bluuebunny/crossref_metadata_2025 huggingface dataset:
traducción y la voz
Authors: Lobos Omar
Published: December 2020

La palabra “literatura” remite a la letra, pero, paradójicamente, el espesor emotivo de las palabras que es su materia fundamental solo se manifiesta como resonancia. Aquello “descartado”, que es la voz –la voz como sonido, como dicción, como mímica, como identidad–, tiene por su parte una relevancia extraordinaria en la configuración de la literatura rusa en general y en la de autores como Gógol, Dostoievski y Platónov en particular. El artículo ofrece una pequeña historización de la configuración de la lengua literaria rusa, caracteriza algunos aspectos estilísticos relacionados con la voz en autores emblemáticos, para reflexionar luego sobre la importancia de tomar en cuenta tales aspectos a la hora de traducir.
"Nuvem de calças"
Authors: Mei Letícia Pedreira
Published: December 2020

Apresentamos o longo poema lírico Nuvem de Calças (1915) do poeta Vladímir V. Maiakóvski e propomos a tradução poética anotada de sua segunda parte — voltada para a crítica da arte de seu tempo — do russo para o português brasileiro.
From Dostoevsky to Yeltsin
Authors: Maguire Muireann
Published: December 2020

This article proposes the metaphor of prizemlenie (landing) as a new investigative approach to Translation Studies. Prizemlenie refers to literary texts which ‘land’ in the target language’s literary field without acquiring wide readership or becoming integrated in the target culture. Focussing on literary translation from Russian to Irish, I survey the record of An Gúm, the Irish Free State’s official publishing organization, with regard to literary translation; undertake a close reading and case study of the first Irish-language translation of Dostoevsky in 1938; and examine the habitus of three of the most significant Russian-to-Irish literary translators. In conclusion, I argue that even the minimal cultural interaction sustained by prizemlenie plays an important role in preserving the target language.
Long‐Term Clinical Outcomes Following Revascularization in High‐Risk Coronary Anatomy Patients With Stable Ischemic Heart Disease
Authors: Bainey Kevin R. , Alemayehu Wendimagegn , Welsh Robert C. , Kumar Arnav , King Spencer B. , Kirtane Ajay J.
Published: December 2020

Background

The ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial failed to show a reduction in hard clinical end points with an early invasive strategy in stable ischemic heart disease (SIHD). However, the influence of left main disease and high‐risk coronary anatomy was left unaddressed. In a large angiographic disease‐based registry, we examined the modulating effect of revascularization on long‐term outcomes in anatomically high‐risk SIHD.

Methods and Results

9016 patients with SIHD with high‐risk coronary anatomy (3 vessel disease with ≥70% stenosis in all 3 epicardial vessels or left main disease ≥50% stenosis [isolated or in combination with other disease]) were selected for study from April 1, 2002 to March 31, 2016. The primary composite of all‐cause death or myocardial infarction (MI) was compared between revascularization versus conservative management. A total of 5487 (61.0%) patients received revascularization with either coronary artery bypass graft surgery (n=3312) or percutaneous coronary intervention (n=2175), while 3529 (39.0%) patients were managed conservatively. Selection for coronary revascularization was associated with improved all‐cause death/MI as well as longer survival compared with selection for conservative management (Inverse Probability Weighted hazard ratio [IPW‐HR] 0.62; 95% CI 0.58 to 0.66;
P
<0.001; IPW‐HR 0.57; 95% CI 0.53–0.61;
P
<0.001, respectively). Similar risk reduction was noted with percutaneous coronary intervention (IPW‐HR 0.64, 95% CI 0.59–0.70,
P
<0.001) and coronary artery bypass graft surgery (IPW‐HR 0.61; 95% CI 0.57–0.66;
P
<0.001).

Conclusions

Revascularization in patients with SIHD with high‐risk coronary anatomy was associated with improved long‐term outcome compared with conservative therapy. As such, coronary anatomical profile should be considered when contemplating treatment for SIHD.
COVID-19 PANDEMİSİNİN TÜRKİYE'DE EKONOMİK BÜYÜMEYE SEKTÖR-SPESİFİK ETKİLERİ: VAR ANALİZİ
Authors: KOYUNCU Tuğba , MEÇİK Oytun
Published: December 2020

Bu çalışmanın amacı ekonomideki sektörlerin pandemi sürecinde nasıl etkilendiği ve sektörler arasındaki etkileşimin nasıl olduğunu araştırmaktır. Bu amaç doğrultusunda Covid-19 pandemisinin oluşturduğu şokların sektörleri nasıl etkilediği VAR analizi yöntemi ile incelenmiştir. Çalışmada 2015 M:1- 2020 M:5 dönemi aylık verileri kullanılarak sanayi üretim endeksi, imalat sanayi kapasite kullanım oranı, inşaat sektörü maliyet endeksi, perakende ticaret ve hizmet sektörü, istihdam oranı, ihracat ve ithalat sektörü endeksi verileri analiz edilmiştir. Çalışma sonucunda Covid-19 pandemisi kapsamında incelenen dönem süresince sektörler arasında negatif bir şoka en geç tepki veren sektörün inşaat sektörü olduğu tespit edilmiştir. Sanayi sektörü, perakende ticaret ve hizmet sektörü ile imalat sektörünün ise olası şoklara en hızlı tepki veren sektörler arasında olduğu bulgusuna ulaşılmıştır.
YENİ TOPLUMSAL RİSKLER ÜZERİNDEN REFAH DEVLETİ ANALİZİ DENEMESİ
Authors: BEKEN Hikmet Gülçin
Published: December 2020

Refah devletleri 1970’lerden beri varlığına ve sürdürülebilirliğine yönelik önemli meydan okumalar, krizler ve eleştirilerle karşı karşıyadır. Refah devletlerinin başarılı bir performans gösterip göstermediği öncelikle refah devletinin temel amaç ve işlevleri üzerinden değerlendirilmelidir. Bireyler yaşam boyunca pek çok risk ile karşılaşmaktadır. Bu riskler karşısında yaşamlarını düzgün ve insani koşullar altında devam ettirebilmeleri refah devletinin kapsayıcılığı ve bu alanda sağladığı desteklerle ilgilidir. Ortaya çıkan yeni toplumsal riskler işgücü piyasası, demografik yapı gibi sanayi sonrası döneme ait koşullarda yaşanan değişim üzerinden birey-devlet ve piyasa bağlamında dönüştürücü olmaktadır. Refah devletinin kendisi de ortaya çıkan bu yeni toplumsal riskler karşısında yeni politikalar ve araçlar uygulamak zorundadır. Yeni toplumsal riskler genellikle refah devletine yönelik meydan okumanın ulusal/içsel bir kaynağı olarak ele alınırken küreselleşme süreci, çok uluslu şirketler ve uluslararası örgütlerin de dışsal bir faktör olarak ortaya çıkardığı etkiler unutulmamalıdır. Çalışma bu yeni toplumsal riskleri tanımlama amacıyla refah devleti-birey ilişkisinin ekonomik, sosyal ve politik alandaki değişimini incelemektedir.
The Horseshoe whip snake (Hemorrhois hippocrepis) on Ibiza: predator release in an invasive population
Authors: Montes Elba , Feriche Mónica , Alaminos Esmeralda , Pleguezuelos Juan Manuel
Published: December 2020

The key to fighting a biological invasion may lie in understanding every variable that can explain its success. The Enemy Release Hypothesis (ERH) states that when an invader arrives to a new environment, the absence of its common enemies (predators, parasites and competitors) facilitates the invasion success. The Horseshoe whip snake (Hemorrhois hippocrepis) has been recently introduced from the Iberian Peninsula to the island of Ibiza, and it is currently threatening the only endemic vertebrate, the Ibiza wall lizard (Podarcis pityusensis). We hypothesized that the snake invasion success is caused by the absence of natural predators, and we checked the ERH by relating the tail breakage rate to predation pressure. The invasive population showed a much lower incidence of tail breakage than the source population, which is in agreement with the almost absence of snake predators among the Ibizan reduced and naïve native vertebrate community. These results confirm the ERH, and support the prolongation of invasive snake trapping campaigns.
Entheogenic Experience and Spirituality
Authors: Johnstad Petter Grahl
Published: December 2020

Spiritual experiences with entheogens have usually been studied as a form of mystical experiences. However, entheogen users have also reported less intense experiences that they refer to as spiritual experiences. Using data from the Cannabis and Psychedelics User Survey, this study analyzed the characteristics of such experiences in 319 participants. It found evidence of two types of entheogenic experience that may be called spiritual. The first involved mystical-type characteristics and was predicted in multivariate linear regression models by the spirituality of the participants, operationalized as a spiritual affiliation, motivation, and practice. The second type involved characteristics representing insight, positive feelings, and improved connections to other people and to nature. This type of entheogenic experience was predicted by spiritual motivation, but not by spiritual affiliation or practices. The article discusses the implications of these findings, which may indicate competing conceptualizations of spirituality among the participants in the study.
Abdominal Wall Thickness is a Predictor for Surgical Site Infections in Patients Undergoing Colorectal Operations
Authors: Chang Yu-Wei W. , Murphy Kyle , Yackzan Daniel , Thomas Sarah , Kay Danielle , Davenport Daniel , Evers Bernard M. , Bhakta Avinash S.
Published: December 2020

Background

Surgical site infections (SSIs) are an established complication following colorectal operations, with rates up to 30% reported in the literature. Obesity is a known risk factor for SSI; however, body mass index (BMI), body fat percentage, waist-hip ratio, or abdominal circumference are imperfect measures. The purpose of our study was to determine whether abdominal wall thickness (AWT) is predictive of SSI.

Methods

We queried our American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) database for patients (age ≥18 years) undergoing a colectomy at the University of Kentucky (UK) from January 1, 2013 to December 31, 2018. The exclusion criteria included patients with open abdomens or the lack of preoperative computed tomography (CT) within 3 months of their operation. AWT was measured at the level of the anterior superior iliac spine (ASIS) on abdominal CT. SSI was defined by superficial SSI, deep SSI, and wound dehiscence.

Results

Of 1261 patients enrolled, 52.2% were female, with an average age of 57.4 years. More patients had laparoscopic operations (51%), and the median length of stay was 7 days. Our study demonstrated an SSI rate of 9.4% and a 30-day readmission rate of 11%. The overall mean AWT was 2.6 cm (range .1-13.1), and patients with the highest AWT quintile were more likely to develop an SSI than the lowest quintile (12% vs. 5%). After controlling for risk factors and confounders, the odds of an SSI were 3.6 times higher for patients with the highest AWT than patients with the lowest AWT.

Conclusions

Among colorectal surgery patients, AWT is an independent risk factor predictive for SSI.
Congenital Diaphragmatic Hernia: Demographics and 30-day Outcomes in Adults
Authors: Brungardt Joseph G. , Nix Quinn A. , Schropp Kurt P.
Published: December 2020

Background

Congenital diaphragmatic hernia (CDH) is a pathology most often affecting the pediatric population, although adults can also be affected. Few studies exist of adults undergoing repair of this defect. Using a national database, we sought to determine demographics and outcomes of this population.

Methods

An analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database (2015-2018) was performed, capturing patients with postoperative diagnosis of CDH, distinct from ventral hernia. Two groups were created based upon surgical approach of open or minimally invasive (MIS) repair. Baseline demographics and outcomes were compared.

Results

110 patients undergoing surgical correction of CDH were captured in the database. We found rates of return to the operating room (4.55%), postoperative respiratory failure (5.45%), and reintubation (3.64%) with no difference between groups. There was no mortality and no difference between groups in length of operation, discharge to home, or postoperative complications. Patients undergoing open repair had a longer length of stay than patients in the MIS group (6.47 ± 10.76 days vs. 3.68 ± 3.74 days, P = .0471). Mesh was used in MIS more often than the open group (47.30% vs. 5.56%, P < .0001).

Discussion

This study describes rates of postoperative complications in patients undergoing repair of CDH, and suggests outcomes those are equivalent between patients receiving open or MIS approaches. Further case series or retrospective studies are needed to further describe this population of patients.
Antibiotic Exposure Is Not Associated With Clearance of Bronchoalveolar Growth: Results From a Prospective Ventilator-Associated Pneumonia Study
Authors: Betzold Richard D. , Dennis Bradley M. , Bellister Seth A. , Guidry Christopher A. , Guillamondegui Oscar D. , Drake Wonder , May Addison K.
Published: December 2020

Background

Ventilator-associated pneumonia is poorly understood in trauma. Ventilated trauma patients can develop bacterial burden without symptoms; the factors that influence this are unknown.

Methods

Injured adults ventilated for > 2 days were enrolled. Mini-bronchoalveolar lavage was performed for 14 days or until extubation. Semi-quantitative cultures were blinded from clinicians. All cultures with > 104 colony forming units (CFU) were assessed for antibiotic exposure (ABXE) and spectrum of coverage. mBAL CFU was assessed daily.

Results

60 patients were ventilated for 9 days (median). There were 75 with > 104 CFU. 46 had > 104 CFU and no ABXE on the sample day. 74% had clearance or a decrease (CoD) in CFU without ABXE. 29 had > 104 CFU and ABXE on the sample day. 19 had ABXE with pathogen coverage. 84% had CoD in CFU. 10 had ABXE with no spectrum of coverage. 1/10 had increased CFU and the remaining 9/10 CoD in CFU. The three groups were not statistically different on chi-squared analysis.

Conclusion

Clearance of pathogens on surveillance cultures was unaffected by ABXE.
Definitive Repair of Injuries to the Liver During Initial Trauma Laparotomy
Authors: Hashavia Eyal , Goldstein Adam Lee , Nachmany Ido , Shimonov Abigail , Klausner Joseph M. , Soffer Dror
Published: December 2020

Introduction

Numerous surgical approaches and hemostatic techniques are used and have been described when operating on the traumatized liver. Despite a substantial decline in operative liver trauma, there still remains a debate on the optimal surgical approach, and goals, during the initial trauma laparotomy. Hepatic resection during the first operation, including the damage control settings, is advocated and practiced in only a select few institutions and remains highly controversial. Here, we describe our success with hepatic resection, repair, and/or hepatic vascular repair, during the trauma laparotomy with our emphasis on the collaboration between the trauma and hepatobiliary surgical teams.

Case Series

From 207 patients with liver injuries during the study period, 7 patients had definitive liver resection or repair during the initial trauma laparotomy. One had hepatic tissue repair, 1 had hepatic vein repair, and 5 had liver resections. All the operations involved a hepatobiliary surgeon together with the trauma team. There were no fatalities in the liver operation group, no sepsis, or need for emergent angiography because of hemorrhage. Four patients needed endoscopic retrograde cholangiopancreatography (ERCP) and stenting because of biliary leak. Three patients were discharged home and 4 to rehabilitation.

Discussion

Hepatic resection, and/or definitive hepatic repair, may be safe and beneficial to the patients during the initial operation even in a damage control setting when the patients’ overall condition allows. We emphasize the benefit of collaboration with experienced and trained liver surgery, especially in lower volume trauma centers. ERCP is commonly needed for postoperative biliary leak and should be readily utilized.
A Review of “First Rib Fracture: A Hallmark of Severe Trauma” (1975)
Authors: Flint Lewis
Published: December 2020

This review is submitted for inclusion in the literary festschrift in honor of J. David Richardson, MD.
Layla’s Got You: Developing a tailored contraception chatbot for Black and Hispanic young women
Authors: Bonnevie Erika , Lloyd Tiffany D , Rosenberg Sarah D , Williams Kara , Goldbarg Jaclyn , Smyser Joe
Published: December 2020

Introduction:

In Onondaga County, New York, around half of all births to Black and Hispanic teenage girls are unintended. The Layla’s Got You campaign consists of a chatbot and social media campaign designed to increase contraception knowledge among 16- to 25-year-old Black and Hispanic women in Onondaga County.

Methods:

The campaign was co-created with local women in the target audience and employed digital and grassroots community building strategies. Focus groups were conducted among 31 women, during which participants selected the campaign’s logo and chatbot name and created the tagline. Participants reviewed chatbot responses and designed Layla’s appearance and features, and Black/Hispanic women are featured in website and promotional photos. A community campaign manager pairs digital strategies with grassroots partnerships among a diverse group of stakeholders, including social media influencers, hair salons and health clinics.

Results:

Since implementation, the chatbot has received 4,390 messages related to contraception or sexual health. Across social media accounts, the campaign has showed 2,483,683 impressions, average daily reach of 1,710 for Facebook and 943 for Instagram, and 32,816 total engagements across all platforms.

Conclusion:

Layla’s Got You provides young women with a confidential place in which to find locally tailored and trustworthy information about contraception. By merging innovative technology-driven strategies, participatory creation techniques and grassroots community building, the initiative delivers impactful, easily updated health information on a large scale. This strategy has promising implications for increasing knowledge and positive attitudes towards contraception among specific at-risk audiences.
Methodology for Development of a Community Level Intervention Module for Physical Illness in Persons with Mental Illness (CLIPMI)
Authors: Govindan Ramanujam , Rangaswamy Thara , John Sujit , Kandasamy Sunitha
Published: December 2020

Background and Objectives:

Medical illnesses seen in persons with psychiatric disorders are important but often ignored causes of increased morbidity and mortality. Hence, a community level intervention program addressing the issue is proposed.

Materials and Methods:

Patients with severe mental illnesses will be identified by a door-to-door survey and assessed for comorbid physical illnesses like anemia, hypertension, diabetes, and so on. They will then be randomized into two groups. The treatment as usual (TAU) group will not receive intervention from the trained community level workers, while the Intervention group will receive it.

Results:

The two groups will be compared for the prevalence and severity of comorbid physical illnesses. The expected outcome is compared to the TAU group, the intervention group will have a greater reduction in the morbidity due to physical illnesses and improved mental health.

Conclusion:

If successful, the module can be incorporated into the community level mental health delivery system of the District Mental Health Program (DMHP).
A meta-ethnographic study of fathers’ experiences of caring for a child with a life-limiting illness
Authors: Postavaru Gianina-Ioana , Swaby Helen , Swaby Rabbi
Published: December 2020

Background:

There is a growing body of qualitative studies examining parents’ experiences of caring for a child with a life-limiting condition, coinciding with recent evidence that indicates an increasing incidence of paediatric life-limiting conditions. However, research focusing on fathers’ needs remains sparse and is often diluted among a predominant ‘mother’s voice’, raising questions about whether practices in clinical settings meet fathers’ needs.

Aim:

To provide an in-depth assembly of the current state of knowledge around fathers’ experiences of caring for their children diagnosed with life-limiting conditions and understand the implications for healthcare services and policies.

Design:

A meta-ethnography was conducted to synthesise findings from existing qualitative studies exploring fathers’ experiences of caring.

Data sources:

Four electronic databases (PubMed, PsycINFO, CINAHL and Science Direct) were searched up until April 2020. Qualitative studies exploring fathers’ care experience and published in English language were included. The Critical Appraisal Skills Programme (CASP) checklist was employed for study quality appraisal. No temporal limits were used.

Results:

Sixty-three studies met the inclusion criteria. Thirty life-limiting conditions were included. Based on responses from 496 fathers, a conceptual model was developed which translates key experiences within the fathers’ caregiving journeys. The overarching concepts identified were: the paradox of support, challenges in the caring process, ‘nobody thinks of men’, impact on family life and the fall of the curtain: an irrevocably altered world. These and associated sub-concepts are discussed, with recommendations for future research and practice provided.

Conclusion:

The findings indicate the value of a family-oriented approach to develop psychosocial interventions and support channels for fathers, thus empowering them whilst reducing the care-giving burden on the family unit.
Preplanned participation of paramedics in end-of-life care at home: A retrospective cohort study
Authors: Surakka Leena K , Peake Minna M , Kiljunen Minna M , Mäntyselkä Pekka , Lehto Juho T
Published: December 2020

Background:

Paramedics commonly face acute crises of patients in palliative care, but their involvement in end-of-life care is not planned systematically.

Aim:

To evaluate a protocol for end-of-life care at home including pre-planned integration of paramedics and end-of-life care wards.

Design:

Paramedic visits to patients in end-of-life care protocol were retrospectively studied.

Setting/Participants:

All of the patients who had registered for the protocol between 1 March 2015 and 28 February 2017 in North Karelia, Finland, were included in this study.

Results:

A total of 256 patients were registered for the protocol and 306 visits by paramedic were needed. A need for symptom control (38%) and transportation (29%) were the most common reasons for a visit. Paramedics visited 43% and 70% of the patients in areas with and without 24/7 palliative home care services, respectively ( p < 0.001); while 58% of all the visits were done outside of office hours. Problems were resolved at home in 31% of the visits. The patient was transferred to a pre-planned end-of-life care ward and to an emergency department in 48% and 16% of the cases, respectively. More patients died in end-of-life care wards in areas without (54%) than with (33%) 24/7 home care services ( p = 0.001).

Conclusions:

Integration of paramedics into end-of-life care at home is reasonable especially in rural areas without 24/7 palliative care services and outside of office hours. The majority of patients can be managed at home or with the help of an end-of-life care ward without an emergency visit.
Postcardiotomy mechanical support in patients with mitral valve prostheses is associated with poor survival
Authors: Pingpoh Clarence , Salama Alaa , Diab Nawras , Kreibich Maximillian , Puiu Paul , Czerny Martin , Benk Christoph , Beyersdorf Friedhelm , Siepe Matthias
Published: December 2020

Aims:

To elaborate on early survival in patients with mitral valve replacement requiring temporary extracorporeal life support system (ECLS).

Methods:

We analyzed survival, significant bleeding, wound infection, and ECLS duration in 421 from 14,400 patients with postoperative need for ECLS from January 2008 to December 2017 at our institution. Finally, patients were stratified according to the type of surgery performed: the mitral group (mitral valve replacement) n = 63 and the control group (any cardiac surgery excluding the mitral valve) n = 358. In order to adjust for preoperative patient characteristics, a propensity matching analysis was performed. Differences in in-hospital mortality were analyzed accordingly.

Results:

In-hospital mortality was significantly higher in the mitral group as compared to the control group before and after adjustment ( p < 0.001). Median duration of ECLS was 4 days in both groups. Perioperative bleeding ( p < 0.001) and wound infection ( p < 0.001) also showed significant worse outcome parameters in the mitral group. The main causes of death in the mitral group were multiorgan failure, n = 48 (76%), stroke, n = 7 (12%), and intracardiac thrombus formation, n = 5 (10%).

Conclusions:

ECLS is associated with a high in-hospital mortality rate in patients after mitral valve replacement.
Assessing the Impact of Sequential Data Presentation on Specific Learning Disabilities Identification Decisions Using Patterns of Strengths and Weaknesses Methods
Authors: Maki Kathrin E. , McGill Ryan J. , Conoyer Sarah J. , Fefer Sarah A. , Ward Thomas
Published: December 2020

Patterns of strengths and weaknesses represent relatively novel methods for identifying specific learning disabilities (SLD) with proponents asserting that the incorporation of multiple sources of assessment data and professional judgment play a key role in their utility. In this study, we examined if the sequential presentation of assessment data impacted school psychologists’ ratings as to whether or not hypothetical students depicted in special education evaluation vignettes should be identified with SLD. Results showed that when participants viewed vignettes that were indicative of SLD (i.e., SLD positive), SLD likelihood ratings increased with the additional presentation of assessment data sources over time. However, when participants viewed vignettes that were indicative of a student not having SLD (i.e., SLD negative), SLD likelihood ratings were relatively consistent over time. Moreover, participants demonstrated relatively high levels of confidence in their SLD identification decisions, and in SLD negative vignettes, confidence increased after the fourth assessment data source was presented. Implications for SLD identification are discussed.
The Impact of Military Service Exposures and Psychological Resilience on the Mental Health Trajectories of Older Male Veterans
Authors: Ureña Stephanie , Taylor Miles G. , Carr Dawn C.
Published: December 2020

Objectives: We examine the impact of exposure to the dead, dying, and wounded (DDW) during military service on the later-life depressive symptom trajectories of male United States veterans, using psychological resilience as an internal resource that potentially moderates negative consequences. Methods: The Health and Retirement Study (2006–2014) and linked Veteran Mail Survey were used to estimate latent growth curve models of depressive symptom trajectories, beginning at respondents’ first report of resilience. Results: Veterans with higher levels of resilience do not have increased depressive symptoms in later life, despite previous exposure to DDW. Those with lower levels of resilience and previous exposure to DDW experience poorer mental health in later life. Discussion: Psychological resilience is important for later-life mental health, particularly for veterans who endured potentially traumatic experiences. We discuss the importance acknowledging the role individual resources play in shaping adaptation to adverse life events and implications for mental health service needs.
The Social Gradient in Mental Health and Well-Being for Indigenous Older Adults Living in Rural Areas: A Cross-Sectional Comparison With Rural Non-indigenous Population in Chile
Authors: Sánchez-Moreno Esteban , Gallardo-Peralta Lorena P. , Leyton Cristián
Published: December 2020

Objectives: To compare differences in depression, loneliness and personal well-being in a sample made up of indigenous (Aymara and Mapuche) and non-indigenous older people resident in original rural territories. Methods: A cross-sectional study involving 800 older adults living in a rural context in Chile, of whom 201 were Aymara, 368 Mapuche and 231 non-indigenous. Validated instruments were included for depression, loneliness and personal well-being (outcome variables). Ordinary least squares regression analyses were performed. Results: Membership of an indigenous group was significantly associated with lower scores for depression and loneliness and higher scores for personal well-being. The interactions of severe deprivation and housing deprivation with indigenous group membership were significantly associated with lower loneliness scores and higher personal well-being scores for Aymara and Mapuche participants. Discussion: Native rural settings and territories may offer a degree of protection to indigenous peoples. Cultural continuity enhanced by rural areas would produce a culturally constructed resilience against deprivation.
Countering corporate violence: Degrowth, ecosocialism and organising beyond the destructive forces of capitalism
Authors: Chertkovskaya Ekaterina , Paulsson Alexander
Published: December 2020

Corporate violence is a form of organised violence motivated or caused by material interest, profit-seeking or economic expansion. It is inflicted on human beings or ecosystems. Complementing a Marxist theoretical frame with literature on ecosocialism and degrowth, we examine how corporate violence is inherent to and has been consistently encouraged by the capitalist mode of production. By drawing on the concepts of primitive accumulation and social metabolism, we visibilise how such violence is manifested within the productive forces of capitalism – natural resources, labour, technology and money. Corporate violence, we argue, may only be countered in a post-capitalist society where the productive forces are radically transformed. We build on degrowth principles to articulate how corporate violence may be countered and how post-growth organising of productive forces may look.
Family mealtime behaviors in children who are tube fed and preparing to transition to oral eating: A comparison to other pediatric populations
Authors: Garcia Andrea M , Beauchamp Marshall T , Patton Susana R , Edwards Sarah , Dreyer Gillette Meredith L , Davis Ann M
Published: December 2020

This study examined differences in observed mealtime behaviors between children preparing to transition to oral feeding and children with various other chronic illnesses using a standardized measure of mealtime beaviors. The parent-child mealtime relationship can become strained due to problematic mealtime behaviors that limit food intake, as well as inadvertent reinforcement of disruptive behavior by caregivers. Frequency/rate of behaviors were compared between children with tube feeding (CwTF) and from previous studies of children with chronic illnesses using the Dyadic Interactive Nomenclature for Eating (DINE). Parents of CwTF used more coaxing, physical prompts, and reinforcement during meals, while parents of children with chronic illnesses used more direct commands and engaged in more parent talk. Findings support differences in parent-child mealtime interactions and eating behaviors across pediatric illness subgroups.
Experimental investigation on composite beams under combined negative bending and torsional moments
Authors: Lin Weiwei
Published: December 2020

In this study, straight composite steel-concrete beams were tested to investigate their mechanical performance under combined negative bending and torsional moments. Two specimens were used in this study, and different ratios between the applied negative bending and torsional moments were induced. Load and deflection relationships, strain development on the steel main girder and shear connectors (stud), and the slip development on the steel-concrete interface were recorded in the test and reported in this paper. The results indicate that increase of torsional moment will result in the significant decrease of the load-carrying capacities (e.g. yield load and ultimate load) of the specimens. It was also found that the normal strains of stud shear connectors in such beams are very large and non-negligible compared to their shear strains. In addition, the maximum interface slip was found occurring at around the 1/4 span, and the support conditions and serious crack of the concrete were considered to be the main causes. The research results obtained in this study can provide references for the design and analysis of steel-concrete composite beams subjected to the combined negative bending and torsional moments.
Reclaiming the narratives: Situated multidimensional representation of underserved Indigenous communities through citizen-driven reporting
Authors: Tsai Jiun-Yi , Bosse Rian , Sridharan Nisha , Chadha Monica
Published: December 2020

Mainstream news outlets continue to ignore Indigenous people or cover them inadequately, resulting in mistrust and alienation by the former towards the latter. Yet, ways to meet Indigenous peoples’ needs for accurate media representation is understudied and undertheorized. Based on 16 in-depth interviews with Native and Indigenous citizens, we develop a conceptual framework of situated multidimensional representation to elucidate the agentic processes for citizen journalists to empower members of various tribal affiliations. Findings reveal that citizen journalists’ situated knowledge and expertise encourages humanizing Indigenous people, engenders media trust through evoking feelings of relatability and belonging, and strengthens Indigenous identity by foregrounding the focus on complex personhood. Our analysis highlights a need for transforming conventional journalistic values and relationship building practices to incorporate marginalized Indigenous perspectives. Theoretical and practical implications are discussed.
A review of policy and provision of emotional support for people living with early-stage dementia in the Republic of Ireland and call for specialist counselling and psychotherapy services
Authors: Morgan Ashley
Published: December 2020

Public policy in Ireland recognises that people living with early-stage dementia are likely to require considerable emotional support following diagnosis; anxiety and depression are very common within this population. Yet psychosocial interventions to support emotional health of people who receive a diagnosis of dementia are sparse; there is no mention of counselling and psychotherapy for people living with early dementia in national guidelines, despite a promising evidence base that has amassed internationally in recent decades. This article explores the psychological impact of receiving a diagnosis and the scant offering of emotional and psychological post-diagnostic support that is available for people living with early-stage dementia in Ireland. The author draws attention to the curious tension between the widely recognised psychological benefits of early diagnosis of dementia and the jarring delay in disclosure that continues to prevail across Irish healthcare delivery. The evidence base for counselling and psychotherapy for people living with mild to moderate dementia in regard to anxiety and depression is discussed. Recommendations are made for further research into specialist counselling and psychotherapy interventions with a strong involvement from people living with dementia embedded in both research and design. The author also calls for public policy to reflect the preference of people living with dementia for earlier diagnosis and to highlight the appetite and ability of people living with dementia to engage in psychotherapeutic interventions.
Probabilistic Risk Assessment of Prophylactic Surgery Before Extended-Duration Spaceflight
Authors: Reyes David P. , Carroll Danielle J. , Walton Marlei E. , Antonsen Erik L. , Kerstman Eric L.
Published: December 2020

Introduction. Prophylactic surgery before spaceflight may eliminate the risk of appendicitis and cholecystitis in astronauts on deep space missions. However, even minimally invasive surgery increases the risk of small bowel obstruction (SBO). Probabilistic risk assessment (PRA) is a method that can be used to estimate the benefits and risks of prophylactic surgery. Methods. Risks of appendicitis and cholecystitis during a 2.5-year Mars mission are compared to the risk of SBO after laparoscopic removal of the appendix, gallbladder, or both. A PRA model using Monte Carlo methodology was used to forecast the risks. Results. Prophylactic appendectomy and cholecystectomy combined, conferred an increased probability of medical evacuation (pEVAC) due to SBO as compared to the no surgery group. A slightly higher probability for the loss of crew life (pLOCL) was found in the no surgery group when compared to the cases in which either prophylactic appendectomy alone, or appendectomy plus cholecystectomy are performed. Discussion. The need for medical evacuation can be viewed as a potential risk for death in the context of a space mission where evacuation is not possible. Because of the higher pEVAC due to SBO and relatively small benefit in the reduction of pLOCL in the prophylactic surgery groups, this analysis does not support the prophylactic removal of appendix and/or gallbladder for spaceflight. Future advances in surgical or medical technique or mission medical capabilities may change these results. This work demonstrates the utility of PRA in providing quantitative answers to “what if” questions where limited information is available.
Frank Hartley and his Contribution to Surgery
Authors: Kostoulas George , Pathiakis Ioannis , Mavrommatis Evangelos
Published: December 2020

Although Frank Hartley (1856-1913) was mostly known as the deviser of the method of bisecting the ganglion of the trigeminal nerve within the skull for the relief of facial neuralgia, it should be noted that he had also done very important work in the surgical treatment of goiter which was neglected at his times but later followed by his successors. Furthermore, he also had interest in the surgical treatment of clubfoot and the exstrophy of the bladder.
Low intratumor heterogeneity correlates with increased response to PD-1 blockade in renal cell carcinoma
Authors: Ran Xia , Xiao Jinyuan , Zhang Yi , Teng Huajing , Cheng Fang , Chen Huiqian , Zhang Kaifan , Sun Zhongsheng
Published: December 2020

Background:

Intratumor heterogeneity (ITH) has been shown to be inversely associated with immune infiltration in several cancers including clear cell renal cell carcinoma (ccRCC), but it remains unclear whether ITH is associated with response to immunotherapy (e.g. PD-1 blockade) in ccRCC.

Methods:

We quantified ITH using mutant-allele tumor heterogeneity, investigated the association of ITH with immune parameters in patients with ccRCC ( n = 336) as well as those with papillary RCC (pRCC, n = 280) from The Cancer Genome Atlas, and validations were conducted in patients with ccRCC from an independent cohort ( n = 152). The relationship between ITH and response to anti-PD-1 immunotherapy was explored in patients with metastatic ccRCC from a clinical trial of anti-PD-1 therapy ( n = 35), and validated in three equal-size simulated data sets ( n = 60) generated by random sampling with replacement based on this clinical trial cohort.

Results:

In ccRCC, low ITH was associated with better survival, more reductions in tumor burden, and clinical benefit of anti-PD-1 immunotherapy through modulating immune activity involving more neoantigens, elevated expression of HLA class I genes, and higher abundance of dendritic cells. Furthermore, we found that the association between the level of ITH and response to PD-1 blockade was independent of the mutation status of PBRM1 and that integrating both factors performed better than the individual predictors in predicting the benefit of anti-PD-1 immunotherapy in ccRCC patients. In pRCC, increased immune activity was also observed in low- versus high-ITH tumors, including higher neoantigen counts, increased abundance of monocytes, and decreased expression of PD-L1 and PD-L2.

Conclusions:

ITH may be helpful in the identification of patients who could benefit from PD-1 blockade in ccRCC, and even in pRCC where no genomic metrics has been found to correlate with response to immune checkpoint inhibitors.
Metastatic small cell carcinoma of the lung with prominent spindle cell morphology and hemangiopericytoma-like vascular pattern: A sarcoma mimicker
Authors: Nsour Esra , Al Khader Ali , Al-Tarawneh Bushra
Published: December 2020

Small cell carcinoma is a malignant neuroendocrine tumor with aggressive clinical behavior. Histologically, the tumor is characterized by the proliferation of small, round, blue cells. Here, we present the case of a 50-year-old man with a 1-month history of enlarging chest wall mass. Microscopic examination of the lesion revealed a highly cellular neoplasm composed of closely packed, atypical spindle cells with scant cytoplasm, inconspicuous nucleoli, and brisk mitotic activity. The hemangiopericytoma-like vascular pattern was prominent. Areas showing a fibrosarcoma-like fascicular pattern were also observed. The tumor was immunohistochemically positive for TTF1, synaptophysin, and chromogranin, confirming small cell carcinoma. Further investigations revealed a lung origin and widespread metastases. The tumor in this case closely mimicked synovial sarcoma or malignant peripheral nerve sheath tumor. Small cell carcinoma demonstrates a hemangiopericytoma-like pattern that can mimic sarcoma histologically. This is a serious pitfall that can significantly affect the speed of diagnosis and management.
Spongiotic osteoma in the external auditory canal: Two cases of a rare tumor
Authors: Lee Kyuin , Choi Yoon Jung , Choi Hyun Seung , Jeong Junhui
Published: December 2020

Osteoma of the external auditory canal is a rare benign tumor with an estimated incidence of 0.05% of total otologic surgeries. In most cases, an osteoma in the external auditory canal does not cause symptoms because the tumor grows slowly and does not occlude the ear canal. However, if the mass grows to occlude the external auditory canal, several symptoms can occur, including conductive hearing loss, aural fullness, and keratin debris accumulation. We present two cases of this rare tumor in a 23-year-old woman and a 19-year-old man. The mass was surgically excised at the level of the peduncle under local anesthesia with microscope assistance. The base of the excised mass was drilled with a diamond burr to remove all osseous lesions. Histopathologic findings showed spongiotic osteomas. In these cases, patients had symptoms of aural fullness, although the osteomas did not completely occlude the external auditory canal, and the symptoms improved after surgical excision without recurrence.
Causes of delayed exploration of the acute scrotum in a regional tertiary centre
Authors: Storey Benjamin , Shugg Nathan , Blatt Alison
Published: December 2020

Background:

Testicular torsion is an organ-threatening surgical emergency with a limited timeframe for intervention.

Objective:

To identify the delays to surgical exploration of patients with an acute scrotum in a tertiary hospital to prevent adverse outcomes associated with this time critical emergency.

Methods:

A retrospective review of medical records for all patients who underwent scrotal exploration for acute scrotal pain in a tertiary hospital in regional New South Wales between January 2008 to December 2018 was performed.

Results:

Retrospective review identified 242 patients, of whom 161 had testicular torsion and 56 resultant orchidectomies. No statistically significant difference in pre-hospital delays between paediatric or adult populations was found. The average time from presentation to theatre was 4 h 36 min. Patients who were delayed > 6 h from presentation to surgical exploration had significantly increased rates of orchidectomy. Delays that significantly affected rates of orchidectomy were transfer from peripheral sites, late presentation, misdiagnosis and representation after discharge.

Conclusion:

The most common reason for delay was diagnostic error with the patient later re-presenting to hospital. Patient transfer from the primary hospital to a tertiary institution and subsequent delayed surgical exploration also contributed to significantly higher rates of orchidectomy. Level of Evidence: 3
Long-term follow-up of Holmium-YAG laser vaporisation of bladder urothelial carcinoma
Authors: Bazo Alvaro , Gowda Arjun , Yao Henry Han-I , Radcliffe Robert , Goodall Phillip , Green William , Sherwood Benedict
Published: December 2020

Introduction:

Many patients with non-muscle invasive bladder cancer (NMIBC) will develop recurrences of their tumour after their first resection. Flexible cystoscopy under local anaesthesia with Holmium-YAG laser ablation of tumour (FHoLAT) is safe, well tolerated procedure with significant cost savings when compared to cystoscopy under general or regional anaesthesia. We retrospectively analysed the outcomes of a large series of patients undergoing FHoLAT at our institution between April 2006 and September 2013.

Patients and methods:

Patients were offered FHoLAT if the tumour recurrence was small and/or they were deemed unfit for regional or general anaesthesia. Patient data was extracted from medical records. The primary outcomes were overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS) and recurrence-free survival (RFS).

Results:

232 patients with a total 522 FHoLAT procedures were included. The median follow-up was 74.8 (43.5–101) months; 18% were discharged after a recurrence free follow-up duration; 52.2% had one FHoLAT, 19.8% had two FHoLATs, 11.2% had three FHoLATs and 16.8% had four or more FHoLAT. At initial diagnosis 24.1% of patients had G1pTa, 47% G2pTa, 9.9% G3pTa and T1 in 18.9%. 4.3% had concurrent carcinoma in situ. At 10 years, OS was 47.4%, CSS was 94.1%, PFS was 82.1%, RFS was 15.8%.

Conclusions:

FHoLAT for bladder tumour recurrences has an acceptable CSS and PFS for patients with small low-grade tumours or patients with high-grade or T1 tumours who are unfit for regional or general anaesthesia. The role of FHoLAT in unfit patients seems clear, but further prospective trials are needed to define its role in other patient groups, particularly high-grade NMIBC.

Level of evidence:

3b-4
Black Memes Matter: #LivingWhileBlack With Becky and Karen
Authors: Williams Apryl
Published: December 2020

“BBQ Becky” and “Karen” memes reference real-world incidents in which Black individuals were harassed by White women in public spaces. In what I term the BBQ Becky meme genre, Black meme creators use humor, satire, and strategic positioning to perform a set of interrelated social commentaries on the behavior of White women. By conducting a visual Critical Technocultural Discourse Analysis (CTDA) of BBQ Becky memes, I argue that Becky and Karen memes are a cultural critique of White surveillance and White racial dominance. I find that memes in the BBQ Becky meme genre call attention to, and reject, White women’s surveillance and regulation of Black bodies in public spaces—making an important connection between racialized surveillance of the past and contemporary acts of “casual” racism. This meme genre also disrupts White supremacist logics and performative racial ignorance by framing Karens and Beckys as racist—not just disgruntled or entitled. Finally, in a subversion and reversal of power dynamics, Karen and BBQ Becky memes police White supremacy and explicitly call for consequences, providing Black communities with a form of agency. Hence, I conclude that Black memes matter in the struggle for racial equity.