bluuebunny/crossref_metadata_2025 huggingface dataset:
Local therapies for liver metastases of rare head and neck cancers: a monoinstitutional case series
Authors: Bergamini Cristiana , Cavalieri Stefano , Cascella Tommaso , Lanocita Rodolfo , Alfieri Salvatore , Resteghini Carlo , Platini Francesca , Orlandi Ester , Locati Laura Deborah , Marchianò Alfonso , Licitra Lisa
Published: September 2020

Introduction:

Transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) are established procedures for treating hepatocellular cancer and selected malignancies with liver metastasis. The aim of this study is to describe a monoinstitutional case series of local approaches in patients with liver metastases from rare head and neck cancers (HNCs).

Methods:

This is a retrospective series of adult patients with HNC treated with liver locoregional approaches (TACE or RFA) at our institution from 2007 to 2018. In case of chemoembolization, the preferred chemotherapeutic drug was doxorubicin. Response according to RECIST (Response Evaluation Criteria in Solid Tumors) was assessed with contrast-enhanced computed tomography scans.

Results:

Thirty-four patients were treated (20 men, median age 58 years) with TACE (27), transarterial embolization (2), or RFA (7). Primary tumours were salivary gland (21), thyroid (6), nasopharyngeal (5), and sinonasal cancers (2). Seventeen patients (50%) had a single metastatic liver nodule; 70% of the remaining 17 patients had at least three liver metastases. The median diameter of the metastatic liver mass undergoing treatment was 39 mm (range 11–100 mm). Median follow-up was 27.6 months. Response rate was 35% (3% complete, 32% partial response). Median progression-free survival and overall survival were 6.9 and 19.6 months, respectively. Treatment-related adverse events occurred in 59% of patients (21% grade ⩾ 3; no grade 5).

Discussion:

This retrospective case series demonstrates that locoregional radiologic approaches for rare HNCs with liver metastases are feasible. These procedures deserve further prospective studies before being considered safe and active in these malignancies where the availability of effective systemic treatments is lacking.
Nebuchadnezzar and the animal mind (Daniel 4)
Authors: Beverly Jared
Published: September 2020

The case of King Nebuchadnezzar’s animal episode in Daniel 4 has typically been read in ways that pathologize animality. I argue, however, that the Hebrew Bible demonstrates at least two views of animals and knowledge: one which casts them as ignorant and stupid and one which celebrates their knowledge, especially knowledge of the divine. Rather than reading Nebuchadnezzar’s experience through the former tradition, I offer an alternative reading in which nonhuman animals are seen as having knowledge, even a special knowledge of the divine. Nebuchadnezzar’s animalization need not be read as punishment or madness, but rather it is meant to educate him. When Nebuchadnezzar is given the ‘mind of an animal’ (4.13), the goal is to reach a better knowledge of God through this animal mind. Finally, I conclude with thoughts about how this interpretation avoids the pitfalls of conflating animality with madness and its relevance for animal ethics today.
Population geography I: Epistemological opportunities of mixed methods
Authors: Finney Nissa
Published: September 2020

Population geography is rightly recognised for its quantitative expertise. Yet, the methodological and epistemological diversification that has taken place within the sub-discipline alongside decades of theoretical developments has gone largely undiscussed. In this report, I suggest that population geography is methodologically multilingual and thus well placed to embrace mixed methods. This would bring epistemological opportunities for population geographers, advancing the sub-discipline and engagement beyond in academia and elsewhere. The confluence of theoretical and methodological developments, and global challenges that demand attention of population scholars, means the time is ripe to broaden the lens of population geographies through deliberate pursuit of mixed methods agendas.
“Branding Bildung”: Commodifying the Uniqueness of Popular Education
Authors: Fejes Andreas , Aman Robert , Nyström Sofia
Published: September 2020

Popular education has a long history in Sweden, dating back to the mid-1800s and having developed in close relationship with the state. This relationship has been sustained over the years by the way popular education is spoken of as being “unique”—as being complementary to formal education. In this article, we focus on how the uniqueness of popular education is shaped today, and how it operates to legitimize further support. We draw on Barthes’ notion of myth, analyzing interviews with managers, principals, study circle leaders and teachers working with adult asylum seekers and refugees at study associations and folk high schools. We argue that the myth of the uniqueness of popular education is made up of three rhetorical figures that are mobilized by a range of actors legitimizing state support for popular education. The myth thus becomes a “tool” that commodifies popular education, that is, that turns the myth into monetary funds.
The Asylum Procedure in Germany: Desperation and Uncertainty as Risk Factors for Violence Among Young Adult Asylum Seekers in Collective Accommodations
Authors: Al Ajlan Ahmad
Published: September 2020

This study explores how violence occurs among young adult asylum seekers in collective accommodations in the state of North Rhine-Westphalia in Germany. It provides an insider perspective to understand a phenomenon related to non-European people who were forced to leave their countries to seek asylum. Based on 16 qualitative interviews with young adult male asylum seekers from Syria and some African countries, seven interviews with social workers, and one interview with a German psychological therapist, the author finds that the asylum procedure in Germany as a total institution catalyzes violence among young adult asylum seekers in collective accommodations. The present study shows that collective accommodations are unhomely places, where “inmates” lack privacy and autonomy. In addition, the asylum procedure deprives them of essential human needs, such as the right to work and to have full access to the health care system. These circumstances make them uncertain and desperate, which leads to violence among them. The author calls for more attention towards the human needs of asylum seekers, rather than making them related to the granting of asylum, which can ultimately take years.
“When Her Visa Expired, the Family Refused to Renew It,” Intersections of Human Trafficking and Domestic Violence: Qualitative Document Analysis of Case Examples from a Major Midwest City
Authors: Koegler Erica , Howland Whitney , Gibbons Patric , Teti Michelle , Stoklosa Hanni
Published: September 2020

This study aimed to further understand typologies of trafficking that occur in the home, by an individual’s intimate partner (IP) or family members and this overlap with extant knowledge on perpetrator manipulation via the Power and Control Wheel. Inductive and deductive techniques were used to analyze secondary data from a federally funded anti-trafficking program in a Midwest metropolitan area recorded between 2008 and 2017. Cases were included if there was indication of sex or labor exploitation initiated by an IP, family member, or other in the domestic setting via elements of abuse; 59 cases of 213 met this criteria. Most cases included the IP as the trafficker, followed by family members, then others in the domestic setting. Abuse was more commonly used than the threat of abuse. From the Power and Control Wheel, the most frequent types of abuse were using privilege, physical abuse, economic abuse, isolation, and sexual abuse. Case typologies included: those with elements of sex trafficking, specifically forced commercial sex by an IP or family member; those with elements of labor trafficking such as domestic servitude (with or without childcare provision abuse), exploitation in a family business by an IP or family member, or work environments by family and non-family; those with elements of sex and labor trafficking included servile partnerships and forced marriage. Trafficking exploitation by an IP, family member, or in the domestic setting is not uncommon. Intimate relationships with a trafficker, psychological coercion, and threats may reduce reporting of abuse, subsequent provision of services, and result in misclassification as victims of IP violence. This study sheds light on various typologies of trafficking and exploitation in the domestic setting, further expanding the anti-trafficking movement’s evidence base for intervention and prevention and adding complexity and nuance to the pathways to trafficking exploitation.
The Well-Being Benefits of Person-Culture Match Are Contingent on Basic Personality Traits
Authors: Gebauer Jochen E. , Eck Jennifer , Entringer Theresa M. , Bleidorn Wiebke , Rentfrow Peter J. , Potter Jeff , Gosling Samuel D.
Published: September 2020

People enjoy well-being benefits if their personal characteristics match those of their culture. This person-culture match effect is integral to many psychological theories and—as a driver of migration—carries much societal relevance. But do people differ in the degree to which person-culture match confers well-being benefits? In the first-ever empirical test of that question, we examined whether the person-culture match effect is moderated by basic personality traits—the Big Two and Big Five. We relied on self-reports from 2,672,820 people across 102 countries and informant reports from 850,877 people across 61 countries. Communion, agreeableness, and neuroticism exacerbated the person-culture match effect, whereas agency, openness, extraversion, and conscientiousness diminished it. People who possessed low levels of communion coupled with high levels of agency evidenced no well-being benefits from person-culture match, and people who possessed low levels of agreeableness and neuroticism coupled with high levels of openness, extraversion, and conscientiousness even evidenced well-being costs. Those results have implications for theories building on the person-culture match effect, illuminate the mechanisms driving that effect, and help explain failures to replicate it.
Prevalence and incidence of systemic lupus erythematosus in Tucumán, Argentina
Authors: Gonzalez Lucero Luciana , Barbaglia Ana L , Bellomio Verónica I , Bertolaccini Maria C , Machado Escobar Maximiliano A , Sueldo Hector R , Yacuzzi Maria S , Carrizo Gustavo A , Robles Norma , Rengel Silvia , Cristofari Alexia , Leal Maria O , Vasquez Doralia L , Quinteros Ana , Seleme Gladys , Molina Maria J , Pera Oscar L , Dip Rodolfo , Olea Ana C , Torres Alberto Y , Espindola Echazu Mariana , Arquez Gustavo , Lazaro Hector , Colombres Francisco , Juarez Laura A , Romano Olga , Paz Silvia , Santana Mirta , Galindo Liliana , Lucero Eleonora
Published: September 2020

The aim of this study was to determine the prevalence and incidence of Systemic Lupus Erythematosus (SLE) in Tucumán, Argentina. Methods: The study included inpatient and outpatient charts from four public hospitals and private practice rheumatology clinics, all of them members of the Tucumán Rheumatology Society. Patients older than 16 years with diagnosis of SLE between January 2005 and December 2012 were included. Prevalence and annual incidence were calculated as the number of cases per 100.000 inhabitants during the period 2005 to 2012. Results: Three hundred fifty-three patients were identified. The mean age at diagnosis was 30.5 ± 11.7 years, 93.5% women, 83% mestizos. Prevalence was 24.3 cases/100.000 inhabitants (CI 95% 22.6–28.8) and age-adjusted (≥16 years) of 34.9 cases/100.000 inhabitants (CI 95% 32.8–41.1). The annual incidence in 2005 was 1.8 cases/100.000 inhabitants (95% CI 1–2.9) and 2012 of 4.2 cases/100.000 inhabitants (95% CI 2.9–5.8). Mortality was 9.1%, with infections being the most frequent cause (14/32). Conclusion: The prevalence of SLE in the province of Tucumán was 34.9 cases/100.000 inhabitants.
Employment Prospects of Graduates From Sino-Foreign Cooperative Universities in China
Authors: Wu Shiyong , Zhou Shuyi , Huang Mingxi , Chen Wei
Published: September 2020

This article aims to examine the employment prospects of graduates from Sino-foreign cooperative universities (SFCUs) compared with those from local Chinese universities. Drawing on the annual employment quality reports released by six SFCUs, the findings indicated that SFCU graduates had distinct advantages in terms of both further study and direct employment. Specifically, the overall employment rate reached 95.84%; over half of the graduates pursued further study abroad in world-class foreign universities, close to one-third continued further studies in elite domestic universities, and one-sixth were employed by transnational or local large organizations. These results suggest that SFCU graduates were equipped with distinct competitive advantages for employment, further supported by an affluent family background and the high-quality requirement for admission. Meanwhile, the findings also raise concerns about brain drain, economic flows, overeducation, reduced entrepreneurial passion, and unemployment dilemma for graduates from lesser known SFCUs.
Feeding and Growth in Infants With Cleft Lip and/or Palate: Relationships With Maternal Distress
Authors: Madhoun Lauren L. , Crerand Canice E. , O’Brien Meghan , Baylis Adriane L.
Published: September 2020

Objective:

To examine relationships between early feeding and growth and maternal distress in infants with and without cleft lip and/or palate (CL/P).

Design:

Cross-sectional.

Setting:

Pediatric academic medical center in the Midwestern United States.

Participants:

Mothers of infants 1 to 12 weeks old with CL/P (n = 30) and without CL/P (control group, n = 30) were recruited at craniofacial clinic or pediatrician appointments.

Main Outcome Measure(s):

Maternal responses on the Feeding/Swallowing Impact Survey (FS-IS), Parenting Stress Index, Fourth Edition, Short Form (PSI-4-SF), and Edinburgh Postnatal Depression Scale. Infant feeding history and growth measurements were obtained.

Results:

Having an infant with CL/P revealed greater impact on maternal health-related quality of life due to feeding problems ( F = 4.83, P = .03). Mothers of infants with CL/P reported average range Total Stress scores on the PSI-4-SF, which were higher than controls ( F = 4.12, P = .05). Edinburgh Postnatal Depression Scale scores did not differ between groups. Compared to controls, infants with cleft palate had lower percentiles for weight ( t = 4.13, P = .04) and length ( t = 2.93, P = .01). Higher FS-IS scores were associated with longer feeding duration ( r = 0.32, P = .01) and lower weight ( r = −0.31, P = .02) and length ( r = −0.32, P = .02).

Conclusions:

Despite receiving early team care and feeding interventions, mothers of infants with CL/P reported higher stress and more challenges with feeding and growth. Future studies should examine targeted psychosocial interventions to improve feeding and growth outcomes in infants with CL/P.
TRENDS: A Red Flag for Participation: The Influence of Chinese Mainlandization on Political Behavior in Hong Kong
Authors: Chan Nathan Kar Ming , Nachman Lev , Mok Chit Wai John
Published: September 2020

This article assesses how contemporary forms of regional assimilation by centralizing states affect the political behavior of threatened social groups within peripheral polities. Recent mainlandization, “the blurring of the physical, social, cultural and psychological border between Mainland China and Hong Kong,” has constrained the region’s autonomy. Here, we consider the political consequences of Chinese mainlandization. How does mainlandization affect the likelihood of political participation in Hong Kong? Drawing and expanding upon theories of social identity, we argue that mainlandization increases the political involvement among those who make the choice to identify as Hong Konger because this is the group under threat by China’s recent actions. Hong Kongers politically mobilize as a response to mainlandization to combat Chinese threat and to improve the status of their identity group, of which their own sense of selves is also tied to. Using an original survey experiment, we find support for our theory. Hong Kongers are influenced by mainlandization to attend contentious protests, recruit others to attend such rallies, and sign pro-democratic petitions. We conclude by noting implications for China’s increasing attempt to assimilate this electoral autocracy and discuss how our research informs Hong Kong political activism in 2019 and 2020.
COVID-19 Infection: Viral Macro- and Micro-Vascular Coagulopathy and Thromboembolism/Prophylactic and Therapeutic Management
Authors: Manolis Antonis S. , Manolis Theodora A. , Manolis Antonis A. , Papatheou Despoina , Melita Helen
Published: September 2020

Coronavirus-2019 (COVID-19) predisposes patients to arterial and venous thrombosis commonly complicating the clinical course of hospitalized patients and attributed to the inflammatory state, endothelial dysfunction, platelet activation and blood stasis. This viral coagulopathy may occur despite thromboprophylaxis and raises mortality; the risk appears highest among critically ill inpatients monitored in the intensive care unit. The prevalence of venous thromboembolism in COVID-19 patients has been reported to reach ∼10-35%, while autopsies raise it to nearly 60%. The most common thrombotic complication is pulmonary embolism, which though may occur in the absence of a recognizable deep venous thrombosis and may be due to pulmonary arterial thrombosis rather than embolism, resulting in thrombotic occlusion of small- to mid-sized pulmonary arteries and subsequent infarction of lung parenchyma. This micro-thrombotic pattern seems more specific for COVID-19 and is associated with an intense immuno-inflammatory reaction that results in diffuse occlusive thrombotic micro-angiopathy with alveolar damage and vascular angiogenesis. Furthermore, thrombosis has also been observed in various arterial sites, including coronary, cerebral and peripheral arteries. Biomarkers related to coagulation, platelet activation and inflammation have been suggested as useful diagnostic and prognostic tools for COVID-19-associated coagulopathy; among them, D-dimer remains a key biomarker employed in clinical practice. Various medical societies have issued guidelines or consensus statements regarding thromboprophylaxis and treatment of these thrombotic complications specifically adapted to COVID-19 patients. All these issues are detailed in this review, data from meta-analyses and current guidelines are tabulated, while the relevant mechanisms of this virus-associated coagulopathy are pictorially illustrated.
Effects of COVID-19 Misinformation on Information Seeking, Avoidance, and Processing: A Multicountry Comparative Study
Authors: Kim Hye Kyung , Ahn Jisoo , Atkinson Lucy , Kahlor Lee Ann
Published: September 2020

We examined the implications of exposure to misinformation about COVID-19 in the United States, South Korea, and Singapore in the early stages of the global pandemic. The online survey results showed that misinformation exposure reduced information insufficiency, which subsequently led to greater information avoidance and heuristic processing, as well as less systematic processing of COVID-19 information. Indirect effects differ by country and were stronger in the U.S. sample than in the Singapore sample. This study highlights negative consequences of misinformation during a global pandemic and addresses possible cultural and situational differences in how people interpret and respond to misinformation.
Impacts of Maryland’s Global Budgets on Medicare and Commercial Spending and Utilization
Authors: Morrison Marisa , Haber Susan , Beil Heather , Giuriceo Katherine , Sapra Katherine
Published: September 2020

In 2014, Maryland incorporated global budgets into its long-running all-payer rate-setting model for hospitals in order to improve health, increase health care quality, and reduce spending. We used difference-in-differences models to estimate changes in Medicare and commercial insurance utilization and spending in Maryland relative to a hospital-based comparison group. We found slower growth in Medicare hospital spending in Maryland than in the comparison group 4.5 years after model implementation and for commercial plan members after 4 years. We identified reductions in Maryland Medicare admissions but no changes for commercial plan members, although their inpatient spending declined. Relative declines in emergency department and other hospital outpatient spending in Maryland drove slower Medicare hospital spending growth, saving $796 million. Our findings suggest global budgets reduce hospital spending and utilization but aligning incentives between hospital and nonhospital providers may be necessary to further reduce utilization and total spending.
Proclaiming the New: An Introduction
Authors: Kuntz Aaron M. , St.Pierre Elizabeth Adams
Published: September 2020

This introduction to a special issue of Qualitative Inquiry on “new approaches to inquiry” questions the need for preexisting social science research methodologies for inquiry that aspires to produce the “new,” that which is unrecognizable and incomprehensible in the Cartesian onto-epistemological arrangement that enables those methodologies. Quite a few contemporary scholars encouraged by the lure of the new have found “old” philosophies promising in dislodging that dogmatic image of thought and its concepts that weigh us down. Whatever the “new” is, it will be different every time, so the articles in the special issue cannot be models of new approaches to inquiry that can be copied and repeated but, instead, are bursts of intensities that have not yet been rendered ordinary. New inquiry, then, is always not-yet, to-come, a force of pure difference pushing through what has been normalized and stratified as it comes into existence.
Seeking Justice: How VAWA Reduced the Stronghold Over American Indian and Alaska Native Women
Authors: Hartman Jennifer L.
Published: September 2020

The Violence Against Women Act (VAWA), originally passed in 1994, was successfully reauthorized in 2000, 2005, and 2013. Over time, VAWA altered the environment for many victims who had previously suffered in silence. This article focuses on how VAWA impacted American Indian (AI) and Alaska Native (AN) victims of dating and domestic violence. AI and AN women experience these crimes at a rate higher than the national average, yet they are often denied justice due to the interplay of federal and state laws and tribal sovereignty. VAWA affirmed tribes’ sovereign authority to exercise criminal jurisdiction over non-Indians who commit crimes against AI and AN victims on tribal lands. This article also discusses future steps to enhance justice reforms.
A Qualitative Study on Friends and the Social Context of Sexual Victimization: Implications for Campus-Based Interventions
Authors: Blayney Jessica A. , Jenzer Tiffany , Read Jennifer P. , Livingston Jennifer , Testa Maria , Carroll Quinn
Published: September 2020

Sexual victimization (SV) risk can begin in social contexts, ones where friends are present, though it is unclear how friends might be integrated into SV prevention. Using focus groups, female college drinkers described (a) the role of friends in preventing SV, (b) the strategies friends use to reduce vulnerability, and (c) the barriers to implementation. Friends-based strategies (keeping tabs on one another, using signals to convey potential danger, interrupting escalating situations, taking responsibility for friends, relying on male friends) and barriers (intoxication, preoccupation, situation ambiguity, social consequences) were discussed. Interventions can draw on these strategies, but must address the critical barriers.
Speech-Language Pathologist and Parent Perspectives on Speech-Language Pathology Services for Children With Autism Spectrum Disorders
Authors: Beverly Brenda L. , Mathews L. Amanda
Published: September 2020

Many speech-language pathologists (SLPs) are underprepared to serve children with autism spectrum disorders (ASDs), despite a growing need and increased expectation for ASD expertise. To understand this practice gap, 60 SLPs and 26 parents of children with ASDs were surveyed regarding SLP knowledge and competency. Of concern was that only about 50% of SLPs correctly identified ASD defining criteria. Respondents rated eight SLP practices as Important to Very Important, but SLPs reported being only Somewhat Competent to Competent. The parents’ rating of SLP competency was significantly lower than parental ratings of importance for one educational practice, use of nonstandardized assessment and observational methods. Also, parents rated the development of the Individualized Education Program significantly higher in importance than SLPs rated it. Findings varied for ASD specialty subgroups. Results support socially valid improvements in preparation for SLPs on the frontlines of assessment, treatment, and development of health and educational systems for children with ASDs.
MRI correlates of clinical disability and hand-motor performance in multiple sclerosis phenotypes
Authors: Cordani Claudio , Hidalgo de la Cruz Milagros , Meani Alessandro , Valsasina Paola , Esposito Federica , Pagani Elisabetta , Filippi Massimo , Rocca Maria A
Published: September 2020

Background:

Hand-motor impairment affects a large proportion of multiple sclerosis (MS) patients; however, its substrates are still poorly understood.

Objectives:

To investigate the association between global disability, hand-motor impairment, and alterations in motor-relevant structural and functional magnetic resonance imaging (MRI) networks in MS patients with different clinical phenotypes.

Methods:

One hundred thirty-four healthy controls (HC) and 364 MS patients (250 relapsing-remitting MS (RRMS) and 114 progressive MS (PMS)) underwent Expanded Disability Status Scale (EDSS) rating, nine-hole peg test (9HPT), and electronic finger tapping rate (EFTR). Structural and resting state (RS) functional MRI scans were used to perform a source-based morphometry on gray matter (GM) components, to analyze white matter (WM) tract diffusivity indices and to perform a RS seed-based approach from the primary motor cortex involved in hand movement (hand-motor cortex). Random forest analyses identified the predictors of clinical impairment.

Result:

In RRMS, global measures of atrophy and lesions together with measures of structural damage of motor-related regions predicted EDSS (out-of-bag (OOB)- R2 = 0.19, p-range = <0.001–0.04), z9HPT (right: OOB- R2 = 0.14; left: OOB- R2 = 0.24, p-range = <0.001–0.03). No RS functional connectivity (FC) abnormalities were identified in RRMS models. In PMS, cerebellar and sensorimotor regions atrophy, cerebellar peduncles integrity and increased RS FC between left hand-motor cortex and right inferior frontal gyrus predicted EDSS (OBB- R2 = 0.16, p-range = 0.02–0.04).

Conclusion:

In RRMS, only measures of structural damage contribute to explain motor impairment, whereas both structural and functional MRI measures predict clinical disability in PMS. A multiparametric MRI approach could be relevant to investigate hand-motor impairment in different MS phenotypes.
Comparison Between Nailing and Plating in the Treatment of Distal Tibial Fractures: A Meta-Analysis
Authors: Ekman E. , Lehtimäki K. , Syvänen J. , Saltychev M.
Published: September 2020

Background and Aims:

To evaluate evidence on the superiority of plate fixation over intramedullary nail fixation in the treatment of distal tibial fractures regarding functional outcomes and complication rates.

Material and Methods:

Cochrane Controlled Trials Register, Medline, Embase, CINAHL, Scopus, and Web of Science databases were searched in December 2019. The risk of systematic bias was assessed according to the Cochrane Collaboration’s domain-based evaluation framework.

Results:

The search resulted in 514 records, the final sample included 10 randomized controlled trials (782 patients). There were statistically significant differences in operating time (−11.2, 95% confidence interval: −16.3 to −6.1 min), time to partial weight bearing (−0.96, 95% confidence interval: −1.8 to −0.1 weeks), time to full weight bearing (−2.2, 95% confidence interval: −4.32 to −0.01 weeks), the rates of deep infections (risk ratio = 0.37, 95% confidence interval: 0.19 to 0.69), and the rates of soft-tissue complications (risk ratio = 0.52, 95% confidence interval: 0.33 to 0.82) favoring intramedullary nail. Intraoperative blood loss (127.2, 95% confidence interval: 34.7 to 219.7 mL) and postoperative knee pain and stiffness (relative risk = 5.6, 95% confidence interval: 1.4–22.6) showed significant differences favoring plate fixation. When combining all complication rates, the difference was risk ratio = 0.77 (95% confidence interval: 0.63 to 0.95) favoring intramedullary nail. No significant differences in radiation time, length of incision, length of hospital stay, time to return to work, time to union, the rates of healing complications or secondary procedures, ankle pain or stiffness, or functional scores were found.

Conclusion:

This meta-analysis suggests that intramedullary nail might be slightly superior in reducing postoperative complications and result in slightly faster healing when compared to plate fixation.
MiR-331-3p Links to Drug Resistance of Pancreatic Cancer Cells by Activating WNT/β-Catenin Signal via ST7L
Authors: Zhan Ting , Chen Xiaoli , Tian Xia , Han Zheng , Liu Meng , Zou Yanli , Huang Shasha , Chen Aifang , Cheng Xueting , Deng Junsheng , Tan Jie , Huang Xiaodong
Published: September 2020

Background:

Pancreatic cancer is an aggressive type of cancer with poor prognosis, short survival rate, and high mortality. Drug resistance is a major cause of treatment failure in the disease. MiR-331-3p has been reported to play an important role in several cancers. We previously showed that miR-331-3p is upregulated in pancreatic cancer and promotes pancreatic cancer cell proliferation and epithelial-to-mesenchymal transition–mediated metastasis by targeting ST7L. However, it is uncertain whether miR-331-3p is involved in drug resistance.

Methods:

We investigated the relationship between miR-331-3p and pancreatic cancer drug resistance. As part of this, microRNA mimics or inhibitors were transfected into pancreatic cancer cells. Quantitative polymerase chain reaction was used to detect miR-331-3p expression, and flow cytometry was used to detect cell apoptosis. The Cell Counting Kit-8 assay was used to measure the IC50 values of gemcitabine in pancreatic cancer cells. The expression of multidrug resistance protein 1, multidrug resistance-related protein 1, breast cancer resistance protein, β-Catenin, c-Myc, Cyclin D1, Bcl-2, and Caspase-3 was evaluated by Western blotting.

Results:

We confirmed that miR-331-3p is upregulated in gemcitabine-treated pancreatic cancer cells and plasma from chemotherapy patients. We also confirmed that miR-331-3p inhibition decreased drug resistance by regulating cell apoptosis and multidrug resistance protein 1, multidrug resistance-related protein 1, and breast cancer resistance protein expression in pancreatic cancer cells, whereas miR-331-3p overexpression had the opposite effect. We further demonstrated that miR-331-3p effects in drug resistance were partially reversed by ST7L overexpression. In addition, overexpression of miR-331-3p activated Wnt/β-catenin signaling in pancreatic cancer cells, and ST7L overexpression restored activation of Wnt/β-catenin signaling.

Conclusions:

Taken together, our data demonstrate that miR-331-3p contributes to drug resistance by activating Wnt/β-catenin signaling via ST7L in pancreatic cancer cells. These data provide a theoretical basis for new targeted therapies in the future.
Reducing Aggression Using a Multimodal Cognitive Behavioral Treatment Approach: A Case Study of a Preschooler With Oppositional Defiant Disorder
Authors: Calub Catrina A. , Rapport Mark D. , Alexander Kristi
Published: September 2020

Individual cognitive behavioral therapies (CBT) have been shown to be effective in decreasing disruptive behaviors in children and adolescents; however, less is known regarding their efficacy with preschoolers given the developmental limitations accompanying this age range. The current case study extends the use of individual CBT to a preschool aged girl with oppositional defiant disorder (ODD), and is the first to investigate its efficacy in combination with behaviorally-based parent training and classroom teacher consultation. A total of 18 CBT sessions with the child and her parents, in addition to school observations and on-site and phone consultations with teachers, were conducted over a 4-month period. Post-treatment and 2-month follow-up assessments demonstrated significant decreases in physical aggression and property destruction, as well as for parent and teacher reported internalizing and externalizing symptoms. Collectively, results of the case study provide preliminary evidence that a multimodal approach can be applied effectively to treat behavioral problems in preschool-age children.
Getting Sucker Punched by Depdc5 Really Hurts
Authors: Weston Matthew
Published: September 2020

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White Matter Hyperintensities Predict Response to Language Treatment in Poststroke Aphasia
Authors: Varkanitsa Maria , Peñaloza Claudia , Charidimou Andreas , Caplan David , Kiran Swathi
Published: September 2020

Background

White matter hyperintensities (WMH) are a radiological marker of brain health that has been associated with language status in poststroke aphasia; however, its association with language treatment outcomes remains unknown.

Objective

To determine whether WMH in the right hemisphere (RH) predict response to language therapy independently from demographics and stroke lesion–related factors in poststroke aphasia.

Methods

We used the Fazekas scale to rate WMH in the RH in 30 patients with poststroke aphasia who received language treatment. We developed ordinal regression models to examine language treatment effects as a function of WMH severity after controlling for aphasia severity, stroke lesion volume, time post onset, age, and education level. We also evaluated associations between WMH severity and both pre-treatment naming ability and executive function.

Results

The severity of WMH in the RH predicted treatment response independently from demographic and stroke-related factors such that patients with less severe WMH exhibited better treatment outcome. WMH scores were not significantly correlated with pretreatment language scores, but they were significantly correlated with pretreatment scores of executive function.

Conclusion

We suggest that the severity of WMH in the RH is a clinically relevant predictor of treatment response in this population.
Examination of a non-orthogonal multiple access scheme for next generation wireless networks
Authors: Shankar Ravi
Published: September 2020

Non-orthogonal multiple access (NOMA) is an important technique that enables fifth-generation (5G) wireless systems to satisfy the heterogeneous requirements of enhanced fairness, huge connectivity, high performance, low latency, and high reliability. In this work, the NOMA technique for 5G wireless communication is investigated, and considering user fairness limitations, the channel capacity has been optimized. Also, bandwidth efficiency (BE) is examined and the relationship between BE and energy efficiency (EE) is derived. Simulation results show that without wasting power the near user gets preference in power allocation when the target rate is greater than 6.4 bps/Hz. Also, when the target rate [Formula: see text] 6.4 bps/Hz, the outage performance of the near user will improve and the performance of the far user will remain the same. Also, it is demonstrated that cooperative NOMA outperforms all other techniques. Simulation outcomes confirm that NOMA performs better than conventional multiple access techniques in terms of EE and BE.
Application of an extracorporeal prefenestrated stent graft in endovascular repair of ascending aorta and aortic arch lesions
Authors: Wang Liang , Bai Lei , Zhang Yujing , Liu Jianglong , Li Xiaodong
Published: September 2020

Objectives

Aortic dissection involving the ascending aorta and aortic arch is a serious condition. Treatment using traditional surgical methods has certain disadvantages. This study investigated the effectiveness of thoracic endovascular repair of aortic dissection using an external prefenestrated stent.

Methods

We present a series of aortic dissection cases involving the ascending aorta and aortic arch treated with an external prefenestrated stent.

Results

Postoperative follow-up of the patients showed that all stents were released at the proper position and that branch vessels were not occluded, and there were no instances of type I endoleak. One patient died suddenly one week after surgery; another experienced retrograde type A aortic dissection in the second week; and type I endoleak occurred in one patient in the first week, although this resolved within six months. No serious complications such as cerebrovascular events, acute spinal cord ischemia, and paraplegia occurred during the perioperative period. All patients had false lumen thrombosis in the ascending aorta and aortic arch.

Conclusion

Prefenestrated stent grafting is a feasible treatment option for repairing an entry tear in the ascending aorta.
Two-year follow-up of bioresorbable vascular scaffolds in severe infra-popliteal arterial disease
Authors: Dia AbdulRahman , Venturini Joseph M , Kalathiya Rohan J , Besser Stephanie , Estrada Jeremy Raider , Friant Janet , Paul Jonathan , Blair John E , Nathan Sandeep , Shah Atman P
Published: September 2020

Objectives

To assess the safety, efficacy, and durability of the Absorb bioresorbable vascular scaffold in predominantly complex, infra-popliteal lesions for the management of chronic limb ischemia at two-year clinical follow-up. Bioresorbable vascular scaffold are biodegradable scaffolds that provide short-term vascular support before undergoing intravascular degradation. A recent trial reported excellent 36-month vessel patency rates in simple infrapopliteal arterial lesions treated with Absorb bioresorbable vascular scaffold.

Methods

This single-center, retrospective study evaluated the use of the Absorb bioresorbable vascular scaffold (everolimus impregnated poly-L-lactic scaffold) in patients with infra-popliteal peripheral arterial disease (PAD) with respect to safety (thrombosis and TIMI bleeding), technical success, and freedom from clinically driven target vessel failure at 24 months.

Results

31 patients (51.6% male) with a median age of 67 years with predominantly advanced infra-popliteal disease were treated with 49 bioresorbable vascular scaffold in 41 vessels. The mean stenosis was 94% (80–100), with 49% of lesions being chronic thrombotic occlusions. No scaffold thrombosis or peri-procedural bleeding was observed. Procedural success was achieved in all patients; 93.5% of patients experienced freedom from clinically driven target vessel failure at 24 months, driven by one revascularization and one amputation. Primary patency was 96.7% at 12 months and 87.1% at 24 months. All patients were alive at 12 and 24 months.

Conclusions

At 24 months, our study found that patients with predominantly advanced infra-popliteal PAD who were treated with Absorb bioresorbable vascular scaffold reported improved clinical status and a low and durable rate of clinically driven target vessel failure extending out to 24 months.
EGFR/c-Met and mTOR signaling are predictors of survival in non-small cell lung cancer
Authors: Crees Zachary D , Shearrow Caleb , Lin Leo , Girard Jennifer , Arasi Kavin , Bhoraskar Aayush , Berei Joseph , Eckburg Adam , Anderson Austin D. , Garcia Christian , Munger Ariana , Palani Sunil , Smith Thomas J , Sreenivassappa Shylendra B , Vitali Connie , David Odile , Puri Neelu
Published: September 2020

Background:

EGFR/c-Met activation/amplification and co-expression, mTOR upregulation/activation, and Akt/Wnt signaling upregulation have been individually associated with more aggressive disease and characterized as potential prognostic markers for lung cancer patients.

Methods:

Tumors obtained from 109 participants with stage I–IV non-small cell lung cancer (NSCLC) were studied for EGFR/c-Met co-localization as well as for total and active forms of EGFR, c-Met, mTOR, S6K, beta-catenin, and Axin2. Slides were graded by two independent blinded pathologists using a validated scoring system. Protein expression profile correlations were assessed using Pearson correlation and Spearman’s rho. Prognosis was assessed using Kaplan–Meier analysis.

Results:

Protein expression profile analysis revealed significant correlations between EGFR/p-EGFR ( p = 0.0412) and p-mTOR/S6K ( p = 0.0044). Co-localization of p-EGFR/p-c-Met was associated with increased p-mTOR ( p = 0.0006), S6K ( p = 0.0018), and p-S6K ( p < 0.0001) expression. In contrast, active beta-catenin was not positively correlated with EGFR/c-Met nor any activated proteins. Axin2, a negative regulator of the Wnt pathway, was correlated with EGFR, p-EGFR, p-mTOR, p-S6K, EGFR/c-Met co-localization, and p-EGFR/p-c-Met co-localization (all p-values <0.03). Kaplan–Meier analysis revealed shorter median survival in participants with high expression of Axin2, total beta-catenin, total/p-S6K, total/p-mTOR, EGFR, and EGFR/c-Met co-localization compared with low expression. After controlling for stage of disease at diagnosis, subjects with late-stage disease demonstrated shorter median survival when exhibiting high co-expression of EGFR/c-Met (8.1 month versus 22.3 month, p = 0.050), mTOR (6.7 month versus 22.3 month, p = 0.002), and p-mTOR (8.1 month versus 25.4 month, p = 0.004) compared with low levels.

Conclusions:

These findings suggest that increased EGFR/c-Met signaling is correlated with upregulated mTOR/S6K signaling, which may in turn be associated with shorter median survival in late-stage NSCLC.
Outcomes of the 2019 novel coronavirus in patients with or without a history of cancer: a multi-centre North London experience
Authors: Joharatnam-Hogan Nalinie , Hochhauser Daniel , Shiu Kai-Keen , Rush Hannah , Crolley Valerie , Wilson William , Sharma Anand , Muhammad Aun , Anwar Muhammad , Vasdev Nikhil , Goldstein Robert , Kantser Ganna , Saha Aramita , Raja Fharat , Bridgewater John , Khan Khurum
Published: September 2020

Background:

This study aims to compare the outcomes of COVID-19-positive disease in patients with a history of cancer to those without.

Methods:

We retrospectively collected clinical data and outcomes of COVID-19 positive cancer patients treated consecutively in five North London hospitals (cohort A). Outcomes recorded included time interval between most recent anti-cancer treatment and admission, severe outcome [a composite endpoint of intensive care unit (ITU) admission, ventilation and/or death] and mortality. Outcomes were compared with consecutively admitted COVID-19 positive patients, without a history of cancer (cohort B), treated at the primary centre during the same time period (1 March–30 April 2020). Patients were matched for age, gender and comorbidity.

Results:

The median age in both cohorts was 74 years, with 67% male, and comprised of 30 patients with cancer, and 90 without (1:3 ratio). For cohort B, 579 patients without a history of cancer and consecutively admitted were screened from the primary London hospital, 105 were COVID-19 positive and 90 were matched and included. Excluding cancer, both cohorts had a median of two comorbidities. The odds ratio (OR) for mortality, comparing patients with cancer to those without, was 1.05 [95% confidence interval (CI) 0.4–2.5], and severe outcome (OR 0.89, 95% CI 0.4–2.0) suggesting no increased risk of death or a severe outcome in patients with cancer. Cancer patients who received systemic treatment within 28 days had an OR for mortality of 4.05 (95% CI 0.68–23.95), p = 0.12. On presentation anaemia, hypokalaemia, hypoalbuminaemia and hypoproteinaemia were identified predominantly in cohort A. Median duration of admission was 8 days for cancer patients and 7 days for non-cancer.

Conclusion:

A diagnosis of cancer does not appear to increase the risk of death or a severe outcome in COVID-19 patients with cancer compared with those without cancer. If a second spike of virus strikes, rational decision making is required to ensure optimal cancer care.
Clinical efficacy and safety of sirolimus in systemic lupus erythematosus: a real-world study and meta-analysis
Authors: Peng Liying , Wu Chanyuan , Hong Ruping , Sun Yiduo , Qian Junyan , Zhao Jiuliang , Wang Qian , Tian Xinping , Wang Yanhong , Li Mengtao , Zeng Xiaofeng
Published: September 2020

Objective:

To provide real-world data and summarize current clinical evidence on the efficacy and safety of sirolimus in active systemic lupus erythematosus (SLE) patients.

Methods:

This was a prospective real-world clinical study. Included SLE patients should have Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) ⩾ 2. They were treated with sirolimus and followed up regularly. The SLEDAI-2K, Physician Global Assessment (PGA), serological activity indices, and remission of organ manifestations were evaluated. We also performed a meta-analysis to integrate current evidence of sirolimus in SLE.

Results:

A total of 49 patients were included in the final analysis. After treatment, the SLEDAI-2K (6.2 ± 3.1 versus 4.0 ± 3.4, p = 0.001) decreased significantly, and the prednisone dosage was tapered successfully (9.9 ± 8.8 mg/day versus 5.9 ± 4.0 mg/day, p = 0.002). Serological activity indices also improved [complement 3 (C3): 0.690 ± 0.209 g/l versus 0.884 ± 0.219 g/l, p < 0.001; complement 4: 0.105 ± 0.059 g/l versus 0.141 ± 0.069 g/l, p < 0.001; anti-dsDNA antibody, 200 ± 178 IU/ml versus 156 ± 163 IU/ml, p = 0.022]. The remission proportions of arthritis, skin rash, and thrombocytopenia were 100%, 88.8%, and 46.2%, respectively. A total of 41.2% of lupus nephritis (LN) patients achieved renal remission, but the average 24-h urine protein level was not significantly changed. Meta-analysis enrolled five studies with 149 patients included, and revealed similar results regarding the changes of SLEDAI-2K [−3.5 (−5.0, −2.1)], C3 [0.224 (0.136, 0.311) g/l] and daily dosage of prednisone [−12.7 (−19.9, −5.6) mg/day].

Conclusion:

Sirolimus might be effective and tolerated in SLE. The role of sirolimus in LN requires further study.