bluuebunny/crossref_metadata_2025 huggingface dataset:
Where Help Is Needed Most? Explaining Reporting Strategies of the International Trade Union Confederation
Authors: Koliev Faradj
Published: April 2020

How do international non-governmental organizations select countries for naming and shaming? I argue that three focal actors influence non-governmental organizations’ shaming decisions: inter-governmental organizations, governments, and non-governmental organization members. Moreover, drawing on existing research, non-governmental organizations might respond differently to focal actors’ preferences, by either targeting states that have been criticized by focal actors or, alternatively, targeting those who have escaped their scrutiny. To test these propositions, the article conducts multiple interviews and gathers original data on shaming within the International Trade Union Confederation during period 1991–2011. The main findings are threefold. First, focal actors, except governments, have a significant influence on International Trade Union Confederation shaming. The members’ preferences regarding which states should be singled out have the strongest impact. Second, the International Trade Union Confederation is likely to adopt a bandwagoning strategy by shaming states that have been targeted by focal actors, rather than focusing on states that have escaped their criticism. Third, as a result of the bandwagoning approach, the International Trade Union Confederation mainly targets states with poor labor rights conditions.
Loud internal life in a silent community: Towards lived aspects of religious life in a cloistered, female monastery
Authors: Jewdokimow Marcin , Palmisano Stefania , Budzanowska-Weglenda Dominika
Published: April 2020

The aim of this article is to present the results of a sociological study on everyday life within a female cloistered monastery. This is a radical form of religious life, highly routinised, distanced from the outside world and conducted in community yet in almost total silence. By elaborating upon the concepts of everyday and lived religion, the scope of our examination complements dominant sociological approaches to the study of this religious phenomenon. By addressing the following research question: ‘Do cloistered monasteries de-individualise and totally regulate the life of nuns?’, we discuss selected aspects of everyday life in the institution and its contemporary transformations related to, among other things, new communication technologies and new generations of nuns. We show that in this highly institutionalised place nuns remain reflexive individuals.
Augmenting posterolateral fusion with transforaminal lumbar interbody fusion cage improves clinical outcome, but not fusion rate, of posterior decompression
Authors: Atici Teoman , Yerebakan Selcan , Ermutlu Cenk , Özyalçın Ali
Published: April 2020

Objective

This study was performed to compare fusion rates and clinical outcomes of posterior decompression by posterolateral fusion (PLF) versus transforaminal lumbar interbody fusion (TLIF) for treatment of lumbar spinal stenosis.

Methods

This retrospective cohort study involved 157 patients with lumbar spinal stenosis treated with instrumented PLF alone or instrumented PLF combined with TLIF from 2010 to 2018. The patients were divided into two groups: the PLF group (Group A), in which posterior decompression with instrumented PLF was performed, and the cage-augmented group (Group B), in which TLIF was added to the procedures described for the PLF group. Patient outcomes (Oswestry Disability Index, visual analog scale score, and 36-Item Short-Form Health Survey scores) and fusion rates were compared.

Results

The fusion rate was similar between the two groups. Among patients with two- and three-level fusion, improvements in the clinical outcome scores were significantly greater in Group B than Group A.

Conclusion

Combining TLIF with PLF provides better clinical outcomes than PLF alone when multilevel fusion is indicated. TLIF augmentation does not improve the fusion rates in either single- or multi-level surgery.
Teaching from experience: foreign training and rebel success in civil War
Authors: Keels Eric , Benson Jay , Widmeier Michael
Published: April 2020

This paper addresses the relationship between rebel training from external sponsors and civil war outcomes. While past research has examined how foreign support, broadly, shapes the dynamics of civil wars, little attention has been paid to how foreign training of rebel fighters affects civil wars. We theorize that rebels that receive training from formerly successful rebels are more likely to experience favorable conflict outcomes than those with no training or with training from sponsors inexperienced with fighting a civil war. These propositions are tested with a quantitative analysis of all intrastate conflicts from 1975 to 2010, providing support for our hypothesis.
Wood processing industry by-products as a source of natural bioactive compounds
Authors: Celeiro Maria , Lamas J Pablo , Arcas Rosa , Lores Marta
Published: April 2020

The chemical composition of several by-products, chips, screw waters, and concentrates from a fiberboards manufacture green industrial process, which only employs wood and water, was deeply evaluated. The three by-products analyzed represent different steps of the industrial process. In addition, different types of wood: pine, walnut, chestnut, oak and cherry tree, were evaluated. For all of them, total polyphenols content, and antioxidant activity have been assessed, showing significant differences. To characterize the volatile compounds, an environmentally friendly technique, solid-phase microextraction has been employed. Besides, aqueous and generally recognized as safe organic extracts obtained from the by-products have been prepared, and their chromatographic fingerprint was obtained by gas chromatography-mass spectrometry and liquid chromatography-tandem mass spectrometry to identify extractable organic wood components. Significant differences were observed between the studied by-products and wood types. More than 30 different compounds were successfully identified in the screw waters, and concentrates, including terpenes, sesquiterpenes, or polyphenols. Regarding the obtained extracts, up to 30 compounds were identified in the chips, screw waters, and concentrate extracts, highlighting the presence of 13 polyphenols in the cherry tree chips and more than 20 compounds with interesting properties in the concentrate extracts. This work contributes to improve the knowledge about the chemical composition of several wood industry by-products, which could be exploited to obtain natural extracts with added value for their reuse in the food, cosmetic, or pharmaceutical industry, reducing also the environmental impact of the industrial activity.
Do the relationships between testate amoebae and fungi reflect the variability of past water table fluctuations in the ombrotrophic peatlands of Central Europe?
Authors: Kołaczek Piotr , Karpińska-Kołaczek Monika , Gałka Mariusz , Miotk-Szpiganowicz Grażyna , Obremska Milena , Lamentowicz Mariusz
Published: April 2020

In this article, we examined the indicative value of a relationship between two non-pollen palynomorphs (NPPs), fungal HdV-10, related to the presence of Calluna vulgaris, and HdV-31A, which is testate amoeba – Archerella flavum. Both are frequently present on slides designated for pollen analysis, prepared from Sphagnum peat. We analysed three profiles from three extensive ombrotrophic peatlands in northern Poland, in which the content of testate amoebae (TA) was examined and TA-inferred depth to the water table (DWT) was reconstructed. The new analysis of palynological samples regarding NPPs revealed that strong increases in HdV-10 content were mostly simultaneous to HdV-31A declines. However, the relations between both types were not statistically significant. The rapid increases in HdV-10, despite the fact that this type of conidiospores is related to drier habitats on peatlands, were tentatively interpreted as an indicator of rapid rises in the water table level which, in consequence, might have stimulated the production of these spores by fungi. In addition, a negative correlation between HdV-31A and Arcella discoides and positive one, but weaker, in case of HdV-10 (attributed by some authors to species Trichocladium opacum (Corda) S Hughes) and A. discoides show a link between mutual fluctuations of both NPPs and hydrological instabilities on peatland. The Bagno Kusowo bog, the westernmost peatland subjected to the study, displayed an intriguing agreement between the presence of peat sections with strong increases in HdV-10 and cold climate events affecting Europe. Our study reveals that counting even a limited number of NPP types during the standard pollen analysis of Sphagnum peat may support the interpretation of results, especially, in cases when the investigation lacks testate amoeba analysis. When the reconstruction of TA-inferred DWT is provided, it may introduce additional information about the patterns of hydrological dynamics.
Outcome of patients with chlorpyrifos intoxication
Authors: Liu H-F , Ku C-H , Chang S-S , Chang C-M , Wang I-K , Yang H-Y , Weng C-H , Huang W-H , Hsu C-W , Yen T-H
Published: April 2020

Introduction:

There is a paucity of literature analyzing outcome of chlorpyrifos intoxication.

Methods:

A total of 40 patients with chlorpyrifos intoxication were seen at Chang Gung Memorial Hospital between 2008 and 2017. Patients were stratified into two subgroups according to their prognosis, as good ( n = 12) or poor ( n = 28). Good prognosis group were defined as patients who survived without serious complications, and poor prognosis group included patients who died and survived after development of severe complications. Demographic, clinical, laboratory, and mortality data were obtained for analysis.

Results:

Patients aged 53.8 ± 16.3 years and most were male (80.0%). All patients (100.0%) developed acute cholinergic crisis such as emesis (45.0%), respiratory failure (42.5%), tachycardia (30.0%), kidney injury (22.5%), and seizure (7.5%). Intermediate syndrome developed in 12.5% of patients, but none had delayed neuropathy (0%). The poor prognosis group suffered higher incidences of respiratory failure ( p = 0.011), kidney injury ( p = 0.026), and prolonged corrected QT interval ( p = 0.000), and they had higher blood urea nitrogen level ( p = 0.041), lower Glasgow coma scale score ( p = 0.011), and lower monocyte count ( p = 0.023) than good prognosis group. All patients were treated with atropine and pralidoxime therapy, but six patients (15.0%) still died of intoxication. In a multivariate logistic regression model, blood urea nitrogen was a significant risk factor for poor prognosis (odds ratio: 1.375, 95% confidence interval: 1.001–1.889, p = 0.049). Nevertheless, no mortality risk factor could be identified.

Conclusion:

The mortality rate of patients with chlorpyrifos intoxication was 15.0%. Furthermore, acute cholinergic crisis, intermediate syndrome, and delayed neuropathy developed in 100.0%, 12.5%, and 0% of patients, respectively.
A surface-free design for phase I dual-agent combination trials
Authors: Mozgunov Pavel , Gasparini Mauro , Jaki Thomas
Published: April 2020

In oncology, there is a growing number of therapies given in combination. Recently, several dose-finding designs for Phase I dose-escalation trials for combinations were proposed. The majority of novel designs use a pre-specified parametric model restricting the search of the target combination to a surface of a particular form. In this work, we propose a novel model-free design for combination studies, which is based on the assumption of monotonicity within each agent only. Specifically, we parametrise the ratios between each neighbouring combination by independent Beta distributions. As a result, the design does not require the specification of any particular parametric model or knowledge about increasing orderings of toxicity. We compare the performance of the proposed design to the model-based continual reassessment method for partial ordering and to another model-free alternative, the product of independent beta design. In an extensive simulation study, we show that the proposed design leads to comparable or better proportions of correct selections of the target combination while leading to the same or fewer average number of toxic responses in a trial.
Smart Cards for All: Digitalisation of Universal Health Coverage in India
Authors: Al Dahdah Marine , Mishra Rajiv K.
Published: April 2020

In less than ten years, India has launched colossal biometric databases. One among them is related to the first ‘free’ health coverage scheme offered by the government of India: the Rashtriya Swasthya Bima Yojna (RSBY). Based on a public–private partnership between government and private companies, RSBY national scheme was launched in 2008, as a first step towards universal health coverage in a country where households endorse 70% of health expenses. The first phase of RSBY offers to cover ₹30,000 ($600) of inpatient expenses per year for five members of a below poverty line household and is now piloted in several Indian States to include outpatient expenses and above poverty line families too. RSBY relies exclusively on a centralised digital artefact to function, made visible by the ‘RSBY Smart Card’, a chip enabled plastic card containing personal data of individual and their family counting and conditioning the granting of health services to them; thus, no smart card means no health coverage. Till date 120 million Indians have been registered in the RSBY database. This article analyses how health accessibility is crafted under the RSBY scheme by questioning two central dimensions of this data-driven digital health scheme: the smart card technology and the public–private partnership, whereas RSBY scheme promises health coverage for all, its digital infrastructures may complicate access to health services, and reveal new patterns of exclusion of individuals. Thus, we will detail how smartcards technologies and private providers condition access to health care in India.
Risk of acute kidney injury after contrast-enhanced computed tomography in emergency department
Authors: Dağar Seda , Emektar Emine , Uzunosmanoğlu Hüseyin , Çorbacıoğlu Şeref Kerem , Öztekin Özge , Çevik Yunsur
Published: April 2020

Background:

Despite its risks associated with renal injury, intravenous contrast media increases diagnostic efficacy and hence the chance of early diagnosis and treatment, which leaves clinicians in a dilemma regarding its use in emergency settings.

Objective:

The aim of this study was to determine the risk and predictors of contrast-induced acute kidney injury following intravenous contrast media administration for computed tomography in the emergency department.

Methods:

All patients aged 18 years and older who had a basal creatinine measurement within the last 8 h before contrast-enhanced computed tomography and a second creatinine measurement within 48–72 h after computed tomography scan between 1 January 2015 and 31 December 2017 were included in the study. Characteristics of patients with and without contrast-induced acute kidney injury development were compared. Multivariate regression analysis was used to assess the predictors for contrast-induced acute kidney injury.

Results:

A total of 631 patients were included in the final statistical analysis. After contrast media administration, contrast-induced acute kidney injury developed in 4.9% ( n = 31) of the patients. When the characteristics of patients are compared according to the development of contrast-induced acute kidney injury, significant differences were detected for age, initial creatinine, initial estimated glomerular filtration rate, and all acute illness severity indicators (hypotension, anemia, hypoalbuminemia, and need for intensive care unit admission). A multivariate logistic regression analysis was performed. The need for intensive care unit admission (odds ratio: 6.413 (95% confidence interval: 1.709–24.074)) and hypotension (odds ratio: 5.575 (95% confidence interval: 1.624–19.133)) were the main factors for contrast-induced acute kidney injury development.

Conclusion:

Our study results revealed that hypotension, need for intensive care, and advanced age were associated with acute kidney injury in patients receiving contrast media. Therefore, we believe that to perform contrast-enhanced computed tomography in emergency department should not be decided only by checking for renal function tests and that these predictors should be taken into consideration.
Tracking Intervention Dosage to Inform Instructional Decision Making
Authors: Mason Erica N. , Smith R. Alex
Published: April 2020

Intervention dosage is an often-overlooked aspect of implementation fidelity. Tracking intervention dosage is critical for ensuring students with disabilities were present for and received the intervention for as many minutes as intended. Used in tandem with student performance data, intervention dosage can provide a clearer picture of intervention success. This article presents strategies for how teachers can plan for, collect, and use intervention dosage data to inform instructional data-based decision making.
A unified damage model for fibrous composite laminae subject to in-plane stress-state and having multi material-nonlinearity
Authors: Abu-Farsakh GA , Asfa AM
Published: April 2020

In the present study, a novel methodology of damage modeling is introduced to predict damage propagation in fibrous composite materials according to the plastic strain energy density induced in the lamina only. The importance of the new damage-model is the ability to assess damage-evolution in fibrous composite laminae irrespective of stress-state and fiber-orientation angle. An energy-based model called as a unified damage model, is proposed to evaluate damage in unidirectional fibrous composite laminae. The aforementioned damage model represents a unique relationship between damage-evolution and the resulting plastic strain energy density induced in the composite lamina, as verified through this study. Damage propagation under a state of in-plane-stress is investigated for three composite laminas; boron/epoxy, graphite/epoxy, and carbon/epoxy. The unified damage model represents a simplified mathematical relation of quantum-damage (or modified-damage) variables in terms of the induced plastic-strain-energy density induced in a composite lamina. The developed unified damage model confirms the results of Ghazi-Ahmad macro-mechanical damage model in which graphite/epoxy has the lowest damage response, whereas boron/epoxy has the highest possible damage response amongst the three composite materials. Also, it is noticed that quantum-damage propagates nonlinearly with the evolved plastic strain energy density in fibrous composite laminae.
Dopamine, Prediction Error and Beyond
Authors: Diederen Kelly M. J. , Fletcher Paul C.
Published: April 2020

A large body of work has linked dopaminergic signaling to learning and reward processing. It stresses the role of dopamine in reward prediction error signaling, a key neural signal that allows us to learn from past experiences, and that facilitates optimal choice behavior. Latterly, it has become clear that dopamine does not merely code prediction error size but also signals the difference between the expected value of rewards, and the value of rewards actually received, which is obtained through the integration of reward attributes such as the type, amount, probability and delay. More recent work has posited a role of dopamine in learning beyond rewards. These theories suggest that dopamine codes absolute or unsigned prediction errors, playing a key role in how the brain models associative regularities within its environment, while incorporating critical information about the reliability of those regularities. Work is emerging supporting this perspective and, it has inspired theoretical models of how certain forms of mental pathology may emerge in relation to dopamine function. Such pathology is frequently related to disturbed inferences leading to altered internal models of the environment. Thus, it is critical to understand the role of dopamine in error-related learning and inference.
Design of distributed piezoelectric modal sensor for a rotating beam with elastic boundary restraints
Authors: Du Jingtao , Chen Qi
Published: April 2020

As an advanced sensing technique, modal sensors have been attracting a lot of research interest in modal filtering and active control fields. Most of the existing investigations are mainly focused on the static structure. In contrast, there is little effort made for its rotating counterpart, which is frequently encountered in various power machineries. Motivated by such limitation, a unified framework for the distributed piezoelectric modal sensor design of rotating beams with elastic boundary restraints is proposed using polyvinylidene fluoride piezoelectric integral equation and the second-order structural modal functions. A boundary smoothed Fourier series is used to obtain the modal information of rotating beams by solving the differential governing equation and elastic boundary conditions, simultaneously. Modal sensor shape of rotating beams can be determined for any boundary condition by simply setting the elastic restraining coefficients accordingly, instead of reformulating the equation or rewriting the codes like other approach usually does. Numerical examples are presented to demonstrate the correctness and effectiveness of the proposed framework. Modal sensitivity coefficient and charge output frequency response under external excitation are calculated to demonstrate the performance of the designed piezoelectric modal sensors. Influence of rotation speed and boundary restraining stiffness on the modal sensing accuracy of the shaped polyvinylidene fluoride sensor is analyzed and addressed. To our best knowledge, this work represents the first time that an analytical solution for the distributed piezoelectric modal sensor design of a rotating beam with general boundary conditions is derived, which can shed some new lights on further design and implementation of polyvinylidene fluoride modal sensing technique for rotating structures.
Choroidal changes in intermediate age-related macular degeneration patients with drusen or pseudodrusen
Authors: Rosa Raffaella , Corazza Paolo , Musolino Maria , Mochi Chiara , Maiello Guido , Traverso Carlo Enrico , Nicolò Massimo
Published: April 2020

Reticular pseudodrusen are associated with a thinner choroid. The aim of our study was to determine the differences in central choroidal thickness and choriocapillaris vascular flow area between eyes with and without reticular pseudodrusen using swept-source optical coherence tomography and swept-source optical coherence tomography angiography. We conducted a retrospective case control study which included 27 eyes from 27 consecutive patients with intermediate age-related macular degeneration and 17 eyes from 17 healthy participants. Complete ophthalmic examinations were carried out including axial length measurements; fundus color retinography; fundus autofluorescence; swept-source optical coherence tomography and swept-source optical coherence tomography angiography; central choroidal thickness and choriocapillaris vascular flow area. Patients were classified as no reticular pseudodrusen, mild reticular pseudodrusen, and severe reticular pseudodrusen. Mean central choroidal thickness in patients exhibiting severe reticular pseudodrusen (110 ± 56 μm) was significantly smaller than in patients with no reticular pseudodrusen (201 ± 76 μm, p < 0.01). Mean choriocapillaris vascular flow area in severe reticular pseudodrusen patients (45.2% ± 3.0%) was also significantly less than in patients with no (47.9% ± 1.6%, p < 0.001) and mild reticular pseudodrusen (47.7% ± 1.0%, p < 0.05). Stepwise multiple regression models confirmed the association of reticular pseudodrusen with central choroidal thickness (p < 0.001) and choriocapillaris vascular flow area (p < 0.01) even after accounting for age, axial length, and refractive error. Soft drusen were not associated with changes in either central choroidal thickness (p = 0.13) nor choriocapillaris vascular flow area (p = 0.29). A significant, positive relationship was found between central choroidal thickness and choriocapillaris vascular flow area (r = 0.44, p = 0.01). Therefore, both central choroidal thickness and choriocapillaris vascular flow area are decreased in eyes with reticular pseudodrusen, as compared to healthy eyes and intermediate age-related macular degeneration eyes not exhibiting reticular pseudodrusen. In addition, central choroidal thickness and choriocapillaris vascular flow area are related, and the reduction of either is directly associated to the severity of reticular pseudodrusen. Further studies are needed to assess the clinical significance of these findings.
Point-of-care ultrasound for assessing arteriovenous fistula maturity in outpatient hemodialysis
Authors: Coritsidis George N , Machado Orlando N , Levi-Haim Farzin , Yaphe Sean , Patel Roshan A , Depa Jayaramakrishna
Published: April 2020

Background:

Point-of-care ultrasound in end-stage renal disease is on the rise. Presently the decision to cannulate an arteriovenous fistula is based on its duration since surgery and physical exam. This study examines the effects of point-of-care ultrasound on decreasing the time to arteriovenous fistula cannulation, time spent with a central venous catheter, and the complications and infections that arise.

Methods:

Prospective point-of-care ultrasound patients were recruited between January 2015 and January 2018, while retrospective data (non-point-of-care ultrasound) were collected via chart review from patients who had fistula creation between November 2011 and May 2014. Patients had point-of-care ultrasound within 3 weeks after arteriovenous fistula creation and were followed for 1 year. Arteriovenous fistula cannulation was initiated when the following parameters were met: diameter > 6 mm (with no depreciable narrowing of more than 20% throughout), depth < 6 mm, and length > 6 cm. Demographic data, as well as time to cannulation and central venous catheter removal, number of infections, complications, and interventions were compared between point-of-care ultrasound and non-point-of-care ultrasound groups using unpaired t-test, chi-square, and Fisher exact test statistical analysis.

Results:

A total of 37 patients with new arteriovenous fistulas were followed by point-of-care ultrasound compared to 29 non-point-of-care ultrasound patients. Point-of-care ultrasound patients had earlier cannulations (35.5 vs 63.3 days, p < 0.05), shorter central venous catheter duration (68.2 vs 98.3 days, p < 0.05), and less infections (12 vs 19) without differences in complication compared to the non-point-of-care ultrasound.

Conclusion:

Point-of-care ultrasound facilitates early and safe arteriovenous fistula cannulation leading to a reduction in central venous catheter time and risk of infection. Point-of-care ultrasound may also aid in earlier identification of complications and difficult cannulations.
Thinking with a Feminist Political Ecology of Air-and-breathing-bodies
Authors: Allen Irma Kinga
Published: April 2020

Social theory has paid little attention to air, despite its centrality to bodily existence and air pollution being named the world’s biggest public health crisis. Where attention to air is found, the body is largely absent. On the other hand, conceptualizing the body without life-sustaining breath fails to highlight breathing as the ongoing metabolic bodily act in which the materiality of human and more-than-human intermingle and transmute one another. Political ecology studies how unequal power structures and knowledge production reproduce human–environment relations, including a nascent focus on the body and air – but as separate issues. This article argues that a political ecology of air would productively fuse with a political ecology of the body to bring the visceral realm into intersectional analysis of air’s contemporary materialities. A feminist political ecology situates explicitly air-and-breathing-bodies, their intimately posthuman, relational, elemental and corpomaterial intra-action, at the heart of such analysis.
Interdisciplinary Perspectives on Breath, Body and World
Authors: Oxley Rebecca , Russell Andrew
Published: April 2020

Breath, the ephemeral materialization of air at the interface of body and world, engages with and alters the quality of both. As a process of inhalation and exhalation that signals its physiological universality, breath is an invisible prerequisite for life, an automated and functional necessity. Yet it is more than simply a reflexive action and can at times be controlled or manipulated. It can also affect or be affected by experiences, environments and relationships. In this essay, like the contributors to the special issue it prefaces, we aim to address the lacuna that exists in the examination of the meanings and embodiment of breath as a central theme in the humanitics and social sciences. Interdisciplinary perspectives that explore breath as a multifaceted phenomenon, both intrinsically shared and contextually distinct, open new directions in the field of breath and body studies.
Outcomes of catheter-directed versus systemic thrombolysis for the treatment of pulmonary embolism: A real-world analysis of national administrative claims
Authors: Geller Bram J , Adusumalli Srinath , Pugliese Steven C , Khatana Sameed Ahmed M , Nathan Ashwin , Weinberg Ido , Jaff Michael R , Kobayashi Taisei , Mazurek Jeremy A , Khandhar Sameer , Yang Lin , Groeneveld Peter W , Giri Jay S
Published: April 2020

Catheter-directed thrombolysis (CDT) and systemic thrombolysis (ST) are used to treat intermediate/high-risk pulmonary embolism (PE) in the absence of comparative safety and effectiveness data. We utilized a large administrative database to perform a comparative safety and effectiveness analysis of catheter-directed versus systemic thrombolysis. From the Optum® Clinformatics® Data Mart private-payer insurance claims database, we identified 100,744 patients hospitalized with PE between 2004 and 2014. We extracted demographic characteristics, high-risk PE features, components of the Elixhauser Comorbidity Index, and outcomes including intracranial hemorrhage (ICH), all-cause bleeding, and mortality among all patients receiving CDT and ST. We used propensity score methods to compare outcomes between matched cohorts adjusted for observed confounders. A total of 1915 patients (1.9%) received either CDT ( n = 632) or ST ( n = 1283). Patients in the CDT group had fewer high-risk features including less shock (5.4 vs 11.1%; p < 0.001) and cardiac arrest (6.8 vs 11.0%; p = 0.004). In 1:1 propensity-matched groups, ICH rates were 1.9% in both the CDT and ST groups ( p = 1.0). All-cause bleeding was higher in the CDT group (15.9 vs 8.7%; p < 0.001), while in-hospital mortality was lower (6.5 vs 10.0%; p = 0.02). Among a nationally representative cohort of patients with PE at higher risk for mortality, CDT was associated with similar ICH rates, increased all-cause bleeding, and lower short and intermediate-term mortality when compared with ST. The competing risks and benefits of CDT in real-world practice suggest the need for large-scale randomized clinical trials with appropriate comparator arms.
A chrome cobalt mandibular advancement appliance for snoring and obstructive sleep apnoea used during active aligner orthodontic treatment
Authors: Ash Simon
Published: April 2020

Adult orthodontics is now mainstream, made all the more acceptable by the advent of removable aligners. These patients may also coincidentally suffer from snoring and obstructive sleep apnoea (OSA), for which the indefinite wearing of a mandibular advancement device (MAD) during sleep may be required. Indefinite removable nocturnal orthodontic retention is now established practice.

This case report describes a cast chrome cobalt MAD and its application in the management of a patient who, having very successfully managed his snoring and mild OSA with a removable cast chrome cobalt MAD, wished to continue this management while undergoing active orthodontic treatment using removable aligners. He also wished to wear a chrome cobalt MAD to incorporate orthodontic retention and inter occlusal splinting as part of his MAD on completion of his active orthodontic treatment.
Associated factors and impacts of sedentary behaviour in patients with heart failure: A longitudinal study
Authors: Chen Mei-Fang , Ke Shin-Rong , Liu Chih-Ling , Wu Tao-Cheng , Yu Ya-Mei , Chiou Ai-Fu
Published: April 2020

Background:

Sedentary behaviours may be related to factors such as self-efficacy, mood and social support. However, there is a paucity of longitudinal follow-up studies examining factors related to sedentary behaviour from physical-psychosocial perspectives in patients with heart failure.

Aims:

The purpose of this study was to explore the multidimensional associated factors and impacts of sedentary behaviour in heart failure patients.

Methods:

A longitudinal design was used. A convenience sample of 128 heart failure patients recruited from two large medical centres in northern Taiwan was obtained. Patients were interviewed with structured questionnaires to assess physical activity, symptom distress, exercise self-efficacy, anxiety and depression, social support, sleep quality and quality of life before discharge and at 3 and 6 months after discharge.

Results:

Heart failure patients reported low physical activity and tended to be sedentary. Sedentary behaviour was gradually reduced from hospitalization to 6 months after discharge. Sleep quality, quality of life, analgesic use, symptom distress and exercise self-efficacy were significant associated factors that explained 42.1–51% of the variance in sedentary behaviour. Patients with high sedentary behaviour had significantly greater depression and poorer sleep and quality of life than those with low sedentary behaviour at hospitalization and showed a significant improvement in depression at 3 and 6 months after discharge.

Conclusion:

Sedentary behaviour is common in heart failure patients and has impacts on depression and quality of life. An appropriate physical activity programme focusing on disease self-management and enhancing self-efficacy is needed for heart failure patients to improve their sedentary behaviour and quality of life.
The paradoxes of practical research: The good intentions of inclusion that exclude and abject
Authors: Popkewitz Thomas S
Published: April 2020

There is an alluring, daunting, and haunting desire for practical knowledge in the contemporary social and education sciences about school change. This desire is not new: it haunts the turn of 20th century social sciences to change urban conditions and populations, and appears today in international school assessments and professional education.

The article explores the paradoxes of practical research through a history of the present. Different historical lines activated in contemporary research are discussed: (a) the object of practical knowledge is making kinds of people; (b) the sciences about changing the present embody desires about the potentialities of society and people that research is to actualize; and (c) the “useful, practical knowledge” paradoxically embodies comparative styles of reasoning that inscribe inequality in the search for equality.

The argument focuses on science as “an actor” in governing. It argues that governing in modernity occurs less through brute force (although it is still present) and more through the principles that order and classify conduct. The sciences of the modern school are central in this governing. The article methodologically draws on social and cultural histories, science and technology studies, and studies of the politics of knowledge.
The art of stage-craft: A dramaturgical perspective on strategic change
Authors: Whittle Andrea , Gilchrist Alan , Mueller Frank , Lenney Peter
Published: April 2020

This article contributes to our understanding of how organisations change the set of practices and practitioners involved in strategising, what we term the ‘strategy arrangement’. Drawing on insights from a qualitative study of the introduction and subsequent removal of a new strategy team, we develop a dramaturgical theory of the practices involved in changing strategy arrangements. First, we conceptualise the relationship between the frontstage performances where impressions are generated and the backstage work that takes place to craft and control those impressions. Second, we distinguish between preventive practices designed to ‘stage the show’, where foresight is used to imagine the impressions of the audience and inform the design of the show, and corrective practices designed to ‘save the show’, where the desired impression has been discredited and repair is needed to restore the desired impression. Third and finally, we distinguish between the more innocuous backstage practice of rehearsing, the ‘behind the scenes’ work that involves taking up the roles of actor, playwright, director, audience and critic to craft the show, and the less innocuous practice of conspiring, where team members work ‘behind the backs’ of the audience to construct false impressions. In so doing, we seek to advance strategy-as-practice research by developing a dramaturgical theory of practice that captures the theatrical dynamics of strategic change.
Successful Percutaneous Transcatheter Closure of a Common Femoral Artery Pseudoaneurysm With Use of MicroVascular Plug Despite Continued Catheter-Directed Thrombolysis
Authors: Talaie Reza , Jalaeian Hamed , D’Souza Donna , Aboufirass Yasmina , Golzarian Jafar
Published: April 2020

Common femoral artery pseudoaneurysm is a known complication of percutaneous vascular access. Treatment options include surgical repair of the pseudoaneurysm or endovascular methods such as ultrasound-guided compression and direct thrombin injection into the pseudoaneurysm sac. Treatment of pseudoaneurysm is more challenging when a patient is undergoing concurrent catheter-directed or systemic thrombolytic therapy. This is a case report of endovascular treatment of an iatrogenic pseudoaneurysm of common femoral artery in a patient receiving concurrent catheter-directed thrombolytic therapy. This was performed successfully by precise deployment of a MicroVascular Plug into the pseudoaneurysm neck with immediate closure of pseudoaneurysm. Midterm follow-up confirmed sustained exclusion of the pseudoaneurysm sac with continued patency of the treated femoral artery.
Pulmonary complications and survival after elective infrarenal endovascular abdominal aneurysm repair in patients with documented chronic obstructive pulmonary disease
Authors: Oussoren Fieke K , Holewijn Suzanne , Claessens Niels , van der Veen Daphne , Reijnen Michel MPJ
Published: April 2020

Background

Elective abdominal aortic aneurysm (AAA) repair is advocated in patients where risk of rupture exceeds the risks of peri-procedural morbidity and mortality. Chronic obstructive pulmonary disease (COPD) is a known risk factor for AAA and increased operative morbidity in general. Since literature on the correlation between the clinical classification of COPD and morbidity following endovascular infrarenal AAA repair (EVAR) is scarce, assessment per individual remains a challenge.

Objective

To analyse the pulmonary and all-cause morbidity and mortality in patients with documented COPD and relate this to their GOLD classification.

Methods

Sixty-eight patients with COPD, documented by a lung function test, who underwent elective EVAR between July 2002 and July 2018 were retrospectively reviewed. The primary endpoint was the incidence of 30-day pulmonary adverse events. Procedural characteristics, length of hospital stay, pulmonary and all-cause morbidity including major adverse events (MAEs) during follow-up and five-year survival divided per GOLD classification were the secondary endpoints.

Results

There was no statistically significant difference in the incidence of pulmonary adverse events between GOLD I/II and GOLD III/IV patients. There was neither procedural nor 30-day mortality in either group. Through 30 days and 1 year, there was no difference in pulmonary and all-cause morbidity between groups. Three MAEs occurred in the GOLD I/II group versus 2 MAE in the GOLD III/IV group during the first postoperative year. The five-year survival was 66.0%, 60.9% and 61.9% for patients with GOLD I, GOLD II and GOLD III, respectively. Three of four GOLD IV died within the first year after EVAR.

Conclusion

EVAR can be safely performed in patients with COPD, with low 30-day morbidity and mortality rates. Although severe co-morbidity should be taken into account, EVAR seems to be justified in patients with COPD with a GOLD classification I, II or III. Further research should focus on optimising the pulmonary condition in patients selected for EVAR.
Altered functional connectivity of the insula in a rat model of recurrent headache
Authors: Jia Zhihua , Yu Shengyuan , Tang Wenjing , Zhao Dengfa
Published: April 2020

Migraine is a pain disorder accompanied by various symptoms. The insula, a “cortical hub,” is involved in many functions. Few studies have focused on the insula in migraine. We explored the resting-state functional connectivity between the insula and other brain areas in rats subjected to repeated meningeal nociception which was commonly used as animal model of migraine. Inflammatory soup was infused through supradural catheters in conscious rats. The rats were subdivided based on the frequency of the inflammatory soup infusions. Magnetic resonance imaging data were acquired on rats 21 days after inflammatory soup infusion and functional connectivity seeded on the insula was analyzed. In the low-frequency inflammatory soup group, magnetic resonance imaging was performed again 1 h after the glyceryl trinitrate injection following baseline scanning. The cerebellum showed increased functional connectivity with the insula in the inflammatory soup groups. The insula showed increased functional connectivity with the medulla and thalamus in the ictal period in the low-frequency inflammatory soup rats. In the high-frequency inflammatory soup group, several areas showed increased functional connectivity with the insula, including the pons, midbrain, thalamus, temporal association cortex, and retrosplenial, visual, and sensory cortices. Our findings support the hypothesis that the headache phase of migraine depends on the activation and sensitization of the trigeminovascular system, and that the chronification of migraine may be related to higher brain centers and limbic cortices. The insula may be a new target for treatment of migraine.
Stereotype-based priming without stereotype activation: A tale of two priming tasks
Authors: Tsamadi Dimitra , Falbén Johanna K , Persson Linn M , Golubickis Marius , Caughey Siobhan , Sahin Betül , Macrae C Neil
Published: April 2020

An extensive literature has demonstrated stereotype-based priming effects. What this work has only recently considered, however, is the extent to which priming is moderated by the adoption of different sequential-priming tasks and the attendant implications for theoretical treatments of person perception. In addition, the processes through which priming arises (i.e., stimulus and/or response biases) remain largely unspecified. Accordingly, here we explored the emergence and origin of stereotype-based priming using both semantic- and response-priming tasks. Corroborating previous research, a stereotype-based priming effect only emerged when a response-priming (vs. semantic-priming) task was used. A further hierarchical drift diffusion model analysis revealed that this effect was underpinned by differences in the evidential requirements of response generation (i.e., a response bias), such that less evidence was needed when generating stereotype-consistent compared with stereotype-inconsistent responses. Crucially, information uptake (i.e., stimulus bias, efficiency of target processing) was faster for stereotype-inconsistent than stereotype-consistent targets. This reveals that stereotype-based priming originated in a response bias rather than the automatic activation of stereotypes. The theoretical implications of these findings are considered.
Second-line treatment in patients with advanced extra-pulmonary poorly differentiated neuroendocrine carcinoma: a systematic review and meta-analysis
Authors: McNamara Mairéad G. , Frizziero Melissa , Jacobs Timothy , Lamarca Angela , Hubner Richard A. , Valle Juan W. , Amir Eitan
Published: April 2020

Background:

There is no standard second-line treatment for patients with advanced extra-pulmonary poorly differentiated neuroendocrine carcinoma (EP-PD-NEC). This study explored data evaluating second-line treatment in these patients.

Methods:

A search of MEDLINE and EMBASE identified studies reporting survival and/or response data for patients with EP-PD-NEC receiving second-line therapy. Association between various factors (age, gender, ECOG performance status, primary tumour location, morphology, Ki-67, treatment and grade 3/4 haematological toxicity) and response rate (RR), progression-free (PFS) and overall survival (OS) were assessed with a mixed effects meta-regression weighted by individual study sample size. Due to a small sample size, associations were reported quantitatively, based on magnitude of beta coefficient rather than statistical significance.

Results:

Of 83 identified studies, 19 were eligible, including 4 prospective and 15 retrospective studies. Analysis comprised 582 patients, with a median number of 19 patients in each study (range 5–100). Median age was 59 years (range 53–66). Median RR was 18% (range 0–50; 0% for single-agent everolimus, temozolomide, topotecan; 50% with amrubicin), median PFS was 2.5 months (range 1.15–6.0) and median OS was 7.64 months (range 3.2–22.0). Studies with a higher proportion of patients with a Ki-67>55% had lower RR (β = –0.73) and shorter OS (β = –0.82).

Conclusion:

Second-line therapy for patients with advanced EP-PD-NEC has limited efficacy and the variety of regimens used is diverse. Ki-67>55% is associated with worse outcomes. Prospective randomised studies are warranted to enable exploration of new treatment strategies.
Induced pluripotent stem cell-derived enteric neural crest cells repopulate human aganglionic tissue-engineered intestine to form key components of the enteric nervous system
Authors: Chang David F , Zuber Samuel M , Gilliam Elizabeth A , Nucho Laura-Marie A , Levin Gabriel , Wang Fengnan , Squillaro Anthony I , Huang Sha , Spence Jason R , Grikscheit Tracy C
Published: April 2020

Models for enteric neuropathies, in which intestinal nerves are absent or injured, are required to evaluate possible cell therapies. However, existing options, including transgenic mice, are variable and fragile. Here immunocompromised mice were implanted with human pluripotent stem cell–derived tissue-engineered small intestine 10 weeks prior to a second survival surgery in which enteric nervous system precursor cells, or saline controls, were injected into the human intestinal organoid–derived tissue-engineered small intestine and analyzed 4 weeks later. Human intestinal organoid–derived tissue-engineered small intestine implants injected with saline as controls illustrated formation of intestinal epithelium and mesenchyme without an enteric nervous system. Second surgical introduction of human pluripotent stem cell–generated enteric nervous system precursors into developing human intestinal organoid–derived tissue-engineered small intestine implants resulted in proliferative migratory neuronal and glial cells, including multiple neuronal subtypes, and demonstrated function in contractility assays.