bluuebunny/crossref_metadata_2025 huggingface dataset:
Assembly line balance research methods, literature and development review
Authors: Jiao Yu-ling , Jin Han-qi , Xing Xiao-cui , Li Ming-juan , Liu Xin-ran
Published: May 2021

With the continuous upgrading of the manufacturing system, the assembly line balancing problem (ALBP) is gradually complicated, and the researches are constantly deepened in the application theory and solution methods. In order to clarify the research direction and development status of assembly line balancing, 89 articles are read and studied. We classify ALBPs to construct the network structure of research from horizontal classification and vertical thinking. The ALBP framework is horizontally given according to the number of models (i.e. the number of products), the layout shape of the assembly line, and the data of task time. The “seven steps for scientific paper” is vertically proposed according to the research steps to comb the research path of scientific and technological literature. The horizontal and vertical extension crosses and constructs the network structure of the ALBP. Any horizontal problem intersects with any step of the vertical “seven steps for scientific paper” to form a research point. We analyze 89 articles according to the development path from the straight line to U-shaped line and then to two-sided U-shaped/parallel U-shaped assembly line, summarize the research algorithm of assembly line balance and count the number of articles, and point out the latest research direction and algorithm development trend of assembly line balance.
Thyroid-Like Cholangiocarcinoma: Histopathological, Immunohistochemical, In-Situ Hybridization and Molecular Studies on an Uncommon Emerging Entity
Authors: Hissong Erika , Chiu Kenrry , Park Hyeon , Solomon James , Song Wei , Jessurun Jose
Published: May 2021

Thyroid-like cholangiocarcinoma is a very uncommon variant of peripheral-type cholangiocarcinoma. To date, only 4 prior cases have been reported. The molecular features of this tumor have not been described. We report a case of a 60-year-old woman with a tumor that evolved over a period of 10 years. A left hepatectomy specimen showed an 11 cm tumor that on histology exhibited areas reminiscent of a thyroid tumor with follicular and insular features which were positive on immunohistochemistry for cytokeratin 7 and in-situ hybridization for albumin. A detailed molecular analysis failed to show mutations common to cholangiocarcinomas but revealed frameshift mutations in 2 chromatin-remodeling genes, CREBBP and KMNT2A. This case confirms that thyroid-like cholangiocarcinoma is a histologic variant of this tumor that is associated with relatively low growth. As most cholangiocarcinomas, it is diffusely positive for cytokeratin 7 and albumin by in-situ hybridization. Given its rarity, the molecular alterations in this specific histologic subtype remain to be fully elucidated.
Protamine Sulfate Neutralization Profile of Various Dosages of Bovine, Ovine and Porcine UFHs and Their Depolymerized Derivatives in Non-Human Primates
Authors: Kouta Ahmed , Jeske Walter , Cera Lee , Farshid Azarfrooz , Duff Richard , Hoppensteadt Debra , Fareed Jawed
Published: April 2021

Introduction:

Currently used unfractionated heparins (UFHs) and low molecular weight heparins (LMWHs) are derived from porcine intestinal mucosa. However, heparins have also been manufactured from tissues of other mammalian species such as cow (Bovine) and sheep (Ovine). Protamine sulphate (PS) is an effective inhibitor of heparin and is used clinically to neutralize both LMWH and UFH. In this study, we determined the PS neutralization profile of these agents in non-human primate model using anti-Xa and anti-IIa methods.

Material and Methods:

UFHs obtained from bovine, ovine and porcine mucosal tissues and their respective depolymerized LMWHs were administered at both, gravimetric (0.5 mg/kg) and potency adjusted (100 U/kg) dosages regimen intravenously to individual groups of primates in cross over studies. PS was administered at a fixed dosage and the relative neutralization of these anticoagulants was measured utilizing amidolytic anti-Xa and anti-IIa methods.

Results:

These studies have demonstrated that, the equi-gravimetric dosages of BMH, PMH and OMH have comparable PS neutralization profiles. At potency adjusted dosages, all UFHs were completely neutralized by PS. Although comparable, the LMWHs were not fully neutralized by PS in both the anti-Xa and anti-IIa assays. PS was more efficient in neutralizing the anti-IIa effects of LMWHs.

Conclusion:

Heparins of diverse origins showed comparable neutralization profiles by PS in the amidolytic anti-Xa and anti-IIa assays.
Cost-Effective Machine Learning Based Clinical Pre-Test Probability Strategy for DVT Diagnosis in Neurological Intensive Care Unit
Authors: Luo Li , Kou Ran , Feng Yuquan , Xiang Jie , Zhu Wei
Published: April 2021

In order to overcome the shortage of the current costly DVT diagnosis and reduce the waste of valuable healthcare resources, we proposed a new diagnostic approach based on machine learning pre-test prediction models using EHRs. We examined the sociodemographic and clinical factors in the prediction of DVT with 518 NICU admitted patients, including 189 patients who eventually developed DVT. We used cross-validation on the training data to determine the optimal parameters, and finally, the applied ROC analysis is adopted to evaluate the predictive strength of each model. Two models (GLM and SVM) with the strongest ROC were selected for DVT prediction, based on which, we optimized the current intervention and diagnostic process of DVT and examined the performance of the proposed approach through simulations. The use of machine learning based pre-test prediction models can simplify and improve the intervention and diagnostic process of patients in NICU with suspected DVT, and reduce the valuable healthcare resource occupation/usage and medical costs.
Blood Urea Nitrogen to Serum Albumin Ratio Independently Predicts Mortality in Critically Ill Patients With Acute Pulmonary Embolism
Authors: Fang Jihong , Xu Bin
Published: April 2021

Acute pulmonary embolism (APE) is one of the prominent causes of death in patients with cardiovascular disease. Currently, reliable biomarkers to predict the prognosis of patients with APE are limited. The present study aimed to investigate the association of blood urea nitrogen to serum albumin (B/A) ratio and intensive care unit (ICU) mortality in critically ill patients with APE. A retrospective cohort study was performed using data extracted from a freely accessible critical care database (MIMIC-III). Adult (≥18 years) patients of first ICU admission with a primary diagnosis of APE in the database were enrolled in the study. The primary endpoint was the ICU mortality rate while the 28-day mortality after ICU admission was the secondary endpoint. The data of survivors and non-survivors were compared. A total of 1048 patients with APE were enrolled in this study, of which 131 patients died in ICU and 169 patients died within 28 days after ICU admission. The B/A ratio in the non-survivors group was significantly higher compared to the survivors group ( P < 0.001). The multivariate analysis revealed that the B/A ratio was an independent predictor of ICU mortality (odds ratio [OR] 1.10, 95% CI 1.07-1.14, P < 0.001) and all-cause mortality within 28 days after ICU admission (hazard ratio [HR] 1.07, 95% CI 1.05-1.09, P < 0.001) in APE patients. The B/A ratio showed a greater area under the curve (AUC) of ICU mortality prediction (0.80; P < 0.001) than simplified acute physiology score II (SAPSII) (0.79), systemic inflammatory response syndrome score (SIRS) (0.62), acute physiology score III (APSIII) (0.76) and sequential organ failure assessment (SOFA) score (0.71). The B/A ratio could be a simple and useful prognostic tool to predict mortality in critically ill patients with APE.
Diagnostic Value of D-Dimer in COVID-19: A Meta-Analysis and Meta-Regression
Authors: Zhan Haoting , Chen Haizhen , Liu Chenxi , Cheng Linlin , Yan Songxin , Li Haolong , Li Yongzhe
Published: April 2021

The prognostic role of hypercoagulability in COVID-19 patients is ambiguous. D-dimer, may be regarded as a global marker of hemostasis activation in COVID-19. Our study was to assess the predictive value of D-dimer for the severity, mortality and incidence of venous thromboembolism (VTE) events in COVID-19 patients. PubMed, EMBASE, Cochrane Library and Web of Science databases were searched. The pooled diagnostic value (95% confidence interval [CI]) of D-dimer was evaluated with a bivariate mixed-effects binary regression modeling framework. Sensitivity analysis and meta regression were used to determine heterogeneity and test robustness. A Spearman rank correlation tested threshold effect caused by different cut offs and units in D-dimer reports. The pooled sensitivity of the prognostic performance of D-dimer for the severity, mortality and VTE in COVID-19 were 77% (95% CI: 73%-80%), 75% (95% CI: 65%-82%) and 90% (95% CI: 90%-90%) respectively, and the specificity were 71% (95% CI: 64%-77%), 83% (95% CI: 77%-87%) and 60% (95% CI: 60%-60%). D-dimer can predict severe and fatal cases of COVID-19 with moderate accuracy. It also shows high sensitivity but relatively low specificity for detecting COVID-19-related VTE events, indicating that it can be used to screen for patients with VTE.
A comprehensive study on statistical prediction and reduction of tire/road noise
Authors: Mohammadi Somaye , Ohadi Abdolreza , Irannejad-Parizi Mostafa
Published: May 2021

Promoting safe tires with low external rolling noise increases the environmental efficiency of road transport. Although tire builders have been striving to reduce emitted noise, the issue’s sophisticated nature has made it difficult. This article aims to make the problem straightforward, relying on recent significant improvements in statistical science. In this regard, the prediction ability of new methods in this field, including support vector machine, relevance vector machine, and convolutional neural network, along with the new architecture of the neural network is compared. Tire noise is measured under the coast-by condition. Two training strategies are proposed: extracting features from a tread pattern image and directly importing an image to the model. The relevance vector method, which is trained using the first strategy, has provided the most accurate results with an error of 0.62 dB(A) in predicting the total noise level. This precise model is used instead of experimentation to analyze the sensitivity of tire noise to its parameters using a small central composite design. The parametric study reveals striking tips for reducing noise, especially in terms of interactions between parameters that have not previously been shown. Finally, a novel two-stage approach for reducing noise by tread pattern optimization is proposed, inspired by two regression models derived from statistical investigation and variance analysis. Changes in tread pattern specifications of two case studies and their randomization have resulted in a reduction of 3.2 dB(A) for a high-noise tire and 0.4 dB(A) decrement for a quieter tire.
Improved variational mode decomposition method for vibration signal processing of flood discharge structure
Authors: Li Huokun , Wang Gang , Wei Bowen , Liu Hanyue , Huang Wei
Published: May 2021

It is crucial for flood discharge structure vibration safety evaluations to filter low-frequency noise, separate dense-frequency components and obtain high-frequency component accurately from vibration signals. Variational mode decomposition, a novel signal adaptive decomposition method, effectively processes flood discharge structures. However, the mode number and quadratic penalty item uncertainty in variational mode decomposition directly affects the vibration signal decomposition. Therefore, an improved variational mode decomposition method for vibration signal processing is proposed in this study. The proposed method adaptively determines the mode number based on singular entropy and frequency stability to completely separate the structural vibration components (including dense-frequency components and high-frequency components) and noise components from the vibration signal. Next, an objective quadratic penalty item function based on sample entropy and mutual information is proposed to quantify the mode mixing between the structural vibration components. Finally, a particle swarm optimisation algorithm based on beetle antenna search is proposed to optimise the quadratic penalty item, which overcomes the shortcomings of traditional algorithms and suppresses the mode mixing between the structural vibration components. The validity and feasibility of the proposed method was verified by the simulation signal and was applied to a sluice prototype project. The results showed that the method effectively filtered noise, greatly improved the vibration response signal-to-noise ratio and obtained the structural vibration component time history signal, which provides a foundation for flood discharge structure vibration safety evaluation and health monitoring.
Maltreatment Type Classifications and Transitions During Childhood for a California Birth Cohort
Authors: Prindle John , Foust Regan , Putnam-Hornstein Emily
Published: May 2021

Childhood maltreatment involves dynamics between the type of maltreatment experienced and the context of maltreatment. Reports of alleged maltreatment to child protective services may overlap and shift over time, complicating understanding of their independent and interacting nature, including how child protection systems respond. Latent class analysis (LCA) and latent transition analysis (LTA) were used to construct data-based models of longitudinal dynamics of alleged maltreatment throughout childhood. We sought to identify patterns leading to system decisions to substantiate allegations of maltreatment and place children in foster care. Using linked birth and child protection records, we defined a cohort of children born in California in 1999, 29.4% of whom had at least one referral for alleged maltreatment before their 18th birthday. Maltreatment and perpetrator indicators were coded, and LCA identified five alleged maltreatment classes and one class of children without referrals. LTA determined consistency of classifications and estimated transitions between classes over age periods. Children with multitype maltreatment patterns or experiences of neglect were most likely to experience future maltreatment allegations. Estimated probabilities of placement indicated children with Multitype Maltreatment allegations were more likely to experience substantiated maltreatment allegations and out-of-home placements. Findings identify a repeatable method for better understanding complex systems.
Who Are You to Me? Relational Distance to Victims and Perpetrators Affects Advising to Report Rape
Authors: Puthillam Arathy , Parekh Aneree , Kapoor Hansika
Published: April 2021

The victim’s decision to report a crime is generally dependent on the advice received from a confidant. The effects of a confidant’s relationship to victims and perpetrators on the advice given to report rape were investigated. Indian participants ( N = 418) read one of the seven scenarios of acquaintance rape as a confidant; the scenarios depicted different relationships between the victim and perpetrator (family vs. friend vs. stranger). Confidants closer to victims were more likely to advise reporting, whereas confidants closer to the perpetrator were less likely to advise reporting. Rape myth acceptance and victim blaming negatively predicted reporting to agencies.
Selection of potential probiotics with cholesterol-lowering properties for probiotic yoghurt production
Authors: Wongrattanapipat Saranya , Chiracharoenchitta Anchukorn , Choowongwitthaya Budsarin , Komsathorn Prapatson , La-ongkham Orawan , Nitisinprasert Sunee , Tunsagool Paiboon , Nakphaichit Massalin
Published: April 2021

From 61 lactic acid bacteria (LAB) isolates, three had good cholesterol-lowering properties, with Limosilactobacillus fermentum KUB-D18 having the highest cholesterol assimilation (68.75%) (51 µg/109 CFU). In addition, Lactiplantibacillus pentosus HM04-25 and L. pentosus HM04-3 had the two highest levels of bile salt hydrolase (BSH) activity (22.60 and 21.45 U/mL, respectively). These three strains could resist four antibiotics (aztreonam, vancomycin, teicoplanin, and nalidixic). However, fortunately, they contained no mobile antibiotic resistance genes. To evaluate the influence of probiotic strains in yoghurt production, L. fermentum KUB-D18, L. pentosus HM04-25, or L. pentosus HM04-3 were simultaneously cultured with commercial yoghurt starter (YF-L812) and incubated at 43 °C for 6 h. During yoghurt fermentation, the total bacteria in the yoghurt tended to increase from 7.39 to 8.90 log CFU/mL. The growth rates of two probiotic strains ( L. pentosus HM04-25 and L. pentosus HM04-3) were stable at 6.06 to 6.62 log CFU/mL. Only the rate for L. fermentum KUB-D18 increased (to 7.5 log CFU/mL). These three probiotics did not affect the physical characteristics of yoghurt. The total soluble solids, pH, and titratable acidity values of the probiotic yoghurts were similar to the control yoghurt at 30[Formula: see text]Brix, 4.91, and 0.90%, respectively. The firmness values of the probiotic yoghurts and the control were not significantly different (p > 0.05). Differentiation of the appearance of color, odor, flavor, and texture between the control yoghurt and the probiotic yoghurts was investigated using 56 volunteers and no significant differences were identified. Additionally, sensory evolution revealed that the acceptability of the probiotic yoghurts was higher than for the control (p ≤ 0.05). Therefore, the three probiotic strains with cholesterol-lowering properties had potential in future yoghurt production.
Year in Review 2020: Noteworthy Literature in Cardiothoracic Anesthesiology
Authors: Clendenen Nathan , Ahlgren Bryan , Robitaille Mark J. , Christensen Elijah , Morabito Joseph , Grae Lyndsey , Lyman Matthew , Weitzel Nathaen
Published: May 2021

The year 2020 was marred by the emergence of a deadly pandemic that disrupted every aspect of life. Despite the disruption, notable research accomplishments in the practice of cardiothoracic anesthesiology occurred in 2020 with an emphasis on optimizing care, improving outcomes, and expanding what is possible for patients undergoing cardiac surgery. This year’s edition of Noteworthy Literature Review will focus on specific themes in cardiac anesthesiology that include preoperative anemia, predictors of acute kidney injury following cardiac surgery, pain management modalities, anticoagulation strategies after transcatheter aortic valve replacement, mechanical circulatory support, and future directions in research.
Heads-up 3D eye surgery: Safety outcomes and technological review after 2 years of day-to-day use
Authors: Del Turco Claudia , D’Amico Ricci Giuseppe , Dal Vecchio Marco , Bogetto Caterina , Panico Edoardo , Giobbio Dora Cecilia , Romano Mario R. , Panico Claudio , La Spina Carlo
Published: April 2021

Background:

3D heads-up visualization systems are aimed to improve the surgical experience by providing high-resolution imaging. Objective of our study is to analyze, over a long-time span, the grade of satisfaction and safety of day-to-day 3D surgery compared to standard surgery and to investigate the technical distinctiveness between the heads-up systems currently in use.

Methods:

In this retrospective observational case series. we reviewed all surgical records of our ophthalmology-dedicated operatory rooms since the arrival of 3D heads-up viewing system, in November 2017. In particular, we compared the procedural complications of 3D-equipped operatory room (3DR) with the standard microscope operatory room (2DR). Moreover, a satisfaction questionnaire was administered to those surgeons shifting on both rooms to test their preferences on seven specific parameters (comfort, visibility, image quality, depth perception, simplicity of use, maneuverability and teaching potential).

Results:

5483 eye surgeries were considered. 2777 (50.6%) were performed in 3DR and 2706 (49.3%) in 2DR. Procedural complication rate was comparable in 3DR and 2DR, also when considering different subtypes of surgery. Twelve surgeons (100% of our surgery team) participated in our satisfaction survey, expressing highest satisfaction score for 3D when applied in retina surgery. For cataract surgery, 3D scored best in all the parameters except for facility in use and depth of field perception.

Conclusion:

Long-term day-to-day use of 3D heads-up visualization systems showed its safety and its outstanding teaching potential in all ophthalmic surgical subtypes, with higher surgeons confidence for retina and cataract surgery.
Efficacy and safety data for the Ab interno XEN45 gel stent implant at 3 Years: A retrospective analysis
Authors: Gabbay Itay E , Goldberg Mordechai , Allen Felicity , Lin Zhiheng , Morley Christine , Pearsall Tahmina , Muraleedharan Veena , Ruben Simon
Published: May 2021

Purpose:

To report efficacy and safety measures of the XEN45 gel stent at 36 months in the UK National Health Service setting.

Methods:

Retrospective non-comparative audit of the records of patients who underwent XEN45 implantation between June 2015 and May 2017 was performed. Main outcome measures were intraocular pressure and number of antihypertensive medications used. Failure was defined as need for further surgery or stent removal. Success was defined as a 20% decrease in intraocular pressure without the need for additional glaucoma medications or a reduction in antihypertensive medications without an increase in baseline intraocular pressure. Needling rates and preoperative factors effect were assessed.

Results:

The cohort included 205 patients (205 eyes) with primary open angle glaucoma (84.4%), angle closure glaucoma (7.8%), or refractory glaucoma (7.8%), 62.9% had a stand-alone procedure and 37.1%, a combined phaco-XEN45 procedure. Mean intraocular pressure was 22.6 ± 7.0 mmHg at baseline compared to 14.7 ± 3.8 mmHg at 24 months and 14.0 ± 2.9 mmHg at 36 months ( p < 0.001 for both). Mean number of medications used was 2.6 ± 1.1 at baseline compared to 0.5 ± 0.9 and 0.6 ± 1.0, at 24- and 36-months, respectively ( p < 0.001 for both). The failure rate at 36 months was 25%. Needling was required in 36.6%. Evaluation of background factors yielded an increased failure rate in non-Caucasians compared to Caucasians (74% vs 21%, p < 0.001).

Conclusion:

XEN45 implantation is effective and safe at 36 months’ follow-up. Patients should be advised regarding the risk of failure and possible need for bleb revisions. Careful patient selection may be required.
Retinal obliterative vasculitis associated to contralateral retinal neovascularization in membranoproliferative glomerulonephritis
Authors: Nicolai Michele , Franceschi Alessandro , Lassandro Nicola Vito , Pelliccioni Paolo , Danieli Luca , Pirani Vittorio , Mariotti Cesare
Published: May 2021

Purpose:

To report our experience with a peculiar case of asynchronous bilateral retinal vascular occlusion in a patient suffering from membranoproliferative glomerulonephritis.

Case report:

A 57-year-old dialysed male affected by membranoproliferative glomerulonephritis who underwent kidney transplantation complained of a sudden vision loss in his right eye (RE). His best-corrected visual acuity (BCVA) was 20/40 in RE and 20/20 in the left eye (LE); ophthalmological and fluorangiographic examinations revealed unilateral retinal obliterative vasculitis with panuveitis and apparent sparing of contralateral eye. About 6 months later the patient developed a branch retinal vein occlusion associated with a papillary neovascular membrane in LE. Corticosteroid therapy was administered and immunosuppressant dosage was increased with macular oedema reduction in both events.

Conclusion:

We report a case of unilateral retinal obliterative vasculitis and subsequent contralateral retinal neovascularization and branch retinal vein occlusion in a patient affected by membranoproliferative glomerulonephritis.
Double versus single suture stenting to manage hypertensive spikes after glaucoma drainage device implantation
Authors: Chemello Francesca , Rodella Anna , Barosco Guido , Ceruti Piero , Tosi Roberto , Marchini Giorgio
Published: May 2021

Purpose:

To evaluate the safety and efficacy of double compared to single intraluminal suture stenting in reducing early postoperative hypertensive spikes (HS) and hypotony after Baerveldt glaucoma implant surgery.

Methods:

For this retrospective study, we reviewed the medical charts of 60 patients (60 eyes) who underwent Baerveldt drainage device surgery between 2017 and 2019. Two groups were formed according to whether a single suture stent was placed within the tube (5-0 polypropylene, 30 eyes, group 1) or a double suture (5-0 and 6-0 polypropylene, 30 eyes, group 2). Intraocular pressure (IOP) was measured at baseline, at 6 h, and on postoperative days 1, 2, 5, 7, 14, 21, 30, 60, 90, 180. The occurrence of HS (IOP ⩾ 30 mmHg), anterior chamber reformation, decompressive paracentesis, anti-glaucoma medication, and adverse events were recorded.

Results:

There was a greater decrease in IOP from baseline at days 1, 2, and 21 ( p < 0.05) and number of HS at 6 h ( p = 0.006) and postoperative day 1 ( p < 0.001) in group 2. The mean number of decompressive paracentesis, anterior chamber reformation procedures, and topical anti-glaucoma medications was the same in both groups; the need for oral acetazolamide was significantly lower in group 2 at days 1, 21, and 30 ( p < 0.05).

Conclusions:

While both stenting methods provide a gradual, controlled decrease in IOP, the double stenting technique was associated with a sooner and greater postoperative reduction in IOP and a good safety profile thanks to fewer HS in the early postoperative period and less need for oral acetazolamide.
Arteriovenous fistula cannulation in hemodialysis: A vascular access clinical practice guidelines narrative review
Authors: Pinto Rui , Sousa Clemente , Salgueiro Anabela , Fernandes Isabel
Published: April 2021

The cannulation of an arteriovenous fistula (AVF) by the hemodialysis (HD) nurse is challenging. Despite it being the focus of extensive research, it is still one of the majors causes of damage making it prone to failure. A considerable number of Clinical Practice Guidelines (CPGs) for the management of vascular access (VA) have been published worldwide over the past two decades. This review aimed to assess all information available in the selected CPG regarding AVF cannulation for HD providing a comprehensive analysis in order to interpret possible future cannulation approaches. A total of seven CPGs were described in a coding table separated in seven subthemes: Initiation of cannulation, preparation, technique, needle selection, surveillance, pain, and education. Our analysis outlines current CPGs for HD VA cannulation with lack of good evidence support for the majority of the recommendations, showing that, there is an urgent need for international collaboration and coordination to ensure relevant and high-quality evidence. Future CPGs must consider recommendations with better grading of evidence aiming patient-centered care and nurse decision models that can potentially represent better AVF cannulation outcomes.
Mind Over Matter: Confronting Challenges in Post-Mortem Brain Biobanking for Glioblastoma Multiforme
Authors: Griffin Cassandra , Vilain Ricardo , King Simon , Nixon Sandy , Gooley Alisha , Bray Samara , Lynam James , Walker Marjorie M , Scott Rodney J , Paul Christine
Published: April 2021

Over the past 10 years, there has been limited progress for the treatment of brain cancer and outcomes for patients are not much improved. For brain cancer researchers, a major obstacle to biomarker driven research is limited access to brain cancer tissue for research purposes. The Mark Hughes Foundation Brain Biobank is one of the first post-mortem adult brain banks in Australia to operate with protocols specifically developed for brain cancer. Located within the Hunter New England Local Health District and operated by Hunter Cancer Biobank, the boundaries of service provided by the Brain Bank extend well into the surrounding regional and rural areas of the Local Health District and beyond. Brain cancer biobanking is challenging. There are conflicting international guidelines for best practice and unanswered questions relating to scientific, psychosocial and operational practices. To address this challenge, a best practice model was developed, informed by a consensus of existing data but with consideration of the difficulties associated with operating in regional or resource poor settings. The regional application of this model was challenged following the presentation of a donor located in a remote area, 380km away from the biobank. This required biobank staff to overcome numerous obstacles including long distance patient transport, lack of palliative care staff, death in the home and limited rural outreach services. Through the establishment of shared goals, contingency planning and the development of an informal infrastructure, the donation was facilitated within the required timeframe. This experience demonstrates the importance of collaboration and networking to overcome resource insufficiency and geographical challenges in rural cancer research programmes.
Patient Satisfaction with HIV/AIDS Services in Health Centers of East Shoa Zone, Oromia, Ethiopia: A Cross-Sectional Study
Authors: Yilma Temesgen Aferu , Beedemariam Gebretekle Gebremedhin , Gedif Fenta Teferi
Published: April 2021

Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) is a major public health, social, and economic problem in Ethiopia. Even though the government is working to scale up Anti-Retroviral Therapy (ART) services, patient loss to follow-up and ensuring adherence to ART regimens remain major challenges of the ART program in the country; little has also been done on the assessment of patient satisfaction on different HIV/AIDS service dimensions. This study aimed at assessing patient satisfaction with HIV/AIDS services in health centers of East Shoa Zone, Oromia region, Ethiopia. The study employed a cross-sectional survey between February and May 2017. Data was collected through exit interviews using five-point Likert scale-based questions and analyzed using Statistical Package for Social Sciences (SPSS) version 20. The overall mean patient satisfaction score was 3.16 (SD = 0.87) on a 1 to 5 scale. Availability of anti-Tuberculosis (anti TB) drugs in pharmacy was an item with the highest mean satisfaction score (4.18 ± 0.61) while waiting time to get pharmacy service was ranked least by the patients (mean score of 1.92, SD = 0.81). Merchants and students were more likely to be satisfied compared to other occupational groups. Overall, there was a wider gap in the study facilities concerning patient satisfaction and, therefore, health facility managers, Zonal and Woreda health offices, and Oromia Region Health Bureau should work in collaboration with other stakeholders to improve patient satisfaction with items for which the satisfaction score was low.
Intersecting Stigmas among HIV-Positive People Who Inject Drugs in Vietnam
Authors: Do Mai , Ho Hien Thi , Dinh Ha Thu , Le Ha Hai , Truong Tien Quang , Dang Trung Vu , Nguyen Duong Duc , Andrinopoulos Katherine
Published: April 2021

HIV-related stigma remains a barrier to ART adherence among people living with HIV (PLWH) globally. People who inject drugs (PWID) may face additional stigma related to their behavior or identity; yet, there is little understanding of how these stigmas may co-exist and interact among these key populations. This study aims to explore the existence of multiple dimensions of HIV-related stigma, and how they may intersect with stigma related to drug injection. The study took place in Vietnam, where the HIV epidemic is concentrated among 3 key population groups; of those, PWID account for 41% of PLWH. The vast majority (95%) of PWID in Vietnam are male. Data came from in-depth interviews with 30 male PWID recruited from outpatient clinics, where they had been receiving ART medications. Deductive, thematic analysis was employed to organize stigma around the 3 dimensions: enacted, anticipated, and internalized stigma. Findings showed that HIV- and drug use-related stigma remained high among participants. All 3 stigma dimensions were prevalent and perceived to come from different sources: family, community, and health workers. Stigmas related to HIV and drug injection intersected among these individuals, and such intersection varied widely across types of stigma. The study revealed nuanced perceptions of stigma among this marginalized population. It is important for future studies to further investigate the influence of each dimension of stigma, and their interactive effects on HIV and behavioral outcomes among PWID.
Rituximab for treatment of refractory multiple sclerosis relapses during pregnancy
Authors: Hollen Chris , Rice Jessica , Park Michelle , Yadav Vijayshree
Published: April 2021

Case Summary: While multiple sclerosis (MS) disease activity declines during pregnancy, there are situations where MS relapses in pregnant women do occur. Mild relapses may be managed with close observation, but severe refractory relapses may require more aggressive management. We describe two cases of rituximab used for severe, refractory multiple sclerosis relapses during pregnancy. Rituximab did not appear to complicate either pregnancy and there were no further relapses for either women. Rituximab should not be overlooked in rare refractory cases, such as the rebound relapses sometimes seen following the discontinuation of lymphocyte-sequestering disease-modifying therapies.
The equalisation of the state pension age in United Kingdom: Indirect sex discrimination?
Authors: Roberts Pauline
Published: April 2021

This commentary examines the Court of Appeal’s decision in R (Delve and Glynn) v. Secretary of State for Work and Pensions, which concerned the judicial review of the incremental increase of the state pension age in the United Kingdom for women born in the 1950s. It focuses on the claims of discrimination contrary to Article 14 of the European Convention on Human Rights, in particular the discussion relating to indirect sex/sex and age discrimination. It is argued that there is scope for greater clarity in the Court’s reasoning which led to its conclusion that the measures did not result in indirect discrimination contrary to Article 14. However, the dismissal of each appeal is not surprising, in view of the adoption of the ‘manifestly without reasonable foundation’ test when scrutinising decisions relating to social welfare policy. In other words, even if the measures resulted in indirect sex discrimination, they were justified.
Moral distress in medicine: An ethical analysis
Authors: Kherbache Alexandra , Mertens Evelyne , Denier Yvonne
Published: May 2021

Moral distress is a negative emotional response that occurs when physicians know the morally correct action but are prevented from taking it because of internal or external constraints. Moral distress undermines a physician’s ethical integrity, leading to anger, poor job satisfaction, reduced quality of care and burnout. Scarce literature exists on the ethical aspects of moral distress in medicine. We conducted an ethical analysis of moral distress as experienced by physicians and analysed it from the literature using two predominant ethical theories: principlism and care ethics. Finally, we consider the emergence of moral distress in medicine during the COVID-19 pandemic.
‘No idea of time’: Parents report differences in autistic children’s behaviour relating to time in a mixed-methods study
Authors: Poole Daniel , Gowen Emma , Poliakoff Ellen , Jones Luke A
Published: April 2021

An emerging body of research suggests that temporal processing may be disrupted in autistic children, although little is known about behaviours relating to time in daily life. In the present study, 113 parents of autistic and 201 parents of neurotypical children (aged 7–12 years) completed the It’s About Time questionnaire and open-ended questions about their child’s behaviour relating to time. The questionnaire scores were lower in the autistic compared with the neurotypical group, suggesting that behaviours are affected. Three key themes were identified using thematic analysis: autistic children had problems with temporal knowledge, learning about concepts relating to time, such as how to use the clock and language around time. There were differences in prospection with autistic children having more difficulties with how they thought about the future and prepared themselves for upcoming events. The final theme, monotropism, described how autistic children viewed their time as precious so they could maximise engagement in their interests. The present study indicates that behaviours relating to time can have a considerable impact on the daily lives of autistic children and their families. Further work exploring the development of temporal cognition in autism would be valuable for targeting effective educational and clinical support.

Lay abstract

Many everyday activities require us to organise our behaviours with respect to time. There is some evidence that autistic children have problems with how they perceive and understand time. However, little is currently known about this, or the ways in which behaviours related to time are impacted in daily life. In this study, 113 parents of autistic children and 201 parents of neurotypical children completed a questionnaire and open-ended questions about their child’s behaviour relating to time. Questionnaire scores were lower in the autistic group compared with neurotypicals, which suggests that behaviours relating to time are affected in autistic children. The open-ended responses further confirmed that the autistic children struggled with time and that this impacted on them and their family. Three key themes were identified. Theme 1: autistic children have problems with learning about concepts relating to time such as telling the time from a clock and using words to describe time (hours, minutes, etc.) appropriately. Theme 2: autistic children think about the future differently. Planning and working under time pressure were described as a problem. Theme 3: autistic children have strong interests which take up a lot of their attention and worrying about having sufficient time to pursue these interests causes anxiety. This research indicates that behaviours related to time can have a considerable impact on the lives of autistic children and that targeted support may be required.
Klaus Mollenhauer: Emancipation, Bildung and six questions for education
Authors: Friesen Norm
Published: May 2021

Klaus Mollenhauer (1928–1998) is one of the most important German theorists of education in the postwar era. Mollenhauer is often remembered in Germany today for his first book titled Education and Emancipation: Polemical Sketches, but he received international renown for his final monograph, Forgotten Connections: On Culture and Upbringing. Although Mollenhauer characterized Forgotten Connections as actually working to move towards a more “substantial conception of emancipation,” many of his followers and colleagues such as Kaufmann et al. saw it as nothing less than an act of “infidelity to those who had taken on his emancipatory pedagogy” ( Kaufmann et al., 1991 : 86). In the light of these differences in emphasis and interpretation, this paper provides an overview of Forgotten Connections that (following Wivestad and Saevi) sees it as presenting six main questions and themes—ranging from “Why do we have children” to “How can we respect and draw out a child’s inherent character?” However, in doing so, this paper simultaneously traces Mollenhauer’s own efforts to develop a more substantial concept of personal and political emancipation in this text.
Evaluating the impact of Syrian refugees on fear of crime in Turkey
Authors: Akyuz Kadir , Akbas Halil , Onat Ismail
Published: May 2021

The forced migration of individuals and groups in the world has increased substantially amid extensive regional and international conflicts. A prime example is the continuing civil war in Syria, during which Turkey has become the host country for more Syrian refugees than any other country in the region. Research on fear of crime has focused mainly on fear of crime in general rather than on fear of crime being committed by specific groups of individuals with a shared identity. The current study used survey data to investigate the extent to which the general crime fear among Turkish citizens differs from their fear that Syrian refugees in the country may commit a crime. Consistent with theoretical assumptions of subgroup threats, the overall results of the study show that Turkish citizens’ relational discomfort with Syrians, their perception that Syrian refugees pose a security threat, and their encounters with Syrian refugees in their neighborhoods are significantly associated with the manifestation of fear of general and group-specific crime. Fear of both types of crime was higher among females, which is consistent with previous research; however, contrary to previous research, young people rather than elderly people were more fearful of crime.
Influencing the Intention to Adopt Anti-Littering Behavior: An Approach With Modified TPB Model
Authors: Singh Jagwinder , Kaur Ranjit
Published: May 2021

Background:

Littering has been identified as a major issue in India that has negative impacts on the environment as well as public health.

Focus of the article:

Guided by the Theory of Planned Behavior, this empirical study determines the influence of three major concepts namely attitude, subjective norms, and self-efficacy on the intention to adopt anti-littering behavior.

Research Hypotheses:

The hypotheses stipulate that attitude, subjective norms, and self-efficacy have a significant influence on the intention to perform anti-littering behavior.

Methods:

In total, 750 individuals were interviewed at 34 locations across the states of New Delhi and Punjab (India) in a field survey. The data have been analyzed through confirmatory factor analysis in AMOS 21.0 to classify the considerations of the antecedents of the intention according to their relative significance using the natural gaps in standardized regression weight values. Subsequently, path analysis has been used to test a series of hypotheses concerning the direct effects of attitude, subjective norms, and self-efficacy on the intention to adopt anti-littering behavior.

Results:

The findings of the study revealed that all three constructs; attitude, subjective norms, and self-efficacy have a significant influence on the intention to adopt anti-littering behavior. Subjective norms influence intention to the highest extent closely followed by attitude.

Recommendations for Research/Practice:

Social marketers are recommended to target subjective norms and attitude while designing social marketing interventions to promote anti-littering behavior.

Limitations:

One limitation of this study is the existing gap between self-reported behavioral intention and actual behavior.
Condorcet Loser in 2016: Apparently Trump; Condorcet Winner: Not Clinton?
Authors: Potthoff Richard F. , Munger Michael C.
Published: May 2021

Using thermometer score data from the ANES, we show that while there may have been no clear-cut Condorcet winner among the 2016 US presidential candidates, there appears to have been a Condorcet loser: Donald Trump. Thus the surprise is that the electorate preferred not only Hillary Clinton, but also the two “minor” candidates, Gary Johnson and Jill Stein, to Trump. Another surprise is that Johnson may have been the Condorcet winner. A minimal normative standard for evaluating voting systems is advanced, privileging those systems that select Condorcet winners if one exists, and critiquing systems that allow the selection of Condorcet losers. A variety of voting mechanisms are evaluated using the 2016 thermometer scores: Condorcet voting, plurality, Borda, (single winner) Hare, Coombs, range voting, and approval voting. We conclude that the essential problem with the existing voting procedure—Electoral College runoff of primary winners of two major parties—is that it (demonstrably) allows the selection of a Condorcet loser.
Why Some Blame Politics for Their Personal Problems
Authors: Baird Vanessa , Wolak Jennifer
Published: May 2021

Why do some people blame the political system for the problems in their lives? We explore the origins of these grievances and how people assign responsibility and blame for the challenges they face. We propose that individual differences in the personality traits of locus of control and self-esteem help explain why some blame the political system for their personal problems. Using responses from a module of the 2016 Cooperative Congressional Election Study, we show that those with low self-esteem and a weaker sense of control over their fates are more likely to blame the political system for the challenges they face in their lives. We also demonstrate that this assignment of blame is politically consequential, where those who intertwine the personal and the political are more likely to evaluate elected officials based on pocketbook economic conditions rather than sociotropic considerations.
Treatment and mechanism of fecal microbiota transplantation in mice with experimentally induced ulcerative colitis
Authors: Zhang Leichang , Ma Xiaofei , Liu Peng , Ge Wei , Hu Lixia , Zuo Zhengyun , Xiao Huirong , Liao Wu
Published: April 2021

Restoring intestinal microbiota dysbiosis with fecal microbiota transplantation is considered as a promising treatment for ulcerative colitis. However, the mechanisms underlying its relieving effects remain unclear. Ulcerative colitis pathogenesis is associated with the involvement of immune cells and inflammatory cytokines. Here, we aimed to investigate the effect of fecal microbiota transplantation on T cell cytokines in a dextran sulfate sodium-induced ulcerative colitis mouse model. Five-aminosalicylic acid (5-ASA) was used as the positive control. Male C57BL/6 mice were randomly assigned to control, model (UC), UC + FMT, and UC + 5-ASA groups. Each group consisted of five mice. The establishment of the mouse model was verified by fecal occult-blood screening and hematoxylin–eosin staining. Results showed that fecal microbiota transplantation reduced colonic inflammation, significantly decreased T helper (Th)1 and Th17 cells, interferon-gamma, interleukin-2 and interleukin-17, as well as significantly increased Th2 and regulatory T (Treg) cells, interleukin-4, interleukin-10, and transforming growth factor-beta, and improved routine blood count. Furthermore, 16S rRNA gene-sequencing analysis showed a significant increase in the relative abundance of genus Akkermansia and a significant decrease in the relative abundance of genus Helicobacter in the ulcerative colitis group. Fecal microbiota transplantation restored the profile of the intestinal microbiota to that of the control group. These findings demonstrated the capability of fecal microbiota transplantation in controlling experimentally induced ulcerative colitis by improving Th1/Th2 and Th17/Treg imbalance through the regulation of intestinal microbiota.