bluuebunny/crossref_metadata_2025 huggingface dataset:
Un-silencing an Experimental Technique: Listening to the Electrical Penetration Graph
Authors: Marshall Owen
Published: June 2021

In scientific work, sonification (i.e., the use of nonspeech audio to convey information) is primarily thought of as a novel way to communicate post hoc research findings to lay audiences but only rarely, if ever, as a component of the research itself. This article argues that, rather than any inherent epistemological limitations of sound as a medium of scientific reasoning, this framing reflects a sociohistorical tendency to “silence” experimental techniques as they become widely adopted—both in terms of the literal silencing of noisy instrumentation and the elision of the role of sound (along with other nonvisual sensory media) in received discovery accounts. This tendency is well-illustrated by the history of electrophysiology research, particularly the case of the electrical penetration graph (EPG), an instrument used by entomologists to study how insects feed on plants. Combining participant observation, interviews, and analysis of EPG technical literature, this article recovers the unacknowledged role of sound in EPG’s exploratory stages and gradual emergence as a standard laboratory technique as well as its gradual silencing as a consequence of this standardizing process.
Rethinking Science as a Vocation: One Hundred Years of Bureaucratization of Academic Science
Authors: Lee You-Na , Walsh John P.
Published: June 2021

One hundred years ago, in his lecture Science as a Vocation, Max Weber prefigured a transition from science as a calling to science as bureaucratically organized work. He argued that a calling for science is critical for sustaining scientific work. Using Weber’s arguments for science as a vocation as a lens, in this paper, we discuss whether a calling for science may become difficult to maintain in increasingly bureaucratized scientific work—and also whether such a calling is necessary for the advance of science. We present empirical evidence for this bureaucratization of scientific work and further develop Weber’s discussion of science by contrasting it with the views of other theorists of science and innovation. Finally, we discuss the implications of these theories, develop a set of policy recommendations, and outline a research agenda designed to develop science policies and a sociology of science that match this shift from vocation to bureaucracy in scientific work.
Natural resource wealth and the informal economy
Authors: Blanton Robert G , Peksen Dursun
Published: June 2021

The ‘resource curse’ associated with natural resource abundance has long been a subject of study across multiple disciplines. Though much research has focused on possible effects of resource wealth on the formal economy, little is known about how such wealth affects the informal sector, a substantial portion of global economic activity. We posit that resource windfalls directly contribute to growth in the informal economy, as investment and spending patterns associated with such revenues limit opportunities within the formal sector and thus channel more labor and businesses into the informal sector. We test these claims across a panel of over 120 countries for the period 1985 to 2012. Across multiple model specifications, we find that resource wealth growth is associated with increased informal economic activity.
Discordance Between Subjective and Objective Measures of Smell and Taste in US Adults
Authors: Jang Sophie S. , Choi Janet S. , Kim James H. , Kim Natalie , Ference Elisabeth H.
Published: June 2021

Objective

Examine the rates and factors associated with under‐ and overreporting of subjective changes in smell or taste as compared with objective measures.

Study Design

Cross‐sectional analysis.

Setting

National Health and Nutrition Examination Survey (2013‐2014).

Methods

We examined participants ≥40 years old who completed subjective questionnaires (smell, n = 3510; taste, n = 3089), validated objective 8‐odor pocket smell tests, and NaCl/quinine taste tests. Over‐ and underreporting was determined by the difference in subjective and objective results. Univariate and multivariate logistic regression analyses incorporated sampling weights.

Results

A majority of participants correctly classified impairment: smell (73.7%; 95% CI, 71.2%‐76.1%) and taste (78.3%; 95% CI, 75.6%‐80.7%). Age ≥65 years (odds ratio, 2.23; P =. 001) was associated with underreporting impairment, and persistent cold symptoms (odds ratio, 2.15; P =. 001) were associated with overreporting smell impairment. Smoke, onion, and natural gas scents were incorrectly identified more frequently by individuals aged ≥65 years after Bonferroni correction. No factors were associated with under‐ and overreporting taste impairment.

Conclusion

Although the concordance rate between subjective and objective assessment of smell and taste impairment remains high, we found that older age was associated with incorrect report of impairment. This suggests that the subjective perception of smell varies across demographical and clinical factors, and it is important to not overlook such factors in clinical practice. Potentially using a simplified odor assessment regularly in the clinical setting may aid in early detection and intervention.
Nutrition knowledge, food choices and diet quality of genotyped and non-genotyped individuals during the COVID-19 pandemic
Authors: Kapellou Angeliki , Silva Gabriela , Pilic Leta , Mavrommatis Yiannis
Published: June 2021

Background: Severe obesity (body mass index ≥ 40 kg/m2) and non-communicable diseases, both influenced by diet, have been associated with COVID-19. Genotype-based personalised nutrition advice may improve nutrition knowledge and enhance behaviour change towards better diet quality compared with conventional recommendations. Aim: To investigate the nutrition knowledge, food choices and diet quality in genotyped and non-genotyped individuals during the COVID-19 pandemic. Methods: One hundred and twenty-three healthy UK adults were recruited using convenience sampling through social networks. The online questionnaire consisted of the General Nutrition Knowledge Questionnaire, the Food Choices Questionnaire, and the EPIC-Norfolk Food Frequency Questionnaire (FFQ). FFQ was used to calculate participant diet quality with the Diet Quality Index-International and socio-demographic and anthropometric data. Results: Median general nutrition knowledge, diet variety and diet balance scores were higher in genotyped compared with non-genotyped individuals (71.0 ± 11.0 vs. 61.0 ± 15.0, p = <.001, 18.00 ± 5.00 vs. 15.00 ± 5.00, p = .007 and 2.00 ± 4.00 vs. 0.00 ± 2.00, p = .025, respectively). Pooled sample multiple regression showed that health motive positively influenced while familiarity motive negatively influenced diet quality index scores ( β = .428, t = 4.822, p = <.001 and β = –.356, t = –4.021, p = .001, respectively). Conclusions: Nutrition knowledge and diet quality indices of balance and variety were higher among genotyped compared with non-genotyped individuals; overall diet quality was similar between groups. This may be due to pandemic-specific factors, such as altered motives of food choice and availability.
Multiomic analysis of the function of SPOCK1 across cancers: an integrated bioinformatics approach
Authors: Han Jie , Rong Yihui , Gao Xudong
Published: June 2021

Objective

To investigate SPARC (osteonectin), cwcv and kazal like domains proteoglycan 1 ( SPOCK1) gene expression across The Cancer Genome Atlas (TCGA) cancers, both in cancer versus normal tissues and in different stages across the cancer types.

Methods

This integrated bioinformatics study used data from several bioinformatics databases (Cancer Cell Line Encyclopedia, Genotype-Tissue Expression, TCGA, Tumor Immune Estimation Resource [TIMER]) to define the expression pattern of the SPOCK1 gene. A survival analysis was undertaken across the cancers. The search tool for retrieval of interacting genes (STRING) database was used to identify proteins that interacted with SPOCK1. Gene Set Enrichment Analysis was conducted to determine pathway enrichment. The TIMER database was used to explore the correlation between SPOCK1 and immune cell infiltration.

Results

This multiomic analysis showed that the SPOCK1 gene was expressed differently between normal tissues and tumours in several cancers and that it was involved in cancer progression. The overexpression of the SPOCK1 gene was associated with poor clinical outcomes. Analysis of gene expression and tumour-infiltrating immune cells showed that SPOCK1 correlated with several immune cells across cancers.

Conclusions

This research showed that SPOCK1 might serve as a new target for several cancer therapies in the future.
Factors associated with microvascular occlusion in patients with ST elevation myocardial infarction after primary percutaneous coronary intervention
Authors: Huang Yinhao , Lei Dazhou , Chen Ziwei , Xu Biao
Published: June 2021

Objective

This study aimed to determine predictors of microvascular occlusion (MVO) in patients with ST elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (pPCI).

Methods

This retrospective, observational study consecutively included 113 patients with STEMI undergoing pPCI. Cardiac magnetic resonance imaging was used to determine the presence of MVO in these patients. Biomarkers in serum were routinely tested 1 day after pPCI. Multivariable logistic regression analysis was used to evaluate significant predictors of occurrence of MVO.

Results

There were 62 patients in the MVO group and 51 patients in the non-MVO group. C-reactive protein (CRP), thrombomodulin, lymphatic vessel endothelial hyaluronan receptor-1, syndecan-1, and troponin T (TnT) levels after the procedure were significantly higher in the MVO group than in the non-MVO group. CRP (hazard ratio [HR]=1.036), TnT (HR=1.316), and syndecan-1 (HR=1.986) levels were independently associated with MVO in patients with acute myocardial infarction after pPCI.

Conclusions

Levels of CRP, TnT, and syndecan-1 can be used as serum biomarkers for MVO in patients with STEMI receiving pPCI.
Improving outcomes of surgery in advanced infiltrative thymic tumours: the benefits of multidisciplinary approach
Authors: Billè Andrea , Bilkhu Rajdeep , Benedetti Giulia , Lucchese Gianluca
Published: June 2021

Background:

For stage III or IVa thymic tumours, a multimodality approach is recommended. The role of surgery is to achieve complete resection.

Aim:

To present the outcomes of patients undergoing surgery for stage III or IVa thymoma.

Methods:

Retrospective review of patients undergoing open surgery for stage III or IVa thymoma between 2016 and 2020 at a single centre was performed. Preoperative imaging, treatment plan, surgical approach, and postoperative outcomes were analyzed.

Results:

Forty-seven patients underwent surgery for thymoma. Patients with clinical stage I/II thymoma or minimally invasive thymectomy were excluded. Thirteen patients with clinical stage III or IVa were included. Median sternotomy approach was used in four patients, of which one was redo sternotomy; a hemi-clamshell in four; and a combination of approaches in the remaining five patients. There was no postoperative mortality. Four patients had postoperative complications. Complete resection was achieved in all but two patients. At a median follow-up of 17.9 months, all patients were alive with no evidence of recurrence except one who died 4 months after surgery from coronavirus disease 2019 (COVID-19) pneumonia.

Conclusions:

Surgery for stage III and IVa thymoma is safe and can be achieved with complete macroscopic resection. To obtain adequate exposure of all structures involved in the tumour, combined surgical approaches can be used with no increased morbidity. The majority of patients, even after extrapleural pneumonectomy, did not receive adjuvant radiotherapy and had no evidence of local relapse.
White Managers, Ethnoracism, and the Production of Black Ethnic Labor Market Disparities
Authors: Adesina Ifatunji Mosi
Published: June 2021

Few have considered the role of White managers in longstanding Black ethnic labor market disparities. Drawing on ethnoracism theory, I conceptualize the previously documented White manager preference for Afro Caribbeans as a form of prejudice that contributes to the relative success of Afro Caribbeans. White managers say they prefer Afro Caribbeans because they work harder and are less racially antagonistic than African Americans. However, using the National Survey of American Life, I show that these populations are virtually indistinguishable in terms of labor quality and racial attitudes. Moreover, net labor quality and racial attitudes, the incomes of English and non-English speaking Afro Caribbeans are greater when working for White managers, but African Americans with White managers receive no greater income than those without a White manager. I conclude with a call for the formal development of a new ontological framework for the study of these kinds of ethnoracially dynamic relationships.
Recommendations for the Management of Incidental Pancreatic Findings in Adults by the Canadian Association of Radiologists Incidental Findings Working Group
Authors: Fung Christopher I. , Bigam David L. , Wong Clarence K. W. , Hurrell Casey , Bird Jeffery R. , Brahm Gary L. , Kirkpatrick Iain D. C.
Published: June 2021

The Canadian Association of Radiologists Incidental Findings Working Group consists of both academic subspecialty and general radiologists and is tasked with adapting and expanding upon the American College of Radiology incidental findings white papers to more closely apply to Canadian practice patterns, particularly more comprehensively dealing with the role of ultrasound and pursuing more cost-effective approaches to the workup of incidental findings without compromising patient care. Presented here are the 2021 Canadian guidelines for the management of pancreatic incidental findings. Topics covered include anatomic variants, fatty atrophy, pancreatic calcifications, ductal ectasia, and management of incidental pancreatic cysts.
Heliox for Pediatric Critical Asthma: A Multicenter, Retrospective, Registry-Based Descriptive Study
Authors: Lew Alicia , Morrison John M. , Amankwah Ernest , Sochet Anthony A.
Published: June 2021

Background:

In cases of critical asthma (CA), heliox may be applied as an adjunctive rescue therapy to avoid invasive mechanical ventilation (MV), improve deposition of aerosolized medications, and enhance laminar airflow through obstructed airways. Using the Pediatric Health Information System (PHIS) registry, we evaluate heliox prescribing and explored for differences in MV rates and hospital length of stay (LOS) among children with and without heliox exposure.

Methods:

We performed a retrospective cohort study using PHIS data from 42 pediatric intensive care units among children 5-17 years of age admitted for CA from 2010 through 2019. Primary outcomes were heliox prescribing rates and trends. Secondary outcomes were invasive MV rates and LOS assessed in a subgroup of children receiving ≥ 1 adjunctive intervention(s).

Results:

Of the 19,780 studied, heliox was prescribed in 12.5% and linearly declined from 16.1% in 2010 to 5.6% in 2019. The overall MV rate was 12.8% and was lower in subjects receiving heliox alone (4.9%) compared to heliox plus alternative adjunctive therapies [31.2%] or children receiving non-heliox adjunctive therapies [22.1%], P < .01). Accounting for MV, no difference in LOS was observed. In exploratory adjusted models, MV free hospitalization was associated with heliox-only exposure (OR: 0.33, 95% CI: 0.17-0.63, P < .01) and exposure to multiple adjunctive therapies was associated with MV (OR: 2.48, 95% CI: 1.56-3.94, P < .01).

Conclusions:

In this multicenter retrospective study from 42 children’s hospitals, heliox prescribing for CA declined over the last decade. Subjects receiving multiple adjunctive therapies more commonly required invasive MV perhaps indicating a greater severity of illness. At this time, prospective trials needed to identify the role of heliox for pediatric CA.
Patient-Specific Risk Factors Associated With the Development of Hyperchloremia in a Neurocritical Care Intensive Care Unit
Authors: Hamilton Leslie A. , Behal Michael L. , Carter Ashley R. , Rowe A. Shaun
Published: June 2021

Background:

Hypertonic sodium chloride (HTS) is used in intensive care unit (ICU) settings to manage cerebral edema, intracranial hypertension, and for the treatment of severe hyponatremia. It has been associated with an increased incidence of hyperchloremia; however, there is limited literature focusing on hyperchloremic risk in neurologically injured patients. Objective: The primary objective of this study was to determine risk factors associated with development of hyperchloremia in a neurocritical care (NCC) ICU population.

Methods:

This was a retrospective case-control study performed in an adult NCC ICU and included patients receiving HTS. The primary outcome was to evaluate patient characteristics and treatments associated with hyperchloremia. Secondary outcomes included acute kidney injury and mortality.

Results:

Overall, 133 patients were identified; patients who were hyperchloremic were considered cases (n = 100) and patients without hyperchloremia were considered controls (n = 33). Characteristics and treatments were evaluated with univariate analysis and a logistic regression model. In the multivariate model, APACHE II Score, initial serum osmolality, total 3% saline volume, and total 23.4% saline volume were significant predictors for hyperchloremia. In addition, patients with a serum chloride greater than 113.5 mEq/L were found to have a higher risk of acute kidney injury (AKI) (adjusted OR 3.15; 95% CI 1.10-9.04).

Conclusions:

This study demonstrated APACHE II Score, initial serum osmolality, and total 3% and 23.4% saline volumes were associated with developing hyperchloremia in the NCC ICU. In addition, hyperchloremia is associated with an increased risk of AKI.
Numerical assessment of natural respiration and particles deposition in the computed tomography scan airway with a glomus tumour
Authors: Singh Digamber
Published: June 2021

The human respiratory tract has a complex airflow pattern. If any obstruction is present in the airways, it will change the airflow pattern and deposit particles inside the airways. This is the concern of breath quality (inspired air), and it is decreasing due to the unplanned production of material goods. This is a primary cause of respiratory illness (asthma, cancer, etc.). Therefore, it is important to identify the flow characteristics in the human airways and airways with a glomus tumour with particle deposition. A numerical diagnosis is presented with an asymmetric unsteady-state light breathing condition (10 l/min). An in vitro human respiratory tract model has been reconstructed using computed tomography scan techniques and an artificial glomus tumour developed 2 cm above a carina on the posterior wall of the trachea. The transient flow characteristics are numerically simulated with a realizable (low Reynolds number) k–ɛ turbulence model. The flow disturbance is captured around the tumour, which influenced the upstream and downstream of the flow. The flow velocity pattern, wall shear stress and probable area of inflammation (hotspot) due to suspended particle deposition are determined, which may assist doctors more effectively in aerosol therapy and prosthetics of human airways illness.
Using Climate-HIV to describe real-world clinical outcomes for people living with HIV taking dolutegravir-based regimens
Authors: Okoli Chinyere , Schwenk Achim , Radford Matthew , Myland Melissa , Taylor Stephen , Barnes Justine , Fox Ashini , Darley Alison , Grimson Fiona , Reeves Iain , Munshi Sajid , Croucher Adam , Boxall Naomi , Paice Alistair , van Wyk Jean , Benn Paul
Published: June 2021

Objectives:

The objective of this study was to describe the real-world use and effectiveness of dolutegravir-based regimens (DBRs) in routine clinical practice in the United Kingdom.

Methods:

Retrospective analysis was conducted using data from four National Health Service trusts using Climate-HIV, an electronic case record system. Eligible patients were aged ≥18 years with HIV-1 infection who were prescribed a DBR from December 2012 to March 2018. Outcome measurements were accessed at DBR initiation and at weeks 24, 48 and 96 and the last recorded visit up to the extraction date (last measurement). The primary endpoint was the proportion of patients with HIV-1 RNA <50 copies/mL at Week 48.

Results:

The study cohort included 934 patients; 337 (36%) were female, 414 (47%) were white and 717 (77%) were treatment experienced (TE). The Kaplan–Meier estimated probability of achieving HIV-1 RNA <50 copies/mL at 48 weeks was 96% for treatment-naive (TN) patients and 86% for TE patients. Median times to viral suppression (<50 copies/mL) were 49 and 57 days for TN and TE patients with detectable baseline viral load, respectively, according to Kaplan–Meier analysis. Median follow-up time was 377 days (interquartile range: 131–683). At last measurement, 87% (809/934) of patients remained on a DBR; among those patients, 681 (84%) had HIV-1 RNA <50 copies/mL.

Conclusions:

High levels of virologic suppression and low rates of discontinuation of DBRs were seen in a large, diverse, UK-based population with HIV-1 infection. These findings are broadly consistent with efficacy data from phase III studies.
Mindfulness and Motivation: A Process View Using Self-Determination Theory
Authors: Ryan Richard M. , Donald James N. , Bradshaw Emma L.
Published: June 2021

Mindfulness and motivation are both highly researched topics of great consequence for individual and social wellness. Using the lens of self-determination theory, we review evidence indicating that mindfulness is differentially related to different types of motivations, playing a facilitating role for highly autonomous forms of motivation, but not for externally controlled or introjected (self-controlling) forms of motivation. A key contribution of this review is our contention that mindfulness confers a range of intra- and interindividual benefits (e.g., well-being and prosociality) in part through its relation to autonomous motivations, a claim for which we outline preliminary evidence. Finally, we discuss how future research connecting mindfulness and motivation is important for both fields of study, for applied practices in areas such as psychotherapy and business, and for enhancing understanding of the processes underlying human wellness.
The Double-Edged Sword of Loyalty
Authors: Berry Zachariah , Lewis Neil A. , Sowden Walter J.
Published: June 2021

Loyalty has long been associated with being moral and upstanding, but recent research has begun documenting how loyalty can lead people to do unethical things. Here we offer an integrative perspective on loyalty and its outcomes. We suggest that a variety of bottom-up and top-down psychological processes lead individuals to be loyal to people and organizations they have obligations to, and that these processes operate in ways that reduce the cognitive dissonance experienced when loyalties conflict with each other or with other moral principles. In this article, we articulate what loyalty is, describe the typical objects of loyalty, explain the mental processes involved in navigating loyalty dilemmas, and end by offering an integrative perspective that illuminates why loyalty leads to both ethical and unethical outcomes and when each type of outcome is likely to occur.
Battleships, D-Day, and naval strategy
Authors: Benbow Tim
Published: June 2021

This article explores the role of the battleship in naval strategy, challenging the contention that they were obsolete before the end of World War II, using the D-Day landings of June 1944 as its focus. It argues that battleships played two indispensable roles. First, they countered the threat from enemy capital ships, both to achieve command of the sea and to protect the invasion fleet. Second, they provided fire support both for the initial assault and also thereafter in defending the bridgehead and assisting the Allied advance, thereby contributing to the collapse of the German strategy for defence.
Using Number Talks to Support Students With High-Incidence Disabilities in Mathematics
Authors: Bouck Emily C. , Bouck Mary K.
Published: June 2021

Number talks are increasingly used in general education mathematics classes to engage students. Yet despite the potential benefits, number talks are given limited attention for students with high-incidence disabilities in special education settings. This article presents special education teachers with both the why and, more important, the how for implementing number talks to support students with high-incidence disabilities in special education settings. Specifically, the authors address how number talks can serve as both a formative assessment and an intervention for fluency and activating students’ background knowledge to be successful in general education settings. The article also provides suggestions for implementing number talks with fidelity and flexibility (e.g., use of manipulatives, pictorial representations, and teacher explicit instruction of numerical strategies).
Modified Z-Palatoplasty for Correction of Acquired Nasopharyngeal Stenosis Following Palatal Surgery: A Case Series
Authors: Eesa Mohamed , Hendawy Ehsan , El-Anwar Mohammad Waheed
Published: June 2021

Objectives:

To evaluate the efficacy of a novel surgical technique in management of nasopharyngeal stenosis (NPS), describing its steps and results. Study Design: Prospective clinical trial.

Setting:

This study was conducted at the Otolaryngology, Head and Neck Surgery Department, Zagazig University.

Methods:

This prospective study was conducted on patients with snoring ± obstructive sleep apnea due to acquired postsurgical NPS of grade Ι and ΙΙ. New surgical repair was employed on the patients and the pre and postoperative results were statistically compared.

Results:

The grade of NPS improved significantly postoperatively ( P = .00136) throughout a follow-up of 1 year. Postoperatively, there was statistically significant improvement of apnea hypopnea index ( P = .0005), Visual Analog Scale (VAS) of nasal obstruction ( P < .0001) and VAS of snoring ( P < .0001). Dysphagia showed early worsening, but it improved completely at 3 months postoperatively.

Conclusion:

The utilized novel procedure appears effective, low cost, and easily applicable, and it does not require implants, special tools, or suture materials. Furthermore, it gives excellent results, with negligible pain, and rapid recovery without significant complications.

Level of Evidence:

4.
Does the Type of MRI Sequence Influence Perceived Quality and Measurement Consistency in Investigations of the Anatomy of the Velopharynx?
Authors: Perry Jamie L. , Haenssler Abigail E. , Kotlarek Katelyn J. , Chen Joshua Y. , Fang Xiangming , Guo Yifan , Mason Kazlin , Webb Michael
Published: June 2021

Purpose:

The purpose of this study was to evaluate perceived image quality, confidence in identifying key velopharyngeal landmarks, and reliability of making velopharyngeal measures between 3-dimensional (3-D) and 2-D magnetic resonance imaging (MRI) methods and between T1-, T2-, and proton density (PD)-weighted sequences.

Methods:

Twelve healthy participants completed an MRI study. Three raters assessed overall image quality and their ability to identify key anatomic features within the images. A single rater evaluated the reliability of making measures between imaging methods and sequence types to determine if image type (2-D and 3-D) or image sequence (T1, T2, PD weighted) resulted in different values for key velopharyngeal landmarks.

Results:

An analysis of variance test revealed image quality was rated significantly different based on the scan type ( P < .001) and the sequence used ( P = .015). Image quality was rated higher among 2-D MR images compared to 3-D, and higher among T2 sequences compared to T1- and PD-weighted imaging methods. In contrast, raters favored 3-D sequences over 2-D sequences for identifying velopharyngeal landmarks. Measures of reliability revealed scan type significantly impacted 2 of the 6 variables but to a minimal degree; however, sequence type had no impact on measures of reliability across all variables.

Conclusion:

Results of the study suggest the scan type and sequence used are factors that likely do not impact the reliability of measures. Based on image quality, the recommended technique for velopharyngeal imaging would be using a 2-D T2-weighted technique. However, based on the ability to identify key landmarks, a 3-D T1- or PD-weighted technique was favored.
Construction and Validation of a Nomogram for the Preoperative Prediction of Lymph Node Metastasis in Gastric Cancer
Authors: Li Shilong , Zhao Zongxian , Yang Huaxiang , Wang Daohan , Sun Weilin , Li Shuliang , Zhang Zhaoxiong , Fu Weihua
Published: June 2021

Background:

Increasing evidence indicated that the tumor microenvironment (TME) plays a critical role in tumor progression. This study aimed to identify and evaluate mRNA signature involved in lymph node metastasis (LNM) in TME for gastric cancer (GC).

Methods:

Gene expression and clinical data were downloaded from The Cancer Genome Atlas (TCGA). The ESTIMATE algorithm was used to evaluate the TME of GC. The heatmap and Venn plots were applied for visualizing and screening out intersect differentially expressed genes (DEGs) involved in LNM in TME. Functional enrichment analysis, gene set enrichment analysis (GSEA) and protein-protein interaction (PPI) network were also conducted. Furthermore, binary logistic regression analysis were employed to develop a 4-mRNAs signature for the LNM prediction. ROC curves were applied to validate the LNM predictive ability of the riskscore. Nomogram was constructed and calibration curve was plotted to verify the predictive power of nomogram.

Results:

A total of 88 LNM related DEGs were identified. Functional enrichment analysis and GSEA implied that those genes were associated with some biological processes, such as ion transportation, lipid metabolism and thiolester hydrolase activity. After univariate and multivariate logistic regression analysis, 4 mRNAs (RASSF2, MS4A2, ANKRD33B and ADH1B) were eventually screened out to develop a predictive model. ROC curves manifested the good performance of the 4-mRNAs signature. The proportion of patients with LNM in high-risk group was significantly higher than that in low-risk group. The C-index of nomogram from training and test cohorts were 0.865 and 0.765, and the nomogram was well calibrated.

Conclusions:

In general, we identified a 4-mRNAs signature that effectively predicted LNM in GC patients. Moreover, the 4-mRNAs signature and nomogram provide a guidance for the preoperative evaluation and postoperative treatment of GC patients.
Excitation performance enhancement based on optimization of structural parameters of precision-controllable vibrator
Authors: Huang Zhiqiang , Wang Ruhao , Li Gang , Zhang Kai
Published: June 2021

This paper focuses on solving the problem of poor excitation performance of precision- controllable vibrator leading to shallow exploration depths, which cannot fully meet the current demand for deep oil and gas resources exploration. For this purpose, the evaluation parameters of the excitation performance of the precision-controllable vibrator are clarified, an optimization model of the structure parameters of the precision-controllable vibrator is established. Particle swarm algorithm and Pareto optimization logic are used to integrate the solution set to optimize the structure of precision-controllable vibrator and enhance the excitation performance of precision-controllable vibrator.
Localised, regional, inter-regional and national memory politics: The case of Spain’s La Ranilla prison and Andalusia’s mnemonic framework
Authors: Hepworth Andrea
Published: June 2021

The article takes as its point of departure the memory initiatives centring on the former Provincial Prison of Seville in Spain, better known as La Ranilla, and the Law on Historic and Democratic Memory of Andalusia, enacted by the regional government of Andalusia in March 2017. The study examines the local and inter-regional entanglement of memories of collectives, such as local neighbourhood associations, trade unions and Francoist political prisoners and their impact on regional and national memory policies. I argue that regional communities such as Andalusia and other autonomous regions have developed distinct regional collective identities and memories and are hence extending and/or opposing national memory politics by drawing on select localised, inter-regional and global paradigms, evident in the production of counter-narratives by regional governments. The study aims to provide new perspectives for understanding the combination and limitations of localised, regional, inter-regional and national memory politics in regional communities. The conclusion examines the limits to regional justice initiatives when opposing state laws such as the 1977 Amnesty Law.
Development and pilot evaluation of an educational programme on infection prevention and antibiotics with English and Scottish youth groups, informed by COM-B
Authors: Hayes Catherine V , Eley Charlotte V , Ashiru-Oredope Diane , Hann Magda , McNulty Cliodna AM
Published: June 2021

Background:

The UK 5-year antimicrobial resistance (AMR) National Action Plan highlights the need to prevent community infections through education of children. Activities around infection prevention (IP) and antibiotics were piloted by UK youth groups in 2016–2018, prompting Public Health England (PHE) to develop a standardised programme. The aim of the study was to develop and pilot an educational programme on IP and antibiotics for use by community youth groups in the UK.

Methods:

A working group, including youth group volunteers interested in IP and AMR, agreed on the programme content through consensus, informed by the Capability, Opportunity, Motivation, Behaviour model (COM-B). The Antibiotic Guardian Youth Badge (AGYB) included learning through interactive e-Bug activities on IP and prudent antibiotic use, action setting through Antibiotic Guardian pledges and consolidation through poster development. The programme was piloted and evaluated with conveniently recruited youth groups in 2019, including quantitative and qualitative questionnaire feedback from community leaders and children.

Results:

Fourteen youth group leaders and 232 children from uniformed Girlguiding/Scout groups in England and Scotland participated in the pilot evaluation, as well as two primary schools. Leaders reported alignment to the themes of their youth organisation, but struggled to teach antibiotics and antibiotic resistance. Children reported enjoyment and intentions to improve hygiene behaviour.

Conclusion:

Community youth groups are a suitable setting for IP and antibiotics education. The AGYB was officially launched in March 2020 and promoted for use with home-schooling children and remote youth group meetings to educate about IP during the coronavirus disease 2019 (COVID-19) pandemic.
Reduction of central line-associated bloodstream infections in a large acute care hospital in Midwest United States following implementation of a comprehensive central line insertion and maintenance bundle
Authors: Wei Abraham E , Markert Ronald J , Connelly Christopher , Polenakovik Hari
Published: June 2021

Background:

Central line-associated bloodstream infection (CLABSI) is a preventable medical condition that results in increased patient morbidity and mortality. We describe the impact of various quality improvement interventions on the incidence of CLABSI in an 848-bed community teaching hospital from 1 January 2013 to 31 December 2017.

Aim:

To reduce CLABSI rates after implementation of a comprehensive central line insertion and maintenance bundle.

Methods:

A comprehensive bundle of interventions was implemented incorporating the standard US Centers for Disease Control and Prevention bundle with additional measures such as root-cause analysis of all CLABSI cases, use of passive disinfection caps on vascular access ports, standardisation of weekly central venous catheter (CVC) site dressing changes, and use of antithrombotic and antimicrobial-coated CVCs with fewer lumens. A retrospective study evaluated CLABSI rates and time of CLABSI onset after CVC placement in both intensive care unit (ICU) and non-ICU settings.

Results:

The annual number of CLABSI cases declined 68% (34 to 11 patients) from 2013 to 2017. There was a 30% decline in CVC days from years 2014 to 2017. Over the same period, CLABSI cases per 1000 CVC days decreased from 0.624 to 0.362: a 42% decline.

Conclusion:

Following the implementation of a comprehensive bundle of interventions for CVC insertion and maintenance, we found a reduction in rates of CLABSI.
Prevalence, prescriptions, outcomes and costs of type 2 diabetes patients with or without prior coronary artery disease or stroke: a longitudinal 5-year claims-data analysis of over 7 million inhabitants
Authors: Maggioni Aldo Pietro , Dondi Letizia , Andreotti Felicita , Ronconi Giulia , Calabria Silvia , Piccinni Carlo , Pedrini Antonella , Esposito Imma , Martini Nello
Published: June 2021

Aims:

To analyze the prevalence, comorbidities, outcomes and costs of type 2 diabetes mellitus (T2DM) patients with and without coronary artery disease (CAD) or stroke in a population of over 7 million inhabitants.

Methods:

T2DM patients were identified in 2015 (accrual period) from the Ricerca e Salute (ReS) database linking administrative records to demographics. Based on 2013–2015 information, four cohorts were considered: #1 with CAD and/or stroke; #2 without CAD and/or stroke; #3 with chronic CAD but no myocardial infarction or stroke; #4 with chronic CAD undergoing percutaneous coronary interventions (PCI). Hospitalizations, drugs and other outpatient care were assessed from 2015 to 2017.

Results:

The prevalence of T2DM was 6% (441,085/7,365,954). CAD and/or stroke in the previous 3 years affected 7.5% of T2DM patients (33,153); this cohort was generally older, of male sex, with more comorbidities, prescriptions, and hospital admissions (50.5% versus 13.4% during the first follow-up year) compared to cohort #2. Yearly costs were over three-fold for cohort #1 versus #2, main drivers being hospitalizations in the former and drugs in the latter. Two-year cardiovascular events were recorded significantly more commonly in cohort #4 compared to the other cohorts. Guideline-recommended lipid-lowering therapy was <80% in all but cohort #4.

Conclusions:

The present analysis points to three areas of potential improvement in T2DM management: (a) guideline-recommended treatment patterns of T2DM patients; (b) three-fold recurrences and costs in T2DM patients with, compared to those without, prior cardiovascular events; (c) high event rates associated with chronic CAD and PCI, warranting specific studies aimed at improved prevention.
Perioperative management with biologics on severe aortic valve regurgitation caused by Behçet syndrome: the experience from a single center
Authors: Sun Luxi , Liu Jinjing , Jin Xiufeng , Wang Zhimian , Li Lu , Bai Wei , Yang Yunjiao , Wu Chanyuan , Chen Wei , Xu Shangdong , Zheng Jun , Zheng Wenjie
Published: June 2021

Background:

To investigate the efficacy and safety of biologics in the perioperative management of severe aortic valve regurgitation (AR) caused by Behçet syndrome (BS).

Methods:

We retrospectively analyzed 20 patients with severe AR caused by BS who were all treated with biologics during the perioperative period of cardiac surgeries in our center between February 2016 and October 2020.

Results:

A total of 20 patients with severe AR were enrolled, including 19 males and 1 female, with a mean age of 39.1 ± 8.8 years and a median course of 8 [interquartile range (IQR) 5.25–10.00] years. Before biologic administration, 92.9% of the patients who underwent aortic valve replacement had failed conventional therapy and developed postoperative paravalvular leakage (PVL) at a median interval of 4 months. Biologics were administered with background glucocorticoids (GCs) and immunosuppressants during the perioperative period for 22 aortic valve surgeries, including preoperatively with a median interval of 3.5 (IQR 2.75–4.25) months in 13 cases and within 3 months postoperatively in 9 cases. After a median follow up of 21 (IQR 15–32) months, 2 out of 13 cases (15.4%) preoperatively, and 1 out of 9 cases (11.1%) postoperatively treated with biologics developed PVL, and the rest were event free. The Behçet’s Disease Current Activity Form score improved significantly (7 versus 0, median, p < 0.0001). Decrease of erythrocyte sedimentation rate [25.0 (IQR 11.00–36.25) mm/h versus 6.5 (IQR 4.0–8.8) mm/h, p < 0.001], and C-reactive protein [20.77 (IQR 7.19–29.58) mg/l versus 1.53 (IQR 0.94–2.92) mg/l, p = 0.001] were achieved rapidly and effectively. The GC dosage tapered from 40 (IQR 30–60) mg/d to 10 (IQR 5–11.25) mg/d, p < 0.0001. Immunosuppressants were tapered in number and dosage in 6 (30%) and 20 patients (100%), respectively. No serious adverse event was observed.

Conclusion:

Our study suggests that biologics were effective and well tolerated for the perioperative management of severe and refractory AR caused by BS, which significantly reduced the occurrence of postoperative PVL and had favorable GC- and immunosuppressant-sparing effect.
Critical Role of General Practitioners in Preventing Readmission Following Emergency Department Alcohol Screening and Brief Intervention Management of Alcohol-Related Problems
Authors: Hazeldine Simon , Davies Imogen , Tait Robert J. , Olynyk John K.
Published: June 2021

Introduction/Objectives:

Alcohol screening and brief intervention (ASBI) strategies are useful in general practice (GP) but their effectiveness in the emergency department (ED) is unclear. We evaluated the effect of ED-based ASBI on re-admissions.

Methods:

453 ED subjects exceeding the threshold score on the three-item Alcohol Use Disorders Identification Test-Consumption (females 3+: males 4+) were randomized. We conducted telephone follow-up at 1 and 3 months and recorded hospital events 6 months pre- and post-enrolment.

Results:

Median weekly alcohol use was 20 standard drinks (interquartile range (IQR) 9-45) on enrolment. After 3 months, 247 (55%) were able to be re-interviewed. Median alcohol use was 10 drinks (IQR 4-26). Six months later, subjects receiving ED-ASBI without GP follow-up had significantly greater risk of re-admission compared with those having GP follow-up (OR 1.68, 95%CI 1.06-2.65; P = .028).

Conclusions:

ASBI reduces the likelihood of ED re-presentation only in subjects who have GP follow-up. The study has been registered as a clinical trial (Australian and New Zealand Clinical Trial Registry ACTRN12617001254381).
Testing the Theory of Communication and Uncertainty Management in the Context of Digital Transformation with Transformational Leadership as a Moderator
Authors: Matsunaga Masaki
Published: June 2021

Digital transformation provokes a great deal of uncertainty among employees. To gain insights into how employees manage the uncertainty driven by digital transformation and also how leaders can support them, this study has drawn on the theory of communication and uncertainty management (TCUM), which posits that the impact of uncertainty varies by how individuals appraise it and social support enhances positive appraisal. Based on those tenets, the current study advanced the following hypotheses: (a) uncertainty has direct and indirect negative effects on employees’ appraisal of digital transformation, self-efficacy, and job performance; (b) in contrast, direct supervisors’ transformational leadership has direct and indirect positive effects on appraisal, self-efficacy, and job performance; and also (c) transformational leadership moderates the impact of uncertainty. SEM with 4-wave time-separated data ( N = 873 employee-supervisor dyads in Japan) found support for these hypotheses. The obtained findings are discussed with reference to TCUM, transformational leadership, and other relevant literature.
Urban informality and the state: Repairing Cairo’s waters through Gehood Zateya
Authors: Wahby Noura M
Published: June 2021

Equitable and just access to urban water presents challenges for global policymakers. In Egypt, providing and maintaining access to water has always been associated with the state. Recently, however, in cities such as Cairo, water shortages have led to the inclusion of multiple actors in the complicated processes of water access and repair. This paper argues that the state’s hegemonic control over water governance is contested by increasingly blurred binaries of formal and informal everyday practices. I show how water governance in Cairo operates through a plurality of informal practices – gehood zateya (individual and community efforts) – which cross boundaries of class, legality and space. By drawing on theories of hybrid infrastructures and urban informality, water access and repair in Cairo emerge as relational processes shaped by socio-technical practices of state and non-state actors. This paper explores two case studies demonstrating the politicization of repair in a marginalized informal area and elite/middle-class gated communities. These cases illustrate how residents living in informal areas maintain relations with the state through community water systems and ‘cultures of repair’, while elite residents engage in ‘private governance’ schemes and rely on networks of privilege. This article offers insights into changing state-society relations during transitions to water privatization and the shaping of Cairo’s uneven urban waterscape.
Enhancing Social Entrepreneurship Education With Dark Side Theory to Frame Social Enterprises
Authors: Talmage Craig A. , Gassert T. Alden
Published: June 2021

Entrepreneurship, even social entrepreneurship, is not unequivocally good despite perceptions otherwise. This article puts forth a case for incorporating dark side theory into entrepreneurship education as a means of challenging this narrative. This article draws on Dart et al.’s ethical frames for social enterprise to supply students with a rubric to define, frame, and legitimize social enterprises. This article leverages Talmage et al.’s dark social enterprise typology and Talmage and Gassert’s exercise to critically analyze the social and economic intentions, processes, and impacts of various enterprises. Examples are provided throughout the article to illuminate how entrepreneurial intentions are linked to enterprise processes and impacts. The article aims to both broaden and deepen students’ critical perspectives on social enterprises, so that aspiring entrepreneurs are deterred from going dark side. This article concludes with essential questions concerning dark side theory’s role in entrepreneurship and social entrepreneurship education.