bluuebunny/crossref_metadata_2025 huggingface dataset:
First Prospective Cross-Sectional Study on the Impact of Immigration Background and Education in Early Detection of Breast Cancer
Authors: Kuehnle Elna , Siggelkow Wulf , Luebbe Kristina , Schrader Iris , Noeding Karl-Heinz , Noeding Stefanie , Noesselt Thomas , Hillemanns Peter , Dörk Thilo , Park-Simon Tjoung-Won
Published: November 2020

Background: Although immigrant health is an important issue in national health policy, there is a serious shortage of data in many countries. Most studies lack information on educational status, which is a major limitation. This prospective cross-sectional study analyzed a real-world breast cancer population on the influence of immigration background and educational status on participation in breast cancer early detection programs in the federal state of Lower Saxony, Germany. Methods: Data collection was conducted from 2012 to 2016 in six certified breast cancer centers using a standardized questionnaire for patients’ interview and tumor-specific data from the patients’ medical records. Results: 2,145/3,047 primary breast cancer cases were analyzed. 17.5% of our patients had a history of immigration, including n = 202 first-generation immigrants and n = 168 second-generation immigrants. Most of them were citizens of EU27 member states. No significant difference was seen in age, tumor stage, histology, grading, Ki-67, Her2/neu-status, and hormone receptor status compared to the native cohort. 100% participation rate in the breast cancer early detection programs were seen in patients with no school graduation. With regards to the national mammography screening program, participation decreased significantly with educational status (p = 0.0003). Conclusions: No tumor biological differences were seen between immigrants and German natives. In first-generation immigrants, early detection programs were well accepted despite sociocultural and language differences. Participation rate decreased significantly with higher education levels irrespective of country of origin. Immigration background does not have a negative effect on the participation in breast cancer screening. This mainly relates to immigrants from EU27 member states.
Complement-Related Proteins and Their Measurements: The Current Status of Clinical Investigation
Authors: Ohtani Katsuki
Published: November 2020

Complement has been considered to be a factor that protects the host against invading microorganisms during infection. However, in recent years, complement-related protein deficiency has been found to be involved in the onset of various diseases, such as autoimmune and inflammatory diseases. In Japan, C3, C4, and CH50 tests were generally performed only when a complement system examination was necessary and there were not enough examinations for other complement factors. Since the complement system has a very complicated activation pathway, at present, it is not well known which molecule must be measured to understand the pathological condition or pathogenesis in complement-related diseases. Furthermore, since the frequency of complement factor gene alleles also differs depending on race, data from foreign countries cannot be directly applied to Japanese populations. Under these circumstances, the Japanese Association for Complement Research (JACR) has prepared approximately 20 items for complement-related examinations, including the 5 categories of functional analysis, complement factors, complement regulators, activation products, and autoantibodies.
Performance Art Is…
Authors: Reed Elliot
Published: November 2020

In this manifesto, the artist inserted his body via dance clips and gestures from the studio throughout the text. The work is an attempt to outline what performance can be in the absence of an audience, when studio practicing has shifted into video work, music, and scores during this national shutdown.
The Legacy of the Mountain Witch: Yasuko Yokoshi's shuffleyamamba
Authors: Copeland Rebecca
Published: November 2020

The contemporary dance production shuffleyamamba by Japan-based dancer, choreographer, and filmmaker Yasuko Yokoshi takes inspiration from the medieval noh play Yamamba (Mountain Crone). Drawing from the female-centered focus of the play and the complexity of the yamamba image, Yokoshi, in collaboration with American sound artist Gelsey Bell, weaves together a multifaceted work that celebrates the enduring legacies of dance and female performance.
The Verticality of White Space: Depths of Ticketing Exposure and Concealment in Chicago’s 42nd Ward
Authors: Henricks Kasey
Published: November 2020

The peaks and valleys written into Chicago’s 42nd Ward outline themselves against what space is legible to ticketers in the city’s hungriest vehicle ticketing district. It is a space that defies the racial geography of ticketing in Chicago, where predatory practices prey on communities of color as though they are the city’s slush fund. In the 42nd Ward, ticketing is like a language that is spoken in a specific geometric dialect. Those who issue them speak with a street-level fluency that omits a vocabulary of verticality, where space is readable only through narrow focus that sees what is at ground-level but not below or above it. In a district that features high volumes of automobility but little street parking, the ward’s ticketing hotspots are territorial soft targets that stand out like italicized font to flag the ticketer’s attention. Camouflaged in the unarticulated White space that separates one word from another are vertical sanctuaries from surveillance and sanction. The district is a White space in both a figurative and literal sense, given the racial position of who wrote these words, which vested interests they advance, and to what ends.
Ketorolac Use for Pain Management in Trauma Patients With Rib Fractures Does not Increase of Acute Kidney Injury or Incidence of Bleeding
Authors: Torabi Julia , Kaban Jody M. , Lewis Erin , Laikhram Dana , Simon Rachel , DeHaan Skylar , Jureller Michael , Chao Edward , Reddy Srinivas H. , Stone Melvin E.
Published: November 2020

Introduction

Ketorolac is useful in acute pain management to avoid opiate-related complications; however, some surgeons fear associated acute kidney injury (AKI) and bleeding despite a paucity of literature on ketorolac use in trauma patients. We hypothesized that our institution's use of intravenous ketorolac for rib fracture pain management did not increase the incidence of bleeding or AKI.

Methods

Rib fracture patients aged 15 years and above admitted between January 2016-June 2018 were identified in our trauma registry along with frequency of bleeding events. AKI was defined as ≥ 1.5x increase in serum creatinine from baseline measured on the second day of admission (after 24 hours of resuscitation) or an increase of ≥ .3 mg/dL over a 48-hour period. Patients receiving ketorolac were compared to patients with no ketorolac use.

Results

Two cohorts of 199 control and 205 ketorolac patients were found to be similar in age, gender, admission systolic blood pressure (SBP), injury severity score, intravenous radiocontrast received, and transfusion requirements. Analysis revealed no difference in frequency of AKI using both definitions (8% vs. 7.3%, P = .79) and (19.6% vs. 15.1%, P = .24), respectively, or bleeding events (2.5% vs. 0%, P = .03). Logistic regression demonstrated that ketorolac use was not an independent predictor for AKI but age and admission SBP < 90 were.

Conclusion

Use of ketorolac in this cohort of trauma patients with rib fractures did not increase the incidence of AKI or bleeding events.
Surgical Palliative Care—Where Are We in 2020?
Authors: Miller Pringl
Published: November 2020

The practice of surgical palliative care is not new. Dr Balfour M. M. Mount, a retired urologic surgeon is considered the father of North American Palliative Care and coined the term Palliative Care in 1975. Dr Geoffrey P. Dunn, a retired general surgeon and hospice and palliative medicine specialist along with other like minded surgical colleagues were instrumental in developing the field of surgical palliative care. Dr Olga Jonasson, championed the American Board of Surgery becoming one of the sponsoring boards of the Hospice and Palliative Medicine certifying exam. Dr Anne Mosenthal advocated for palliative care to be integrated as parallel clinical aims so espoused in the Trauma Quality and Improvement Program Palliative Care Best Practice Guidelines. Dr Mosenthal currently chairs the American College of Surgeons Committee on Surgical Palliative Care. This introductory article is a brief history about the origins of surgical palliative care and sheds light on the current landscape of surgeons integrating primary and specialty palliative care into surgical practice. The aim of this surgical palliative care symposium is to take everyday surgical problems and highlight the application and benefit of palliative care when treating surgical patients with serious illness. Integrating palliative care principles into standard clinical management is evidenced based patient-centered practice.
Malignant Bowel Obstruction in the Time of the COVID-19 Pandemic
Authors: Fallon Eleanor A. , Miner Thomas J.
Published: November 2020

Regardless of the anatomic site of malignant bowel obstruction leading to the need for palliative intervention, decisions must consider the natural history of the disease, the availability and success of nonsurgical treatments, the individual patient’s symptom severity, goals, preferences, quality, and expectancy of life. Therapy for symptoms must remain flexible and individualized because the specific needs of the patient will change as disease progresses. Because strangulation is uncommon, malignant bowel obstruction is usually not a surgical emergency. There is usually time to proceed with deliberate and thoughtful decisions on how best to meet the needs and expectations of the individual patient and family. Providers must be well versed in both surgical and nonsurgical therapeutic options, the natural history of disease, and be active and compassionate providers to foster meaningful ongoing dialogue focused on excellent care even after cure is no longer possible. The palliative triangle not only allows patient, family, and surgeon to effectively utilize the full continuum of care that can be delivered, but also it supports end-of-life decisions when continuity in care matters most. Due to social distancing requirements, the dynamics of communication between patient, family, and surgeon have changed. Zoom, Skype, and FaceTime have become tools in our communication armamentarium
The Effects of the COVID-19 Pandemic on Trauma Presentations in a Level One Trauma Center
Authors: Devarakonda Aditya K. , Wehrle Chase J. , Chibane Fairouz L. , Drevets Peter D. , Fox Elizabeth D. , Lawson Andrew G.
Published: November 2020

Background

Over 28 million confirmed cases of COVID-19 have been reported to date, resulting in over 900 000 deaths. With an increase in awareness regarding the virus, the behavior of general population has changed dramatically. As activities such as driving and hospital presentation patterns have changed, our study aimed to assess the differences in trauma case variables before and during the COVID-19 pandemic.

Methods

Trauma data for the period of March 1st-June 15th were compared for the years 2015-2019 (pre-COVID) and 2020 (COVID). The data were analyzed across the following categories: injury severity score, injury mechanism, motor vehicle crashes (MVCs) vs. other blunt injuries, alcohol involvement, and length of hospital stay.

Results

The median injury severity score pre-COVID and during COVID was 9, representing no change. There was no difference in overall distribution of mechanism of injury; however, there was a significant decrease in the percentage of MVCs pre-COVID (36.39%) vs. COVID (29.6%, P < .05). Alcohol was significantly more likely to be involved in trauma during COVID-19 ( P < .05). The mean hospital stay increased from 3.87-5.4 days during COVID-19 ( P < .05).

Discussion

We saw similar results to prior studies in terms of there being no change in trauma severity. Our observation that motor vehicle collisions have decreased is consistent with current data showing decreased use of motor vehicles during the pandemic. We also observed an increase in alcohol-related cases which are consistent with the reported changes in alcohol consumption since the pandemic began.
Augmented Two-Dimensional Correlation Spectroscopy for the Joint Analysis of Correlated Changes in Spectroscopic and Disparate Sources
Authors: Schulze H. Georg , Rangan Shreyas , Vardaki Martha Z. , Iworima Diepiriye G. , Kieffer Timothy J. , Blades Michael W. , Turner Robin F. B. , Piret James M.
Published: November 2020

Here, we present an augmented form of two-dimensional correlation spectroscopy, that integrates in a single format data from spectroscopic and multiple non-spectroscopic sources for analysis. The integration is affected by augmenting every spectrum in a hyperspectral data set with relevant non-spectroscopic data to permit two-dimensional correlation analysis(2D-COS) of the ensemble of augmented spectra. A k-means clustering is then applied to the results of the perturbation domain decomposition to determine which Raman peaks cluster with any of the non-spectroscopic data. We introduce and explain the method with the aid of synthetic spectra and synthetic non-spectroscopic data. We then demonstrate this approach with data using Raman spectra from human embryonic stem cell aggregates undergoing directed differentiation toward pancreatic endocrine cells and parallel bioassays of hormone mRNA expression and C-peptide levels in spent medium. These pancreatic endocrine cells generally contain insulin or glucagon. Insulin has disulfide bonds that produce Raman scattering near 513 cm–1, but no tryptophan. For insulin-positive cells, we found that the application of multisource correlation analysis revealed a high correlation between insulin mRNA and Raman scattering in the disulfide region. In contrast, glucagon has no disulfide bonds but does contain tryptophan. For glucagon-positive cells, we also observed a high correlation between glucagon mRNA and tryptophan Raman scattering (∼757 cm–1). We conclude with a discussion of methods to enhance spectral resolution and its effects on the performance of multisource correlation analysis.
Prediction of α-Lactalbumin and β-Lactoglobulin Composition of Aqueous Whey Solutions Using Fourier Transform Mid-Infrared Spectroscopy and Near-Infrared Spectroscopy
Authors: Tonolini Margherita , Sørensen Klavs Martin , Skou Peter B. , Ray Colin , Engelsen Søren Balling
Published: November 2020

Characterization and quantification of individual whey proteins are of crucial importance to many industrial dairy processes. Labor intensive wet-chemical methods are still being used for this purpose, but a rapid quantification method for individual whey proteins is highly desired. This work investigate the utility of Fourier transform mid-infrared spectroscopy and Fourier transform near-infrared spectroscopy for rapid quantification of the two main whey proteins (β-lactoglobulin and α-lactalbumin) in complex aqueous whey solutions simulating production process streams. MIR and NIR spectra obtained on whey samples with known and varying amounts of the proteins of interest and are used to develop partial least squares prediction models. Selection of informative wavelength regions allowed for prediction of β-lactoglobulin and α-lactalbumin concentrations with very high precision and accuracy (root mean square error of cross-validation, or RMSECV, of 0.6% and R2 of 0.99 for NIR), demonstrating the potential of being implemented for rapid in-line monitoring of protein composition in industrial whey streams. Two-dimensional MIR-NIR correlation spectroscopy is used to identify the most informative parts of the NIR spectra in relation to protein secondary structure. In addition multivariate curve resolution is applied to the MIR data to resolve mixture spectra and to elucidate the spectral ranges that were most useful in distinguishing between the two whey proteins. The study concludes that NIR spectroscopy has potential for accurate in-line protein quantification and overall secondary protein structure quantification which open new possibilities for in-line industrial applications.
Advanced Practice Providers Utilization Trends in Otolaryngology From 2012 to 2017 in the Medicare Population
Authors: Ge Marshall , Kim Jee‐hong , Smith Stephanie Shintani , Paul Julianna , Park Christine , Su Peiyi , Ference Elisabeth H.
Published: November 2020

Objective

Nurse practitioners and physician assistants form a growing advanced practice provider (APP) group. We aim to analyze the trends and types of services provided by APPs in otolaryngology.

Study Design

Cross‐sectional study.

Setting

Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use Files, 2012‐2017.

Methods

The Medicare database was searched for 13 commonly used otolaryngology‐specific Current Procedural Terminology (CPT) codes, and 10 evaluation and management (E/M) codes were evaluated by provider type. Changes in code utilization were compared between physicians and APPs over time.

Results

From 2012 to 2017, there was a 51% increase in the number of otolaryngology APPs, compared to a 2.2% increase in physician providers. APPs increased their share of new and established patient visits from 4% to 7%d 11% to 15%, respectively. There was not a significant difference over time in number of patient visits performed annually per provider according to provider type. The increase in number of APP vs physician providers was significantly greater for every procedure except for balloon sinus dilation and tympanostomy tube placement.

Conclusion

Due to increasing numbers, APPs are accounting for more patient visits and procedures over time. The physician workforce and the numbers of procedures performed per physician have remained relatively stable from 2012 to 2017. Increasing complexity of patients seen and a broader range of procedures offered by work‐experienced or postgraduate‐trained APPs may further improve access to health care in the face of possible physician shortages.
Evaluating a Prototype Nasolaryngoscopy Hood During Aerosol‐Generating Procedures in Otolaryngology
Authors: Plocienniczak Michal J. , Patel Ravi , Pisegna Jessica , Grillone Gregory , Brook Christopher D.
Published: November 2020

Objective

During the COVID‐19 pandemic, there has been considerable interest in identifying aerosol‐ and droplet‐generating procedures, as well as efforts to mitigate the spread of these potentially dangerous particulates. This study evaluated the efficacy of a prototype nasolaryngoscopy hood (PNLH) during various clinical scenarios that are known to generate aerosols and droplets.

Study Design

Prospective detection of airborne aerosol generation during clinical simulation while wearing an PNLH.

Setting

Clinical examination room.

Methods

A particle counter was used to calculate the average number of 0.3‐µm particles/L detected during various clinical scenarios that included sneezing, nasolaryngoscopy, sneezing during nasolaryngoscopy, and topical spray administration. Experiments were repeated to compare the PNLH versus no protection. During the sneeze experiments, additional measurements with a conventional N95 were documented.

Results

There was a significant increase in aerosols detected during sneezing, sneezing during nasolaryngoscopy, and spray administration, as compared with baseline when no patient barrier was used. With the PNLH in place, the level of aerosols returned to comparable baseline levels in each scenario. Of note, routine nasolaryngoscopy did not lead to a statistically significant increase in aerosols.

Conclusion

This study demonstrated that the PNLH is a safe and effective form of protection that can be used in clinical practice to help mitigate the generation of aerosols during nasolaryngoscopy. While nasolaryngoscopy itself was not shown to produce significant aerosols, the PNLH managed to lessen the aerosol burden during sneezing episodes associated with nasolaryngoscopy.
The Iron Henry: How One Sword Swallower Advanced Modern Medicine
Authors: Long Barry D. , Pine Harold S.
Published: November 2020

Sword swallowing is an ancient skill that was developed by the fakirs of India and slowly permeated the globe leading up to the late 19th century. Its rise as a popular circus act in Europe coincided with the surge of inventive young minds in the medical community. This crossroad brought about a working relationship between Dr Adolf Kussmaul and a sword swallower named the “Iron Henry.” Together, they developed a scope that could be passed through the esophagus for evaluation of disease states from the upper aerodigestive tract all the way to the antrum of the stomach. The unique abilities refined by years of sword swallowing were vital in the work to develop and perform the first successful esophagoscopy and then disseminate the technology. This story should not be forgotten and can give insight into how historical practices and modern invention can come together to great effect.
Suspicion about a partner’s deception and trust as roots of relational uncertainty during the post-deployment transition
Authors: Knobloch Leanne K. , Knobloch-Fedders Lynne M. , Yorgason Jeremy B. , Basinger Erin D. , Abendschein Bryan , McAninch Kelly G.
Published: November 2020

Relational uncertainty is both prominent and pivotal during the transition from deployment to reintegration. Most prior research has considered the outcomes rather than the origins of relational uncertainty, hampering the development of interventions for military couples. We theorize about two predictors of relational uncertainty during the post-deployment transition: suspicion about a partner’s deception and trust. Results of an 8-wave longitudinal study involving 287 U.S. military couples ( N = 4,147 observations) revealed that relational uncertainty increased over the transition for both returning service members and at-home partners. Suspicion about a partner’s deception, and particularly trust, predicted the relational uncertainty of military couples at homecoming and over time. These findings advance knowledge about the roots of relational uncertainty and suggest ways to assist military couples upon reunion.
The framing of 9/11 in American, French, and Dutch national newspapers (2001–2015): An inductive approach to studying events
Authors: van Dooremalen Thijs , Uitermark Justus
Published: November 2020

In this article, the authors employ work on events, framing, and social problems to develop an inductive approach to studying events. The article’s central premise is that tracing direct references made to events offers a fruitful strategy to investigate their framing cross-nationally and over time. The authors apply their approach to the case of 9/11 in American, French, and Dutch national newspapers (2001–2015). By combining word counting, topic modeling, and content analysis they examine the amount of attention given to 9/11, the issues to which it has been linked, and the implications attributed to it. The results indicate that the framing of 9/11 in the above three countries has been stable and uniform regarding foreign issues. There are however enduring, marked cross-national differences with respect to domestic issues. In France, 9/11 has barely been related to such issues; in the United States, the event has been connected principally to national security; and in the Netherlands, it has mainly prompted the problematization of Muslim immigrants. Because 9/11 has been a significant event many years after its occurrence, albeit differently so in each country of study, the findings point to the relevance of studying the framing of events cross-nationally and over extended periods of time.
A phase 2, randomized, double-blind, placebo-controlled trial of AMG 301, a pituitary adenylate cyclase-activating polypeptide PAC1 receptor monoclonal antibody for migraine prevention
Authors: Ashina Messoud , Doležil David , Bonner Jo H , Zhou Lifen , Klatt Jan , Picard Hernan , Mikol Daniel D
Published: November 2020

Objective

To assess the safety and efficacy of AMG 301, an inhibitor of the pituitary adenylate cyclase-activating polypeptide (PACAP)-1 (PAC1) receptor, for prevention of migraine.

Methods

In a double-blind trial, patients were randomized 4:3:3 to placebo, AMG 301 210 mg every 4 weeks, or AMG 301 420 mg every 2 weeks for 12 weeks. Effect on monthly migraine days and other secondary measures were assessed over weeks 9–12. Safety and tolerability were assessed.

Results

Of 343 randomized patients (mean age, 41.8–42.5 years), the majority were women (85.4–90.4%), white (94.1–96.2%), and had episodic migraine (62.5–67.9%). A total of 305 patients completed treatment (placebo, n = 124; AMG 301 210 mg, n = 94; AMG 301 420 mg, n = 87). Least squares mean reduction at week 12 in monthly migraine days from baseline was −2.5 (0.4) days for placebo and −2.2 (0.5) days for both AMG 301 treatment groups. No difference between AMG 301 and placebo on any measure of efficacy was observed; mean (95% confidence interval) treatment difference versus placebo for monthly migraine days for AMG 301 210 mg, 0.3 (−0.9 to 1.4); AMG 301 420 mg, 0.3 (−0.9 to 1.4). The incidence of adverse events was similar across groups.

Conclusion

AMG 301 offered no benefit over placebo for migraine prevention; further studies may be necessary to fully understand the role of PACAP isoforms and its receptors in migraine pathophysiology.

Study Registration

ClinicalTrials.gov: NCT03238781
Open Sesame? The Paradoxical Development of C2C E-commerce in China
Authors: Li Ju
Published: November 2020

In this article, I analyze the paradoxical development of consumer-to-consumer (C2C) e-commerce in China by investigating three dimensions in its ecosystem: the rent extraction of the platform capital, the labor-intensive mini-enterprises under the demand-driven supply chain of e-commerce, and the widespread commodification and dispossession. I argue that its development has deepened and broadened the exploitative relationship among various forms of labor and capital. To a great extent, although the largely unregulated development of e-commerce has created more employment and provided opportunities for some previously marginalized places and social groups, especially during the early stage, it has quickly engendered malicious competition, notorious counterfeiting, and shrinking profits and bankruptcy for mini-merchants and mini-entrepreneurs, while on top of that a few huge monopolistic e-commerce platform companies have arisen and expanded rapidly.

JEL classification: O11, O33, O53, P21
Judgment, normativity and the subject
Authors: Cooper Andrew
Published: November 2020

One of the fundamental questions in post-Fregean philosophy is how to account for the normativity involved in assertoric claims once the traditional subject-object view of thinking is rejected. One of the more productive lines of inquiry in the contemporary literature attributes normativity to second nature, which is presented as a sui generis space of reason giving and receiving distinct from the space of nature studied by the natural sciences. In this paper I suggest an alternative account by drawing from Castoriadis’s philosophical interpretation of autopoiesis. For Castoriadis, the idea of second nature protects the modern conception of nature from undergoing the radical critique it requires, for it restricts normativity to the anthropic sphere. In contrast, he proposes an autopoietic account of the subject that grounds the capacity to know that one knows in the activity of the living being. Castoriadis demonstrates that the normativity of assertoric claims is not a vertical break from nature but rather a horizontal transformation of the biological capacity for self-referentiality.
Talking about my generation : comment les valeurs façonnent la consommation de luxe
Authors: Pueschel Julia , Parguel Béatrice , Chamaret Cécile
Published: November 2020

En matière de luxe, les jeunes consommateurs cèderaient plus facilement aux sirènes de la contrefaçon que leurs aînés du fait de revenus plus faibles et de différences de valeurs. Nous le contestons en étudiant le cas des Emirats Arabes Unis, dont les nationaux présentent un égal accès au luxe, mais diffèrent en termes de valeurs suivant qu’ils sont nés avant ou après le boom économique fulgurant des années 1990. S’appuyant sur les théories fonctionnelles des attitudes, nous montrons que la consommation de luxe ne remplit pas les mêmes fonctions psychologiques pour les cohortes générationnelles nées avant le boom (avant 1990) ou après, et soulignons l’influence des valeurs dans l’arbitrage entre luxe authentique et luxe contrefait. Les valeurs expliquent ainsi à la fois l’influence négative de l’âge sur la consommation de contrefaçon dans les pays occidentaux et son influence positive dans le Golfe. Ces résultats permettent de formuler des recommandations pour les managers du luxe et les décideurs publics opérant dans le Golfe.
A Multicenter Observational Cohort Study of Angiotensin II in Shock
Authors: Smith Susan E. , Newsome Andrea S. , Guo Yanglin , Hecht Jason , McCurdy Michael T. , Mazzeffi Michael A. , Chow Jonathan H. , Kethireddy Shravan
Published: November 2020

Introduction:

Angiotensin II (Ang-2) is a non-catecholamine vasopressor that targets the renin-angiotensin-aldosterone system by agonism of the angiotensin type 1 receptor. Its utility as a vasopressor and a catecholamine-sparing agent was demonstrated in the pivotal ATHOS-3 trial, and numerous post-hoc analyses have shown reduced mortality in certain subsets of the population.

Methods:

Consecutive adult patients at 5 centers who received Ang-2 from 2017-2020 were included in this multicenter, retrospective observational cohort study. Patient demographics, hemodynamics, and adverse events were collected. The primary outcomes of the study were the mean difference in MAP and norepinephrine (NEpi)-equivalent dose at hours 0 and 3 following initiation of Ang-2 therapy.

Results:

One hundred and sixty-two patients were included in this study. The primary outcomes of an increase in MAP (mean difference 9.3 mmHg, 95% CI 6.4-12.1, p < 0.001) and a reduction in NEpi equivalent dose (mean difference 0.16 µg/kg/min, 95% CI 0.10-0.22, p < 0.001) between hours 0 and 3 were statistically significant. The median time to reach a MAP ≥65 was 16 minutes (IQR 5-60 min). After stratifying patients by the NED dose and number of vasopressors administered prior to the initiation of Ang-2, those with a NED dose < 0.2 µg/kg/min, NED dose < 0.3 µg/kg/min, or those on ≤ 3 vasopressors had a significantly greater reduction in NED by hour 3 than those patients above these thresholds.

Conclusion:

Ang-2 is an effective vasopressor and reduces catecholamine dose significantly. Its effect is rapid, with target MAP obtained within 30 minutes in most patients. Given the critical importance of adequate blood pressure to organ perfusion, Ang-2 should be considered when target MAP cannot be achieved with conventional vasopressors. Ang-2 should be utilized early in the course of shock, before the NED dose exceeds 0.2-0.3 µg/kg/min and before the initiation of the fourth-line vasopressor.
Fixed-time three-dimensional guidance law with input constraint and actuator faults
Authors: Li Peng , Liu Qi , He Chen-Yu , Liu Xiao-Qing
Published: November 2020

This paper investigates the three-dimensional guidance with the impact angle constraint, actuator faults and input constraint. Firstly, an adaptive three-dimensional guidance law with impact angle constraint is designed by using the terminal sliding mode control and nonhomogeneous disturbance observer. Then, in order to solve the problem of the input saturation and actuator faults, an adaptive anti-saturation fault-tolerant three-dimensional law is proposed by using the hyperbolic tangent function based on the passive fault-tolerant control. Finally, the effectiveness of the designed guidance laws is verified by using the Lyapunov function and simulation.
Feed rate control in robotic bone drilling process
Authors: Boiadjiev Tony , Boiadjiev George , Delchev Kamen , Chavdarov Ivan , Kastelov Roumen
Published: November 2020

The bone drilling process is characterised by various parameters, the most important of which are the feed rate (mm/s) and the drill speed (rpm). They highly reflect the final effects and results of the drilling process, such as mechanical and thermal damages of bone tissue and hole quality. During manual drilling, these parameters are controlled by the surgeon based on his practical skills. But automatic drilling can assure an optimal result of the manipulation where such parameters are under control. During bicortical automatic bone drilling such a process consists of several stages: searching the contact with the first cortex, cortex drilling and automatic stop; searching the contact with the second cortex, cortex drilling and automatic stop; drill bit extraction. This work presents a way to control the feed rate during different stages of the bone drilling process (an original feed rate control algorithm) using the orthopaedic drilling robot (ODRO). The feed rate control is based on a proposed algorithm created and realised by specific software. During bicortical bone drilling process the feed rate takes various values in any stage in the range 0.5–6 mm/s. These values depend on drill bit position and real time force sensor data. The novelty of this work is the synthesis of an original feed rate control algorithm to solve the main problems of bone drilling in orthopaedic surgery – minimisation the drilling time (the heat generation); eliminating of the drill bit slip at the first (near) cortex and the drill bit bending at the second (far) cortex; minimising the risk of micro cracks which causes Traumatic Osteonecrosis; improving hole quality of the drilled holes; eliminating of the drill bit slip and the drill bit bending at the second cortex; minimising the value of the second cortex drill bit penetration by bicortical bone drilling.
A prospective study of reproductive factors in relation to risk of systemic lupus erythematosus among black women
Authors: Cozier Yvette C , Barbhaiya Medha , Castro-Webb Nelsy , Costenbader Karen H , Rosenberg Lynn
Published: November 2020

Objective

Systemic lupus erythematosus (SLE) occurs most commonly among reproductive age women, compatible with a potential role of reproductive factors, although past studies including women of mainly European ancestry have yielded conflicting results. We assessed relationships of reproductive factors to SLE risk among black women.

Methods

We followed 58,243 participants in the Black Women’s Health Study (BWHS) from 1995 – 2015 using biennial health questionnaires, on which participants reported reproductive and other factors. Self-reported incident SLE cases were confirmed as meeting 1997 American College of Rheumatology SLE classification criteria by medical record review. Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for SLE for several reproductive factors, controlling for potential confounders.

Results

During 954,476 person-years of follow-up, 125 incident cases of SLE were confirmed. Later age at menarche and longer duration of breast feeding were associated with increased risk of SLE. The multivariable HRs were 2.31 (95% CI, 1.30–4.11) for age at menarche ≥15 relative to age 12, and 1.73 (95% CI, 1.01–2.94) for breast feeding ≥6 months relative to none. There were no clear associations with parity, age at first birth, menopausal status, hysterectomy, age at menopause, or history of endometriosis.

Conclusion

Our results suggest that later menarchal age and breastfeeding of infants for ≥6 months vs. none may be associated with increased SLE risk among black women, while other reproductive factors did not appear related. The biological mechanisms underlying these potential associations should be pursued.
Brexit and the location of Japanese direct investment in European regions
Authors: Cieślik Andrzej , Ryan Michael
Published: November 2020

This paper investigates how the Brexit announcement affects Japanese direct investment into Europe at the regional NUTS-2 level. Political and economic uncertainty is an important factor affecting the economic performance of a country and its regions. In this study, Japanese annual firm-level data between the years 2000 and 2018 for 31 European countries is used. Negative binomial estimations indicate a significant negative relationship between uncertainty associated with the Brexit announcement and Japanese foreign direct investment (FDI) in the UK regions. Strong FDI path dependence currently acts to dampen this effect. However, depending upon future European Union Single Market access rules, such path dependence could act to magnify Brexit’s effect on inward-UK FDI.

JEL Classification Codes: F23, R12.
Behavioural Intention Factors Influencing Sharing Economy Innovations: An Exploratory Research of Uber in South Africa
Authors: Molobi Lemohang , Kabiraj Sajal , Siddik Md. Nur Alam
Published: November 2020

This research explores factors associated with the use of the Uber application, a successful sharing economy innovation, in South Africa. The exploratory research adapted a technology acceptance model with two other factors, perceived risks and company characteristics on behavioural intention to utilize Uber. Using a survey data of 396 respondents, this research empirically finds that ease of use, company characteristics, attitude, perceived usefulness, and level of education have significant positive impacts on behavioural intention to use Uber applications. Meanwhile, gender and age groups have negative impacts on behavioural intention. Furthermore, the study found that perceived risk has a negative impact on behavioural intention to use Uber. The research findings are of significance for management on how user insights can be applied to take advantage of new prospects to innovate and to expand their businesses and for policymakers on how to seize the opportunities presented by such innovation and develop appropriate policy frameworks.
Book review: David M. Rubenstein. 2020. How to Lead: Wisdom from the World’s Greatest CEOs, Founders and Game Changers
Authors: Pande Neerja
Published: November 2020

David M. Rubenstein. 2020. How to Lead: Wisdom from the World’s Greatest CEOs, Founders and Game Changers. Simon & Schuster, pp. 448, ₹599 (Paperback), ISBN (Print): 978-1982158750.
Prenatal Diagnosis of Robin Sequence: Sensitivity, Specificity, and Clinical Relevance of an Index for Micrognathia
Authors: Kruse Teresa , Neuschulz Julia , Wilhelm Lucas , Ritgen Jochen , Braumann Bert
Published: November 2020

Objective:

Micrognathia in connection with glossoptosis (called Robin sequence) may lead to life-threatening respiratory problems immediately after birth. An objective detection during prenatal routine ultrasound sonography is possible using an index that relates fetal lower jaw length to femur length or gestational age. The aim of this study was to test the method’s sensitivity and specificity and to discuss its predictive power concerning neonatal respiratory insufficiency.

Design:

Patients with subjectively identified suspicious signs in the sagittal profile view were included in the study: Two-dimensional serial ultrasound scans of their fetal mandible were used to measure the lower jaw lengths and compare them to predicted values according to an index, derived from 313 healthy fetuses. Follow-up data provided additional information on the clinical appearance of the newborns.

Results:

The index showed a high sensitivity: 15 of the 16 cases with a micrognathia were correctly diagnosed (sensitivity of 93.75%). Follow-up data showed that newborns with similar index values differed in terms of their upper airway obstruction and treatment need.

Conclusion:

Fetal mandibular micrognathia can be objectively evaluated with the help of the index. The method allows an early detection of micrognathia, which helps to take the necessary steps for proper treatment of potential life-threatening respiratory impairment. Observations ranging outside the prediction interval could prompt the ultrasonographer to check for other associated malformations.
Utility of Thromboelastography to Identify Hypercoagulability in Lung Cancer Related Ischemic Stroke Patients
Authors: Quan Xuemei , Qin Qixiong , Que Xianting , Chen Ya , Wei Yunfei , Chen Hao , Li Qianqian , Meng Chaoguo , Liang Zhijian
Published: November 2020

Lung cancer related hypercoagulability could increase the risk of ischemic stroke. Routine coagulation tests may have limited capacity in evaluating hypercoagulability. The aim of this study was to investigate the ability of thromboelastography (TEG) in the identification of hypercoagulability in patients with lung cancer and cryptogenic ischemic stroke (LCIS). Between January 2016 and December 2018, whole citrated blood from LCIS patients (n = 35) and age- and gender-matched lung cancer patients and healthy volunteers were used for TEG and routine coagulation tests. The coagulation indicator and clinical data were compared among the 3 groups. There were 27/35 (77.14%) on TEG and 18/35 (51.43%) on routine coagulation tests of LCIS patients who had evidence of hypercoagulability. The detection rate of hypercoagulability by TEG in LCIS patients was higher than routine coagulation tests ( P = 0.018). Comparing with lung cancer patients and healthy controls, LCIS patients have a significantly higher maximum amplitude (MA), fibrinogen, and D-dimer. Multivariate analysis showed that D-dimer and MA were significantly associated with ischemic stroke in lung cancer patients. ROC curve showed that the area under the curve of TEG (0.790 ± 0.048, 95% CI: 0.697-0.864) was significantly higher than routine coagulation tests (0.673 ± 0.059, 95% CI: 0.572-0.763) ( P = 0.04) in identifying hypercoagulability in LCIS patients. Therefore, TEG could identify hypercoagulability in LCIS patients and healthy controls. Identification of hypercoagulability in lung cancer patients by TEG may be helpful to prevent the occurrence of LCIS.
A study on nonlinear, parametric aeroelastic energy harvesters under oscillatory airflow
Authors: Meshki Mohammad Mehdi , Nobari Ali Salehzadeh , Sadr Mohammad Homayoune
Published: November 2020

In this study, based on parametric excitation originating from airflow oscillation, a novel nonlinear aeroelastic energy harvester is proposed. In this respect, first, the governing equation of the system is derived and studied thoroughly to understand the direct and indirect effects of airflow oscillation on the local and global responses of the system. Then, by using a pseudo-arclength continuation method based on the harmonic balance method, the stable and unstable periodic and quasi-periodic responses of the system are tracked and analyzed. It is demonstrated that the proposed self-parametric (combination parametric and self-excitation) energy harvester can extract more power than the respective nonparametric system for a wide range of amplitudes and frequencies. The gained knowledge of parametric, aeroelastic systems is applicable for both aero-harvesters and other aeroelastic systems undergoing flow oscillation.
“Where Is the Women’s Center Here?”: The Role of Information in Refugee Women’s Help Seeking for Intimate Partner Violence in a Resettlement Context
Authors: Wachter Karin , Cook Heffron Laurie , Dalpe Jessica , Spitz Alison
Published: November 2020

A qualitative study examined factors that hinder help seeking for intimate partner violence among women who resettled to the United States as refugees. A refugee resettlement agency recruited female clients ( n = 35) and service providers and stakeholders ( n = 53) in the metropolitan area. The study employed individual interviews and focus group discussions to collect data. An inductive and interpretive thematic approach guided the analytical process. The analysis revealed challenges related to information gaps and communication struggles complicating help-seeking processes. The findings point to the importance of bolstering information sharing within and across informal and formal networks to help women navigate support and services in resettlement.
Linear peridynamics for triclinic materials
Authors: Mikata Yozo
Published: November 2020

The governing equation of linear peridynamics is developed for the most general anisotropic materials (triclinic materials). As a departure from the standard peridynamic theory, the linear constitutive equation in the form of a micromodulus is determined by directly requiring the resulting peridynamic equation to converge to a comparable classical elastodynamic equation for a triclinic material as the generalized material horizon approaches zero. As a result, a new peridynamic governing equation is obtained for triclinic peridynamic materials. As an application of the newly obtained peridynamic equation, a plane wave solution is analytically obtained and discussed, and dispersion curves are plotted for triclinic peridynamic materials.
Suturing large therapeutic corneal grafts based on donor size: A simplified technique for the novice corneal surgeon
Authors: Bafna Rahul Kumar , Kalra Nidhi , Asif Mohamed Ibrahime , Lata Suman , Rathod Aishwarya , Balaji Akshaya , Sharma Namrata
Published: November 2020

Purpose:

We describe a simple technique for achieving radial and equally spaced sutures by novice corneal surgeon in cases of large penetrating keratoplasties.

Method:

A simple mathematical equation was derived for precise calculation of spacing between interrupted sutures in large grafts ( n = 50). The ubiquitous and easily available Castroviejo calipers were used to mark the donor cornea according to the derived formula. Interrupted sutures were passed over the pre-marked points and tied. Radiality was assessed in the post-operative period.

Results:

A total of 50 eyes undergoing therapeutic keratoplasty with graft size between 9 and 12 mm were enrolled. Equally spaced and radially aligned sutures were achieved in all cases postoperatively with watertight apposition of the graft host junction using our simple technique.

Conclusion:

The Castroviejo caliper can be effectively used for equidistant spacing of interrupted sutures in large therapeutic grafts by a novice surgeon thereby simplifying the procedure and reducing the surgical time.