bluuebunny/crossref_metadata_2025 huggingface dataset:
Fiscal Incentives for Conflict: Evidence from India's Red Corridor
Authors: Shapiro Jacob N. , Vanden Eynde Oliver
Published: April 2021

Can tax regimes shape the incentives to engage in armed conflict? Indian mining royalties benefit the states but are set by the central government. India's Maoist belt is mineral rich, and states are responsible for counterinsurgency operations. We exploit the introduction of a 10% ad valorem tax on iron ore that increased royalty collections of the affected states by a factor of 10. We find that the royalty hike was followed by a significant intensification of violence in districts with important iron ore deposits. The royalty increase was also followed by an increase in illegal mining activity in iron mines.
Leader Identity and Coordination
Authors: Bhalotra Sonia , Clots-Figueras Irma , Iyer Lakshmi , Vecci Joseph
Published: April 2021

This paper examines policy effectiveness as a function of leader identity. We experimentally vary leader religious identity in a coordination game implemented in India and focus on citizen reactions to leader identity, controlling for leader actions. We find that minority leaders improve coordination, and majority leaders do not. Alternative treatment arms reveal that affirmative action for minorities reverses this result, while intergroup contact improves the effectiveness of leaders of both identities. We also find that minority leaders are less effective in towns with a history of intergroup conflict. Our results demonstrate that leader and policy effectiveness depend on citizen reactions, conditioned by social identity and past conflict.
Emotion at the Edge
Authors: Casey Edward S.
Published: April 2021

It is a modernist article of faith that emotion belongs to the human subject—that it is possessed by this subject from within. We find this view espoused by thinkers as various as Descartes, Hume, and Kant. It is also found in the conventional belief that emotions have their seat “in the heart.” In this essay I explore an alternative paradigm whereby emotion exists as much, if not more, at the outer edges of the subject: in expressive gestures and other forms of what I call “exophany,” i.e., the showing-forth of emotion from without. Instead of concerning ourselves with the endogeny of emotions—its internal generation in the body, brain, or soul—I look at the peripherality of emotions. Examining concrete examples, I demonstrate that emotions are transmissible thanks to their capacity for being located at the edges of our lives.
The identification of Rana ocellata Linnaeus, 1758. Nomenclatural impact on the species currently known as Leptodactylus ocellatus (Leptodactylidae) and Osteopilus brunneus (Gosse, 1851) (Hylidae)
Authors: LAVILLA ESTEBAN O. , LANGONE JOSE A. , CARAMASCHI ULISSES , HEYER W. RONALD , DE SÁ RAFAEL O.
Published: April 2021

The usage of the name Rana ocellata Linnaeus, 1758, is plagued by misidentifications and misinterpretations. After an exhaustive bibliographic review, we conclude that the Linnaeus 1758 name refers to Osteopilus brunneus (Gosse, 1851) from Jamaica, while the taxon currently known as Leptodactylus ocellatus corresponds to Rana latrans Steffen, 1815. Herein, we designate and provide descriptions of the neotypes of Leptodactylus latrans (Steffen, 1815), revalidated, new combination, and Osteopilus ocellatus (Linnaeus, 1758), new combination, as a senior synonym of Osteopilus brunneus (Gosse, 1851).
Research on Effect of Exosome Excreted by RAW264.7 Cell on Damage of Mice Lung Function and Its Mechanism
Authors: Chao Dong , Li Qingxin , Hu Gawei
Published: April 2021

The exosome excreted by RAW264.7 cell was found to participate in the damage of lung function. Our purpose was to assess the exact mechanism. The animal experiment was adopted in our study. It was provided reference for clinical experiment. 30 healthy male rats were selected and assigned
into normal control group, normal exosome group and LPS with exosome group by random number table followed by analysis of the size and form of exosome under electron microscope, the lung structural change by hematoxylin and eosin staining, TNF-α and IL-1β secretion
by immunohistochemistry, and the expression of tightly bound protein one (ZO-1), closed protein, β-chain protein and two groups of exosome-marked protein (CD9 and CD63) by western blot. In normal control group, the lung structure was very integral with clear alveolar space. The
cell wall was smooth relatively without exudation substance in alveolar space and mesenchyme. Normal exosome group showed relatively integral lung structure and thicker cell wall. The inside of alveolar space was very clear without exudation substance in alveolar space and mesenchyme. LPS
+ exosome group presented abundant inflammatory cells in alveolar space and mesenchyme with obvious bleeding. Inflammatory factor secretion such as TNF-α (1.334 ± 0.205%) and IL-1β (0.803 ± 0.097%)was significantly higher and the content of closed protein
(0.203 ±0.017%) was lower in LPS with exosome group than the other two groups (P < 0.05). The exosome secreted by RAW264.7 cell after stimulation by lipopolysaccharide could impair the lung function in rats and is related with the decline of closed protein.
The Effect of Shikonin on U87 Cells Through Notch2 Signaling Pathway and Its Mechanism
Authors: Yuan Lei , Zhang Ting , Pan Hong , Wang Fei
Published: April 2021

Background: The paper explored the inhibitory effect of Shikonin on Notch2 signaling pathway of U87 cells and elucidated the mechanism.Material and methods: CCK-8 was used to determine the viability of U87 cells. The Kit was used to detect the levels of ROS and GSH in the cells. After Annexin V-FITC/PI staining, flow cytometry was used to detect the effect of Shikonin on U87 cell apoptosis. Western Blotting was used to detect the expressions of Notch2, Notch3, Hes1 and Hey1. The levels of NH4Cl and MG132 were determined to measure the effect of Shikonin inhibiting Notch2 protein level in U87 cells, and the effect of Shikonin on Itch inhibiting Notch2 protein level.Results: Shikonin can inhibit the expressions of Notch2 and Notch3 proteins and the levels of downstream signaling molecules Hes1 and Hey1 in U87 cells, and in a concentration- and time dependent manner. Shikonin can promote the degradation of Notch2 via the lysosomal pathway, which is associated with the up-regulation of the Itch expression. The inhibition of Notch2 and cell viability is related to the levels of GSH and ROS in cells, and Shikonin can down-regulate Notch2 to inhibit the proliferation of U87 cells.Conclusion: Shikonin inhibits the malignancy of glioma cells by promoting the degradation of Notch2 through the lysosomal pathway, which is related to the antioxidant effect. The results of our experiments provided certain experimental and theoretical basis for Shikonin treating glioma.
CC Chemokine Ligand 17 Promoted Cell Metastasis via Tumor Necrosis Factorα/Nuclear Factor Kappa-B Signaling Pathway
Authors: Wang Chunli , Wang Shuang , Lei Xuexue , Zang Mingcui
Published: April 2021

Hepatocellular carcinoma (HCC) consist in a proinflammatory tumor environment that is characterized by the presence of many chemokines and cytokines. Expression of CCL17 associated with diagnoses and poor prognosis in different cancers. There are few investigations indicated the relationship
between CCL17 and HCC. Thus, this study aims to investigate the role of CCL17 in HCC progression. qRT-PCR and Western Blot were performed to detect expression of CCL17 in HCC cell lines and normal hepatocyte. Elisa was used to determine TNFα, IL-6 and IL-1β. Wound-healing
assay and Transwell assay were performed to assed cell metastasis. CCL17 signaling was examined utilizing Western Blot. Here, we showed that CCL17 levels markedly increased in HCC cell lines. At the same time, TNFα, IL-6 and IL-1 β were increased time-dependent after
treating human recombinant CCL17 protein. Cell metastasis was significantly promoted by CCL17 while TNFa inhibitor (Lenalidomide) reversed the effects of CCL17. NF-κB signaling pathway was activated by CCL17 and TNFα inhibitor suppressed the effects of CCL17. In conclusion,
CCL17 promoted cell metastasis via TNFα/NF-κB signaling pathway. CCL17 may be a potential biomarker for HCC progression.
Reactive Oxygen Species/Caspase 3 Promotes Autophagy of Nigral Dopaminergic Neuron in Parkinson’s Disease
Authors: Chen Zejie , Wang Yamin , Yi Yanchun , Liu Fengrong
Published: April 2021

Parkinson’s disease (PD) is characterized as bradykinesia and sleep disorder, troubling numerous people. In the present study, we aimed to explore whether reactive oxygen species (ROS)/caspase 3 promotes PD to provide a basis for novel treatments of PD. Firstly, we applied 1-methyl-4-phenylpyridinium
(MPP+) to stimulate PC12 cell lines to establish a PD cell model. Western blot and qRT-PCR analyses detected protein and mRNA expression of caspase 3, IL-1β, Bax, and BCL2. Finally, ROS detection kit determined ROS content. Compared with the controls, MPP+-treated PC12 exhibited
significantly elevated caspase 3, caspase 3, and IL-1β at the protein level (p < 0.001). In addition, MMP + treatment increased Bax protein level in vitro, while decreased Bcl-2 protein expression (p <0.001). Moreover, MPP + induced oxidative stress which
contributes to autophagy. The ROS in MPP + group was increased significantly (p < 0.001). ROS and caspase 3 participate in the pathogenesis of PD and enhances autophagy of nigral dopaminergic neuron.
Evaluation of the Influence of Bone Resorption on Dental Implant Systems Using Taguchi Method and Finite Element Analysis
Authors: Liu Chien-Wei , Chuang Kai-Jen , Chen Chien-Tsu , Lin Kuan-Chou
Published: April 2021

Dental implants are currently the mainstay of dental restoration procedures. They are used to reestablish normal chewing functions for patients. Several studies have reported their high success rate, but post-op bone resorption at the implant site increases the risk of implant fracture, which is especially significant in the posterior mandibular tooth (PMT) area. This study focused on bone resorption at the PMT area to assess and understand the mechanism of implant failure. This study used three implant systems on the posterior mandibular area. Computer tomography (CT) scans and reverse engineering were used to construct mandible and implant systems. The Taguchi method and finite element analysis (FEA) were used to explore the role of biting force on the components of various implant systems in the development of bone resorption. The results of this study found that when the implant site with bone resorption takes a biting force, the stress on the implant is inversely proportional to implant diameter and proportional to its length. For the stress loading, cortical bone thickness does not play a significant role. Instead, the most significant factor is implant diameter, followed by implant length. For better operation outcomes, it is recommended to use implants of larger diameter and less length. Also, it is recommended to avoid the use of implants less than 4.5 mm in diameter, regardless of the implant system, in order to prevent early implant damage or fracture due to bone resorption.
Preliminary Development of a Competitive Fluorescent Quantum Dot-Based Immunochromatographic Test Strip for Sensitive Saxitoxin Detection
Authors: Bruno John G. , John Jeremy
Published: April 2021

Rapid and portable detection of saxitoxin (STX) and its many congeners is highly desirable to prevent paralytic shellfish poisoning due to red tide or harmful algal blooms. In this work, we describe successful preliminary efforts to develop a very sensitive general STX family test strip
employing highly fluorescent red quantum dots (Qdot 655) to detect as little as 0.5 to 1 part per billion (ppb or ng/ml) of STX with a dynamic range extending to 20,000 ppb after the prototype dipstick assay was optimized. A competitive format was necessitated by the small molecule nature
of STXs having only one epitope, but the decrease in Qdot fluorescence was clearly visible to the naked eye as a function of increasing STX concentration in aqueous buffer. The competitive displacement assay format required conjugation of a primary amine in STX to carboxyl-Qdot 655 via a covalent
carbodiimide coupling reaction which was validated by an electrophoretic mobility band shift assay.
Spatial variations of North Atlantic landfalling tropical cyclone wind speed decay over the continental United States
Authors: Zhu Yi-Jie , Collins Jennifer M. , Klotzbach Philip J.
Published: April 2021

Understanding tropical cyclone wind speed decay during the post-landfall stage is critical for inland hazard preparation. This paper examines the spatial variation of wind speed decay of tropical cyclones over the continental United States. We find that tropical cyclones making landfall over the Gulf Coast decay faster within the first 24 hours after landfall than those making landfall over the Atlantic East Coast. The variation of the decay rate over the Gulf Coast remains larger than that over the Atlantic East Coast for tropical cyclones that had made landfall more than 24 hours prior. Besides an average weaker tropical cyclone landfall intensity, the near-parallel trajectory and the proximity of storms to the coastline also help to explain the slower post-landfall wind speed decay for Atlantic East Coast landfalling tropical cyclones. Tropical cyclones crossing the Florida peninsula only slowly weaken after landfall, with an average of less than 20% post-landfall wind speed drop while transiting the state. The existence of these spatial variations also brings into question the utility of a uniform wind decay model. While weak intensity decay over the Florida peninsula is well estimated by the uniform wind decay model, the error from the uniform wind decay model increases with tropical cyclones making direct landfall more parallel to the Atlantic East Coast. The underestimation of inland wind speed by the uniform wind decay model found over the western Gulf Coast brings attention to the role of land-air interactions in the decay of inland tropical cyclones.
Influence of the Indian Ocean Dipole on the Large-Scale Circulation in South America
Authors: Sena Ana C. T. , Magnusdottir Gudrun
Published: April 2021

The influence of each phase of the Indian Ocean dipole (IOD) on the large-scale circulation in South America is investigated using rainfall observations, fully coupled, large-ensemble, historical simulations (LENS), and forced experiments using the coupled model’s atmospheric component. IOD events often occur when El Niño–Southern Oscillation (ENSO), the largest source of interannual variability of precipitation in South America, is active. To distinguish from effects of ENSO, only cases during neutral ENSO conditions are analyzed in LENS and observations. During the positive IOD polarity, a perturbation in the local Walker circulation leads to increased convection over equatorial South America, resulting in wet anomalies in the Amazon basin. This signal is the opposite of what is expected during El Niño events. Tropical convection anomalies in the Indian Ocean also force an extratropical Rossby wave train that reaches subtropical South America. During positive IOD, the moisture flux from the Amazon to central and southeastern Brazil weakens, resulting in a drying of the area associated with the South Atlantic convergence zone. Meanwhile, the South Atlantic subtropical high strengthens, contributing to a drying in southeastern Brazil. During negative IOD, the induced wave train from the Indian Ocean leads to increased moisture transport to the La Plata basin, leading to wet anomalies in the region.
A Calibrated and Consistent Combination of Probabilistic Forecasts for the Exceedance of Several Precipitation Thresholds Using Neural Networks
Authors: Schaumann P. , Hess R. , Rempel M. , Blahak U. , Schmidt V.
Published: April 2021

The seamless combination of nowcasting and numerical weather prediction (NWP) aims to provide a functional basis for very-short-term forecasts, which are essential (e.g., for weather warnings). In this paper we propose a statistical method for precipitation using neural networks (NN) that combines nowcasting data from DWD’s radar-based RadVOR system with postprocessed forecasts of the high resolving NWP ensemble COSMO-DE-EPS. The postprocessing is performed by Ensemble-MOS of DWD. Whereas the quality of the nowcasting projections of RadVOR is excellent at the beginning, it declines rapidly after about 2 h. The postprocessed forecasts of COSMO-DE-EPS in contrast start with lower accuracy but provide meaningful information on longer forecast ranges. The combination of the two systems is performed for probabilities that the expected precipitation amounts exceed a series of predefined thresholds. The resulting probabilistic forecasts are calibrated and outperform both input systems in terms of accuracy for forecast ranges from 1 to 6 h as shown by verification. The proposed NN-model generalizes a previous statistical model based on extended logistic regression, which was restricted to only one threshold of 0.1 mm. The various layers of the NN-model are related to the conventional design elements (e.g., triangular functions and interaction terms) of the previous model for easier insight.
A Case-Control Study of Accidental Falls During Surgical Hospitalizations
Authors: Valencia Morales Diana J. , Laporta Mariana L. , Johnson Rebecca L. , Schroeder Darrell R. , Sprung Juraj , Weingarten Toby N.
Published: April 2021

Background

Postoperative falls are preventable complications. The study aims were to describe the rate and circumstances surrounding postoperative falls and explore potential associations with patient and procedural characteristics with emphasis on the use of sedative medications.

Methods

Medical records of hospitalized patients undergoing non-lower extremity surgery under general anesthesia from January 1, 2010, through April 30, 2018 were reviewed for falls within 72 postoperative hours. Perioperative use of sedatives, sleep aids, gabapentinoids, and opioids were abstracted. Each fall case was matched with two controls on age, sex, and procedure type. Descriptive statistics and multivariable analysis accounting for the matched design were performed.

Results

There were 343 falls among 200 186 hospitalized surgical patients (incidence of 17.1 [95% CI: 15.4, 19.0] falls per 10 000 procedures) with largest proportion of falls occurring on postoperative day 2 (n = 134, 39.1%). Most falls occurred in the general hospital wards (n = 304, 88.6%) and were unwitnessed (n = 186, 55.9%). The incidence of major injuries was 1.0 (95% CI: .1 – 3.6) per 100 000 procedures. Home use of non-benzodiazepine hypnotics (odds ratio 2.68, 95% CI: 1.47, 4.88, P=.001) and blood transfusions were associated with increased fall risk. Hospital stay was longer in patients who fall (7 [4, 15] vs. 5 [3, 9] days, P < .001).

Conclusions

The rate of postoperative falls in our institution was low and frequently unwitnessed. The use of non-benzodiazepine hypnotics is a modifiable risk factor associated with postoperative falls. Serious complications after falls were rare.
‘We must have a new VIPS meeting soon!’ Barriers and facilitators for implementing the VIPS practice model in primary health care
Authors: Røsvik Janne , Mjørud Marit
Published: April 2021

Introduction

Person-centred care is a philosophy of care rather than a method ready for implementation and utilisation in daily work. Internationally, few methods for the implementation of person-centred care have been widely adopted in clinical and care practice. In Norway, the VIPS practice model is a commonly used model for person-centred care implementation.

Method

Qualitative manifest content analysis was used. Managers and leaders in the municipalities, care institutions and domestic nursing care services were eligible for inclusion if their workplace had implemented the VIPS practice model and conducted the consensus meeting regularly for a minimum of 12 months. Seventeen respondents were included. Individual interviews were conducted either via FaceTime, Skype or telephone.

Results

Three global categories emerged describing the implementation process: (1) factors that impact the decision made at municipal level to implement person-centred care; (2) requirements for a good start at unit level and (3) factors that help to support the new routines in the unit. The categories were entwined; the results of one affected the results of the others. The informants from both domestic nursing care and institutions described the same factors as important for the implementation of the VIPS practice model.

Conclusion

To implement person-centred care by use of the VIPS practice model, the frontline staff need sufficient information about the rationale for implementing the model. The management’s vision and ethos of person-centred care must be followed by time set aside for staff training and regularly scheduled VIPS practice model consensus meetings. Head nurses are key to getting the new routines established and maintained and should be supported by the management.
Improvisation as a Teaching Tool for Improving Oral Communication Skills in Premedical and Pre-Biomedical Graduate Students
Authors: Phelps Marianne , White Catrina , Xiang Lin , Swanson Hollie I
Published: April 2021

Objective:

To evaluate the relationship between training in theatre improvisation and empathy, communication, and other professional skills.

Methods:

Undergraduate and graduate students who were participants of a 10-week summer undergraduate research program engaged in theatre improvisation techniques during a 3-hour workshop. In Study #1, a de-identified, self-report questionnaire (known as the Empathy Quotient) was administered prior to and following the workshop. Paired sample 2-tailed t-tests were performed to evaluate pre- and post-test scores. To identify additional benefits of engaging in theatre improvisation techniques, Study #2 was performed. Here, a survey was administered to the participants following their completion of the workshop to assess the impact on their personal growth and professional skills. An additional survey was administered at the end of the 10-week program to evaluate all program activities.

Results:

Study #1. Paired t-test analyses indicated that pre-test versus post-test Empathy Quotient scores were not significantly different, implying that participation in the theatre improvisation workshop did not impact empathy. Study #2. Survey results indicate that participation in the theatre improvisation workshop encouraged feelings of support by peers and creative thinking as well as increasing communication skills.

Conclusion:

Incorporating a theatre improvisation workshop into educational programs for pre-medical and pre-biomedical students is of value for enhancing self-confidence, oral communication skills and ability to think creatively.
Effects of comprehensive geriatric care models on postoperative outcomes in geriatric surgical patients: a systematic review and meta-analysis
Authors: Saripella Aparna , Wasef Sara , Nagappa Mahesh , Riazi Sheila , Englesakis Marina , Wong Jean , Chung Frances
Published: April 2021

Background

The elderly population is highly susceptible to develop post-operative complications after major surgeries. It is not clear whether the comprehensive geriatric care models are effective in reducing adverse events. The objective of this systematic review and meta-analysis is to determine whether the comprehensive geriatric care models improved clinical outcomes, particularly in decreasing the prevalence of delirium and length of hospital stay (LOS) in elderly surgical patients.

Method

We searched Medline, PubMed, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Emcare Nursing, Web of Science, Scopus, CINAHL, ClinicalTrials. Gov, and ICTRP between 2009 to January 23, 2020. We included studies on geriatric care models in elderly patients (≥60 years) undergoing elective, non-cardiac high-risk surgery. The outcomes were the prevalence of delirium, LOS, rates of 30-days readmission, and 30-days mortality. We used the Cochrane Review Manager Version 5.3. to estimate the pooled Odds Ratio (OR) and Mean Difference (MD) using random effect model analysis.

Results

Eleven studies were included with 2672 patients [Randomized Controlled Trials (RCTs): 4; Non-Randomized Controlled Trials (Non-RCTs): 7]. Data pooled from six studies showed that there was no significant difference in the prevalence of delirium between the intervention and control groups: 13.8% vs 15.9% (OR: 0.76; 95% CI: 0.30–1.96; p = 0.57). Similarly, there were no significant differences in the LOS (MD: -0.55; 95% CI: − 2.28, 1.18; p = 0.53), 30-day readmission (12.1% vs. 14.3%; OR: 1.09; 95% CI: 0.67–1.77; p = 0.73), and 30-day mortality (3.2% vs. 2.1%; OR: 1.34; 95% CI: 0.66–2.69; p = 0.42). The quality of evidence was very low.

Conclusions

The geriatric care models involved pre-operative comprehensive geriatric assessment, and intervention tools to address cognition, frailty, and functional status. In non-cardiac high-risk surgeries, these care models did not show any significant difference in the prevalence of delirium, LOS, 30-days readmission rates, and 30-day mortality in geriatric patients. Further RCTs are warranted to evaluate these models on the postoperative outcomes.

Trial registration

PROSPERO registration number - CRD42020181779.
Maxillary sinusitis developed as sequelae of accidental middle turbinectomy that occurred during nasotracheal intubation: a case report
Authors: Kim Joungmin , Pyeon Taehee , Lee Hyun Jung , Yang Hyung Chae
Published: April 2021

Background

Nasotracheal intubation is a very useful technique for orofacial or dental surgery. However, the technique itself can be more traumatic than that of orotracheal intubation. Complications such as turbinectomy or bleeding are often reported. However, little is known about the follow-up of patients after these complications.

Case presentation

The present case describes an accidental middle turbinectomy that led to endotracheal tube obstruction during nasotracheal intubation, and discusses its long-term follow-up. A 19-year-old man underwent mandibular surgery under general anesthesia and nasotracheal intubation. His right middle turbinate was completely avulsed and became firmly occluded within the tube during nasotracheal intubation. The nasotracheal intubation was performed again and the operation was completed safely. The patient was discharged without sequelae after postoperative care. However, he had symptoms of nasal obstruction and sleep disturbance for 3 months postoperatively. Synechiae were detected between the nasal septum and lateral nasal wall on a right rhinoscopic examination and facial computed tomography at 3 months postoperatively. Additionally, he showed ipsilateral maxillary sinusitis on facial computed tomography at the 2-year follow-up examination.

Conclusions

Nasotracheal intubation can cause late complications as well as early complications. Therefore, if nasotracheal intubation is to be performed, the anesthesiologist should identify the nasal anatomy of the patient accurately and prepare appropriately. In addition, if complications occur, follow-up observation should be performed.
Acute kidney injury predicts poor left ventricular function for patients with peripartum cardiomyopathy
Authors: Zhu Jiajia , Liu Wenxian
Published: April 2021

Background

The aim of this study was to explore the risk factors associated with a poor left ventricular (LV) function among patients with peripartum cardiomyopathy (PPCM) and to determine the influence of acute kidney injury (AKI) on the LV function of the patients.

Methods

Sixty patients with PPCM were recruited between January 2007 and June 2018, among which 11 had AKI. The participants were divided into two groups, the recovery group (32 cases) and the nonrecovery group (28 cases), with their clinical features, echocardiography and electrocardiogram findings, laboratory results, and treatments compared between groups. We further determined the risk factors associated with nonrecovery and the influence posed by AKI on the LV function of the patients.

Results

Compared with the patients in the recovery group, those in the nonrecovery group had higher proportions of multiparity [78.6% (22/28) vs. 43.8% (14/32)], function class III– IV heart failure [92.9% (26/28) vs. 71.9% (23/32)], and a higher incidence of AKI [35.7% (10/28) vs. 3.1% (1/32)]. Logistic regression analysis showed that having AKI [odds ratio (OR): 10.556; 95% confidence interval (CI) 1.177–94.654;P = 0.035] and left ventricular ejection fraction (LVEF) < 40% [OR: 4.533; 95% CI 1.118–18.382;P = 0.034] were independently associated with nonrecovery of PPCM.

Conclusions

The prognosis of patients with PPCM and AKI during hospitalization was poor compared to those without AKI; therefore, clinicians should pay more attention to this phenomenon.
Patterns of pathologic lymph nodes in anal cancer: a PET-CT-based analysis with implications for radiotherapy treatment volumes
Authors: Frennered Anna , Scherman Jonas , Buchwald Pamela , Johnsson Anders , Sartor Hanna , Zackrisson Sophia , Trägårdh Elin , Nilsson Martin P.
Published: April 2021

Background

This study investigates the patterns of PET-positive lymph nodes (LNs) in anal cancer. The aim was to provide information that could inform future anal cancer radiotherapy contouring guidelines.

Methods

The baseline [18F]-FDG PET-CTs of 190 consecutive anal cancer patients were retrospectively assessed. LNs with a Deauville score (DS) of ≥3 were defined as PET-positive. Each PET-positive LN was allocated to a LN region and a LN sub-region; they were then mapped on a standard anatomy reference CT. The association between primary tumor localization and PET-positive LNs in different regions were analyzed.

Results

PET-positive LNs (n = 412) were identified in 103 of 190 patients (54%). Compared to anal canal tumors with extension into the rectum, anal canal tumors with perianal extension more often had inguinal (P < 0.001) and less often perirectal (P < 0.001) and internal iliac (P < 0.001) PET-positive LNs. Forty-two patients had PET-positive LNs confined to a solitary region, corresponding to first echelon nodes. The most common solitary LN region was inguinal (25 of 42; 60%) followed by perirectal (26%), internal iliac (10%), and external iliac (2%). No PET-positive LNs were identified in the ischiorectal fossa or in the inguinal area located posterolateral to deep vessels. Skip metastases above the bottom of the sacroiliac joint were quite rare. Most external iliac PET-positive LNs were located posterior to the external iliac vein; only one was located in the lateral external iliac sub-region.

Conclusions

The results support some specific modifications to the elective clinical target volume (CTV) in anal cancer. These changes would lead to reduced volumes of normal tissue being irradiated, which could contribute to a reduction in radiation side-effects.
An atlas of the tissue and blood metagenome in cancer reveals novel links between bacteria, viruses and cancer
Authors: Borchmann Sven
Published: April 2021

Background

Host tissue infections by bacteria and viruses can cause cancer. Known viral carcinogenic mechanisms are disruption of the host genome via genomic integration and expression of oncogenic viral proteins. An important bacterial carcinogenic mechanism is chronic inflammation. Massively parallel sequencing now routinely generates datasets large enough to contain detectable traces of bacterial and viral nucleic acids of taxa that colonize the examined tissue or are integrated into the host genome. However, this hidden resource has not been comprehensively studied in large patient cohorts.

Methods

In the present study, 3025 whole genome sequencing datasets and, where available, corresponding RNA-seq datasets are leveraged to gain insight into novel links between viruses, bacteria, and cancer. Datasets were obtained from multiple International Cancer Genome Consortium studies, with additional controls added from the 1000 genome project. A customized pipeline based on KRAKEN was developed and validated to identify bacterial and viral sequences in the datasets. Raw results were stringently filtered to reduce false positives and remove likely contaminants.

Results

The resulting map confirms known links and expands current knowledge by identifying novel associations. Moreover, the detection of certain bacteria or viruses is associated with profound differences in patient and tumor phenotypes, such as patient age, tumor stage, survival, and somatic mutations in cancer genes or gene expression profiles.

Conclusions

Overall, these results provide a detailed, unprecedented map of links between viruses, bacteria, and cancer that can serve as a reference for future studies and further experimental validation.
The interrater reliability of a routine outcome measure for infants and pre-schoolers aged under 48 months: Health of the Nation Outcome Scales for Infants
Authors: Brann Peter , Culjak Gordana , Kowalenko Nick , Dickson Rosemary , Coombs Tim , Sved Williams Anne , Hoehn Elisabeth , Davies Simon , Hoyland Margaret , Burgess Philip
Published: April 2021

Background

A review of Australian mental health services identified a gap in routine outcome measures addressing social, emotional and behavioural domains for pre-schoolers and infants. The Child and Adolescent Mental Health Information Development Expert Advisory Panel Working Group developed the Health of the Nation Outcome Scales for Infants (HoNOSI), a clinician-reported routine outcome measure for use with those aged under 4 years. Prior psychometric testing showed that the HoNOSI was considered to show face validity, and that it met the standards for concurrent validity and internal consistency.

Aims

We aimed to investigate the interrater reliability of the HoNOSI.

Method

Forty-five infant mental health clinicians completed HoNOSI ratings on a set of five case vignettes.

Results

Quadratic weighted kappa interrater reliability estimates showed the HoNOSI to haveAlmost Perfectinterrater reliability for the HoNOSI total score. Of the 15 scales, one hadModerate, seven hadSubstantialand seven hadAlmost Perfectinterrater reliability. Ten of the fifteen scales and the total score exceeded the COnsensus-based Standards for the Selection of Health Measurement INstruments criteria for interrater reliability (κw≥ 0.7).

Conclusions

There has been a clear need for a routine outcome measure for use with infants and pre-schoolers. This study provides evidence of interrater reliability. The current findings, combined with the face and concurrent validity studies, support further examination of HoNOSI in real-world settings.
Literature, Powerlessness, and Modernity: A Reading of Takeuchi Yoshimi's “What Is Modernity?”
Authors: Wang Qin
Published: April 2021

While the Japanese sinologist Takeuchi Yoshimi is frequently mentioned in discussions of “alternative modernity” on the part of Asia, people have not sufficiently addressed the asymmetrical relationship between literature and politics in Takeuchi's thinking, as his literary analysis is oftentimes associated with a Hegelian reading of subjectivity. Through a reading of Takeuchi's “What Is Modernity?,” published in 1948, this article examines Takeuchi's discourses on politics from a literary standpoint that is radically nondialectical and “powerless” with regard to “politics” as he understands it. Takeuchi's critique of modernity as well as his idea of Asian nationalism cannot do without his idiosyncratic understanding of literature, especially his reading of Lu Xun, and his insistence on the powerlessness of literary resistance. Takeuchi's literary reshuffling of the political, the article argues, opens up a horizon where the very historico-political condition of possibility of existing political institutionalizations can be put into reexamination—it helps us reconsider the concepts of relation, otherness, and equality, which are still in operation to frame our understanding of the world.
Ideological Conversion: Mongolia's Transition from Socialism to Postsocialism
Authors: Sorace Christian
Published: April 2021

After the collapse of socialism in Mongolia, democracy promised life after ideology. This article argues that what disappeared during the democratic transition was not ideology but a conceptualization of ideology as an explicit object, field of intervention, and responsibility. By analyzing the urban form as an invention of ideology, it is possible to locate ideology in material artifacts, cinematic representations, and the cultivation of embodied desires in Mongolia's capital city Ulaanbaatar that originated in the socialist era and continue today, albeit unacknowledged as ideology, and modified to fit the needs of capital and democratic legitimacy. The article concludes with a call to embrace ideology as a self-reflexive concept and practice on the grounds that there is still much to excavate and learn from the ruins of twentieth-century state socialism.
Humoral and Tissue Factors in Tissue Differentiation
Authors: Gaillard P. J.
Published: April 2021

It was shown by Gaillard (1931,1935,1942) that pure strains of fibroblastic cells are very sensitive to those differences in the culture media which go hand in hand with the process of ageing of the donors used for preparing the media, the dimensional growth of the explants being used as a criterion. Moreover, strains of different origin reacted in a different way, thus demonstrating that cells which are morphologically alike can behave quite differently in vitro. When cultivating such a pure strain derived from the anlage of the frontal bone of a 15-day-old chicken embryo successively in a range of culture media prepared from 10-, 15-, and 18-day-old embryos, serum from a newly hatched chicken, and serum from an adult hen, histological bone formation occurred after 12 days of cultivation. This means that the realization of this obviously existing potentiality depended on the composition of the successive media.
Trypan blue induced teratogenesis of rat embryos cultivated in vitro
Authors: Turbow M. M.
Published: April 2021

Trypan blue is known to produce embryonic abnormalities in a wide variety of animals, including rats (Gillman, Gilbert, Gillman & Spence, 1948), mice (Waddington & Carter, 1953; Hamburgh, 1954), amphibians (Waddington & Perry, 1956), chickens (Beaudoin & Wilson, 1958;Stéphan & Sutter, 1961), rabbits (Ferm, 1956), and hamsters (Ferm, 1958). Studies on the teratogenic action of this dye have also been made in culture (Mulherkar, 1960).
Sensing of transposable elements by the antiviral innate immune system
Authors: Gázquez-Gutiérrez Ana , Witteveldt Jeroen , Heras Sara R. , Macias Sara
Published: April 2021

Around half of the genomes in mammals are composed of transposable elements (TEs) such as DNA transposons and retrotransposons. Several mechanisms have evolved to prevent their activity and the detrimental impact of their insertional mutagenesis. Despite these potentially negative effects, TEs are essential drivers of evolution, and in certain settings, beneficial to their hosts. For instance, TEs have rewired the antiviral gene regulatory network and are required for early embryonic development. However, due to structural similarities between TE-derived and viral nucleic acids, cells can misidentify TEs as invading viruses and trigger the major antiviral innate immune pathway, the type I interferon (IFN) response. This review will focus on the different settings in which the role of TE-mediated IFN activation has been documented, including cancer and senescence. Importantly, TEs may also play a causative role in the development of complex autoimmune diseases characterized by constitutive type I IFN activation. All these observations suggest the presence of strong but opposing forces driving the coevolution of TEs and antiviral defense. A better biological understanding of the TE replicative cycle as well as of the antiviral nucleic acid sensing mechanisms will provide insights into how these two biological processes interact and will help to design better strategies to treat human diseases characterized by aberrant TE expression and/or type I IFN activation.
Conceptualizing Medical Resident’s Journey through Wonderland of Clinical Practice: From transitional shock to role adaptation to independent practice
Authors: Sohail Marium , Yasmeen Rahila
Published: April 2021

Objectives: To explore experiences of medical residents about stages and nature of transitional journey from induction into residency program to achievement of consultant title.

Methods: Qualitative phenomenological study was conducted at Sir Gangaram hospital and Fatima Memorial Hospital, Lahore for six months from Feb 2019-July 2019 after IRB/ERC approval from Islamic International Medical College (Ref# Riphah/IIMC/ERC/19/0320). Using purposive criterion sampling, 16 semi-structured interviews in four departments, four strata of junior residents, senior residents, newly-qualified consultants, and supervising consultants with four participants each were conducted till theoretical saturation of data was achieved. After informed consent, audio recorded data was transcribed verbatim & analyzed through Atlas.ti 7 using Interpretive Phenomenological Analysis. After Bracketing and horizontalization, data was coded line by line. Codes (324) were merged to categories (19) for structural and textural description. Composite description of phenomenon was done by abstraction of themes (eight for stages and two for nature of journey).

Results: Eight themes for stages as merriment, anguish, melancholy, acceptance and efforts, intensive learning, burnishing to shine, identity formation and intra-stage oscillations were identified. Two themes for journey’s nature were exponential learning & oscillating journey.

Conclusion: The transitional journey is a multi-stage complex, oscillating journey. An oscillating electron model is presented upon the findings of this study to explain resident transition

doi: https://doi.org/10.12669/pjms.37.4.3853

How to cite this:Sohail M, Yasmeen R. Conceptualizing Medical Resident’s Journey through Wonderland of Clinical Practice: From transitional shock to role adaptation to independent practice. Pak J Med Sci. 2021;37(4):1048-1053.  doi: https://doi.org/10.12669/pjms.37.4.3853

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Clinical outcomes of maitland mobilization in patients with Myofascial Chronic Neck Pain: A randomized controlled trial
Authors: Shabbir Maryam , Arshad Naveed , Naz Anam , Saleem Nadia
Published: April 2021

Background and Objective: Myofascial neck pain is a common musculoskeletal problem caused by presence of trigger points and local and referred pain patterns. Chronic neck pain is responsible for the involvement of joints, ligaments, fascia and connective tissue as well. The objective of this study was to assess the effect of Maitland mobilization in patients with myofascial chronic neck pain.

Methods: In this randomized, placebo treatment-controlled trial, 30 patients consecutively aged 25-45 years meeting inclusion criteria were isolated into two groups. The study group was treated with Maitland mobilization consistently for eight weeks while the control group got placebo treatment for a similar timeframe. Visual analog Scale (VAS), Neck disability index (NDI) and cervical range of motion (ROM) questionnaire was filled by patients before, intermediate and after the intervention to evaluate the severity of pain, functional ability and range of motion.

Results: Following eight weeks of treatment, when compared the post treatment effects of both groups, the significance value for VAS was 0.008, for NDI p=0.030, for Flexion p=0.573, for extension p=0.001, for right rotation p<0.001, for left rotation p=0.002, for right and left side bending p<0.001.

Conclusion: The study concluded that Maitland mobilization grades (I-IV) are effective in reducing pain and improving functional level of NDI scale and the ranges of cervical spine in patients with myofascial chronic neck pain.

doi: https://doi.org/10.12669/pjms.37.4.4220

How to cite this:Shabbir M, Arshad N, Naz A, Saleem N. Clinical outcomes of maitland mobilization in patients with Myofascial Chronic Neck Pain: A randomized controlled trial . Pak J Med Sci. 2021;37(4):1172-1178. doi: https://doi.org/10.12669/pjms.37.4.4220

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Το δικαίωμα στη δημόσια διαβούλευση στο ενωσιακό και ελληνικό δημόσιο δίκαιο
Authors: Μήτση Χριστίνα
Published: April 2021

Η παρούσα διδακτορική διατριβή πραγματεύεται το δικαίωμα στη δημόσια διαβούλευση στο Ενωσιακό και Ελληνικό δημόσιο δίκαιο συγκριτικά με τις έννομες τάξεις της Γαλλίας και του Ηνωμένου Βασιλείου. Η διατριβή διαρθρώνεται σε δύο κεφάλαια με άξονα την κατοχύρωση του διαβουλευτικού δικαιώματος και τη δικονομική προστασία του. Σε πρώτο πλαίσιο προσδιορίζεται η δημόσια διαβούλευση ως «έννομη σχέση». Επιλέγεται να έρθει στο επίκεντρο της μελέτης ο de lege lata ορισμός του δικαιώματος. Εξετάζεται αρχικά το περιεχόμενο του δικαιώματος μέσα από τους κανόνες του διεθνούς δικαίου και διερευνάται η ενσωμάτωση των κανόνων αυτών στο ισχύον δημόσιο δίκαιο, ενώ αναλύονται ιστορικά τα νομοθετικά ρεύματα διαβουλευτικών δικαιωμάτων στις επιμέρους εθνικές έννομες τάξεις. Διαπιστώνεται ιδίως ότι η υποχρέωση των δημοσίων οργάνων για δημόσια διαβούλευση δεν κατοχυρώνεται στο ίδιο επίπεδο σε όλες τις υπό μελέτη έννομες τάξεις. Η αντίληψη, ιδίως περί του τι είναι Σύνταγμα και ποια είναι η έκταση των συνταγματικών κανόνων διαφέρει ως ένα βαθμό σε κάθε μία από αυτές. Παρουσιάζεται ο τρόπος με τον οποίο ερμηνεύεται το οργανωτικό μέρος ενός Συντάγματος και ο σύγχρονος θεωρητικός διάλογος γύρω από το ειδικότερο ζήτημα της συνταγματικής κατοχύρωσης ειδικών διαβουλευτικών δικαιωμάτων και υποχρεώσεων. Γίνεται αναφορά στους περιορισμούς της διαβουλευτικής διαδικασίας. Μεταξύ των άλλων, παρατηρείται ότι η υποχρέωση της διοίκησης ή του νομοθέτη για δημόσια διαβούλευση περιορίζεται υπό έκτακτες συνθήκες. Ωστόσο, ο ευρύτερος δημόσιος διάλογος εξακολουθεί να υπάρχει. Εξετάζεται, γι’ αυτό, η δυνατότητα εφαρμογής μιας θεωρίας περί οργανωτικού κεκτημένου για τα διαδικαστικά διαβουλευτικά δικαιώματα. Σε δεύτερο πλαίσιο, στη διδακτορική διατριβή επανεξετάζεται το είδος και η έκταση του ελέγχου που ασκείται από το Δικαστή. Αναφορικά με τις προϋποθέσεις παραδεκτού άσκησης των ένδικων μέσων και βοηθημάτων για την προστασία του συμμετοχικού δικαιώματος, μελετάται ιδίως το έννομο συμφέρον και το τεκμήριο γνώσης από το οποίο άρχεται η προθεσμία άσκησης ενδίκου μέσου ή βοηθήματος. Στη συνέχεια, γίνεται αναλυτική συστηματοποίηση της νομολογίας αναφορικά με την παραβίαση υποχρέωσης διαβούλευσης και τη παραβίαση των ειδικότερων διαβουλευτικών εγγυήσεων κατά περίπτωση. Διερευνώνται επίσης ορισμένα ειδικά θέματα δικαστικής προστασίας του δικαιώματος συμμετοχής του κοινού και συγκεκριμένα: α) η προστασία της διασυνοριακής διαβούλευσης, β) η αστική ευθύνη του Δημοσίου, λόγω δημόσιας διαβούλευσης και γ) η προκαταρκτική διαβούλευση στις δημόσιες συμβάσεις.