bluuebunny/crossref_metadata_2025 huggingface dataset:
A Prognostic 14-Gene Expression Signature for Lung Adenocarcinoma: A Study Based on TCGA Data Mining
Authors: Liu Jie , Hou Shiqiang , Wang Jinyi , Chai Zhengjun , Hong Xuan , Zhao Tian , Sun Zhengliang , Bai Liandi , Gao Hongyan , Gao Jing , Chen Guohan
Published: December 2020

Background. Lung adenocarcinoma (LUAD), a major and fatal subtype of lung cancer, caused lots of mortalities and showed different outcomes in prognosis. This study was to assess key genes and to develop a prognostic signature for the patient therapy with LUAD. Method. RNA expression profile and clinical data from 522 LUAD patients were accessed and downloaded from the Cancer Genome Atlas (TCGA) database. Differentially expressed genes (DEGs) were extracted and analyzed between normal tissues and LUAD samples. Then, a 14-DEG signature was developed and identified for the survival prediction in LUAD patients by means of univariate and multivariate Cox regression analyses. The gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed to predict the potential biological functions and pathways of these DEGs. Results. Twenty-two out of 5924 DEGs in the TCGA dataset were screened and associated with the overall survival (OS) of LUAD patients. 14CID="C008" value=" "DEGs were finally selected and included in our development and validation model by risk score analysis. The ROC analysis indicated that the specificity and sensitivity of this profile signature were high. Further functional enrichment analyses indicated that these DEGs might regulate genes that affect the function of release of sequestered calcium ion into cytosol and pathways that associated with vibrio cholerae infection. Conclusion. Our study developed a novel 14-DEG signature providing more efficient and persuasive prognostic information beyond conventional clinicopathological factors for survival prediction of LUAD patients.
Splenectomy with Portoazygous Disconnection for Correction of Systemic Hemodynamic Disorders in Hepatic Cirrhosis Patients with Portal Hypertension: A Prospective Single-Center Cohort Study
Authors: Zeng Dao-Bing , Di Liang , Guo Qing-Liang , Ding Jing , Zhao Xiao-Fei , Lu Shi-Chun
Published: December 2020

Objective. To investigate the effect of splenectomy for correction of systemic hemodynamic disorders in hepatic cirrhosis patients with portal hypertension. Methods. Hepatic cirrhosis patients with portal hypertension were enrolled from April 2015 to July 2018. Systemic hemodynamic parameters (heart rate, mean arterial pressure (MAP), cardiac output, and total peripheral vascular resistance (TPR)) were prospectively measured at baseline and 1 week, 1, 3, and 6 months, and 1, 2, and 3 years postoperatively. Paired analysis was conducted. Results. Sixty-nine patients were eligible, and 55 (79.7%) cases had a history of upper gastrointestinal bleeding. Child–Pugh classification was grade A in 41 (59.4%) cases, grade B in 26 (37.7%) cases, and grade C in 2 (2.9%) cases. The heart rate was significantly higher at 1 week postoperatively versus the baseline (

P
<
0.001

). Meanwhile, the heart rate was significantly lower from 3 months to 2 years postoperatively versus the baseline (

P
<
0.05

). The MAP was significantly higher at 6 months to 2 years postoperatively versus the baseline (

P
<
0.05

). At 1 month postoperatively and 6 months to 2 years, the cardiac output was significantly lower versus the baseline (

P
<
0.05

). At 1 month postoperatively and 6 months to 2 years, the TPR was significantly higher versus the baseline (

P
<
0.05

). Conclusion. Splenectomy corrects systemic hemodynamic disorder in hepatic cirrhosis patients with portal hypertension, and the effect is rapid and durable.
Endogenous Retroelement Activation by Epigenetic Therapy Reverses the Warburg Effect and Elicits Mitochondrial-Mediated Cancer Cell Death
Authors: Fresquet Vicente , Garcia-Barchino Maria J. , Larrayoz Marta , Celay Jon , Vicente Carmen , Fernandez-Galilea Marta , Larrayoz Maria J. , Calasanz Maria J. , Panizo Carlos , Junza Alexandra , Han Jiahuai , Prior Celia , Fortes Puri , Pio Ruben , Oyarzabal Julen , Martinez-Baztan Alvaro , Paiva Bruno , Moreno-Aliaga Maria J. , Odero Maria D. , Agirre Xabier , Yanes Oscar , Prosper Felipe , Martinez-Climent Jose A.
Published: December 2020

For millions of years, endogenous retroelements have remained transcriptionally silent within mammalian genomes by epigenetic mechanisms. Modern anticancer therapies targeting the epigenetic machinery awaken retroelement expression, inducing antiviral responses that eliminate tumors through mechanisms not completely understood. Here, we find that massive binding of epigenetically activated retroelements by RIG-I and MDA5 viral sensors promotes ATP hydrolysis and depletes intracellular energy, driving tumor killing independently of immune signaling. Energy depletion boosts compensatory ATP production by switching glycolysis to mitochondrial oxidative phosphorylation, thereby reversing the Warburg effect. However, hyperfunctional succinate dehydrogenase in mitochondrial electron transport chain generates excessive oxidative stress that unleashes RIP1-mediated necroptosis. To maintain ATP generation, hyperactive mitochondrial membrane blocks intrinsic apoptosis by increasing BCL2 dependency. Accordingly, drugs targeting BCL2 family proteins and epigenetic inhibitors yield synergistic responses in multiple cancer types. Thus, epigenetic therapy kills cancer cells by rewiring mitochondrial metabolism upon retroelement activation, which primes mitochondria to apoptosis by BH3-mimetics.

Significance:

The state of viral mimicry induced by epigenetic therapies in cancer cells remodels mitochondrial metabolism and drives caspase-independent tumor cell death, which sensitizes to BCL2 inhibitor drugs. This novel mechanism underlies clinical efficacy of hypomethylating agents and venetoclax in acute myeloid leukemia, suggesting similar combination therapies for other incurable cancers.

This article is highlighted in the In This Issue feature, p. 995
The Emergence of Artificial Intelligence within Radiation Oncology Treatment Planning
Authors: Netherton Tucker J. , Cardenas Carlos E. , Rhee Dong Joo , Court Laurence E. , Beadle Beth M.
Published: December 2020

Background: The future of artificial intelligence (AI) heralds unprecedented change for the field of radiation oncology. Commercial vendors and academic institutions have created AI tools for radiation oncology, but such tools have not yet been widely adopted into clinical practice. In addition, numerous discussions have prompted careful thoughts about AI’s impact upon the future landscape of radiation oncology: How can we preserve innovation, creativity, and patient safety? When will AI-based tools be widely adopted into the clinic? Will the need for clinical staff be reduced? How will these devices and tools be developed and regulated? Summary: In this work, we examine how deep learning, a rapidly emerging subset of AI, fits into the broader historical context of advancements made in radiation oncology and medical physics. In addition, we examine a representative set of deep learning-based tools that are being made available for use in external beam radiotherapy treatment planning and how these deep learning-based tools and other AI-based tools will impact members of the radiation treatment planning team. Key Messages: Compared to past transformative innovations explored in this article, such as the Monte Carlo method or intensity-modulated radiotherapy, the development and adoption of deep learning-based tools is occurring at faster rates and promises to transform practices of the radiation treatment planning team. However, accessibility to these tools will be determined by each clinic’s access to the internet, web-based solutions, or high-performance computing hardware. As seen by the trends exhibited by many technologies, high dependence on new technology can result in harm should the product fail in an unexpected manner, be misused by the operator, or if the mitigation to an expected failure is not adequate. Thus, the need for developers and researchers to rigorously validate deep learning-based tools, for users to understand how to operate tools appropriately, and for professional bodies to develop guidelines for their use and maintenance is essential. Given that members of the radiation treatment planning team perform many tasks that are automatable, the use of deep learning-based tools, in combination with other automated treatment planning tools, may refocus tasks performed by the treatment planning team and may potentially reduce resource-related burdens for clinics with limited resources.
Stepwise target controllability identifies dysregulations of macrophage networks in multiple sclerosis
Authors: Bassignana Giulia , Fransson Jennifer , Henry Vincent , Colliot Olivier , Zujovic Violetta , De Vico Fallani Fabrizio
Published: December 2020

Identifying the nodes able to drive the state of a network is crucial to understand, and eventually control, biological systems. Despite recent advances, such identification remains difficult because of the huge number of equivalent controllable configurations, even in relatively simple networks. Based on the evidence that in many applications it is essential to test the ability of individual nodes to control a specific target subset, we develop a fast and principled method to identify controllable driver-target configurations in sparse and directed networks. We demonstrate our approach on simulated networks and experimental gene networks to characterize macrophage dysregulation in human subjects with multiple sclerosis.
New Latrunculiidae (Demospongiae, Poecilosclerida) from the Agulhas ecoregion of temperate southern Africa
Authors: SAMAAI TOUFIEK , KELLY MICHELLE , NGWAKUM BENEDICTA , PAYNE ROBYN , TESKE PETER R. , JANSON LIESL , KERWATH SVEN , PARKER DENHAM , GIBBONS MARK J.
Published: December 2020

Sixteen species of Latrunculiidae Topsent, 1922, belonging to the genera Latrunculia du Bocage, 1869, Strongylodesma Lévi, 1969, Cyclacanthia Samaai & Kelly, 2004, Samaai & Kelly, 2002, are currently known from the temperate waters of South Africa. Extensive new sponge collections from the Amathole region of South Africa revealed the existence of three new species of Tsitsikamma, T. amatholensis sp. nov., T. madiba sp. nov., and T. beukesi sp. nov., and a new species of the endemic South African genus Cyclacanthia, C. rethahofmeyri sp. nov. With the recent addition of two new species of Tsitsikamma from Algoa Bay and Tsitsikamma National Park (T. michaeli Parker-Nance, 2019; T. nguni Parker-Nance, 2019) the total number of known South African Latrunculiidae is now 20 species in four genera. Here we propose two new subgenera of Tsitsikamma, Tsitsikamma Samaai & Kelly, 2002 and Clavicaulis subgen. nov., based on the morphological groups “favus” and “pedunculata” hypothesized by Parker-Nance et al. (2019). Species in the nominotypical subgenus Tsitsikamma, containing the type species, are thick encrusting to hemispherical with a rigid honeycombed choanosome, while species in the new subgenus Clavicaulis subgen. nov. have a purse or sac-like morphology with little choanosomal structure. Despite the obvious species-level differences in morphology, multivariate analysis based on spicule measurements (anisostyle length, discorhabd length, shaft and whorl length) was not able to distinguish between the proposed Tsitsikamma species, but separated known species T. favus Samaai & Kelly, 2002, T. pedunculata Samaai & Kelly, 2003, and T. scurra Samaai & Kelly, 2003, from each other. Similarly, DNA barcoding of the mitochondrial COI  and the nuclear ITS of Tsitsikamma specimens failed to clearly differentiate between species, but was able to differentiate sister taxon relationships within the Latrunculiidae.
The effect of a mobile application on the foot care of individuals with type 2 diabetes: A randomised controlled study
Authors: Dincer Berna , Bahçecik Nefise
Published: December 2020

Objective:

This study aimed to develop an animation-supported Mobile Diabetic Foot Care Education (M-DFCE) application for use by individuals with type 2 diabetes and identify its effects on knowledge, self-efficacy and foot care behaviour.

Design:

Randomised, controlled experimental study.

Setting and Method:

The study was carried out between October 2016 and September 2017. The sample consisted of 130 individuals with diabetes (65 in the experimental group and 65 in the control group). The experimental group received M-DFCE. Data were collected using the Patient Assessment Form, the Diabetes Foot Knowledge Questionnaire, the Diabetic Foot Care Self-Efficacy Scale and the Foot Self-Care Behaviour Scale. Differences between the groups were examined using Student’s t, Mann–Whitney U, Wilcoxon Signed Rank and Paired Sample tests.

Results:

Although there was no difference between the groups at initial evaluation, individuals in the experimental group who received animation-supported M-DFCE had significantly higher knowledge, self-efficacy and foot care behaviour levels than the control group.

Conclusion:

The animation-supported mobile application developed for foot care education was effective in increasing the individuals’ knowledge, self-efficacy and behaviour with respect to foot care.
Masking Between Reserved Alarm Sounds of the IEC 60601-1-8 International Medical Alarm Standard: A Systematic, Formal Analysis
Authors: Bolton Matthew L. , Edworthy Judy R. , Boyd Andrew D.
Published: December 2020

Objective

In this work, we systematically evaluated the reserved alarm sounds of the IEC 60601-1-8 international medical alarm standard to determine when and how they can be totally and partially masked.

Background

IEC 60601-1-8 gives engineers instruction for creating human-perceivable auditory medical alarms. This includes reserved alarm sounds: common types of alarms where each is a tonal melody. Even when this standard is honored, practitioners still fail to hear alarms, causing practitioner nonresponse and, thus, potential patient harm. Simultaneous masking, a condition where one or more alarms is imperceptible in the presence of other concurrently sounding alarms due to limitations of the human sensory system, is partially responsible for this.

Methods

In this research, we use automated proof techniques to determine if masking can occur in a modeled configuration of medical alarms. This allows us to determine when and how reserved alarm sound can mask other reserved alarms and to explore parameters to address discovered problems.

Results

We report the minimum number of other alarm sounds it takes to both totally and partially mask each of the high-, medium-, and low-priority alarm sounds from the standard.

Conclusions

Significant masking problems were found for both the total and partial masking of high-, medium-, and low-priority reserved alarm sounds.

Application

We show that discovered problems can be mitigated by setting alarm volumes to standard values based on priority level and by randomizing the timing of alarm tones.
The alternative derivation procedure of equations of the law of the junction for the study of the p-n junction theory
Authors: Baskys Algirdas
Published: December 2020

The methodology that increases the student interest and provides modern knowledge to the study of the p-n junction theory has been proposed. It is based on two methods: increasing the interest of students using a new approach in derivation of equations of the law of the junction that allows obtaining more comprehensive knowledge about the operation of the p-n junctions and engaging students using the storytelling technique. The reaction of students to the lecture, obtained statistics on the student activity and the results of the student survey show that the proposed methodology allows increasing the student engagement in the p-n junction theory lectures.
Impact behavior of hollow glass bubble reinforced foam core LNG insulation panel in cryogenic temperature
Authors: Lee Dong-Ha , Bae Jin-Ho , Hwang Byeong-Kwan , Kim Jeong-Hyeon , Kim Seul-Kee , Lee Jae-Myung
Published: December 2020

Composite sandwich panels are applied to numerous structures owing to their excellent mechanical properties and thermal performance. In marine craft, sandwich panels are located on the inner walls as an insulation system for the liquefied natural gas (LNG) cargo containment systems (CCSs). Polyurethane foam (PUF), as an insulation material, is commonly used as the core material against a cryogenic temperature of –163°C for the LNG CCSs. Owing to its excellent thermal performance that prevents heat flow from the outside, and because LNG is transported at cryogenic temperatures, PUF is the preferred choice as a core material. However, the LNG CCS is subjected to fluid impact load due to sloshing during a laden voyage, and therefore, the core material needs to be reinforced. In this study, a reinforcement material made of hollow glass bubbles (HGBs) was added to PUF to help withstand the sloshing loads, and the performance of the specimens was investigated in terms of their impact strength and absorption energy. The mechanical impact strength of the final products was investigated through an impact test at cryogenic temperatures and the absorption energy was analyzed along with the dynamic compressive behavior of the sandwich panels.
Design and topology optimization of air conditioning suspension bracket for metro
Authors: Xiao Qian , Guo Wei-nian , Yang Li-ting , Zhou Sheng-tong , Chen Dao-yun
Published: December 2020

During the operation of subway vehicles, the vibration of air conditioning units is mainly transmitted to the vehicle body through the suspension support, which seriously affects the stability and comfort of the vehicle during operation. Therefore, the design and optimization of the suspension support of air conditioning units has become a hot topic in the research of the dynamic characteristics of subway vehicles. In this paper, the rigid and flexible coupling dynamic model of metro is firstly calculated to simulate the stress of the suspension point of air conditioning of the vehicle body when the vehicle is running. The initial structure design of the suspension support is carried out, and the stress of the air conditioning suspension point is taken as the load input to analyze the stiffness and strength of the initial structure of the suspension support. Then, the fatigue life is taken as the topology constraint, and the variable density method (SIMP) is used to optimize the topology of the suspension bracket. Finally, the optimized suspension support is validated. The results show that after topological optimization, the maximum displacement and maximum stress of the suspension support under vertical, horizontal, and vertical loads are reduced by 80%, 93%, and 99%, respectively, compared with the original structure model, and the maximum stress under vertical loads is reduced by 50%.
Rethinking Graduate School Research Genres: Communicating With Industry, Writing to Learn
Authors: Watts Julie
Published: December 2020

Technical and professional communication master’s students work with a faculty advisor to complete a three-credit independent research (IR) project, featuring original research. Stakeholders recommended the IR thesis be revised to better communicate IR to industry. Using a writing, activity theory, and genre theory lens, I analyzed what contradictions emerged between academic and workplace activity systems as stakeholders recommended genre revisions. I analyzed faculty and professional advisory board meeting transcripts, alumni and student surveys, and a Graduate School director and thesis examiner interview. Results indicated the thesis’ spectrum of functions, from its strengths encouraging students’ research proficiency to the limiting way it showcases IR as a product, not a process. Stakeholders suggested no thesis changes but recommended IR genre system modifications. As agents of change, students are uniquely positioned to use the IR genre system to address workplace communication problems and help mend our discipline’s academia-industry divide.
The Father I Knew: Early Paternal Engagement Moderates the Long-term Relationship between Paternal Accessibility and Childhood Behavioral Difficulties
Authors: Craig Angus G. , Thompson John M. D. , Slykerman Rebecca , Wall Clare , Murphy Rinki , Mitchell Edwin A. , Waldie Karen E.
Published: December 2020

The long-term impact of a father’s involvement in offspring development is understudied. The current study investigated the relations between early paternal engagement (i.e., the amount of time fathers engaged in one-to-one activity with their child), paternal accessibility (i.e., fathers’ physical proximity to their children) and later child behavioral difficulties. Data were obtained from five phases of the Auckland Birthweight Collaborative (ABC) longitudinal cohort study: at the study children’s birth; at 12 months; 3.5 years; 7 years; and 11 years of age. Moderated linear regression analyses revealed that there was a negative, long-term effect of paternal departure from the family household (i.e., reduced paternal accessibility) by 3.5 years of age on children’s total behavioral difficulties and conduct problems scores, but only if departed fathers had been highly engaged during the child’s first year of life. These findings suggest that the relationship between paternal accessibility and paternal engagement is potentially more nuanced than previously thought.
Experience of endomyocardial biopsy from a tertiary care center in India
Authors: Nakra Tripti , Arava Sudheer , Seth Sandeep , Ojha Vineeta , Jagia Priya , Ray Ruma
Published: December 2020

Background

Endomyocardial biopsy is the gold standard and has a definite role in the surveillance of cardiac allograft rejection. Its role in other cardiac diseases is limited. However, it is required for conclusive diagnosis of a few entities in which it can influence patient management. There is no reported data regarding the utility of endomyocardial biopsy in the Indian population. Thus, this study was undertaken in a tertiary care center in India to assess the utility of endomyocardial biopsy in various cardiac diseases in the context of clinical diagnoses.

Methods

All endomyocardial biopsies conducted over a 27-year period were evaluated. Clinical details including indication for biopsy were collected. Histopathological findings were recorded and classified as definitive diagnosis, probable diagnosis with features consistent with the clinical diagnosis, and nonspecific morphological findings.

Results

A total of 927 endomyocardial biopsies from 719 patients were reviewed. Endomyocardial biopsy was diagnostic in 12.5% of native cardiac biopsies and 52.1% showed nondiagnostic findings. The most frequent diagnoses were amyloidosis (58.7%) and myocarditis (8.6%). Endomyocardial biopsy had a diagnostic role in evaluation of restrictive cardiac diseases. Endomyocardial fibrosis and tubercular myocarditis, relatively more prevalent in the Indian population, were also identified. Cases of rheumatic heart disease, desmin cardiomyopathy, and microfibrillar cardiomyopathy were surprise findings, proving the usefulness of endomyocardial biopsy in detecting some rare cardiac conditions.

Conclusion

Endomyocardial biopsy is an important tool for the diagnosis of specific cardiac diseases including some rare entities, and for conditions which are more prevalent in our country, requiring biopsy confirmation.
Relationships of interleukin-17 polymorphisms with recurrent aphthous ulcer risk in a Han Chinese population
Authors: Xiang Haidong , Cheng Dongmei , Guo Han , Wang Yan , Jia Zhiyu , Gao Qi
Published: December 2020

Objective

Interleukin (IL)-17 is a multifunctional cytokine with important roles in inflammatory and autoimmune diseases. This case–control study explored the relationships of IL-17A rs2275913 and IL-17F rs763780 single-nucleotide polymorphisms (SNPs) with recurrent aphthous ulcer (RAU) morbidity and severity.

Methods

IL-17A rs2275913 and IL-17F rs763780 SNPs were measured in 125 patients with RAU and 116 healthy control participants. The genotype distributions, disease risks, and relationships with RAU severity were analyzed.

Results

RAU risk was associated with rs2275913 after adjustment for age, body mass index, sex, smoking status, and drinking status (AA vs. GG: odds ratio [OR], 2.759; 95% confidence interval [CI], 1.381–5.512; A allele vs. G allele: OR, 1.783; 95% CI, 1.242–2.560). TC and CC genotypes in rs763780, and the corresponding C allele, demonstrated greater prevalence among patients with RAU, compared with the TT genotype (TC vs. TT, OR: 1.895; 95% CI: 1.088–3.301; CC vs. TT, OR: 4.080, 95% CI: 1.079–15.425; C allele vs. T allele, OR: 1.969, 95% CI: 1.257–3.083). Serum IL-17 concentrations were also higher in patients with RAU than in control participants. These concentrations were associated with IL-17 polymorphisms.

Conclusions

IL-17 polymorphisms might be associated with greater risk of RAU pathogenesis.
Support for the Death Penalty in Cases of Rape and Sexual Assault: Variation between Victim Age Categories
Authors: Dierenfeldt Rick , Scott Samantha , Iles Gale , Rosenberger Jared , Smith Merideth
Published: December 2020

Research exploring attitudes toward the death penalty is common in the field of criminal justice. Additionally, a substantial body of literature has examined public perceptions of sex offenders and punishment in the U.S. Unfortunately, few studies have sought to examine perceptions of the death penalty in relation to sexual offending. This study contributes to the literature by examining perceptions of the college students at a mid-sized university in the Southeastern United States as they relate to support for the death penalty in cases of sexual assault across victim age categories. Findings suggest that respondent perceptions are shaped by biological sex, political affiliation, college major, fear of crime, and parents’ level of education, and these relationships are uniform across victim age categories. Further, support for the death penalty appears inversely related with victim age.
Diet Quality Is Lower for Those Who Skip Lunch Among a Sample of Predominantly Black Adolescents
Authors: Spruance Lori Andersen , Clason Spencer , Burton Jordyn Hansen , Myers Leann , O’Malley Keelia , Johnson Carolyn C.
Published: December 2020

Purpose:

To compare the dietary quality among adolescents who skip lunch and those who do not and explore associations between school-level variables, demographic variables and lunch skipping.

Design:

Cross-sectional

Setting:

Public schools in New Orleans, Louisiana (n = 21)

Participants:

718 adolescents

Methods:

Adolescents participated in a 24-hour dietary recall using the Automated Self-Administered 24-Hour (ASA24) Dietary Assessment Tool early in 2013. Data were converted into Healthy Eating Index (HEI-2010) scores. Mean scores were compared between students who skipped lunch and those who did not. A multilevel analysis was conducted to assess relationships between school environment, demographics, and lunch skipping.

Results:

Of the 718 respondents, 88.3% were Black and 15.3% skipped lunch. Students who ate lunch had a mean HEI score of 46.6 compared to a mean score of 41.7 for students who skipped lunch (p < .001). Students who skipped lunch also had significantly lower intake of total vegetables (p = .02), whole fruits (p < .001), total dairy (p = .003), total protein (p < .001).

Conclusions:

Skipping lunch was associated with lower quality diet, though diet quality was low among all students. Considering over 15% of the sample did not eat lunch in a closed-campus school setting, further research should consider how to encourage students to participate in the National School Lunch Program, which has the ability to increase diet quality in adolescents.
Factors Associated With Breastfeeding Very Low Birth Weight Infants at Neonatal Intensive Care Unit Discharge: A Single-Center Brazilian Experience
Authors: Oliveira Mariana González de , Valle Volkmer Desirée de Freitas
Published: December 2020

Background

The mothers of very low birth weight infants face many challenges to achieve breastfeeding at hospital discharge, especially during long stays.

Research aim

The aim of this study was to describe the incidence and factors associated with breastfeeding rates (exclusive or with formula) at discharge, for very low birth weight infants, in a private Neonatal Intensive Care Unit in southern Brazil.

Methods

We conducted a prospective longitudinal cohort study of infants ( N = 335) with very low birth weight and/or less than 30 weeks gestational age, who survived to discharge and had no contraindication to mother’s own milk. Participants were initially divided into three groups (exclusive breastfeeding, some breastfeeding, and no breastfeeding) based on their feedings at discharge; however, later, two groups were analyzed (any breastfeeding, no breastfeeding).

Results

Most (93.4%; n = 313) were breastfeeding directly at least once daily at discharge, of which 16.1% ( n = 54) were receiving exclusive mother’s milk and 77.3% ( n = 259) mixed feeding (mother’s milk and formula). Breastfeeding at discharge was associated with gestational age ≥ 28 weeks, higher birth weight, not developing neonatal sepsis or bronchopulmonary dysplasia during the hospital stay, shorter lengths of stay, and lower weight at discharge. After Poisson regression, breastfeeding at discharge was associated only with a shorter length of stay (RR 0.98; CI 95% [0.95, 0.99], p < .05).

Conclusions

In our single unit experience in Brazil, most infants were breastfeeding at discharge. NICU staff might address mothers of infants who have prolonged hospitalization with specific strategies. Mothers and infants at risk can be identified early and personalized interventions can be developed for improving breastfeeding rates at discharge.
Living Quality: A Reprise and More
Authors: Parse Rosemarie Rizzo
Published: December 2020

The purpose of this paper is to illuminate and elaborate the inherent core knowings of living quality. The core knowings are fortifying wisdom, discerning witness, and penetrating silence. In deep contemplation with the core knowings, essences and paradoxes surfaced for the author enhancing understanding of living quality. The essences and paradoxes are specified here.
Reflections on Fortifying Wisdom
Authors: Bunkers Sandra Schmidt
Published: December 2020

The author in this article explores seven day-to-day living experiences that expand understanding of the humanbecoming concept of fortifying wisdom. Poetry is used to enhance understanding of the seven living experiences of (a) the use of words, (b) the experience of the body, (c) love, (d) compassion, (e) faith, (f) hope, and (g) forgiveness.
Presence in Teaching-Learning: Insights From the Movie Patch Adams and Others
Authors: Yancey Nan Russell
Published: December 2020

As social distancing seems to have become the new normal in the ongoing struggle to prevent the spread of COVID-19, this column focuses on the challenge of presence in the teaching-learning endeavor that often is lived in virtual settings. When presence is defined as being in the same place at the same time as another, suggesting that presence is essential to teaching-learning would certainly run counter to the recommended practice of social distancing. However, the question must be asked if it is essential for the teacher and learner to be in a particular place at the same moment for presence in teaching-learning to be known. Clarity of the meaning of presence in the teaching-learning endeavor is pursued through considering insights gained from the movie Patch Adams. Further, insights from the humanbecoming paradigm are explored to provide new ways of moving onward in teaching-learning.
The distribution of the guanaco (Lama guanicoe) in Patagonia during Late Pleistocene–Holocene and its importance for prehistoric human diet
Authors: Rindel Diego D , Moscardi Bruno F , Perez S Ivan
Published: December 2020

The great importance of the guanaco ( Lama guanicoe) for the subsistence of the human populations of Patagonia during the Holocene has been demonstrated in numerous studies. This species is considered as the main prey of the hunter-gatherer groups of the Patagonian interior, indicating the existence of a strong ecological relationship of predator-prey type. Despite the importance of this ungulate for prehistoric human populations, its spatial distribution throughout the Holocene has not been systematically explored, assuming that it was ubiquitously distributed in almost all of Patagonia. In this work, the spatial distribution of the guanaco in Patagonia during different periods of the final Pleistocene and Holocene is explored using zooarchaeological and paleontological evidence together with species distribution models and paleoclimatic reconstructions. Likewise, the spatial variation in the importance of this species for the diet of human populations is assessed. The results show that there were large differences in the distribution of guanaco in Patagonia over time. In general terms, this camelid suffered a constant contraction in range since the Late Pleistocene period to the present. There is an Andean range and peri-cordilleran core of population distribution that remains observable during all this time. Human subsistence was strongly influenced by this pattern of distribution. The differences in the guanaco distribution described in this work are important not only for archaeological and paleontological problems, but also for the current conservation of guanacos.
Financial Inclusion in Ondo State, Nigeria: Determinants and Its Impact on Poverty
Authors: Enisan Akinlo A. , Akinwumi Sharimakin
Published: December 2020

The study examined the determinants of financial inclusion in Ondo State, Nigeria, and investigated its impact on poverty in the state. The study used a survey method to obtain primary data by administering questionnaires on 450 adult individuals aged 18 years and above in the 18 local government areas of Ondo State. A multi-stage sampling procedure was used to identify the units of analysis individual. The results from logistic regression showed that the main determinants of financial inclusion in the state were age, genders, financial discipline, religion, income, location, trust, alternatives, ICT inclination, documentation, household size, tertiary education, married, civil servant, self-employed, distance2 and distance3. Asides, financial inclusion was found to have a significant effect on poverty in the state. The article recommends increased financial inclusion in Ondo state to enhance the welfare of the people.
Social Representations of Immigrant Patients: Physicians’ Discourse
Authors: Chatzimpyros Vasileios , Baka Aphrodite , Dikaiou Maria
Published: December 2020

With the global increase of migration and the effects of the economic crisis, health systems around the world are facing new challenges. In this context, we investigated the social representations of health provision to immigrant patients, held by physicians. We conducted 40 interviews with Greek physicians working in the public health system, the private health system, the health system in jails, and nongovernmental organizations. Using principles from thematic analysis, results show a social representation of immigrant patients as a burden to the health system. This social representation is constructed by themes focusing on immigrant patients as a group with mental health issues and on the construction of the health system as unable to provide health to noncitizens. Results are discussed in relation to current issues of social exclusion and the need to protect the human right of health.
Lurbinectedin: A New Treatment Option for Relapsed/Refractory Small-Cell Lung Cancer
Authors: Shinn Lauren T. , Vo Katrina A. , Reeves David J.
Published: December 2020

Objective

To assess the clinical application of lurbinectedin and its role in the therapy of small-cell lung cancer (SCLC).

Data Sources

PubMed database and ClincialTrials.gov were utilized to perform a comprehensive literature search from August 2011 to mid-November 2020 with the terms lurbinectedin and PM01183.

Study Selection and Data Extraction

English-language clinical trials of lurbinectedin were evaluated.

Data Synthesis

Lurbinectedin, as second-line therapy in SCLC, demonstrated an overall response (OR) rate of 35.2% and median overall survival of 9.3 months. Phase II studies in multiple cancers revealed myelosuppression (>95%), increased liver enzymes (>70%), nausea (up to 80%), vomiting (54%), and fatigue (>50%) as the most common adverse events associated with lurbinectedin. CYP3A4 drug interactions affect lurbinectedin exposure (severe pancytopenia occurred after coadministration with aprepitant), and protein binding can affect its clearance. Patients with cardiac comorbidities were not included in published lurbinectedin trials because of cardiotoxicity associated with trabectedin.

Relevance to Patient Care and Clinical Practice

Lurbinectedin is an option in SCLC after failure of a platinum-based regimen. Dose adjustments, drug interactions, antiemetic regimen choice, and patient comorbidities are important clinical considerations with lurbinectedin use. Likewise, its place in therapy in the era of immune checkpoint inhibitors requires further exploration.

Conclusions

With a promising OR compared with other second-line options, lurbinectedin should be considered in patients who have failed first-line therapy. Studies are ongoing with lurbinectedin in combination with other agents in SCLC, and a phase III trial is assessing use in combination with doxorubicin compared with other second-line regimens.
Suture Button vs Conventional Screw Fixation for Isolated Lisfranc Ligament Injuries
Authors: Cho Jaeho , Kim Jahyung , Min Tae-Hong , Chun Dong-Il , Won Sung Hun , Park Suyeon , Yi Young
Published: December 2020

Background:

Suture buttons have been used for isolated Lisfranc ligament (ILL) fixation. However, no study has reported on its clinical and radiologic outcomes.

Methods:

In this retrospective comparative study, patients with ILL injuries were divided into 2 groups according to the treatment method: 32 conventional screw group and 31 suture button group. The clinical and radiologic outcomes at preoperation, 6 months and 1 year postoperation, and last follow-up period were measured. Plantar foot pressure was measured at postoperative month 6 months. Postoperative complications at the last follow-up were evaluated.

Results:

The suture button group showed better American Orthopaedic Foot & Ankle Society midfoot scale ( P < .001) and visual analog scale ( P < .001) scores compared with the conventional screw fixation group at the postoperative month 6 period before screw removal. However, no significant difference in clinical outcome between the 2 groups was found at postoperative year 1 or last follow-up. No differences in radiologic outcomes were found between the 2 groups. Plantar foot pressure was significantly elevated in the conventional screw group at the great toe and first metatarsal head area compared with the contralateral foot just before screw removal. Recurrent Lisfranc joint diastasis was found in a single case in the conventional screw group and 2 cases in the suture button group.

Conclusion:

Suture button fixation in the treatment of ILL injuries may provide comparable fixation stability and clinical outcome with conventional screw fixation in the early postoperative period.

Level of Evidence:

Level III, retrospective case-control study, therapeutic.
Comparison of Preoperative Bone Density in Patients With and Without Periprosthetic Osteolysis Following Total Ankle Arthroplasty
Authors: Lee Gun-Woo , Seo Hyoung-Yeon , Jung Dong-Min , Lee Keun-Bae
Published: December 2020

Background:

Modern total ankle arthroplasty (TAA) prostheses are uncemented press-fit designs whose stability is dependent on bone ingrowth. Preoperative insufficient bone density reduces initial local stability at the bone-implant interface, and we hypothesized that this may play a role in periprosthetic osteolysis. We aimed to investigate the preoperative bone density of the distal tibia and talus and compare these in patients with and without osteolysis.

Methods:

We enrolled 209 patients (218 ankles) who underwent primary TAA using the HINTEGRA prosthesis. The overall mean follow-up duration was 66 (range, 24-161) months. The patients were allocated into 2 groups according to the presence of periprosthetic osteolysis: the osteolysis group (64 patients, 65 ankles) and nonosteolysis group (145 patients, 153 ankles). Between the 2 groups, we investigated and compared the radiographic outcomes, including the Hounsfield unit (HU) value around the ankle joint and the coronal plane alignment.

Results:

HU values of the tibia and talus measured at 5 mm from the reference points were higher than those at 10 mm in each group. However, comparing the osteolysis and nonosteolysis groups, we found no significant intergroup difference in HU value at every measured level in the tibia and talus ( P > .05). Concerning the coronal plane alignment, there were no significant between-group differences in the tibiotalar and talar tilt angles ( P > .05).

Conclusion:

Patients with osteolysis showed similar preoperative bone density of the distal tibia and talus compared with patients without osteolysis. Our results suggest that low bone density around the ankle joint may not be associated with increased development of osteolysis.

Level of Evidence:

Level III, retrospective cohort study.
Venous Thromboembolism in Patents With Lung Cancer
Authors: Suzuki Takahito , Fujino Susumu , Inaba Shouta , Yamamura Ryo , Katoh Hiromasa , Noji Yoshihiro , Yamaguchi Masato , Aoyama Takahiko
Published: December 2020

Lung cancer is the leading cause of death from cancer in Japan. Studies in other countries have reported a venous thromboembolism (VTE) rate of 4%–20% in cancer patients. In this study, we aimed to determine the incidence of VTE in lung cancer patients in Japan and compared the characteristics of patients with and without VTE. In this retrospective cohort study, the clinicopathological characteristics of study patients with and without concomitant VTE were compared. Patients with lung cancer treated at Fukui Prefectural Hospital, Japan from 2008 to 2017. Of the 1471 patients with lung cancer studied, 28 developed VTE. Five patients developed pulmonary thromboembolism (PTE) alone, 9 PTE with concomitant deep vein thrombosis, and 14 deep vein thrombosis alone. Compared with patients in the non-VTE group, the VTE group was significantly younger (mean value ± SD 66.3 ± 10.1 vs. 73.0 ± 10.6 years, p = 0.001), contained significantly more patients with stage IIIb–IV disease (p = 0.002), and had a significantly higher rate of chemotherapy (p < 0.001) and radiation therapy (p = 0.007). There was no significant difference in median survival time from lung cancer diagnosis between the VTE and non-VTE groups. The 1-year mortality rate after VTE diagnosis was 60.7%. Lung cancer was the most frequent cause of death, followed by infection and VTE. Several baseline characteristics differed between patients with and without VTE. The prognosis may worsen after development of VTE, suggesting that lung cancer patients should be carefully monitored for it.
Evaluation of Green Procurement Practices Among Mining Companies’ Hospitals in Ghana: A Qualitative Analysis
Authors: Guo Du Jian , Sarpong Patrick Boateng , Asante Antwi Henry , Adjei Mensah Isaac
Published: December 2020

This study focuses on the evaluation of the green procurement practices among 7 mining hospitals in Ghana via qualitative analysis techniques. Thus, in this study, based on a 5-year case study, the practices of procurement officers in 7 hospitals belonging to mining companies in Ghana are explored. Within this period, interviews were conducted with key persons with recognizable responsibilities within the supply chain and procurement setup of the facilities. Details of their procurement practices, procedures, and policies were analyzed. A qualitative approach to organizational learning and practice is used to appreciate the existence of these differences observed and also to give a meaning to new perspectives on the challenges in establishing green procurement in the 7 mining companies’ hospitals. The results of the analysis demonstrated that adjustments in the buyers’ practices are not as much dependent on whether they understand, for instance, policies, tools, and procedures, but rather a matter of whether the buyers actually put their knowledge into practice.
Children’s assent within clinical care: A concept analysis
Authors: Montreuil Marjorie , Fortin Justine , Racine Eric
Published: December 2020

Seeking children’s assent has been put forward as a way to foster children’s involvement in the healthcare decision-making process. However, the functions of the concept of assent within clinical care are manifold, and methods used to recognize children’s capacities and promote their involvement in their care remain debated. We performed an instrumentalist concept analysis of assent, with 58 included articles. Final themes were jointly identified through a deliberative process. Two distinct perspectives of assent were predominant: as an affirmative agreement for a specific decision and as part of a continuous, interactive process of care. Differing standards were provided as to how and when to apply the concept of assent. The concept of dissent was largely omitted from conceptions of assent, especially in situations for which children’s refusal would lead to severe health consequences. Ethical implications included fostering autonomy, reducing physical/psychological harm to the child, respecting the child as a human being, and fulfilling the universal rights of the child. There remain important gaps in the theory of assent and its desirable and possible practical implications. Practical standards are largely missing, and evidence supporting the claims made in the literature requires further investigation.
Concrete crack detection and 3D mapping by integrated convolutional neural networks architecture
Authors: Chaiyasarn Krisada , Buatik Apichat , Likitlersuang Suched
Published: December 2020

This paper presents an image-based crack detection system, in which its architecture is modified to use deep convolutional neural networks in a feature extraction step and other classifiers in the classification step. In the classification step, classifiers including Support Vector machines (SVMs), Random Forest (RF) and Evolutionary Artificial Neural Network (EANN) are used as an alternative to a Softmax classifier and the performance of these classifiers are studied. The data set was created from various types of concrete structures using a standard digital camera and an unmanned aerial vehicle (UAV). The collected images are used in the crack detection system and in creating a 3D model of a sample concrete building using an image- based 3D photogrammetry technique. Then, the 3D model is used to create a mosaic image, in which the crack detection system was applied to create a global view of a crack density map. The map is then projected onto the 3D model to allow cracks to be located in the 3D world. A comparative study was conducted on the proposed crack detection system and the results prove that the combined architecture of CNN as a feature extractor and SVM as a classifier shows the best performance with the accuracy of 92.80. The results also show that the modified architecture by integrating CNN and other types of classifiers can improve a system performance, which is better than using the Softmax classifier.