bluuebunny/crossref_metadata_2025 huggingface dataset:
Making public policy fun: How political aspects and policy issues are found in video games
Authors: Akbar Fitrawan , Kusumasari Bevaola
Published: July 2021

The study of video games can be fun, and it is interesting to see what players can explore inside video games. This paper explores public policy practice and its political content or aspects in video games. The very idea itself may sound vague and unclear; can such a thing be found inside a mere video game? To strengthen the argument of what kind of political aspects can be found in video games, the authors use a comparative case study, comparing two games: Animal Crossing: New Horizon and Genshin Impact. By comparing the two games, this paper forms an understanding of how political aspects are found inside each game and their influence on affairs and issues in certain countries. The result of this research shows that video games have become an election-winning strategic political marketing and communication policy. Video games have also used procedural rhetoric, which reveals how game producers promote certain ideologies through legislation and rules in their games.
Utilisation of Image Guidance to Enhance Safety of Deployment of the Mynx Control Vascular Closure Device
Authors: Dolan Steven G. , Mulholland Douglas , Thulasidasan Narayanan , Diamantopoulos Athanasios
Published: July 2021

The Mynx Control device (Cardinal Healthcare, Dublin, Ohio, USA) was recently licensed and allows for entirely extravascular arteriotomy closure. It uses a polyethylene glycol sealant plug which is absorbed fully within 30 days, alleviating concerns around difficulties with regaining access in future. The Mynx device uses a balloon, inflated within the artery and retracted against the arteriotomy to achieve haemostasis, with the extravascular sealant plug then deployed outside the vessel wall. While the manufacturer’s instructions for use do not include utilisation of imaging guidance, we routinely employ fluoroscopic and/or ultrasound to ensure safe use of the device. These techniques allow confirmation of balloon position against the arteriotomy, hence avoiding inadvertent deployment of the plug partially or fully intraluminally. Visualisation of the balloon within the lumen also eliminates risk of plaque disruption in diseased vessels on retraction of the device. Image guidance adds little time to device deployment, and the safety benefits are such that we recommend that practitioners elsewhere consider adopting our techniques. Here, we describe the process involved in both techniques.
Experimental study on lapping ceramic balls with variable-radius groove plate
Authors: Zhou Fenfen , Yao Weifeng , Yuan Julong , Lyu Binghai , Zhao Tianchen , Zhao Ping
Published: July 2021

The method of lapping precision ball with variable-radius groove is developed in recent years. An experimental study on lapping ceramic balls with variable-radius groove was carried out. Taguchi method was used to design the orthogonal experiment of rough lapping, and the material removal rate ( MRR) and the roundness were selected as evaluation indicators. The signal to noise ratio (S/N) and the analysis of variance were used to analyze experimental results. The optimal parameters combination with load pressure of 2.5 N/Ball, abrasive concentration of 10 wt% and rotation speed of 15 rpm was obtained. During rough lapping, the maximum reduction rate of average roundness is 50%, the maximum reduction rate of roundness deviation is 81%, the MRR is 16.9 μm/h, and the reduction rate of variation of ball lot diameter ( VDWL) is 90%. After semi-lapping and polishing, the best surface roughness is up to 10 nm, the best roundness is 0.128 μm, and the VDWL is 0.24 μm. The surface roughness and VDWL of the five balls tested all meet the requirements of ceramic ball with G5 grade, and the roundness value is close to the requirement of G5. The variable-radius groove lapping method is very suitable for improving the precision of batch lapping for ceramic balls.
Effectiveness of collateral arteries embolization before endovascular aneurysm repair to prevent type II endoleaks: A systematic review and meta-analysis
Authors: Zhang Hanfang , Yang Yaoguo , Kou Lei , Sun Hong , Chen Zhong
Published: July 2021

Objectives

This study aimed to evaluate the effect of preventive collateral arteries embolization before endovascular aneurysm repair (EVAR) to reduce type II endoleaks (T2EL), aneurysm enlargement, and re-interventions.

Methods

A comprehensive search of PubMed, MEDLINE, Web of Science, and Embase was conducted to identify articles in English, related to preventive collateral arteries embolization before EVAR, published until October 2020.

Results

A total of 12 relevant studies, including 11 retrospective studies and one randomized controlled trial, were identified and fulfilled the specified inclusion criteria. A total of 1706 patients in 11 studies were involved in the meta-analysis. The overall incidence of T2EL was 17.3% in the embolization group vs. 34.5% in the control group (OR 0.36, p < 0.01). The incidence of persistent T2EL was 15.3% vs. 30.0% (OR 0.37, p < 0.01). Five studies reported the incidence of sac enlargement, with the rate 10.2% vs. 24.9% (OR 0.25, p < 0.01). Nine studies reported T2EL related re-interventions, and it was 1.3% in the embolization group and 10.4% in control (OR 0.14, p < 0.01). The technical success of collateral arteries embolization was 92.1% (455/494) in the 12 studies. 1.2% (10/829) patients suffered a mild complication of collateral arteries embolization, and 2/829 patients died because of the embolization.

Conclusion

Collateral arteries embolization is a promising measure to prevent the occurrence of T2EL, sac enlargement, and re-intervention. High-quality studies need to be conducted to provide stronger evidence-based medical suggestions about the embolize operation.
Usefulness of dynamic ultrasound in the diagnosis of epigastric herniation of stomach
Authors: Corvino Antonio , Corvino Fabio , Tafuri Domenico , Catalano Orlando
Published: July 2021

Introduction

Abdominal wall hernia contents usually consist of omental or mesenteric fat or loops of small or large bowel. Gastric involvement has been only rarely reported.

Case report

We present a case of a 62-year-old woman who was admitted to our hospital due to epigastric pain and vomiting. On physical examination, the only observed abnormality was a soft, painless, epigastric bulge located in the upper midline. Based on the clinical presentation, the patient was diagnosed with a probable epigastric hernia. Dynamic ultrasound evaluation of the palpable bulge confirmed the presence of epigastric hernia demonstrating the movement of abdominal contents through a large wall defect. Surprisingly, the herniated contents were found to contain also the anterior wall of the distal stomach together with omental fat and vessels. The patient opted for surgery, which confirmed the presence of an epigastric hernia containing the distal portion of stomach.

Discussion

In this case, dynamic ultrasound provided added value over computed tomography by clearly demonstrating stomach passing from the abdominal cavity to enter into the hernia sac and it is therefore reported for both its rarity and interest. To our knowledge, this is the first such ultrasound-based case report presented in literature and certainly the best sonographically documented.

Conclusion

We anticiapte that this case report will promote the use of dynamic ultrasound in current practice as an effective imaging tool to recognise unusual types of hernias.
Dangerous or political? Kenyan youth negotiating political agency in the age of ‘new terrorism’
Authors: Mohamed Miraji Hassan
Published: July 2021

This article examines how the online Kenyan press constructs ‘radicalization’ and how youth challenge these constructions. Using Critical Discourse Analysis (CDA) through NVivo, the author analyzed two corpora, one of news texts and the second composed of transcripts from two focus group discussions conducted with youth in Mombasa. The analysis shows the media persistently depoliticize youth by constructing them as a dangerous ‘Other’. In contrast, youth challenge this image by claiming political agency through (re)defining their identities using language and material practices. The construction of actors in discourses of radicalization highlights a specific understanding of radicalism and violence, and impacts framing of the Preventing/Countering Violent Extremism (P/CVE) agenda. The author concludes by showing the implications of the different constructions of youth identities and how youth legitimately enact agency within these bounds. This article raises crucial questions on the practices of meaning-making by individuals and media actors.
Case series of COVID-19 infection in pregnancy complicated by ketoacidosis and symptomatic breathlessness
Authors: Thorne Iona , Steele Samantha , Martineau Marcus , Girling Joanna
Published: July 2021

Background

The differential diagnosis of acute shortness of breath in a pregnant woman with COVID-19 is broad. Pregnancy is a ketosis-prone state, which can result in metabolic acidosis and tachypnoea.

Methods

We describe four pregnant women with COVID-19 and breathlessness where ketoacidosis was found to contribute to symptomatic tachypnoea.

Results

One patient did not have associated COVID-19 pneumonitis, but presented with severe tachypnoea and metabolic acidosis; three women had pneumonitis and metabolic acidosis. Corrective treatment for the metabolic abnormalities resulted in resolution of the ketoacidosis in all cases. No women had coexistent diabetes.

Conclusion

This is the first series of COVID-19 in pregnancy complicated by ketoacidosis and symptomatic tachypnoea. Ketoacidosis associated with COVID-19 is an important cause of tachypnoea requiring specific treatment, which should not be overlooked. Potential mechanisms for this are discussed with a framework for interpretation of blood gas results during pregnancy.
Psychological response to the COVID-19 pandemic in Canada: main stressors and assets
Authors: Généreux Mélissa , Roy Mathieu , David Marc D. , Carignan Marie-Ève , Blouin-Genest Gabriel , Qadar S.M. Zeeshan , Champagne-Poirier Olivier
Published: July 2021

Background:

The COVID-19 crisis has unique features that increase the sense of fear, and comes with additional stressors (e.g., confusion, discrimination, quarantine), which can lead to adverse psychological responses. There is however limited understanding of differences between sociocultural contexts in psychological response to pandemics and other disasters.

Objective:

To examine how Canadians in different provinces, and with different governance modes and sociocultural contexts, understand and react to the COVID-19 pandemic.

Methods:

A web-based survey was conducted from April 8–11, 2020, among a representative sample of 600 Canadian adults from two different contexts ( n=300 in Quebec, the French part of Canada, and n=300 elsewhere in Canada). Two psychological outcomes were assessed: probable post-traumatic stress disorder (PTSD), and probable generalized anxiety disorder (GAD). The roles of various stressors (i.e., threat perceived for oneself or family/friends, quarantine or isolation, financial losses, victims of stigma), assets (i.e., trust in authorities, information received, and compliance with directives) and sources of information used on these two outcomes were also examined. Chi-square tests were performed to examine differences in the distribution of probable PTSD and GAD according to these stressors and assets.

Results:

Probable PTSD and GAD were observed in 25.5% and 25.4% of the respondents, respectively. These proportions were significantly lower in Quebec than elsewhere in Canada. Perceiving a high level of threat and being a victim of stigma were positively associated with probable PTSD and GAD (but not quarantine/isolation and financial losses). A high level of trust in authorities was the only asset associated with a lower risk of PTSD or GAD. Interestingly, this asset was more frequently reported in Quebec than elsewhere in Canada.

Conclusion:

The COVID-19 pandemic represents a unique opportunity to evaluate the psychosocial impacts on various sociocultural groups and contexts, providing important lessons that could help respond to future disasters.
Tobacco epidemic in Jordan: the time to act is now
Authors: Al-Tammemi Ala’a B.
Published: July 2021

Tobacco use still represents a major threat to global public health and this calls for extensive efforts to control tobacco products and advocate harm-reduction policies. Recent global trends of prevalence rates in smoking are promising, as trajectories show a decline in all World Health Organization regions. Yet, this decline varies significantly at the national level. Jordan, as a country in the Eastern Mediterranean Region, has been in a long battle against tobacco. Despite that, the country is found to have one of the highest prevalence rates of tobacco use in the region and the world. Many challenges slow down effective and successful anti-tobacco policy implementation in Jordan, most notably cultural influences on smoking and the interference of the tobacco industry in tobacco policy making. Decision makers in Jordan should consider strengthening of anti-tobacco measures to avoid a public health catastrophe if tobacco use keeps rising at the current pace.
Clinical features of DDX41 mutation-related diseases: a systematic review with individual patient data
Authors: Wan Ziqi , Han Bing
Published: July 2021

Background:

DDX41 serves as a DNA sensor in innate immunity and mutated DDX41 is pathogenic, mainly for myeloid neoplasms.

Methods:

In this study, “ DDX41” was searched in PubMed and Web of Science between 1 January 2015 and 29 April 2021 with individual-patient data seeking. A meta-analysis was not valid here due to the absence of a large dataset. Thirty articles were finally included in the qualitative analysis and 277 patients from 20 studies without overlap were involved in the quantitative summary.

Results:

Pooled incidence was 3.3% (95% confidence interval 2.4–4.2%) of unselected myeloid neoplasms. Patients with hematologic disorders harboring mutated DDX41 were featured as 80% males, median 66 (20–88) years old at diagnosis, 75% acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS), 64% with normal karyotype. Eighty-five percent of patients had germline variants which were nationally diverse and more of frameshift type, whereas 64% of patients had somatic DDX41 variants where p.R525H and missense dominated. ASXL1 and TP53 were the top frequent concomitant somatic mutations. Therapeutically, 70% overall response rate was obtained of hypomethylating agents in MDS, 96% complete remission of chemotherapy in AML, and 8% of relapse in hematopoietic stem cell transplant. Neither overall survival nor progression-free survival could be summed.

Conclusions:

Several significant clinical differences were observed in different diagnosis groups, familial and sporadic cases, and p.R525H compared with other somatic variants. In conclusion, myeloid neoplasms carrying DDX41 mutations were mainly older, male, MDS, and AML patients who had promising responses to treatment. Both germline and somatic DDX41 variants possessed unique characteristics and groups of interest presented certain differences worth further research. (CRD42021228886)
A rare case of constrictive pericarditis with Budd–Chiari syndrome due to right atrial thrombosis
Authors: Pillay Somasundram , Moffat Nokwazi
Published: July 2021

Patients living with HIV (PLWH) with previous pulmonary tuberculosis, presenting with disproportionate ascites to peripheral congestion, should alert the clinician to consider constrictive pericarditis and Budd–Chiari syndrome (BCS). Constrictive pericarditis is the scarring and loss of the pericardial sac elasticity. The aetiology of constrictive pericarditis varies between developed and developing countries, with infective causes like tuberculosis being significant in South Africa. Budd–Chiari syndrome is a group of disorders characterised by hepatic venous outflow obstruction. The level of obstruction in Budd–Chiari syndrome varies globally. In Asia, South Africa, India, and China, obstruction is predominantly found in the inferior vena cava while in Western countries, hepatic vein obstruction occurs. Patients living with HIV are at increased risk of arterial and venous thromboembolism. The clinician must consider Budd–Chiari syndrome in patients living with HIV presenting with ascites. In patients living with HIV, tuberculosis co-infection has been associated with a higher risk of pericarditis. Both constrictive pericarditis and Budd–Chiari syndrome share a remarkably similar clinical presentation, with ascites and hepatomegaly. There is a dearth of literature on co-existent constrictive pericarditis and Budd–Chiari syndrome. We describe a 31-year-old HIV-infected female, on anti-retroviral therapy (CD4 count 208 cells/uL, undetected viral load), with previous pulmonary tuberculosis, who presented with a 2-month history of abdominal swelling, peripheral oedema, and New York Heart Association grade 4 dyspnoea. Examination revealed an elevated jugular venous pulsation with CV waves, atrial fibrillation, right-sided S3 gallop, pansystolic murmur (3/6) at the left sternal border, tender hepatomegaly, and massive ascites with minimal peripheral oedema. The discordant size of ascites prompted investigations, namely, ultrasound abdomen, echocardiogram, and computed tomography (chest and abdomen). These revealed constrictive pericarditis and Budd–Chiari syndrome with thrombus formation in the right atrium, hepatic vein, and inferior vena cava. She was initiated onto anti-coagulation, anti-tuberculosis therapy and referred for pericardiectomy. Clinicians must maintain a suspicion for constrictive pericarditis and Budd–Chiari syndrome in HIV-infected patients, especially in those with a previous tuberculosis, presenting with features of right heart failure.
Congenital anterior urethrocutaneous fistula: Variable clinical features and their management
Authors: Jain Prashant , Prasad Ashish , Jain Sarika
Published: July 2021

Anterior congenital urethrocutaneous fistula is a rare urethral anomaly with only a few cases and short case series being reported in the literature. The anomaly can present with variable clinical features and other associated anomalies. It is important to have a good understanding of the anomaly for an optimal outcome. We reviewed our successfully managed three cases of congenital anterior urethrocutaneous fistula with variable presentation requiring different treatment strategies.

Level of evidence: Not applicable for this multicentre audit.
Chinese views on nuclear weapons: Evidence from an online survey
Authors: Egel Naomi , Hines R. Lincoln
Published: July 2021

What are Chinese public attitudes regarding nuclear weapons? Although scholars have studied Chinese elites’ views on nuclear weapons, surprisingly little is known about the views of China’s public. To understand Chinese public views on nuclear weapons, we conduct an online survey ( N = 1066) of Chinese respondents. This is, to our knowledge, the first survey of Chinese public attitudes towards nuclear weapons. We find that although Chinese citizens view the possession of nuclear weapons as important for their country’s security, they strongly oppose the use of nuclear weapons under any circumstances. We also provide respondents an opportunity to describe their views on nuclear weapons in their own words. Using computer-assisted text analysis, we assess patterns in these open-ended responses and compare across age groups. We find that younger respondents emphasize non-material factors such as having a greater voice internationally, whereas older respondents emphasize self-defense. Overall, this analysis sheds light on the public attitudes that may shape China’s evolving approach to nuclear weapons.
Hazing Practices in South African Schools: A Case of Grade 12 Learners in Gauteng Province
Authors: Huysamer Carolyn , Seroto Johannes
Published: July 2021

Hazing is an ancient, universal practice. In past and modern societies, the need to join a group is an aspect of humanity. The process of joining a group frequently includes the need to be hazed to legitimate full membership. This article uses the theoretical frameworks of Foucault and Bourdieu’s perspectives of social order, Tajfel and Turner’s theory of social identity, and Bandura’s theory of moral disengagement to inform the phenomenon of individuals joining groups. In particular, the study has sought to ascertain why those who haze are motivated to act. A grounded theory was developed through interviewing young adults, who planned hazing activities while in positions of leadership as Grade 12 learners in Gauteng schools. The grounded theory shows that hazing although enacted by an individual is not solely driven by that person, but rather hazing is a means of cultural reproduction. The developed theory is grounded and was verified through interviewing stakeholders in the school community who had extensive knowledge of the school culture and of Grade 12 learners.
Food Insecurity: What Are Its Effects, Why, and What Can Policy Do About It?
Authors: Hines Caitlin T. , Markowitz Anna J. , Johnson Anna D.
Published: July 2021

Food insecurity—lack of access to sufficient food for an active and healthy lifestyle—affects more than 10 million children in the United States. Ample research links food insecurity to hampered child physical, cognitive, and social-emotional development and provides insights for policy. After introducing food insecurity and its measurement, this article summarizes what is known about the effects of food insecurity on child development. It then considers how food insecurity harms children and explores both direct pathways through child health and indirect pathways through parenting and parent well-being. Finally, after reviewing existing policy for reducing food insecurity, we provide suggestions for new policy and policy-targeted research.
Determinants of Tooth Loss in a Medicaid Adult Population
Authors: Tiwari T. , Tranby E. , Thakkar-Samtani M. , Frantsve-Hawley J.
Published: July 2021

Background:

The objective of this retrospective cohort study is to examine the determinants of tooth loss in a Medicaid-enrolled population using claims data from 2016 to 2018.

Methods:

Deidentified administrative claims data for Medicaid-enrolled adults between the ages of 50 and 90 y in 2016 to 2018 were examined using the IBM Watson MarketScan Medicaid Database. The sample size was 91,468. The entire sample was divided into 2 cohorts: no tooth loss cohort (n = 54,786) and tooth loss cohort (n = 36,682). The tooth loss cohort was further divided into 2 groups: 1 to 5 teeth lost (n = 29,141) and 6 or more teeth lost (n = 7,541). Tooth loss was described by age, gender, race, number of commodities, and if periodontal treatment was performed. Logistic regression models were conducted to examine factors associated with tooth loss.

Results:

Within the tooth loss cohort, the patients who had periodontal treatment had higher odds of losing at least 1 tooth (odds ratio [OR], 1.15; confidence interval [CI], 1.10–1.20) and lower odds of losing 6 or more teeth (OR, 0.25; CI, 0.22–0.29). In the regression analysis, the predictive margins of tooth loss for 1 tooth and 6 or more teeth follow a linear path. Compared to no comorbidities, the odds of losing 6 or more teeth increased with 1, 2, or 3+ comorbidities.

Knowledge Transfer Statement:

This study provides significant information about the quantification of comorbidities and its direct correlation with the increased odds of tooth loss. This study also highlighted the protective effect of periodontal treatment on tooth loss. This knowledge can be useful to dental care providers to understand the risk of tooth loss in their patient population.
Opening the Black Box of Benefits Management in the Context of Projects
Authors: Aubry Monique , Boukri Sanaa El , Sergi Viviane
Published: July 2021

Benefits management has recently gained in popularity but remains difficult to implement and conduct in organizations. Inspired by the practice perspective and building on an exploratory study, we reveal that defining benefits is a complex task, as the concept of benefit is understood in a variety of ways. We also expose the evolving nature of benefits management, highlighting that benefits management is far from a linear activity. Our study uncovers some of the social and political aspects of benefits management, which have up until now been neglected and may be connected to the challenges of this activity.
Sustained minimal residual disease negativity in newly diagnosed multiple myeloma and the impact of daratumumab in MAIA and ALCYONE
Authors: San-Miguel Jesus , Avet-Loiseau Hervé , Paiva Bruno , Kumar Shaji , Dimopoulos Meletios A. , Facon Thierry , Mateos María-Victoria , Touzeau Cyrille , Jakubowiak Andrzej , Usmani Saad Z. , Cook Gordon , Cavo Michele , Quach Hang , Ukropec Jon , Ramaswami Priya , Pei Huiling , Qi Mia , Sun Steven , Wang Jianping , Krevvata Maria , DeAngelis Nikki , Heuck Christoph , Van Rampelbergh Rian , Kudva Anupa , Kobos Rachel , Qi Ming , Bahlis Nizar J.
Published: July 2021

In patients with transplant-ineligible newly diagnosed multiple myeloma (NDMM), daratumumab reduced the risk of disease progression or death by 44% in MAIA (daratumumab/lenalidomide/dexamethasone [D-Rd]) and 58% in ALCYONE (daratumumab/bortezomib/melphalan/prednisone [D-VMP]). Minimal residual disease (MRD) is a sensitive measure of disease and response to therapy. MRD-negativity status and durability were assessed in MAIA and ALCYONE. MRD assessments using next-generation sequencing (10−5) occurred for patients achieving complete response (CR) or better and after at least CR at 12, 18, 24, and 30 months from the first dose. Progression-free survival (PFS) by MRD status and sustained MRD negativity lasting ≥6 and ≥12 months were analyzed in the intent-to-treat population and among patients achieving at least CR. In MAIA (D-Rd, n = 368; lenalidomide and dexamethasone [Rd], n = 369) and ALCYONE (D-VMP, n = 350; bortezomib/melphalan/prednisone [VMP], n = 356), the median duration of follow-up was 36.4 and 40.1 months, respectively. MRD-negative status and sustained MRD negativity lasting ≥6 and ≥12 months were associated with improved PFS, regardless of treatment group. However, daratumumab-based therapy improved rates of MRD negativity lasting ≥6 months (D-Rd, 14.9% vs Rd, 4.3%; D-VMP, 15.7% vs VMP, 4.5%) and ≥12 months (D-Rd, 10.9% vs Rd, 2.4%; D-VMP, 14.0% vs VMP, 2.8%), both of which translated to improved PFS vs control groups. In a pooled analysis, patients who were MRD negative had improved PFS vs patients who were MRD positive. Patients with NDMM who achieved MRD-negative status or sustained MRD negativity had deep remission and improved clinical outcomes. These trials were registered at www.clinicaltrials.gov as #NCT02252172 (MAIA) and #NCT02195479 (ALCYONE).
Optimisation Method for Determination of Crack Tip Position Based on Gauss-Newton Iterative Technique
Authors: Yang Bing , Wei Zhanjiang , Liao Zhen , Zhou Shuwei , Xiao Shoune , Zhu Tao , Yang Guangwu , Wang Mingmeng
Published: July 2021

In the digital image correlation research of fatigue crack growth rate, the accuracy of the crack tip position determines the accuracy of the calculation of the stress intensity factor, thereby affecting the life prediction. This paper proposes a Gauss-Newton iteration method for solving the crack tip position. The conventional linear fitting method provides an iterative initial solution for this method, and the preconditioned conjugate gradient method is used to solve the ill-conditioned matrix. A noise-added artificial displacement field is used to verify the feasibility of the method, which shows that all parameters can be solved with satisfactory results. The actual stress intensity factor solution case shows that the stress intensity factor value obtained by the method in this paper is very close to the finite element result, and the relative error between the two is only − 0.621%; The Williams coefficient obtained by this method can also better define the contour of the plastic zone at the crack tip, and the maximum relative error with the test plastic zone area is − 11.29%. The relative error between the contour of the plastic zone defined by the conventional method and the area of the experimental plastic zone reached a maximum of 26.05%. The crack tip coordinates, stress intensity factors, and plastic zone contour changes in the loading and unloading phases are explored. The results show that the crack tip change during the loading process is faster than the change during the unloading process; the stress intensity factor during the unloading process under the same load condition is larger than that during the loading process; under the same load, the theoretical plastic zone during the unloading process is higher than that during the loading process.
Deep Learning-Driven Data Curation and Model Interpretation for Smart Manufacturing
Authors: Zhang Jianjing , Gao Robert X.
Published: July 2021

Characterized by self-monitoring and agile adaptation to fast changing dynamics in complex production environments, smart manufacturing as envisioned under Industry 4.0 aims to improve the throughput and reliability of production beyond the state-of-the-art. While the widespread application of deep learning (DL) has opened up new opportunities to accomplish the goal, data quality and model interpretability have continued to present a roadblock for the widespread acceptance of DL for real-world applications. This has motivated research on two fronts: data curation, which aims to provide quality data as input for meaningful DL-based analysis, and model interpretation, which intends to reveal the physical reasoning underlying DL model outputs and promote trust from the users. This paper summarizes several key techniques in data curation where breakthroughs in data denoising, outlier detection, imputation, balancing, and semantic annotation have demonstrated the effectiveness in information extraction from noisy, incomplete, insufficient, and/or unannotated data. Also highlighted are model interpretation methods that address the “black-box” nature of DL towards model transparency.
Correction to: Diversity and evolution of the transposable element repertoire in arthropods with particular reference to insects
Authors: Petersen Malte , Armisén David , Gibbs Richard A. , Hering Lars , Khila Abderrahman , Mayer Georg , Richards Stephen , Niehuis Oliver , Misof Bernhard
Published: July 2021

An amendment to this paper has been published and can be accessed via the original article.
High risk groups for severe COVID-19 in a whole of population cohort in Australia
Authors: Liu Bette , Spokes Paula , He Wenqiang , Kaldor John
Published: July 2021

Background

Increasing age is the strongest known risk factor for severe COVID-19 disease but information on other factors is more limited.

Methods

All cases of COVID-19 diagnosed from January–October 2020 in New South Wales Australia were followed for COVID-19-related hospitalisations, intensive care unit (ICU) admissions and deaths through record linkage. Adjusted hazard ratios (aHR) for severe COVID-19 disease, measured by hospitalisation or death, or very severe COVID-19, measured by ICU admission or death according to age, sex, socioeconomic status and co-morbidities were estimated.

Results

Of 4054 confirmed cases, 468 (11.5%) were classified as having severe COVID-19 and 190 (4.7%) as having very severe disease. After adjusting for sex, socioeconomic status and comorbidities, increasing age led to the greatest risk of very severe disease. Compared to those 30–39 years, the aHR for ICU or death from COVID-19 was 4.45 in those 70–79 years; 8.43 in those 80–89 years; 16.19 in those 90+ years. After age, relative risks for very severe disease associated with other factors were more moderate: males vs females aHR 1.40 (95%CI 1.04–1.88); immunosuppressive conditions vs none aHR 2.20 (1.35–3.57); diabetes vs none aHR 1.88 (1.33–2.67); chronic lung disease vs none aHR 1.68 (1.18–2.38); obesity vs not obese aHR 1.52 (1.05–2.21). More comorbidities was associated with significantly greater risk; comparing those with 3+ comorbidities to those with none, aHR 5.34 (3.15–9.04).

Conclusions

In a setting with high COVID-19 case ascertainment and almost complete case follow-up, we found the risk of very severe disease varies by age, sex and presence of comorbidities. This variation should be considered in targeting prevention strategies.
LncRNA MCM3AP-AS1 sponges miR-148a to enhance cell invasion and migration in small cell lung cancer
Authors: Luo Hua , Zhang Yukun , Qin Guangmei , Jiang Bing , Miao Lili
Published: July 2021

Background

MCM3AP-AS1 is a recently characterized lncRNA playing an oncogenic role in several cancers. However, its role in lung cancer remains unknown. Here, we aimed to explore the functions of MCM3AP-AS1 in small cell lung cancer (SCLC) and the possible underlying mechanisms.

Methods

MCM3AP-AS1 and ROCK1 levels in SCLC patients were analyzed by qPCR. RNA pull-down and luciferase assays were performed to analyze the interaction between MCM3AP-AS1 and miR-148a. ROCK1 mRNA and protein levels were detected by qPCR and Western blot, respectively. Cell invasion and migration were analyzed by Transwell assays.

Results

MCM3AP-AS1 was upregulated in patients with SCLC, and a high MCM3AP-AS1 level was accompanied by a low survival rate. The binding of MCM3AP-AS1 to miR-148a predicted by bioinformatics analysis was verified by RNA pull-down and luciferase assays. However, MCM3AP-AS1 and miR-148a did not affect each other’s expression. ROCK1 was upregulated in SCLC tissues and positively correlated with MCM3AP-AS1. In SCLC cells, MCM3AP-AS1 overexpression increased ROCK1 and promoted cancer cell invasion and migration, while miR-148a overexpression showed the opposite effects and attenuated the effects of MCM3AP-AS1 overexpression on ROCK1 expression and cell behaviors.

Conclusions

MCM3AP-AS1 sponges miR-148a, thereby increasing SCLC cell invasion and migration via upregulating ROCK1 expression.
The incidence, risk factors and predictive nomograms for early death of lung cancer with synchronous brain metastasis: a retrospective study in the SEER database
Authors: Shen Heng , Deng Gang , Chen Qianxue , Qian Jin
Published: July 2021

Background

The prognosis of lung cancer with synchronous brain metastasis (LCBM) is very poor, and patients often die within a short time. However, little is known about the early mortality and related factors in patients with LCBM.

Methods

Patients diagnosed with LCBM between 2010 and 2016 were enrolled from the Surveillance, Epidemiology, and End Result (SEER) database. Univariate and multivariate logistic regression analysis were used to identify significant independent prognostic factors, which were used to construct nomograms of overall and cancer-specific early death. Then, the prediction ability of the model was verified by receiver operating characteristic (ROC) curve. At last, the clinical application value of the model was tested through decision curve analysis (DCA).

Results

A total of 29,902 patients with LCBM were enrolled in this study. Among them, 13,275 (44.4%) patients had early death, and 11,425 (38.2%) cases died of lung cancer. The significant independent risk factors for overall and cancer-specific early death included age, race, gender, Gleason grade, histological type, T stage, N stage, bone metastasis, liver metastasis and marital status, which were used to construct the nomogram. The ROC curve demonstrated good predictive ability and clinical application value. The areas under the curve (AUC) of the training group was 0.793 (95% CI: 0.788–0.799) and 0.794 (95% CI: 0.788–0.799), in the model of overall and cancer-specific early death respectively. And the AUC of the validation group were 0.803 (95% CI: 0.788–0.818) and 0.806 (95% CI: 0.791–0.821), respectively. The calibration plots of the model showed that the predicted early death is consistent with the actual value. The DCA analysis indicated a good clinical application value of this model.

Conclusions

We established a comprehensive nomogram to predict early death in lung cancer patients with synchronous brain metastases. Nomograms may help oncologists develop better treatment strategies, such as clinical trials and hospice care.
“Applying Intersectionality in designing and implementing health interventions: a scoping review”
Authors: Ghasemi Elham , Majdzadeh Reza , Rajabi Fatemeh , Vedadhir AbouAli , Negarandeh Reza , Jamshidi Ensiyeh , Takian Amirhossein , Faraji Zahra
Published: July 2021

Background

Given the potential of intersectionality to identify the causes of inequalities, there is a growing tendency toward applying it in the field of health. Nevertheless, the extent of the application of intersectionality in designing and implementing health interventions is unclear. Therefore, this study aimed to determine the extent to which previous studies have applied intersectionality and its principles in designing and implementing health interventions.

Methods

The title and abstract of the articles which were published in different databases e.g. PubMed, Web of Science, Proquest, Embase, Scopus, Cochrane, and PsychInfo were screened. Those articles that met the screening criteria were reviewed in full text. The data about the application of principles of intersectionality, according to the stages heuristic model (problem identification, design & implementation, and evaluation), were extracted through a 38-item researcher-made checklist.

Results

Initially, 2677 articles were found through reviewing the target databases. After removing the duplicated ones and screening the titles and abstracts of 1601 studies, 107 articles were selected to be reviewed in detail and 4 articles could meet the criteria. The most frequently considered intersectionality principles were “intersecting categories” and “power”, particularly at the stages of ‘problem identification’ as well as ‘design & implementation’. The results showed that “multilevel analysis” principle received less attention; most of the studies conducted the interventions at the micro level and did not aim at bringing about change at structural levels. There was a lack of clarity regarding the attention to some of the main items of principles such as “reflexivity” as well as “social justice and equity". These principles might have been implemented in the selected articles; however, the authors have not explicitly discussed them in their studies.

Conclusions

Given the small number of included studies, there is still insufficient evidence within empirical studies to show the implication of intersectionality in designing and conducting health interventions. To operationalize the intersectionality, there is a need to address the principles at various stages of health policies and interventions. To this end, designing and availability of user-friendly tools may help researchers and health policymakers appropriately apply the intersectionality.
Clinical characteristics, injury pattern and management of pediatric pelvic fracture: An observational retrospective study from a level I trauma center
Authors: Alhammoud Abduljabbar , Moghamis Isam , Abdelrahman Husham , Ghouri Syed Imran , Asim Mohammad , Babikir Elhadi , Al-Thani Hassan , El-Menyar Ayman
Published: July 2021

Background

Pediatric pelvic fractures (PPF) are uncommon among children requiring hospitalization after blunt trauma. The present study explored our experience for the prevalence, patients demographics, clinical characteristics, injury pattern and management of pediatric pelvic fractures in a level I trauma center.

Methods

This is a retrospective review of prospectively collected data obtained from trauma registry database for all pediatrics trauma patients of age ≤18 years. Data were analyzed according to different aspects relevant to the clinical applications such as Torode classification for pelvic ring fracture (Type I–IV), open versus closed triradiate cartilage, and surgical versus non-surgical management.

Results

During the study period (3 and half years), a total of 119 PPF cases were admitted at the trauma center (11% of total pediatric admissions); the majority had pelvic ring fractures (91.6%) and 8.4% had an acetabular fracture. The mean age of patients was 11.5 ± 5.7, and the majority were males (78.2%). One hundred and four fractures were classified as type I (5.8%), type II (13.5%), type III (68.3%) and type IV (12.5%). Patients in the surgical group were more likely to have higher pelvis AIS (p = 0.001), type IV fractures, acetabular fractures and closed triradiate cartilage as compared to the conservative group. Type III fractures and open triradiate cartilage were significantly higher in the conservative group (p < 0.05). Patients with closed triradiate cartilage frequently sustained spine, head injuries, acetabular fracture and had higher mean ISS and pelvis AIS (p < 0.01) than the open group. However, the rate of in-hospital complications and mortality were comparable among different groups. The overall mortality rate was 2.5%.

Conclusion

PPF are uncommon and mainly caused by high-impact trauma associated with multisystem injuries. The majority of PPF are stable, despite the underlying high-energy mechanism. Management of PPF depends on the severity of fracture as patients with higher grade fractures require surgical intervention. Furthermore, larger prospective study is needed to understand the age-related pattern and management of PPF.
Engaging family caregivers and health system partners in exploring how multi-level contexts in primary care practices affect case management functions and outcomes of patients and family caregivers at end of life: a realist synthesis
Authors: Warner Grace , Baird Lisa Garland , McCormack Brendan , Urquhart Robin , Lawson Beverley , Tschupruk Cheryl , Christian Erin , Weeks Lori , Kumanan Kothai , Sampalli Tara
Published: July 2021

Background

An upstream approach to palliative care in the last 12 months of life delivered by primary care practices is often referred to as Primary Palliative Care (PPC). Implementing case management functions can support delivery of PPC and help patients and their families navigate health, social and fiscal environments that become more complex at end-of-life. A realist synthesis was conducted to understand how multi-level contexts affect case management functions related to initiating end-of-life conversations, assessing patient and caregiver needs, and patient/family centred planning in primary care practices to improve outcomes. The synthesis also explored how these functions aligned with critical community resources identified by patients/families dealing with end-of-life.

Methods

A realist synthesis is theory driven and iterative, involving the investigation of proposed program theories of how particular contexts catalyze mechanisms (program resources and individual reactions to resources) to generate improved outcomes. To assess whether program theories were supported and plausible, two librarian-assisted and several researcher-initiated purposive searches of the literature were conducted, then extracted data were analyzed and synthesized. To assess relevancy, health system partners and family advisors informed the review process.

Results

Twenty-eight articles were identified as being relevant and evidence was consolidated into two final program theories: 1) Making end-of-life discussions comfortable, and 2) Creating plans that reflect needs and values. Theories were explored in depth to assess the effect of multi-level contexts on primary care practices implementing tools or frameworks, strategies for improving end-of-life communications, or facilitators that could improve advance care planning by primary care practitioners.

Conclusions

Primary care practitioners’ use of tools to assess patients/families’ needs facilitated discussions and planning for end-of-life issues without specifically discussing death. Also, receiving training on how to better communicate increased practitioner confidence for initiating end-of-life discussions. Practitioner attitudes toward death and prior education or training in end-of-life care affected their ability to initiate end-of-life conversations and plan with patients/families. Recognizing and seizing opportunities when patients are aware of the need to plan for their end-of-life care, such as in contexts when patients experience transitions can increase readiness for end-of-life discussions and planning. Ultimately conversations and planning can improve patients/families’ outcomes.
Anticoagulation for patients with mechanical heart valves at the end of life: understanding clinician attitudes and improving decision making
Authors: Raby Jonathan , Bradley Victoria , Sabharwal Nikant
Published: July 2021

Background

Decisions regarding continuation or cessation of anticoagulation for patients with mechanical heart valves nearing the end of life represent a difficult balance of risks. The risk of suffering and disability that may result from thromboembolism must be weighed against the burden of continued anticoagulation therapy and the excess bleeding risk this confers. Data allowing quantification of the relative risks are scarce, and this translates to a lack of published guidance on the topic. Here we describe how this lack of guidance is impacting upon healthcare professionals and their patients through misconception of risk and under-confidence in decision-making. We also present local guidance we have developed that aims to improve objective risk assessment and promote individualised, patient-centred decision-making.

Methods

Our survey was developed by specialists in palliative care and cardiology. The survey explored respondents' conception of the risks of stopping anticoagulation for patients with mechanical heart valves at the end of life, as well as their ability to identify patient factors that modify this risk. Respondent decision-making, confidence, and readiness to accept further guidance were also explored. Healthcare professionals at two university teaching hospitals were invited to participate in the survey. The study population included hospital specialists, generalists, and trainees.

Results

Fifty-two healthcare professionals completed the survey, including 16 palliative care specialists. 47 (90%) of respondents felt poorly informed of the risks of stopping or continuing anticoagulation. 6 (12%) correctly identified risk of thromboembolism in patients with mechanical heart valves who are not anticoagulated. The remainder overestimated risk by a factor of two (18, 35%) or five (27, 52%). 49 (94%) would find further guidance on this issue helpful.

Conclusions

The healthcare professionals we surveyed felt poorly informed and ill-equipped to make decisions regarding anticoagulation for patients with mechanical heart valves at the end of life. They were objectively poor at estimating the risks involved. In the absence of robust data to support protocolisation of practice, we believe these decisions must be taken in conversation with the patient, taking account of individual circumstances and priorities. We have developed guidance for local use to support such individualised decision-making.