bluuebunny/crossref_metadata_2025 huggingface dataset:
Results of a longitudinal survey on quality of life (QoL) in 935 patients with supradiaphragmatic early stage Hodgkin lymphoma (HL) enrolled in the EORTC-GELA H8 trial (# 20931)
Authors: Heutte N. , Mounier N. , Flechtner H. , Mellink A. M. , Meerwaldt J. H. , Fermé C. , Eghbali H. , Henry-Amar M.
Published: April 2020

8582

Background: To study the change in posttreatment QoL and fatigue in patients with supradiaphragmatic early stage HL. Methods: QoL assessment was made using the EORTC QLQ-C30 core questionnaire and fatigue was assessed using the MFI-20 questionnaire. Questionnaires were given immediately after treatment completion and every 6 months thereafter for at least a period of 5 years. Mixed models (Med Decis Making 2003;3:54–66) were used to assess statistically reliable changes of the variables tested with time because they allow unequal number of assessments per patients. Variables tested were the 7 functioning scales and the fatigue scale of the QLQ-C30 questionnaire, the 5 MFI-20 fatigue scales, and time using 6 time periods: 0–6, 7–14, 15–21, 22–32, 33–47, ≥48 months following the end of treatment. The impact of gender, age (<30, 30–49, ≥50 years), treatment (mantle-field irradiation, subtotal nodal irradiation (STNI), 3, 4 or 6 MOPP-ABV and involved-field irradiation or 4 MOPP-ABV and STNI) and treatment-related acute grade 3–4 toxicity was also tested. Patients were censored at relapse when occurred. Results: Of the 1577 patients enrolled in the trial (1993–1998), 935 (59%, median follow-up 7 years) participated for a total of 3,227 assessments. Main clinical characteristics did not differ between patients with missing QoL forms and those with complete data. There were no significant differences in disease-free survival between treatment arms. Significant (P<0.001) improvement with time was observed for all QoL and fatigue variables tested. Overall, young age and male sex significantly (P<0.01) correlated with improvement in all QLQ-C30 dimensions except cognitive functioning. Treatment duration ≥6 months had a significant (P<0.005) negative impact on global QoL. Age≥30 years and treatment duration ≥2 months negatively (P<0.05) influenced MFI-20 variable changes. Previous toxicity and age ≥30 years altered mental fatigue and motivation. Conclusions: QoL data from the reintegration process of patients into normal life during the first follow-up years show substantial limitations. The impact of treatment is limited. Fatigue remains of great concern in these patients.

No significant financial relationships to disclose.
Stress, immunity, and cervical cancer: Psychoneuroimmunologic (PNI) results of a randomized telephone counseling intervention
Authors: Nelson E. L. , Wenzel L. B. , Osann K. , Monk B. J. , Dogan-Ates A. , Chantana N. , Reina-Patton A. A. , Chicz-Demet A. , Dupont N. , Laust A. K.
Published: April 2020

8585

Background: The association between counseling benefit and improved cancer patient survival is controversial. If such an association exists, it requires biological control of tumor growth, with the immune system as the most likely effector arm. It is widely held that for anti-tumor immunity a T helper type 1 (Th1) immune response is more advantageous, by supporting antigen-specific cytotoxicity, than a T helper type 2 (Th2). The purpose of this study was to test potential QOL, neuroendocrine and immune benefits obtained from psychosocial telephone counseling (PTC). Methods: Fifty cervical cancer patients were randomized to PTC or usual care. QOL and biological specimens were collected at baseline (3–15 months post diagnosis), and four months post-enrollment, Time 2. QOL was assessed by the FACT-Cx. Saliva was collected for the evaluation of cortisol and DHEA. Blood was collected for evaluation of selected neuroendocrine and immune parameters. We defined a Th1:Th2 ratio based upon cytokine precursor frequency determined from ELISpot assays for interferon (IFN) gamma and interleukin-(IL-) 5 performed using anti-CD3 and anti-CD28 lymphocyte stimulation. Results: We demonstrated a significant improvement in overall QOL from baseline to Time 2 for PTC participants compared to the control population (absolute difference 8.15, p=0.05). We observed longitudinal changes, up to 15 fold, in the Th1:Th2 ratio. Improvement in QOL was significantly associated with an increased Th1 immune system bias and conversely a decline in QOL with a more pronounced Th2 bias, p= 0.0097 two tailed Fisher’s exact T test and Spearman Correlation Coefficient r= 0.6368 (p= 0.0002, two tailed). Evaluation of association between QOL and the neuroendocrine parameters, salivary cortisol and DHEA, demonstrated the predicted trends, but did not reach statistical significance. Conclusions: PTC can improve QOL for cervical cancer survivors. Importantly, we have shown for the first time that changes in QOL are significantly associated with a shift of immune system Th1:Th2 stance. This provides support for a biobehavioral model, which identifies potential mechanisms by which interventions that lead to improvement in QOL could also result in improved clinical outcomes.

No significant financial relationships to disclose.
Symptom clusters in newly-diagnosed brain tumor patients
Authors: Gleason J. , Case D. , Rapp S. , Ip E. , Naughton M. , Butler J. , McMullen K. , Stieber V. , Saconn P. , Shaw E.
Published: April 2020

8587

Background: A symptom cluster is 2 or more co-occurring symptoms. Patients with brain tumors experience disease and treatment-related symptoms that impact their health-related quality of life (QOL). Identifying symptom clusters will facilitate treatment and improve QOL outcomes. Methods: 66 patients were enrolled in a phase III, placebo-controlled, double-blind, prospective randomized clinical trial assessing the effect of prophylactic d-methylphenidate (d-MPH) on QOL in newly diagnosed brain tumor patients receiving brain radiation therapy (RT). Inclusion criteria were: age ≥ 13 years, primary or metastatic brain tumor, partial or whole brain RT with a total dose of ≥ 2,500 cGy in ≥ 10 fractions, KPS ≥ 70, and life expectancy ≥ 3 months. Patients received d-MPH 5–15 mg BID (or placebo) starting week 1 of RT and continuing for 8 weeks post-RT. QOL data were collected at baseline, the end of RT, and 4, 8, and 12 weeks following RT using the Functional Assessment of Cancer Therapy-Brain (FACT-Br) and the Center for Epidemiologic Studies Depression Scale (CES-D). Symptom data were analyzed using exploratory factor analysis, multi-dimensional scaling (MDS), and cluster analysis. Results: The study failed to show a treatment effect for d-MPH (Butler J et al, Int J Radiat Oncol Biol Physics 63 [Supp1]:80, 2005).Thus, both d-MPH and placebo patients were analyzed together. 58 and 48 patients were analyzed at baseline and the end of RT, respectively. Two symptom clusters were identified using exploratory factor analysis and supported by MDS and cluster analysis: an expressive language cluster including difficulty reading, writing, and finding the right words, and a mood cluster including feeling sad, anxious, and having depressed mood. Conclusions: Two symptom clusters were identified in patients undergoing brain RT: an expressive language cluster and a mood cluster. This suggests that interventions that target both cognitive function and mood should be utilized. Further research on symptom clusters in cancer patients is needed. This study was supported by NCI grant 1 U10 CA81851.

No significant financial relationships to disclose.
The relationship between older cancer survivors’ reports of depression, anxiety and pain to health providers’ findings and mortality
Authors: Seo P. H. , Sloane R. , Ingram S. S. , Misra D. , Clipp E. C. , Montana G. S. , Cohen H. J.
Published: April 2020

8597

Background: Older cancer survivors may experience psychological distress due to their cancer experience and aging health. This study aimed to compare primary care and specialty providers’ inquiries of pain, depression and anxiety to older cancer survivors’ questionnaire responses. Methods: 153 patients seen in oncology clinics at the Veterans Affairs Medical Center (Durham, NC) from November 1999 until April 2000 completed the Hospital Anxiety and Depression Scale and a pain thermometer questionnaire. Blinded chart review examined health provider inquiries of pain, anxiety and depression. Cox proportional hazards survival analyses were performed on subjective pain, anxiety and depression with comorbidities and Karnofsky performance status (KPS) added in controlled models. Results: Patients were on average aged 68, had 5.4 comorbidities, 87.4% KPS, and were 3.1 years from a cancer diagnosis. Health providers missed 17 of 94 patients with significant levels of self-reported pain (sensitivity 0.82). Although 28 (20.6%) and 33 (25.8%) patients screened positively for depression and anxiety respectively, providers asked 7 patients about anxiety (sensitivity 0.15) and 16 patients about depression (sensitivity 0.25). The overall three year mortality was 37.9%. Pain was not associated with mortality. Patients screening for depression [HR 2.03 (95% CI: 1.03, 4.01)] and anxiety [HR 2.02 (95% CI: 1.01, 4.04)] had lower 3 year survival. KPS and comorbidities diminished these effects. Conclusions: In older cancer survivors, anxiety and depression may have an association with mortality. To improve detection, oncology and primary care providers should routinely inquire about mood and aim to intervene with pharmacologic or supportive treatments.

No significant financial relationships to disclose.
The development of a prediction tool for chemotherapy-induced anemia in patients with advanced non-small cell lung cancer (NSCLC) palliative receiving chemotherapy
Authors: Vincent M. , Dranitsaris G. , Clemons M. , Verma S. , Lau C. , Gascon P. , Van Belle S. , Ludwig H.
Published: April 2020

8600

Background: Anemia remains a common complication in patients with advanced NSCLC on palliative chemotherapy. Many oncologists believe that anemia is unpredictable, acting on a low hemoglobin value once the patient is anemic (i.e. reactively). However, patient care could be substantially improved if severe anemia could be accurately predicted by validated mathematical models. The development and validation of our cycle-based prediction model for severe anemia (hemoglobin ≤ 100 g/L) is described. Methods: Data on 536 European patients receiving palliative chemotherapy was prospectively collected as part of the European Cancer Anemia Survey (Ludwig et al, 2004), including information on clinical and biochemistry parameters that could potentially be associated with anemia. The sample was randomly divided into a 2/3 model derivation and 1/3 validation sample. Multivariable logistic regression techniques were applied for the initial model. A risk scoring system based on regression parameters was created, from 0 to 15. Finally a receiver operating characteristic curve (ROC) analysis was undertaken to measure predictive accuracy of the validation sample. Results: Precycle hemoglobin, low body surface area, advanced age, poor performance status, recurrent/persistent disease and platinum or gemcitabine-based chemotherapy were identified as being important predictors for severe anemia. The ROC analysis on the derivation and internal validation datasets had areas under the ROC curve of 0.80 (95%CI: 0.74 - 0.85) and 0.86 (95%CI: 0.83 - 0.89). A risk score of ≥ 8 to < 10 was identified as being the optimal cut-off to maximize sensitivity (83.1%) and specificity (67.8%) of the prediction tool. Patients with a score of ≥ 8 would be considered at high risk for developing severe anemia following a particular cycle of chemotherapy. Conclusions: This study outlines the development of an accurate anemia prediction tool for NSCLC patients receiving chemotherapy. The application and planned continued refinement of this prediction tool will be an important source of patient specific risk information for the practicing oncologist and can enhance patient care by utilizing anemia therapies earlier and pro-actively.

[Table: see text]
Screening for unmet psycho-social needs in cancer care
Authors: Doebbeling C. , Losee L. , Powers J. , Johns S. , Connor J.
Published: April 2020

8633

Background: Persons receiving cancer care are at risk for undiagnosed depression, but the burden of anxiety symptoms and social work needs is not well described. The objectives of the clinical intervention were: 1) to describe the burden of depression, anxiety and social distress; and 2) to determine whether an unmet need for psycho-social services existed in a sample of cancer patients at a university cancer center with an active psycho-social referral program. Methods: We developed a survey composed of the Memorial Distress Thermometer (MDT), specific social work needs, and the depression and anxiety modules from the Patient Health Questionnaire (PHQ). The clinical survey was administered to a convenience sample presenting for either referral visits or ongoing cancer treatment at the Indiana University Cancer Center for a four month period. Patient request for services, indicated need, and standardized threshold scores were used to determine need for referral (MDT ≥ 4; PHQ depression ≥ 10; PHQ anxiety ≥ 10). Descriptive statistics were calculated. Results: 184 patients (70% male) completed the survey. One-third of those screened met criteria for social work referral. 78% reported at least some distress (mean score 3.6) on the MDT, with 46% (n=81) scoring 4 or above. Social work needs included helping children cope with parental illness (11%), pharmaceutical expenses (11%), insurance assistance (6%), discussing illness with spouse (6%), and lodging during treatment (5%). Mental health distress was common. 34% met criteria for referral to psychological or psychiatric services. The mean PHQ depression score was 4.7, with moderate to severe depression (score ≥ 10) in 13%. Symptoms of generalized anxiety were also common, with a mean score of (5.0) and 11% scoring ≥ 10. Conclusions: In persons receiving cancer care, previously unknown distress, social work needs, depression, and anxiety were common. The burden of symptoms resulted in a markedly increased need for psycho-social services. These data reflect upon the significant need for regular screening and integration of psycho-social services with cancer treatment.

No significant financial relationships to disclose.
Updates to the ASCO Patient-Centered Oncology Payment Model
Authors: Ward Jeffrey C. , Bourbeau Brian , Chin Alexander L. , Page Ray D. , Grubbs Stephen S. , Kamin Deborah Y. , Green Sybil R. , Rappaport Mary
Published: April 2020

The past decade has seen considerable innovation in the delivery of care and payment in oncology. Key initiatives have included the development of oncology medical home care delivery standards, the Medicare Oncology Care Model, and multiple commercial payer initiatives. Looking forward, our next challenge is to reflect on lessons learned from these limited-scale demonstration projects and work toward models that are scalable and sustainable and reflect true collaboration between payers and providers sharing common objectives and methods to advance cancer care delivery. To this end, ASCO continues its work on care delivery standards, quality measurement, and alternative payment models. Over the past year, ASCO has received input from physicians, administrators, payers, and employers to update its Patient-Centered Oncology Payment (PCOP) model. PCOP incorporates current work on provider-payer collaboration, the oncology medical home, and the value of clinical pathways and recognizes the need for common quality measurement, performance methodology, and payment structure across multiple sources of payment. The following represents a summary of the entire model. The model includes chapters on PCOP communities, clinical practice transformation, payment methodology, consolidated payments for oncology care, performance methodology, and implementation considerations. In future work, ASCO will continue its support of the PCOP model, including further development of care delivery standards, quality measures, and technology solutions (eg, CancerLinQ).
Postpartum Thyroiditis in Women With Euthyroid and Hypothyroid Hashimoto’s Thyroiditis Antedating Pregnancy
Authors: Moleti Mariacarla , Mauro Maria Di , Alibrandi Angela , Vita Roberto , Benvenga Salvatore , Vermiglio Francesco
Published: April 2020

Context

Postpartum thyroiditis (PPT) is defined as the occurrence of de novo autoimmune thyroid disease accompanied by thyroid dysfunction in the first year postpartum. However, hormonal changes resembling the typical pattern of PPT have been reported to occur even in women with pregestational Hashimoto’s thyroiditis (HT) on levothyroxine (LT4).

Objective

To evaluate the risk of PPT in women with HT antedating pregnancy.

Design/Setting

Retrospective chart review of pregnant women with HT antedating pregnancy seen in a university hospital (2008-2017), who were followed from preconception up to 1 year after delivery.

Patients

167 women preconceptionally diagnosed with HT and classified as hypothyroid HT (hypo-HT; n = 98) or euthyroid HT (eu-HT; n = 69), according to their thyroid status at the time of diagnosis.

Outcome Measures

PPT occurrence and associated clinical characteristics/risk factors.

Results

PPT occurred in 65/167 women, with a rate statistically greater in the eu-HT than in the hypo-HT group (68.1% vs 18.4%; odds ratio [OR] 9.49, 95% confidence interval [CI] 4.62-19.49). Most of the women experiencing PPT in both groups were euthyroid at the time of first-trimester evaluation (39/47 eu-HT [83%] and 16/18 hypo-HT [88.9%]). Multivariate regression analysis showed eu-HT group and first-trimester euthyroidism to be positively associated with PPT occurrence (ORs 10.71 and 3.89, respectively).

Conclusion

PPT may occur in hypo-HT women on LT4 therapy, although significantly less frequently than in eu-HT women. The 4-fold higher risk of PPT in HT women maintaining euthyroidism at first -trimester of gestation suggests that the risk of PPT could be related to the amount of unaffected thyroid tissue.
Evolving Evidence of Diabetic Ketoacidosis in Patients Taking Sodium-Glucose Cotransporter 2 Inhibitors
Authors: Fleming Nicola , Hamblin Peter Shane , Story David , Ekinci Elif I
Published: April 2020

Introduction

Sodium glucose cotransporter 2 inhibitors (SGLT2i) have emerged as an important class of blood glucose–lowering medications, due to cardiovascular, metabolic, and renal benefits. However, there is a small but significant risk of diabetic ketoacidosis (DKA) associated with their use.

Methods

A literature search was conducted in Ovid MEDLINE and Embase to July 2019 using variants on the key search terms sodium-glucose cotransporter 2, diabetic ketoacidosis, and type 2 diabetes. A broad spectrum of evidence was incorporated to facilitate a comprehensive narrative review. Further sources were identified through hand searching of reference lists.

Discussion

Although cardiovascular outcome trials demonstrated mixed evidence of SGLT2i associated DKA, increasing evidence from case reports and cohort studies has identified an increased risk. SGLT2i use is associated with a ketotic state caused by an increased glucagon:insulin ratio and stimulated by factors including stress-induced hormonal changes, insufficient insulin, decreased glucose, increased ketone resorption, and hypovolemia. Atypical presentations of DKA with lower-than-expected blood glucose levels are possible with SGLT2i use, so clinical and biochemical monitoring is vital for early identification and management. DKA risk is particularly increased with precipitating factors, therefore optimization of risk factors is vital. Recommendations for perioperative and sick day management of patients taking SGLT2i have been suggested based on available evidence.

Conclusion

SGLT2i are an excellent class of drug in the physician’s toolkit for managing type 2 diabetes. However, both clinicians and patients must be aware of the potential for DKA and the need for increased monitoring, both clinically and biochemically, when potential precipitating factors are present. In acutely unwell patients, these medications should be withheld to reduce the risk of DKA.
Changes in the Homeostatic Appetite System After Weight Loss Reflect a Normalization Toward a Lower Body Weight
Authors: DeBenedictis Julia Nicole , Nymo Siren , Ollestad Karoline Haagensli , Boyesen Guro Akersveen , Rehfeld Jens Frederik , Holst Jens Juul , Truby Helen , Kulseng Bard , Martins Catia
Published: April 2020

Objective

To compare appetite markers in reduced-obese individuals with a nonobese control group.

Methods

A total of 34 adults with obesity who lost 17% body weight at week 13 and maintained this weight loss (WL) at 1 year were compared with 33 nonobese controls matched for body composition. Basal and postprandial subjective appetite ratings and appetite-related hormone concentrations (ghrelin, total peptide YY, peptide YY3-36, total and active glucagon-like peptide 1, and cholecystokinin) were measured in all participants and repeated at week 13 and 1 year in the weight-reduced group.

Results

WL led to a reduction in prospective food consumption and an increase in feelings of hunger, fullness, and ghrelin secretion (basal and postprandial), but these new ratings were no different from those seen in controls. Postprandial concentrations of active glucagon-like peptide 1, total peptide YY, and cholecystokinin were lower in individuals with obesity at all time points compared with controls.

Conclusion

The increased drive to eat (both subjective feelings of hunger and ghrelin concentrations) seen in reduced-obese individuals, both after acute and sustained WL, reflects a normalization toward a lower body weight. Overall, WL does not have a sustained negative impact on satiety peptide secretion, despite a blunted secretion in individuals with obesity compared with nonobese controls.
Comparison of CT-guided localization using hook wire or coil before thoracoscopic surgery for ground glass nodules
Authors: Liu Junzhong , Wang Xinhua , wang Yongming , Sun Minfeng , Liang Changsheng , Kang Liqing
Published: April 2020

Objective:

To compare two kinds of metal markers for preoperative localization of ground glass nodules (GGNs).

Methods:

We retrospectively investigated data from 198 cases of GGN localization and compared the success rate and complications of both approaches.

Results:

In the hook wire and coil groups, the success rates of CT-guided localization for GGNs were 99.2 and 98.7%, respectively (p = 1.000). The success rates of video-assisted thoracoscopic surgery in both groups were 100% without transthoracic surgery. The post-localization complication rates in the hook wire group and coil group were 36.9 and 32.9% (p = 0.568), and the postoperative complication rates in the hook wire and coil groups were 13.9 and 11.8%, respectively (p = 0.672).

Conclusions:

Preoperative localization of GGNs with both hook wire and coil methods proved to be useful and effective. Both methods have acceptable preoperative and postoperative complication rates, but the localization and operation times were shorter for the hook wire group than the coil group.

Advances in knowledge:

Most of previous articles studied a single preoperative localization method. Few studies have compared the preoperative and postoperative methods for metal markers. This paper compared two preoperative localization methods for GGNs to provide clinical guidance.
Accessory flexor carpi ulnaris: case report and review of the literature
Authors: Pressney Ian , Upadhyay Bhavin , Dewlett Sherine , Khoo Michael , Fotiadou Anastasia , Saifuddin Asif
Published: April 2020

Most of the accessory muscles of the forearm described in the radiology literature are located either in the radial aspect of the forearm or towards the hypothenar eminence. We present an unusual case of an ulnar-sided distal forearm accessory flexor carpi ulnaris muscle presenting as a “pseudotumour“ demonstrated with both ultrasound and MRI, rarely reported in the current surgical and anatomical literature. Given the location and relation to the ulnar nerve towards Guyon’s canal, the accessory muscle may also predispose to distal ulnar nerve entrapment.
Analysis of the deterioration of photostimulable phosphor plates
Authors: Souza-Pinto Gustavo Nascimento de , Santaella Gustavo Machado , Coli Amanda Achkar , Oenning Anne Caroline , Haiter-Neto Francisco
Published: April 2020

Objectives:

To assess, objectively to determine the deterioration of the photostimulable phosphor plates (PSPs) after several acquisitions.

Methods:

Two new PSPs without preliminary use were exposed with an intraoral X-ray unit, and the EXPRESS® (Instrumentarium Imaging, Tuusula, Finland) unit was used for scanning of the PSPs. A 12-stepwedge aluminum scale were used superimposed with the PSPs during the X-rays exposures to perform the objective analyses. Objective analysis was carried out by mean gray values using the Image J software through a region of interest (ROI) of 0.1 × 0.1 mm, and the data were analyzed statistically using ANOVA.

Results:

For each, the Express® PSP a total of 1800 images were acquired during 60 days. The objective analysis showed loss of the mean gray values between the initial and final images. Besides, the percentage of mean gray values’ loss was between 0.7%, for the thickest step, and 8.4%, for the lowest thickness step.

Conclusion:

After many X-ray exposures of the Express® PSP a singular deterioration in the mean gray values could be observed.
Dificuldades, caminhos e potencialidades da descentralização do atendimento à tuberculose
Authors: De Santana Suelí , Teixeira Carla Farias dos Santos , Rodrigues Amanda Silva , Skalinski Lacita Menezes
Published: April 2020

Objetivo: compreender as dificuldades e os caminhos para a descentralização do atendimento à tuberculose por meio da opinião dos enfermeiros atuantes em um Centro de Referência. Método: trata-se de pesquisa qualitativa e transversal. Os dados foram coletados mediante um questionário semiestruturado, com aplicação da técnica Análise de Conteúdo. Resultados: as principais dificuldades apontadas foram a desestruturação da rede, falta de compromisso da gestão, desorganização do serviço e qualificação profissional insuficiente. Os caminhos sugeridos para atingir a descentralização foram a melhoria na estrutura das unidades, organização do serviço, educação permanente, motivação da equipe e mobilização da gestão. Entre os benefícios, foram citados os objetivos do Programa de Controle da Tuberculose. Considerações finais: é preciso cautela quando a Rede de Atenção à Saúde não está estruturada para descentralizar os serviços, especialmente porque é necessário garantir o suporte no tratamento das pessoas atendidas no município.
Analysis of Sonographic Measurement by Anatomical Area in Carpal Tunnel Syndrome and Correlation the Measurement with Electrodiagnostic Study
Authors: Park JungWoo
Published: April 2020

Purpose: To evaluate effectiveness of ultrasonographic measurement of carpal tunnel by anatomical area and correlation with electrodiagnostic study in diagnosis of carpal tunnel syndrome.Methods: From September 2018 to March 2019, we performed the ultrasonography for 30 cases with carpal tunnel syndrome diagnosed with electrodiagnosis and 30 cases as control group. We measured median nerve diameter, cross-sectional area (CSA), and flattening ratio (FR) by area of carpal tunnel. We analyzed the difference of measurement between two groups and correlate the measurement with electrodiagnosis findings.Results: There was significant statistically differences in sonographic measurement between two groups by independent t-test (CSA zone 1, p=0.01; FR zone 2, p=0.000; FR zone 3; p=0.001). With Pearson correlation test, there was correlation between sonographic measurement and electrodiagnostic findings (terminal latency and nerve conduction velocity) statistically, but the Pearson coefficient was low (r<0.4). Conclusion: By anatomical area, the available value of sonographic measurement was different. But, as the values were has low power to diagnose the carpal tunnel syndrome, ultrasonography is proper to use as a complementary tool in diagnosis of carpal tunnel syndrome.
Every Contact Matters: the Role of the GDP
Authors: Gill Balraj
Published: April 2020

‘Making Every Contact Count’ (MECC) is a government initiative headed by Public Health England and other organizations to provide support for patients to make positive behaviour changes to their health and wellbeing. The aim of MECC is to reduce the number of long-term diseases in the population that are attributable to behavioural risks factors. Primary dental practitioners are well positioned to provide the recommended brief advice on smoking, alcohol consumption and other factors. This article will highlight current guidance relating to these modifiable risk factors, and explain how dentists can interact with general medical practitioners in order to improve patient health. The aim of this paper is to provide details on what health issues the dentist should screen for, as well as the ways in which information can be passed onto the doctor in order to provide the best possible care for the patient.

CPD/Clinical Relevance: Dentists are well positioned to ask and investigate issues relating to the patient's general health. This key information can be passed onto the general practitioner in order to address patient needs effectively.
The pleasures and pitfalls of life as a new consultant – an Anecdotal review part 1
Authors: Flett Andrew MC
Published: April 2020

This first of a two-part article aims to provide a road map to the budding clinician wishing to take on the role of a Consultant Orthodontist. Part 1 suggests what to consider when taking up a new post and how to create an ideal unit. Part 2 will provide the author's personal insight into the first 18 months of a consultant post. Hints and tips from other newly qualified consultants are also provided, to enable future consultants to avoid the pitfalls and enjoy the pleasures of an immensely rewarding job.

CPD/Clinical Relevance:

To provide first-hand, real world knowledge of life as a new consultant orthodontist in the 21st century NHS.
Analysis of the smoothing performance of a rapid polarization rotation smoothing scheme
Authors: Zhang Yinrui , Huang Yuan , Zhong Zheqiang , Zhang Bin
Published: April 2020

In order to improve the irradiation uniformity on the target plane and reduce the parametric backscattering in indirect-drive inertial confinement fusion facilities, a rapid polarization rotation smoothing scheme is proposed. In this scheme, there is a central wavelength shift between adjacent beams in a laser quad. Two of these beams are transformed into left-rotating circularly polarized beams by using polarization control plates, and the other two are transformed into right-rotating circularly polarized beams. Moreover, conjugate spiral phase plates are adopted to transform the beams into conjugate Laguerre–Gaussian beams. As a result of the frequency beat among the beams with counter-rotating polarization and conjugate spiral phases, both the intensity distribution and polarization of the focal spot would rotate rapidly on the picosecond timescale. The physical model of the rapid polarization rotation smoothing scheme is built up, and the smoothing performance affected by the parameters of spiral phase plates, polarization control errors, wavelength shift, and wavefront distortions is analyzed in detail. The results indicate that the rapid polarization rotation smoothing scheme has a relatively wide tolerance to the polarization errors and the spiral phase plates, and can improve the smoothing performance effectively with the combination of the smoothing by spectral dispersion scheme.
Imaging intracellular motion with dynamic micro-optical coherence tomography
Authors: Leung Hui Min , Wang Michelle L. , Osman Hany , Abouei Elham , MacAulay Calum , Follen Michele , Gardecki Joseph A. , Tearney Guillermo J.
Published: April 2020

This paper describes a new technology that uses 1-µm-resolution optical coherence tomography (µOCT) to obtain cross-sectional images of intracellular dynamics with dramatically enhanced image contrast. This so-called dynamic µOCT (d-µOCT) is accomplished by acquiring a time series of µOCT images and conducting power frequency analysis of the temporal fluctuations that arise from intracellular motion on a pixel-per-pixel basis. Here, we demonstrate d-µOCT imaging of freshly excised human esophageal and cervical biopsy samples. Depth-resolved d-µOCT images of intact tissue show that intracellular dynamics provides a new contrast mechanism for µOCT that highlights subcellular morphology and activity in epithelial surface maturation patterns.
Guiding and confining of light in a two-dimensional synthetic space using electric fields
Authors: Chalabi Hamidreza , Barik Sabyasachi , Mittal Sunil , Murphy Thomas E. , Hafezi Mohammad , Waks Edo
Published: April 2020

Synthetic dimensions provide a promising platform for photonic quantum
simulations. Manipulating the flow of photons in these dimensions
requires an electric field. However, photons do not have charge and do
not directly interact with electric fields. Therefore, alternative
approaches are needed to realize electric fields in photonics. One
approach is to use engineered gauge fields that can mimic the effect
of electric fields and produce the same dynamical behavior. Here, we
demonstrate such an electric field for photons propagating in a
two-dimensional synthetic space. Generation of electric fields in a
two-dimensional synthetic lattice provides the possibility to guide
photons and to trap them through the creation of quantum confined
structures. We achieve this using a linearly time-varying gauge field
generated by direction-dependent phase modulations. We show that the
generated electric field leads to Bloch oscillations and the revival
of the state after a certain number of steps dependent on the field
strength. We measure the probability of the revival and demonstrate a
good agreement between the observed values and the theoretically
predicted results. Furthermore, by applying a nonuniform electric
field, we show the possibility of waveguiding photons. Ultimately, our
results open up new opportunities for manipulating the propagation of
photons with potential applications in photonic quantum
simulations.
Rotational quantum beat lasing without inversion
Authors: Richter Maria , Lytova Marianna , Morales Felipe , Haessler Stefan , Smirnova Olga , Spanner Michael , Ivanov Misha
Published: April 2020

In standard lasers, light amplification requires population inversion between an upper and a lower state to break the reciprocity between absorption and stimulated emission. However, in a medium prepared in a specific superposition state, quantum interference may fully suppress absorption while leaving stimulated emission intact, opening the possibility of lasing without inversion. Here we show that lasing without inversion arises naturally during propagation of intense femtosecond laser pulses in air. It is triggered by the combination of molecular ionization and molecular alignment, both unavoidable in intense light fields. The effect could enable inversionless amplification of broadband radiation in many molecular gases, opening unusual opportunities for remote sensing.
Foreign places as Korean spaces: Representations of national trauma in the South Korean dramas Ireland and Descendants of the Sun
Authors: Mercier Faye
Published: April 2020

The study of Korean media, and K-dramas specifically, has been dominated largely by discourses surrounding the ‘Korean Wave’ and the increased popularity of South Korean popular culture abroad. More specifically, many English-language analyses have tended to focus their attention on the Korean Wave as an analytical framework, thus failing to acknowledge the ways in which these texts address domestic audiences and societal issues specific to South Korea. Thus, little attention has been paid to more implicit representations of the nation and its past in these K-dramas, a particularly noteworthy oversight when we consider that melodrama, a distinctly reflexive genre, is the governing mode of many contemporary K-dramas. Thus, this article aims to demonstrate the multiplicity of meanings that can exist within these media texts, paying particular attention to the reflexive capacities of the melodramatic mode. Through the examination of two case studies, Ireland and Descendants of the Sun, this article will discuss the ways in which shifting inter-Korean relations have been articulated in both dramas through sociopolitical contextualization and narrative analysis. This article will examine the use of foreign places and foreign crises in these dramas, and demonstrate their capacity to function as arenas for the expression and exploration of national trauma relating to the Korean war and the division of the Korean peninsula. This article aims to demonstrate that despite the increasing hybridization of Asian media, it remains important to analyse the relationship between K-dramas and domestic audiences in order to better understand the ways in which they address and work through significant social and political concerns for South Korean audiences.
Notes of a Crocodile, Qiu Miaojin (2017)
Authors: Brand Quentin
Published: April 2020

Review of: Notes of a Crocodile, Qiu Miaojin (2017)

New York Review Books Classics, 242 pp.,

ISBN 978-1-68137-076-7, p/bk, USD 15.95
Adapting social change: Swedish crime fiction as a medium for system correction
Authors: Larsen Mads
Published: April 2020

Nordic Noir’s progenitor The Man on the Balcony from 1967 critiques social democracy from a Marxist viewpoint. The novel’s 1993 film adaptation, however, reuses the same crime to challenge neo-liberal globalization. From a story perspective, this is a drastic deviation from ideological fidelity. But a systems perspective shows that the adaptation adheres to functional fidelity for crime fiction as a medium for social discourse. By examining how the two works engage their respective eras’ contemporary issues, we see how Nordic Noir has become a mediator of error correction for Sweden as a social system. Adaptations are therefore expected to show greater fidelity to format than to content, which a systems approach can help facilitate. This perspective also suggests that our nation states – as we lose shared arenas for cultural discourse – will adapt less effectively to changes because it becomes harder to agree on what is real and what is fake.
Adaptations in the Franchise Era, 2001–16, Kyle Meikle (2019)
Authors: Winckler Reto
Published: April 2020

Adaptations in the Franchise Era, 2001–16, Kyle Meikle (2019)

New York and London: Bloomsbury Academic, 181 pp.,

ISBN 978-1-50131-872-6, p/bk, £19.99
The game of narrative authority: Subversive wandering and unreliable narration in The Stanley Parable
Authors: Beyvers Sarah E.
Published: April 2020

This article explores how players’ attempts at subversive wandering in The Stanley Parable (2013) render the game’s narration unreliable and thus reveal its comments on the nature of ‘agency’ in video games. Unreliability brings the act of narration itself to the fore and exposes its mechanisms of manipulation. Players of The Stanley Parable may seek to contradict the voice-over narration subversively. They must find out, however, that, even though the narrator’s authorial omniscience and power are an illusion, they cannot break away from the predetermined path the game lays out. The narrator and the player are constantly fighting over who gets to tell the story and who therefore wins the game of narrative authority. Subversive wandering, as will be theorized in this article, exposes the impossibility of true player agency in the game’s set structure and comments on how player movement and interaction construct parts of a game’s narrative.
Dirty footprints and degenerate archives: Tabitha Nikolai’s impure walking sims
Authors: Gallagher Rob
Published: April 2020

Tabitha Nikolai’s Shrine Maidens of the Unseelie Court and Ineffable Glossolalia are impure specimens of the walking sim. While these are still first-person games that see players exploring eerily underpopulated environments and archiving textual fragments, they are at once more aesthetically reflexive and more referentially dense than many walking sims. Accommodating giant spiders, Weimar sexologists, messageboard trolls and quotations from Roman poetry, Nikolai’s unorthodox spins on the ‘archival adventure’ reflect her interest in queer and trans history and her commitment to interrogating discourses of purity, progress and redemption. Reviewing critical discussions of the walking sim alongside queer, trans and decolonial perspectives on archives, identity and subjectification, the article argues that while walking sims have often been praised for telling emotionally engaging stories, in Nikolai’s hands the form assumes different function: that of reckoning with history and exploring subjectivity.
Capitalist realism: Glimmers, working-class authenticity and Andrea Dunbar in the twenty-first century
Authors: Beswick Katie
Published: April 2020

This article thinks through how registers of ‘the real’ have operated in working-class representations, from social realism (in film, theatre, drama and soap opera) to reality television and appeals to ‘authenticity’ in publicity and marketing materials for cultural products purporting to represent the working class. It argues that the ubiquity of ‘the real’ in representations of working-class experience is one way in which Fisher’s ‘capitalist realism’ asserts itself. The article argues that experiments with form and intertextuality can offer ‘glimmers’ through which slippages in claims to absolute reality are revealed. It explores the possibility for such ‘glimmers’ in experimentations with Andrea Dunbar’s work in the twenty-first century, reasserting the importance of form in dismantling the neo-liberal political project.
From documentary networks to documentary worknets: Strategies of participation and co-creation in emerging practices of factual storytelling
Authors: Wiehl Anna
Published: April 2020

Starting from the premises that documentary assemblages are networks in the sense that they are not given but need to be established and are in constant flux leads us to the assessment that any interactive documentary environment is a collaboratory but also precarious endeavour. In this context, bringing into dialogue network theories, namely ANT ‘and after’, the concept of ‘assemblage’ and discourses around participation and co-creation can lead to fresh perspectives on different strategies and tactics of participation in collaborative factual storytelling. Still, two aspects need to be revisited: the symmetric approach to networks and the notion of distributed agency. These concepts will be discussed in terms of their value to derive strategies and tactics of (shared) authorship, the striving for a documentary argument and documentary authority on the one hand and participation, interaction and plurivocality on the other hand. In this regard, ANT makes certainly inspiring points but also has its shortcomings. One solution can consist in relating the axiom of ANT as an analytic tool to actual documentary long-term strategies as well as to stand-up tactics as, e.g. interventionist media-making, open space documentary and context-provision. Thinking of emerging documentary configurations not only in terms of hybrid transdisciplinary, transprofessional networks but pragmatic worknets can lead to a better understanding of how to balance different agents within these networks|worknets – always keeping in mind that we are dealing with an approach that calls for constant self-reflection as it presents a case of what Law describes as ‘uncertain method’. All theoretical reflections are accompanied by an analysis of a paradigmatic documentary networks|worknet, The Quipu Project (2015).
Ways of affection: How interactive documentaries affect the interactor’s felt experience and performance
Authors: Nogueira Patrícia
Published: April 2020

This article intends to explore how interactivity and new technologies promote new spectatorship performances and subsequently affect the interactor’s subjectivity. Through the analysis of three interactive documentaries, I propose and describe a taxonomy for addressing the felt experience of interacting in digital environments. Each selected documentary corresponds to a different mode of interaction and, therefore, engages the audience in a particular way: Bear 71 (hyperlink mode), Fort McMoney (conversational mode) and A Journal of Insomnia (participative mode). Throughout the analysis, I consider the interactor and the digital object as two interrelated and dependent entities that influence and shape one another. I argue the objects of interaction affect the viewers by inducing bodily felt sensations and shaping their subjectivity. As so, the sensuous encounter between the interactor and the digital documentary provides a virtual gratification for the spectator’s performance. Delving into a phenomenological and post-phenomenological investigation, I focus my attention in the microperceptions, as structures of sensory perception in the bodily dimensions of experience, translated as senses. As fragmented, multilinear and dynamic forms, interactive documentaries provide the audience with the agency of manipulating and developing the narrative, while conversely engender in the interactors what I address as ways of affection. I propose or adapt eight digitally disrupted and induced sensations, or senses of, for describing how interactive documentary affects users during the interaction performance: sense of control, sense of presence, sense of Self, sense of place, sense of belonging, sense of almightiness, sense of endlessness, sense of incompleteness.
The Introspective Realist Crime Film, Luis M. García-Mainar (2016)
Authors: Platten David
Published: April 2020

Review of: The Introspective Realist Crime Film, Luis M. García-Mainar (2016)

London: Palgrave Macmillan, 207 pp.,

ISBN 978-1-13749-652-2, h/bk, £89.99
Autonomy-connectedness, gender and culture: A comparative study on the interplay of personality functioning and social context
Authors: Moleiro Carla , Marto Laurence , Santos João M. , Ratinho Inês
Published: April 2020

Abstract Autonomy-connectedness refers to the need and ability the individual has for self-governance, as well as the capacity for intimacy and interpersonal relationships. The present study aimed to examine and compare participants (N=121) of four different cultural
groups, namely Portuguese natives as well as Brazilian, British and Ukrainian immigrants residing in Portugal, on the different autonomy-connectedness components (self-awareness: SA; sensitivity to others: SO; capacity for managing new situations: CMNS). It also aimed at investigating the
relationship between autonomy-connectedness and acculturation among the groups of immigrants. The results showed significant gender differences and among the cultural groups on SO. Adherence to the heritage culture was associated with the distinct dimensions of autonomy-connectedness differently
for the various groups, and time of residence was also key in how the dimensions were endorsed cross time. This study contributes to the theoretical framework of the concept of autonomy-connectedness in light of cross-cultural perspectives.