived quality, popularity and brand personality), (2) analyze if Shujaaz brand equity components are associated with changes in SRH practices among youth, and (3) explore if Shujaaz brand loyalty could be better defined as an outcome, not a component of brand equity. The study uses data from a survey among 450 Kenyan youth interviewed three times; in 2016, 2017, and 2018. The analytical sample includes only those participants who self-reported exposure to Shujaaz. Fixed-effect logistic regression models were used to analyze the association between measures of brand equity and SRH outcomes, and to measure the association between brand equity measures and brand loyalty. Regression estimates indicate that loyalty to the Shujaaz brand was significantly associated with ever using condoms ( OR = 1.79), ever using modern contraception ( OR = 1.95), and with the likelihood of recommending condoms ( OR = 1.88). Shujaaz brand personality was significantly associated with ever using a condom ( OR = 1.87). When analyzing brand loyalty as the outcome of interest, we observe that brand personality, brand awareness, and popularity are positively associated with loyalty. However, no significant association was observed for perceived brand quality. This study underscored the role of brand loyalty as a determinant of health behavior change. However, loyalty to the brand is strongly associated with popularity, awareness, and brand personality, highlighting the need for mediation models to further study the dynamics of brand equity.
Impedance modelling of acoustically treated circumferential grooves for over-tip-rotor fan noise suppression
Authors: Palleja-Cabre Sergi , Tester Brian J , Astley R Jeremy , Beriot Hadrien
Published: September 2020

Experimental investigation of Over-Tip-Rotor circumferential groove liners has shown potential for fan noise suppression in turbofan engines whilst providing minimal penalty in fan aerodynamic performance. The validation of Over-Tip-Rotor liner analytical prediction models against published experimental data requires the modelling of an equivalent impedance for such acoustic treatments. This paper describes the formulation of two analytical groove impedance models as semi-locally reacting liners, that is locally reacting in the axial direction and non-locally reacting in the azimuthal direction. The models are cross-verified by comparison with high-order FEM simulations, and applied to a simplified Over-Tip-Rotor configuration consisting of multiple grooves excited by a monopole point source located close to the grooved surface.
Cost and Effectiveness of Reminders to Promote Colorectal Cancer Screening Uptake in Rural Federally Qualified Health Centers in West Virginia
Authors: Conn Mary Ellen , Kennedy-Rea Stephenie , Subramanian Sujha , Baus Adam , Hoover Sonja , Cunningham Cheryl , Tangka Florence K. L.
Published: September 2020

The purpose of this study is to evaluate the effectiveness of the West Virginia Program to Increase Colorectal Cancer Screening in implementing patient reminders to increase fecal immunochemical test (FIT) kit return rates in nine federally qualified health centers (FQHCs). Using process measures and cost data collected, the authors examined the differences in the intensity of the phone calls across FQHCs and compared them with the return rates achieved. They also reported the cost per kit successfully returned as a result of the intervention. Across all FQHCs, 5,041 FIT kits were ordered, and the initial return rate (without a reminder) was 41.1%. A total of 2,201 patients received reminder phone calls; on average, patients received 1.61 reminder calls each. The reminder interventions increased the average FIT kit return rate to 60.7%. The average total cost per FIT kit returned across all FQHCs was $60.18, and the average cost of only the reminders was $11.20 per FIT kit returned. FQHCs achieved an average increase of 19.6 percentage points in FIT kit return rates, and costs across clinics varied. Clinics with high-quality health information systems that enabled tracking of patients with minimal effort were able to implement lower cost reminder interventions.
The Effectiveness and Cost to Improve Colorectal Cancer Screening in a Federally Qualified Homeless Clinic in Eastern Kentucky
Authors: Hardin Vicky , Tangka Florence K. L. , Wood Teri , Boisseau Brian , Hoover Sonja , DeGroff Amy , Boehm Jennifer , Subramanian Sujha
Published: September 2020

The objective of this study was to analyze the effectiveness and cost of patient incentives, together with patient navigation and patient reminders, to increase fecal immunochemical test (FIT) kit return rates and colorectal cancer screening uptake in one federally qualified health center (FQHC) in Appalachia. This FQHC is a designated homeless clinic, as 79.7% of its patient population are homeless. We collected process, outcome, and cost data from the FQHC for two time periods: usual care (September 2016–August 2017) and implementation (September 2017–September 2018). We reported the FIT kit return rate, the increase in return rate, and the additional number of individual screens. We also calculated the incremental cost per additional screen. The patient incentive program, with patient navigation and patient reminders, increased the number of FIT kits returned from the usual care period to the implementation period. The return rate increased by 25.9 percentage points (from 21.7% to 47.6%) with an additional 91 people screened at an incremental cost of $134.61 per screen. A patient incentive program, together with the assistance of patient navigators and supplemented with patient reminders, can help improve CRC screening uptake among vulnerable and homeless populations.
Economic Evaluation of Interventions to Increase Colorectal Cancer Screening at Federally Qualified Health Centers
Authors: Tangka Florence K. L. , Subramanian Sujha , Hoover Sonja , DeGroff Amy , Joseph Djenaba , Wong Faye L. , Richardson Lisa C.
Published: September 2020

The Centers for Disease Control and Prevention (CDC) has a long-standing commitment to increase colorectal cancer (CRC) screening for vulnerable populations. In 2005, the CDC began a demonstration in five states and, with lessons learned, launched a national program, the Colorectal Cancer Control Program (CRCCP), in 2009. The CRCCP continues today and its current emphasis is the implementation of evidence-based interventions to promote CRC screening. The purpose of this article is to provide an overview of four CRCCP awardees and their federally qualified health center partners as an introduction to the accompanying series of research briefs where we present individual findings on impacts of evidence-based interventions on CRC screening uptake for each awardee. We also include in this article the conceptual framework used to guide our research. Our findings contribute to the evidence base and guide future program implementation to improve sustainability, increase CRC screening, and address disparities in screening uptake.
Dual HER2 Blockade in Neoadjuvant Treatment of HER2+ Breast Cancer: A Meta-Analysis and Review
Authors: Wang Chaokun , Chen Jing , Xu Xiangyun , Hu Xiaochen , Kong Dejiu , Liang Gaofeng , Wang Xinshuai
Published: September 2020

Background:

To investigate the pathologic complete response (pCR) rates of dual human epidermal growth factor receptor 2 (HER2) blockade in a neoadjuvant setting for HER2+ breast cancer.

Methods:

We searched randomized clinical trials (RCTs) using dual HER2 blockade in a neoadjuvant setting for HER2+ breast cancer in PubMed, the Cochrane Library, Embase and ClinicalTrials.gov up to July 5, 2020, and all included studies were assessed according to the Cochrane Collaboration tool for assessing the risk of bias of RCTs, and the statistical analyses were performed using STATA 14.0 software.

Results:

A total of 9 RCTs involving 2758 patients were included. Meta-analysis indicated that the pCR rates of lapatinib/pertuzumab/neratinib plus trastuzumab versus trastuzumab [relative risk (RR) = 1.31; 95% confidence interval (CI): 1.21-1.43; p < 0.001)] and lapatinib plus trastuzumab versus lapatinib (RR = 1.39; 95%CI: 1.25-1.53; p < 0.001) showed a significant statistical difference between dual HER2-blockade treatment and single-agent treatment in a neoadjuvant setting for HER2+ breast cancer. Additionally, there was no statistically significant difference in disease-free survival (HR = 0.72; 95% CI: 0.47-1.09; p = 0.123), incidence of serious adverse events (SAEs) (RR = 1.04; 95%CI: 0.81-1.33; p = 0.778) and cardiotoxicity(RR = 1.30; 95%CI: 0.81-2.08; p = 0.280), and the pCR rate was unaffected by hormone receptor status.

Conclusions:

The pCR rate of neoadjuvant dual-target therapy for HER2+ breast cancer was significantly higher than that of single-target therapy. Furthermore, the results indicated that the safety of dual-target therapy is similar to that of single-target therapy.
Safety and Efficacy of the Metabolic Profiling of the BIMRT Utilizing 18F FDG PET-CT
Authors: Dang Ya-Zheng , Zhang Dong-Xian , Wang Guo-Dong , Zhao Hong-Liang , Huang Shi-Gao , Li Jie
Published: September 2020

Aim:

This study aims to evaluate the safety and efficacy of fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) guided intensity-modulated radiation therapy (IMRT) for patients with peritoneal metastases.

Patients and Methods:

A total of 55 patients with peritoneal metastases were treated with 18F-FDG-PET/CT-guided IMRT (BIMRT) from January 2012 to January 2019. They were prescribed with a fraction of the median dose of 2 Gy to a total dose of 50.4 Gy. The multivariate analysis was used the Cox proportional hazard model and the Kaplan-Meier plot was used to perform local control rate (LCR), progression-free survival (PFS), and overall survival (OS) analysis.

Results:

The 1-year, 2-year, and 3-year LCR were 72.7%, 36.4%, and 9.1%, respectively; the 1-year, 2-year, and 3-year PFS were 69.1%, 30.9%, and 7.3%, respectively, and the median PFS time was 18 months. The 1-year, 3-year and 5-year OS were 70.9%, 28.7%, and 4.2%, respectively. Based on the multivariate analysis using the Cox proportional hazard model, the Karnofsky performance status (KPS) score and radiotherapy joint chemotherapy (RJC) method were independent prognostic-related indicators (P < 0.0001).

Conclusion:

BIMRT may be a safe and effective treatment for patients with peritoneal metastases, especially for patients who cannot undergo surgery. In addition, the results indicated that the patient’s KPS score and RJC method were independent prognostic-related indicators for patients survival time.
Genetic Contributions to Acquired Epilepsies
Authors: Perucca Piero , Scheffer Ingrid E.
Published: September 2020

Whether genetic factors contribute to acquired epilepsies has long been controversial. Supporters observe that, among individuals exposed to seemingly the same brain insult, only a minority develops unprovoked seizures. Yet, only in relatively recent years have studies started to build a case for genetic contributions. Here, we appraise this emerging evidence, by providing a critical review of studies published in the field.
Psychological Effects of Skin Incision Size in Minimally Invasive Valve Surgery Patients
Authors: Piarulli Alessandra , Chiariello Giovanni Alfonso , Bruno Piergiorgio , Cammertoni Federico , Rabini Alessia , Pavone Natalia , Pasquini Annalisa , Ferraro Francesco , Mazza Andrea , Nesta Marialisa , Iafrancesco Mauro , Colizzi Christian , Massetti Massimo
Published: September 2020

Objective

Clinical benefits of minimally invasive cardiac valve surgery (MIVS) have been reported. Improved postoperative mental status was never analyzed with dedicated psychological tests. In the present study we intend to investigate potential benefits of MIVS for patient psychological well-being, with special attention to the relevance of the patient perception of the chest surgical scar, of the self body image and cosmetic aspects.

Methods

Between 2016 and 2017, 87 eligible patients, age 66.5 ± 14.5 years, operated on for heart valve surgery, underwent either conventional full sternotomy (CS; n = 48) or MIVS by V-shape hemi-sternotomy approach ( n = 39). Before selection of the surgical approach, patients had undergone preoperative evaluation of their psychological status using Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory Form Y (STAI-Y), and EuroQol-5D (EQ-5D) psychological tests. Six months postoperatively, patients filled in dedicated questionnaires to assess their psychological status, quality of life, and subjective perception, thus repeating the above-mentioned tests and adding the Body Image Questionnaire (BIQ) and Patient and Observer Scar Assessment Scale (POSAS) v2.0 tests for scar-healing process evaluation.

Results

No patient died during the study.The 4 post-test scales of psychological well-being (BDI-II P = 0.04, STAI-Y P = 0.04, 2 indices of EQ-5D P = 0.03, P = 0.01) showed significant differences between the MIVS group and CS group, with MIVS-small incision patients having lower level of depression and anxiety symptoms and better quality of life. Mean score differences of scar perception (BIQ and POSAS v2.0) were significant, with MIVS patients having evaluated the scar quality significantly better than CS patients.

Conclusions

MIVS appears associated with significant esthetical and related psychological benefits, as documented by technical tests. These findings should be considered when selecting the most appropriate technique for heart valve surgery.
Study on the influence of blade outlet cutting on hydraulic noise of centrifugal pump with low specific speed
Authors: Cheng Xiaorui , Li Tianpeng , Wang Peng
Published: September 2020

In order to study the influence of blade outlet cutting width on hydrodynamic excitation noise of the centrifugal pump with low specific speed, five schemes are used to perform V-shaped cutting on the outlet of the impeller blade are studied in this study. Based on Lighthill acoustic analogy, combining computational fluid dynamics and computational acoustics, RNG k-ε turbulence model is used to calculate internal unsteady flow field of the centrifugal pump, and the acoustic solution is based on the flow field calculation. The results show that the pressure pulsation can reflect the sound pressure level to a certain extent; proper cutting of the blade outlet can improve the flow state of the rear cavity of the centrifugal pump and make the flow uniform; the V-shaped cutting of the blade outlet also can reduce the dynamic and static interference between the impeller outlet and the volute tongue, effectively reducing the sound pressure level of the internal sound field, when the blade outlet cutting width is a/ b2 = 33.33%, the inlet sound pressure level and the outlet sound pressure level are decreased by 4.8% and 7.2%, respectively. In terms of internal sound field, the sound pressure level at the outlet of the pump is obviously higher than that at the inlet.
Proactive and reactive control mechanisms in navigational search
Authors: Briscoe Josie , Gilchrist Iain D
Published: September 2020

Reactive and proactive cognitive control are fundamental for guiding complex human behaviour. In two experiments, we evaluated the role of both types of cognitive control in navigational search. Participants searched for a single hidden target in a floor array where the salience at the search locations varied (flashing or static lights). An a-priori rule of the probable location of the target (either under a static or a flashing light) was provided at the start of each experiment. Both experiments demonstrated a bias towards rule-adherent locations. Search errors, measured as revisits, were more likely to occur under the flashing rule for searching flashing locations, regardless of the salience of target location in Experiment 1 and at rule-congruent (flashing) locations in Experiment 2. Consistent with dual mechanisms of control, rule-adherent search was explained by engaging proactive control to guide goal-maintained search behaviour and by engaging reactive control to avoid revisits to salient (flashing) locations. Experiment 2 provided direct evidence for dual mechanisms of control using a Dot Pattern Expectancy task to distinguish the dominant control mode for a participant. Participants with a reactive control mode generated more revisits to salient (flashing) locations. These data point to complementary roles for proactive and reactive control in guiding navigational search and propose a novel framework for interpreting navigational search.