bluuebunny/crossref_metadata_2025 huggingface dataset:
“A Major Quality of Life Issue”: A Survey-Based Analysis of the Experiences of Adults With Laryngotracheal Stenosis with Mucus and Cough
Authors: Clunie Gemma M. , Anderson Catherine , Savage Matthew , Hughes Catherine , Roe Justin W. G. , Sandhu Gurpreet , McGregor Alison , Alexander Caroline M.
Published: October 2021

Objectives:

To investigate how the symptoms of mucus and cough impact adults living with laryngotracheal stenosis, and to use this information to guide future research and treatment plans.

Methods:

A survey was developed with the support of patient advisors and distributed to people suffering with laryngotracheal stenosis. The survey comprised 15 closed and open questions relating to mucus and cough and included the Leicester Cough Questionnaire (LCQ). Descriptive statistics, X2 and thematic analyses were completed.

Results:

In total, 641 participants completed the survey, with 83.62% (n = 536) reporting problems with mucus; 79% having daily issues of varying severity that led to difficulties with cough (46.18%) and breathing (20.90%). Mucus affected voice and swallowing to a lesser degree. Respondents described a range of triggers; they identified smoky air as the worst environmental trigger. Strategies to manage mucus varied widely with drinking water (72.26%), increasing liquid intake in general (49.35%) and avoiding or reducing dairy (45.32%) the most common approaches to control symptoms. The LCQ showed a median total score of 14 (interquartile range 11-17) indicative of cough negatively affecting quality of life. Thematic analysis of free text responses identified 4 key themes—the Mucus Cycle, Social impact, Psychological impact, and Physical impact.

Conclusion:

This study shows the relevance of research focusing on mucus and cough and its negative impact on quality of life, among adults with laryngotracheal stenosis. It demonstrates the inconsistent advice and management strategies provided by clinicians for this issue. Further research is required to identify clearer treatment options and pathways.
Parental aspirations, schools, and the limits of flexible citizenship: Examining elite return migrants’ schooling decisions
Authors: Lee Atterberry Adrienne
Published: October 2021

This article investigates how return migrant parents navigate primary and secondary education options in Bangalore, a city in southwest India, by addressing the following question: What factors do return migrant parents consider when making schooling decisions? Through analyzing interviews with return migrant parents from 37 different families, the author argues that parents ultimately want to give their children the skills necessary to pursue their educational and professional interests anywhere in the world. To do so, parents select the ‘best’ school for their child, taking into consideration its demographics, curriculum, and reputation. However, in the process of crafting their children’s transnational futures, parents encounter stumbling blocks as they prepare for the transition from high school to college.
Negotiating euthanasia: Civil society contesting ‘the completed life’
Authors: Weicht Bernhard , Forchtner Bernhard
Published: October 2021

Autonomy and independence have become crucial elements of end-of-life decision making. Opinions on the latter are, however, strongly contested in public discourses. This contribution analyses arguments in favour of and against a Dutch civil society initiative which promotes the extension of the legislation on euthanasia. The authors investigate Dutch newspapers associated with three groups: religious, liberal and humanist perspectives, and do so by utilising quantitative and qualitative elements from a discourse-analytical perspective, raising the following questions: Which stances can be identified? How do different parties position themselves with regard to a ‘completed life’ and a ‘good death’? To what extent do these positions create demarcations between ‘us’ and ‘them’? The authors show that the debate developed along the lines of three key topoi: the topos of autonomy, the topos of human worth and the topos of embeddedness. The authors thereby identify how the different discursive positions define different visions of dying as ‘legitimate’ and as a proper end to a completed life.
Paraprofessional and Teacher Relationships in Working With Students With or At Risk of Disruptive Behavior Disorders
Authors: Bronstein Briana , Reddy Linda A. , Glover Todd A. , Wiggs Nicole B. , Dudek Christopher M.
Published: October 2021

Limited research has been conducted examining the relationship between paraprofessionals and teacher supervisors. This study examined 175 paraprofessionals of students with or at risk of disruptive behavior disorders who reported relationships with classroom teachers in 59 U.S. elementary schools. Overall, paraprofessionals rated their relationship with their classroom teachers as positive. Differences in relationship qualities were examined in relation to paraprofessional race/ethnicity, level of education, years of experience, and school economic status (i.e., percentage of students receiving free and reduced-price lunch). Results indicated that Latinx and Black paraprofessionals reported lower overall relationship quality with their classroom teachers than White paraprofessionals. Paraprofessionals with more years of experience, in general, reported better relationship quality and communications with their classroom teachers; no differences were found for educational level. Negative correlations ( rs = −.25, −.26) were found between relationship qualities and school economic status. Implications for practice and research are discussed.
Fuzzy Frontiers? Testing the Fluidity of National, Partisan and Brexit Identities in the Aftermath of the 2016 Referendum
Authors: Kenny John , Heath Anthony , Richards Lindsay
Published: October 2021

British and English national identities have long been considered to have porous boundaries whereby English individuals consider the terms more or less interchangeable. However, there is no empirical evidence to demonstrate whether primary feelings of either Britishness or Englishness are highly fluid within-individuals or whether individuals are consistent in their perceptions of their British or English identity. This is especially relevant in the post-Brexit referendum context where national identity is highly correlated with Brexit attitudes. Using panel data, we demonstrate that there is a notable degree of fluidity between identifying as British or English. This is higher than the fluidity between other national identities in the UK as well as more fluid than moving between any partisan or EU referendum identities. Remainers are more fluid than Leavers in their Englishness, whereas they are similar in the fluidity of their Britishness.
What Does It Mean to Be a Clinical Track Faculty Member in Public Health? A Survey of Clinical Track Faculty Across the United States
Authors: August Ella , Power Laura , Youatt Emily J. , Anderson Olivia S.
Published: October 2021

Objectives

The clinical professor track has expanded and reflects a trend toward hiring non–tenure-track faculty in public health; however, little is known about this track. We documented characteristics of clinical faculty at US schools of public health.

Methods

We surveyed clinical faculty at Council on Education for Public Health–accredited schools of public health in the United States in 2019, identified via each school’s website. We invited faculty (n = 264) who had the word clinical in their title (ie, apparently eligible faculty), had a working email address, and were not authors of this article to provide information about their rank, degree credentials, expectations for teaching, service, research and practice, and promotion criteria at their institution. In addition, we used open-ended responses to explain and contextualize quantitative data.

Results

Of 264 apparently eligible faculty surveyed, 88 (33.3%) responded. We included 81 eligible clinical faculty in our final sample, of whom 46 (56.8%) were assistant professors and 72 (88.9%) had a terminal degree; 57 of 80 (71.3%) had an initial contract of ≤2 years or no contract. Most clinical faculty listed service (96.2%), teaching (95.0%), and student advising/mentoring (86.3%) as duties; fewer clinical faculty reported research (55.0%), practice (33.8%), or clinic (7.5%) duties. Only 37.1% of respondents agreed or strongly agreed that promotion policies for clinical track faculty were clear.

Conclusions

If most clinical faculty are at the lowest academic rank, with short contracts and unclear expectations, it will be difficult for clinical faculty to advance and challenging for schools of public health to benefit from this track. Clear institutional expectations for scope of work and promotion may enhance the contribution of clinical faculty to schools of public health and help define this track.
Customizing Early Intervention Treatment for Psychosis in the UTHealth – Harris County Psychiatric Center
Authors: Warner Alia R , Shen Gordon C , Hamilton Jane E , Lavagnino Luca , Lane Scott D
Published: October 2021

High-need, high-cost patients include those with diagnosed serious mental illnesses (e.g., schizophrenia; SMI). They often delay or fail to seek treatment. If they receive treatment, care is often sought from generalist settings (e.g., primary care or emergency medicine) or is suboptimal due to the provision of limited, non-evidence-based intervention and lack of communication, integration, and coordination among providers. This results in high aggregate costs and poor outcomes. Value-based health care requires care coordination to address the medical and social needs of this population. We describe a unique early intervention program for SMI that emanates from an inpatient setting: The Early Onset Treatment Program (EOTP) at the University of Texas Health Science Center at Houston–Harris County Psychiatric Center. The EOTP offers free, phase-specific, multidisciplinary treatment to young adults without health insurance with the aim of improving their long-term outcomes and reducing the rate of rehospitalization. An evaluation of the EOTP indicates program participants were significantly less likely to be rehospitalized at six months (4.73 times less likely) and at 12 months (3.5 times less likely) than a comparison group ( p <.001), and participants’ scores of symptomatology and disability significantly decreased following treatment.
Caregivers’ Use of Personal and Social Resourcefulness: Differences by Care Recipient Condition
Authors: Zauszniewski Jaclene A. , Burant Christopher J. , Martin Richard J. , Sweetko John S. , DiFranco Evelina
Published: October 2021

Although family caregivers who use both the personal and social resourcefulness skills have the best health outcomes, it is unknown whether their tendency toward personal or social resourcefulness varies by their care recipient’s condition. This cross-sectional study of existing data from 234 caregivers of persons with various conditions examined five item pairs from the Resourcefulness Scale© with responses capturing personal and social resourcefulness in relation to anxiety, anger, sadness, indecision, and financial distress. Caregivers were categorized by the recipient’s condition (amyotrophic lateral sclerosis, cancer, dementia, mental illness, Parkinson’s disease, stroke, traumatic brain injury, other, or multiple conditions). Findings showed that across most groups, caregivers used both personal and social resourcefulness when angry, sad, or indecisive and personal resourcefulness when anxious or managing money. Caregivers of persons with cancer, traumatic brain injury, stroke, and mental illness differed. The findings provide a basis for future clinical trials across diverse caregiver groups.
Lived Experiences of Women with Dissociative Disorder: An Interpretative Phenomenological Analysis
Authors: Emran Ashti , Sharma Vibha , Singh Ravinder , Jha Manisha , Iqbal Naved
Published: October 2021

Background:

In the Indian setting, several studies have documented that dissociative disorders (DDs) are more common in females, and the most commonly elicited stressors are interpersonal. However, much of the research up to now has been quantitative. There is a notable paucity of qualitative studies exploring the subjective experiences of women with DD. Therefore, the present study sought to explore and gain an in-depth understanding of the lived experiences of women diagnosed with DD.

Methods:

Five women were recruited who were seeking psychological treatment for dissociative symptoms at a tertiary care neuropsychiatric institute in North India. In-depth interviews were conducted with each, and the transcripts were analyzed using the analytic method of interpretative phenomenological analysis.

Results:

Three superordinate themes that emerged were: patients’ illness perspectives, the salience of relationships, and dealing with relationship conflicts.

Conclusions:

Our findings highlight the role of culture in influencing the participants’ illness perspectives. Women with DD tend to define their self in relational terms and, thus, inhibit the expression of one’s needs and opinions, to avoid conflict and to maintain harmony in relationships.
Levosimendan administration is not associated with increased risk of bleeding and blood transfusion requirement in patients undergoing off-pump coronary artery bypass grafting: a retrospective study from single center
Authors: Wang Li-hong , Wang Xiao-hong , Tan Jie-chao , He Li-xian , Fu Run-qiao , Lin Yong , Yao Yun-tai
Published: October 2021

Background:

Levosimendan (LEVO) is a positive inotropic drug which could increase myocardial contractility and reduce the mortality rate in cardiac surgical patients. However, Whether LEVO is associated with postoperative bleeding and blood transfusion in cardiac surgical patients is controversial. Therefore, the current study was designed to investigate the impact of LEVO administration on bleeding and blood transfusion requirement in off-pump coronary artery bypass grafting (OPCAB) patients.

Methods:

In a retrospective analysis, a total of 292 patients, aged 40–87 years, undergoing elective OPCAB between January 2019 and July 2019, were divided into LEVO group ( n = 151) and Control group ( n = 141). Patients in LEVO group continuously received LEVO at a rate of 0.1–0.2 μg kg−1 min−1 after anesthesia induction until 24 hours after OPCAB or patients in Control group received no LEVO. The primary outcome was postoperative chest drainage volume. The secondary outcomes were reoperation for postoperative bleeding, transfusion requirement of red blood cells (RBCs), fresh frozen plasma (FFP) and platelet concentrate (PC), etc. Comparisons of two groups were performed with the Student’s t-test or Wilcoxon-Mann-Whitney test.

Results:

There was no significant difference with respect to chest drainage volume ((956.29 ± 555.45) ml vs (1003.19 ± 572.25) ml, p = 0.478) and the incidence of reoperation for postoperative bleeding (1.32% vs 1.42%, p = 0.945) between LEVO group and Control group. The transfusion incidence and volume of allogeneic RBCs, FFP, and PC were comparable between two groups.

Conclusions:

LEVO administration was neither associated with more postoperative blood loss nor increased allogeneic blood transfusion requirement in OPCAB patients.
Pharmacokinetic analysis of different contrast agents on multiphase enhanced MRI for microvascular invasion: preoperative prediction in hepatocellular carcinoma
Authors: Lin Zehong , Wang Xinxin , Zhang Guijie , Zhou Xueyan , Zhou Yang
Published: October 2021

Background

The preoperative diagnosis of microvascular invasion (MVI) for the solitary small hepatocellular carcinoma (sHCC) is crucial for the decision of surgical strategies.

Purpose

To compare the kinetic parameters and diagnostic effects of two contrast agents for preoperatively predicting MVI of sHCC on multiphase enhanced magnetic resonance imaging (MRI).

Material and Methods

Two groups of patients with known solitary sHCC underwent an enhanced MRI examination before hepatic resection: Data A (n = 61) patients underwent Gd-EOB-DTPA-enhanced MRI, and Data B (n = 41) patients had a normal contrast agent. The two sets of data were processed in the same way. Arterial peritumoral enhancement measured from multiphase enhanced MRI was analyzed using quantitative kinetic parameters, including initial signal enhancement (SE1), peak signal enhancement (SEpeak), and calculation of the signal enhancement ratio (SER).

Results

The statistical analysis showed that the average SE1 and SER (Data A) for the MVI-positive group were significantly higher ( P < 0.05) than those in the MVI-negative group. The SER (Data B) and SEpeak showed no significant difference for either group. In Data A, the receiver operating characteristic analysis between the two groups had an area under the curve of 0.74 and 0.71 for SE1 and SER, respectively, which was higher than that of Data B. The different contrast agents had the same enhancement curve trend.

Conclusion

Gd-EOB-DTPA-enhanced MRI had a better quantitative kinetic parameter analysis effect for arterial peritumoral enhancement on predicting MVI of sHCC in clinical practice.
The effects of group keyboard music making on the mood states of college students
Authors: Van Kekerix Todd , Elder William , Crappell Courtney , Neuhauser Claudia , Nesic-Taylor Olivera
Published: October 2021

Our pilot study explored the effects of a new, five-session group keyboard music-making protocol on the mood states of non-musician college students. Twenty-five math and engineering students participated in a keyboard music-making program without the expectation or need for extensive technical preparation or regular music practice. To assess changes in mood states before and after music-making activities, we administered the Profile of Mood States-Short Form (POMS-SF) questionnaire. Here, we show significant and lasting improvements in participant’s negative and positive mood states, which were more robust than mood improvements reported with other Recreational Music Making (RMM) protocols, suggesting a strong therapeutic potential of our group keyboard music-making program.
Thinking with attachments: Appreciating a generative analytic
Authors: de Laet Marianne , Driessen Annelieke , Vogel Else
Published: October 2021

Much current work in Science and Technology Studies inflects knowing with care. Analyses of the ethos of objectivity, and of the practices by which objectivity is crafted, have shown that knowing and caring cannot be thought apart from each other. Using case studies from our own work we analyse how, in the sociotechnical relationships that we study, knowing and caring are entangled through ‘attachments’. We appreciate – both in the sense of valuing or respecting and in the sense of evaluating or assessing – how the notion of ‘attachment’ invites re-imagining relations between the social and the technical, between knowers and objects known, and between sociotechnical work and the affective sensibilities that enable, and are brought to life by, such work. Our respective ethnographic engagements with dog-human relations, obesity surgery and dementia care demonstrate that it is agents’ diverse and shifting attachments to technologies and techniques that shape the ways in which bodies, knowledge and practices form. The affects that arise in this process, or so we claim in neo-pragmatist fashion, are not preconditions to, but rather the result of such practices of attachment; rather than a prerequisite, they are an effect of the work of attaching itself. Thinking with attachments recognizes how techno-scientific work builds and shapes passions, aesthetics and sensory experience, allowing us to trace how varied sensibilities to what constitutes ‘the good’ come to be and come to matter in practices of relating between humans, animals and things.
One-Way Coupling of Fire and Egress Modeling for Realistic Evaluation of Evacuation Process
Authors: Cheong He-in , Wu Zhiyu , Majumdar Arnab , Yotto Ochieng Washington
Published: October 2021

In the discipline of fire engineering, computational simulation tools are used to evaluate the available safe egress time (ASET) and required safe egress time (RSET) of a building fire. ASET and RSET are often analyzed separately, using computational fluid dynamics (CFD) and crowd dynamics, respectively. Although there are advantages to coupling the ASET and RSET analysis to quantify tenability conditions and reevaluate evacuation time within a building, the coupling process is computationally complex, requiring multiple steps. The coupling setup can be time-consuming, particularly when the results are limited to the modeled scenario. In addition, the procedure is not uniform throughout the industry. This paper presents the successful one-way coupling of CFD and crowd dynamics modeling through a new simplified methodology that captures the impact of fractional effective dose (FED) and reduced visibility from smoke on the individual evacuee’s movement and the human interaction. The simulation tools used were Fire Dynamics Simulator (FDS) and Oasys MassMotion for crowd dynamics. The coupling was carried out with the help of the software development kit of Oasys MassMotion in two different example geometries: an open-plan room and a floor with six rooms and a corridor. The results presented in this paper show that, when comparing an uncoupled and a coupled simulation, the effects of the smoke lead to different crowd density profiles, particularly closer to the exit, which elongates the overall evacuation time. This coupling method can be applied to any geometry because of its flexible and modular framework.
Club Formation and Response To Natural Disaster: An Example From South Carolina
Authors: Kyer Ben L. , Maggs Gary E.
Published: October 2021

In 2016, Hurricane Matthew caused approximately 10 billion dollars of damage in the United States and nearly 350 million dollars in South Carolina. The historic rainfall damaged or completely destroyed roads, bridges, buildings, crops, and dams. This paper documents how one small lakefront community in eastern South Carolina formed a de facto Buchanan Club to fund the reconstruction of a dam destroyed by Matthew and restore a small lake, an exemplary club good. This private response was needed because both the Federal and State governments declined public assistance. In the end and roughly approximately two years after Matthew, the dam was repaired and the lake refilled with the rainfall of Hurricane Florence.

JEL Classifications: H00, H41, H89
Macroeconomic Risk and Political Stability: Perspectives from Emerging and Developing Economies
Authors: Abaidoo Rexford , Agyapong Elvis
Published: October 2021

This study examines the impact of macroeconomic risk on political stability, using data compiled from 38 countries in the sub-region of sub-Saharan Africa (SSA), from 1996 to 2018. Macroeconomic risk index employed in this study is constructed using principal component analysis (PCA) from key economic variables. Empirical estimates verifying the relationship in question are conducted using the two-step system generalized method of moments (TS-SGMM) estimation technique. Presented empirical estimates suggest that macroeconomic risk has an adverse impact on political stability, all things being equal. Reported coefficient estimates further suggest that improvement in rule of law among economies in the sub-region significantly moderates the negative impact exerted on the political environment by macroeconomic risk. Coefficient estimates additionally suggest that improvement in governance and institutional variables (corruption control, government effectiveness, regulatory quality and rule of law) augment efforts at promoting political stability even in an environment characterized by volatile output growth.
Bio-inspired aquatic propulsion using piezoelectric effect
Authors: Bhamra Navinder Singh , Vijayan Kiran , Nagarajan Vishwanath
Published: October 2021

Underwater propulsion of fishes have inspired many biomimetic structures. Generally, the bio-inspired structures mimics the flapping behaviour of various control surfaces/fins in fishes. The present study mimics the flapping behaviour using a piezoelectric structure. The system is analyzed as a fluid structure interaction problem. The dynamic behaviour of a cantilever beam surrounded by a bounded fluid domain open at top is analyzed. The structure is modeled as a Euler-Bernoulli beam and the fluid is modeled using potential flow theory. The influence of domain size on the wet natural frequencies of the system was analyzed. The dimensions of the fluid domain wherein the variation in wet natural frequencies becomes insensitive were determined. The influence of added mass on the wet natural frequency was parametrized based on Non-dimensional Added Mass Increment (NAVMI) factor. The NAVMI factors were observed to be relatively higher for lower wet modes of the structure. Therefore, the peizo-beam was analyzed by exciting the lower wet modes. The thrust generated at different excitation frequencies were determined using tip velocity of the cantilever beam following Lighthill’s analogy. The results from the study indicated that higher propulsive thrust was produced for lower modes of excitation of the structure.
“My mom calls it Annaland”: A Qualitative Study of Phenomenology, Daily Life Impacts, and Treatment Considerations of Sluggish Cognitive Tempo
Authors: Becker Stephen P. , Fredrick Joseph W. , Foster Josalyn A. , Yeaman Kiley M. , Epstein Jeffery N. , Froehlich Tanya E. , Mitchell John T.
Published: October 2021

Objective: To conduct qualitative analysis of interviews to understand phenomenology, daily life impact, and treatment considerations of sluggish cognitive tempo (SCT) behaviors in children and adolescents. Method: Youth with elevated SCT symptoms ( N = 15, ages 9–16 years) and their parents completed interviews focused on their perception and daily life impact of SCT behaviors. Parents were also asked about intervention targets. Results: Parents and youth had both negative and positive perceptions of SCT, with SCT fostering creativity/imagination and a break from stressors while also negatively impacting daily functioning. The domains most frequently selected by parents as SCT intervention targets were academics, emotions, mind wandering, morning routines, and self-esteem. Conclusion: Children and their parents share negative and positive views of SCT behaviors, while also detailing specific ways that SCT negatively impacts day-to-day functioning. This study offers insights into possible intervention targets as provided by youth and parents directly impacted by SCT.
Refractory iatrogenic pigmentary glaucoma secondary to cosmetic laser treatment: A case report
Authors: Ong Ariel Yuhan , Ching-A-Sue Gemma , Krilis Matthew , Guirao-Navarro Maria Concepion , Hornby Stella , Jutley Gurjeet
Published: October 2021

Purpose

To report a case of bilateral iatrogenic pigmentary glaucoma secondary to cosmetic iris-lightening laser treatment.

Case report

A 39-year-old patient presented with bilateral iatrogenic pigmentary glaucoma. She had elevated intraocular pressures (IOPs), scattered iris pitting, and intense angle pigmentation secondary to the cosmetic laser treatment she underwent 4 weeks prior to presentation. Her IOPs were refractory to maximal medical treatment and she subsequently underwent trabeculectomy.

Conclusion

The true scale of complications related to cosmetic laser treatments is as yet unknown. Robust clinical investigations into its safety profile, including long-term data, are required. Prospective patients should consider this with great care. Clinicians should be aware of the potential risks of this procedure, as early recognition of cosmetic laser-induced pigmentary glaucoma may avert further sequelae.
Sedoanalgesia with intravenous midazolam and fentanyl for angioplasty of dysfunctional arteriovenous access: A retrospective single-center analysis
Authors: Huang Shih-Ming , Hsu Honda , Hii Ing-Heng , Chang Chien-Hwa
Published: October 2021

Background:

Endovascular therapy, such as percutaneous transluminal angioplasty (PTA), stenting, or embolization, is a well-established form of treatment to prolong the lifespan of arteriovenous access. These procedures, especially PTA, can be accompanied with severe pain. We reviewed and analyzed the efficacy, safety, and outcome of sedoanalgesia using intravenous midazolam and fentanyl, for pain relief during these procedures.

Methods:

Two hundred and two consecutive patients with dysfunctional dialysis access that had undergone endovascular procedure in our institute between July and November 2017 were included in this study. The dialysis access profile, procedure complication, and 10-point Visual Analog Scale (VAS) were collected. One-year clinical follow-up record was also collected to evaluate arteriovenous access patency and long-term complications.

Results:

Among the 202 patients, the mean age was (mean ± SD) 67.0 ± 12.08 years. Dialysis access profile of these patients were 119 (58.9%) native arteriovenous fistula and 162 (74.2%) forearm access. The number of lesions treated were 1.63 ± 0.802. Immediate complications included 11 (5.44%) nausea/vomiting, 24 (11.88%) desaturation (SpO2 < 90%, resolved after pillow removal or jaw trust), 16 (7.9%) hypotension (SBP < 90 mmHg, resolved without inotropic agents). There was a low average pain score (1.16 ± 1.594) during the procedure with 136 (67.3%) no pain (VAS 0–1) and 56 (27.7%) mild pain (VAS 2–4). Higher VAS score correlated with overweight patients, longer PTA time and pain after procedure. Six-month primary patency rate was 49.17% and primary assisted patency rate was 93.04%.

Conclusions:

Sedoanalgesia with intravenous midazolam and fentanyl is an easy, safe, and effective method for surgeons.
Traction effects on the dynamics of ball bearings
Authors: Zhao Yang , Liu Heng , Fan Bowen
Published: October 2021

In the paper, a combined model of traction and ball bearings dynamics is established, considering the interaction among the cage, races, and balls. A curve-fitted traction model, which can be used to analyze the effect of the geometry of the bearing and parameters of the lubricant, is applied. The traction that is affected by certain parameters is analyzed; then, the effect of the traction on ball bearings is investigated. The displacements of balls and contact angles are different under different surface roughness. The changes in displacements of balls and contact angles are obtained with different roughness, load, and velocities. The amplitudes of axial displacement of balls are bigger with the roughness being higher. The amplitudes of ball-inner contact angles increase with greater roughness, and the amplitudes of ball-outer race contact angles decrease with greater roughness. The simulated vibration results of ball bearings under different levels agree with the actual by the model.
Children as co-researchers and confessional research tales: Researcher positionality and the (dis)comforts of research
Authors: Supski Sian , Maher Jane Maree
Published: October 2021

In a study on children, families and food messages in Victoria, Australia, we utilised a multi-methods approach that included visual data produced by primary-school aged children. Working with 50 families, we provided each child investigator with an iPad for 3–4 days and invited them to photograph family food events important to them. The analysis of visual data alongside child and family interviews revealed the diverse meaning-making practices children draw on to understand food practices at home and school. These research practices aspired to locate the researchers and children as co-creators. In this paper, we reflect on the challenges and (dis)comfort we faced as researchers as the implications of co-creation emerged and we engaged with children’s voices, photos and families inside their homes. The multi-methods approach supported a comprehensive and rich engagement with commensality and pleasure in food practices at home for children, but illuminated the complex emotional and intellectual terrain of such research practices.
Excitotoxic lesions of the perirhinal cortex leave intact rats’ gustatory sensory preconditioning
Authors: Robinson Jasper , Jones Peter M. , Whitt Emma J.
Published: October 2021

We report findings from two sensory preconditioning experiments in which rats consumed two flavoured solutions, each with two gustatory components (AX and BY), composed of sweet, bitter, salt, and acid elements. After this pre-exposure, rats were conditioned to X by pairing with lithium chloride. Standard sensory preconditioning was observed: Consumption of flavour A was less than that of B. We found that sensory preconditioning was maintained when X was added to A and B. Both experiments included one group of rats with lesions of the perirhinal cortex, which did not influence sensory preconditioning. We discuss our findings in the light of other sensory preconditioning procedures that involve the perirhinal cortex and conclude that differences in experimental variables invoke different mechanisms of sensory preconditioning, which vary in their requirement of the perirhinal cortex.
The role of upadacitinib in the treatment of moderate-to-severe active rheumatoid arthritis
Authors: Avci Ali Berkant , Feist Eugen , Burmester Gerd Rüdiger
Published: October 2021

Despite recent promising developments in the treatment of rheumatoid arthritis (RA), a substantial proportion of patients still cannot achieve the treatment targets: low disease activity and remission. Janus kinase (JAK) inhibitors have the potential to fill this important gap with their high efficiency, rapid onset of action, and acceptable safety profile. The fact that the previously approved two JAK inhibitors, tofacitinib and baricitinib, inhibit more than one JAK molecule raised the question whether a safer profile can be possible by inhibiting fewer JAK molecules. Upadacitinib, a JAK 1 selective molecule developed in this context has been evaluated in the SELECT phase-III study program and demonstrated a high and rapid efficacy in monotherapy as well as in combination with csDMARDs both in csDMARD-naive RA patients and in patients refractory to csDMARD and bDMARD treatments. Upadacitinib 15 mg once daily displayed a similar safety profile except for increased creatine phosphokinase (CPK) levels and herpes zoster (HZ) risk compared to its active comparators methotrexate (MTX) and adalimumab. Most of the CPK elevations were asymptomatic, and most of the HZ cases were not serious. Along with the randomized-controlled studies and meta-analysis results, upadacitinib 15 mg once daily has a favorable efficacy/safety profile. Long-term extensions of current studies and real-world data will be important to fully appreciate its potential in the treatment of RA.
Many Marxisms
Authors: Glassman Jim
Published: October 2021

Revolutionary projects travelling around the world in the last century under the heading of “Marxism” have always morphed into significantly different forms, depending upon precisely where, when, and how they travelled. In this think piece honoring the career of Richard Peet, I argue that Marxism has thus been less a singular and unified phenomenon than a sprawling and variegated experience of resistance to capitalism, colonialism, and imperialism. Nonetheless, if there is one common thread in virtually all forms of Marxist thought, it is an emphasis on class. But what conception of class? I assert the centrality of class analysis to Marxist thought, albeit versions of class analysis that flexibly address the gendering and racialization of class relations along with other factors that shape and express class in given contexts. I illustrate the argument by noting the importance of Marxist class analysis to critical studies of imperialism, racism, and gender relations.
Gender-specific reference intervals for serum prolactin concentrations before and after precipitation by polyethylene glycol
Authors: Chincholkar Pallavi , Yeo Chin Pin , Ho Clement Kam Man
Published: October 2021

Prolactin, a hormone secreted by the anterior pituitary, exists in three major forms in circulation. The macroprolactin form is biologically inactive but contributes to elevated serum prolactin concentrations. Precipitation of macroprolactin by polyethylene glycol (PEG) is widely used in clinical laboratories for the screening of macroprolactin. The aim of this study was two-fold. Firstly, we sought to establish locally relevant reference intervals for serum prolactin and post-PEG precipitation prolactin concentrations in both genders on the Roche Cobas Prolactin II electrochemiluminescence immunoassay. Secondly, the prolactin concentrations after precipitation by PEG dissolved in phosphate-buffered saline (post-PEG(PBS)) were compared with those after precipitation by PEG dissolved in deionised water (PEG(diH2O)). Prolactin concentrations were measured by using the Prolactin Gen II assay on a Roche Cobas e601 analyser. Recoveries of prolactin after precipitation by PEG in PBS and PEG in diH2O were 64.7%–115.8% and 60.9–100.8%, respectively. Post-PEG (PBS) prolactin concentrations were not statistically different from post-PEG (diH2O) prolactin concentrations in either gender.
Pure primary non-gestational choriocarcinoma originating in the ovary: A case report and literature review
Authors: Yu Xiujie , Du Qiuyue , Zhang Xiaojing , Liu Yixin , Shen Yan
Published: October 2021

Non-gestational choriocarcinoma (NGCO) of the ovary is rare, with a prevalence of less than 0.6% of all ovarian germ-cell tumors; and when found with other germ cell tumors, pure NGCO is exceedingly rare. We herein report the case of a 22-year-old woman who complained of menstrual disorders for over 2 months. MRI examination revealed an 11.4 cm right adnexal mass of the uterus, and the patients manifested an elevated serum level of β-hCG of 77,928 mIU/ml. Fertility-preserving surgery was performed, and the pathologic diagnosis was pure NGCO; immunohistochemical staining showed cancer cells that were positive for β-hCG, CK, hPL, SALL4, and Ki-67 (>80% of cells stained). We performed polymorphic DNA analysis and non-gestational origin was confirmed. The patient was then treated with six courses of chemotherapy with a BEP regimen, after which her serum β-hCG levels declined to normal levels, and she was free of disease at the 30-month follow-up.
Classifying and tracking rehabilitation interventions through machine-learning algorithms in individuals with stroke
Authors: Espinoza Bernal Victor C , Hiremath Shivayogi V , Wolf Bethany , Riley Brooke , Mendonca Rochelle J , Johnson Michelle J
Published: October 2021

Introduction

Stroke is the leading cause of disability worldwide. It has been well-documented that rehabilitation (rehab) therapy can aid in regaining health and function for individuals with stroke. Yet, tracking in-home rehab continues to be a challenge because of a lack of resources and population-scale demands. In order to address this gap, we implemented a methodology to classify and track rehab interventions in individuals with stroke.

Methods

We developed personalized classification algorithms, including neural network-based algorithms, to classify four rehab exercises performed by two individuals with stroke who were part of a week-long therapy camp in Jamaica, a low- and middle-income country. Accelerometry-based wearable sensors were placed on each upper and lower limb to collect movement data during therapy.

Results

The classification accuracy for traditional and neural network-based algorithms utilizing feature data (e.g., number of peaks) from the sensors ranged from 64 to 94%, respectively. In addition, the study proposes a new method to assess change in bilateral mobility over the camp duration.

Conclusion

The results of this pilot study indicate that personalized supervised learning algorithms can be used to classify and track rehab activities and functional outcomes in resource limited settings such as LMICs.
Dedifferentiated liposarcoma with abrupt transition of low-grade and high-grade dedifferentiation: A rare case report
Authors: Wen Yang , He Xianglei , Zhao Ming
Published: October 2021

Dedifferentiated liposarcoma is a unique subtype of liposarcoma, which has obvious histological heterogeneity. In affected patients, the condition typically manifests as the dedifferentiation of high-grade histological morphology, but it may also manifest as the dedifferentiation of low-grade histological morphology. In some cases, unique histological or immunophenotypic characteristics are observed. We describe, herein, a rare case of dedifferentiated liposarcoma, in which the high-grade and low-grade dedifferentiated components coexisted with a relatively sharp transition in pathology.
Association of race and ethnicity with clinical phenotype, genetics, and survival in pediatric acute myeloid leukemia
Authors: Conneely Shannon E. , McAtee Casey L. , Gupta Rohit , Lubega Joseph , Scheurer Michael E. , Rau Rachel E.
Published: October 2021

Black and Hispanic children with acute myeloid leukemia (AML) have worse outcomes compared with White children. AML is a heterogeneous disease with numerous genetic subtypes in which these disparities have not been specifically investigated. In this study, we used the Therapeutically Applicable Research to Generate Effective Treatments (TARGET) database to examine the association of race-ethnicity with leukemia cytogenetics, clinical features, and survival outcomes within major cytogenetic subgroups of pediatric AML. Compared with White non-Hispanic patients, t(8;21) AML was more prevalent among Black (odds ratio [OR], 2.22; 95% confidence interval [CI], 1.28-3.74) and Hispanic patients (OR, 1.74; 95% CI, 1.05-2.83). The poor prognosis KMT2A rearrangement t(6;11)(q27;q23) was more prevalent among Black patients (OR, 6.12; 95% CI, 1.81-21.59). Among those with KMT2Ar AML, Black race was associated with inferior event-free survival (EFS) (hazard ratio [HR], 2.31; 95% CI, 1.41-3.79) and overall survival (OS) (HR, 2.54; 1.43-4.51). Hispanic patients with KMT2Ar AML also had inferior EFS (HR, 2.20; 95% CI, 1.27-3.80) and OS (HR, 2.07; 95% CI, 1.09-3.93). Similarly, among patients with t(8;21) or inv(16) AML (ie, core-binding factor [CBF] AML), Black patients had inferior outcomes (EFS HR, 1.93; 95% CI, 1.14-3.28 and OS HR, 3.24; 95% CI, 1.60-6.57). This disparity was not detected among patients receiving gemtuzumab ozogamicin (GO). In conclusion, racial-ethnic disparities in survival outcomes among young people with AML are prominent and vary across cytogenetic subclasses. Future studies should explore the socioeconomic and biologic determinants of these disparities.
Venetoclax and azacitidine compared with induction chemotherapy for newly diagnosed patients with acute myeloid leukemia
Authors: Cherry Evan M. , Abbott Diana , Amaya Maria , McMahon Christine , Schwartz Marc , Rosser Julie , Sato Audrey , Schowinsky Jeffrey , Inguva Anagha , Minhajuddin Mohd , Pei Shanshan , Stevens Brett , Winters Amanda , Jordan Craig T. , Smith Clayton , Gutman Jonathan A. , Pollyea Daniel A.
Published: October 2021

Venetoclax (ven) plus azacitidine (aza) is the standard of care for patients with newly diagnosed acute myeloid leukemia (AML) who are not candidates for intensive chemotherapy (IC). Some patients who are IC candidates instead receive ven/aza. We retrospectively analyzed patients with newly diagnosed AML who received ven/aza (n = 143) or IC (n = 149) to compare outcomes, seek variables that could predict response to 1 therapy or the other, and ascertain whether treatment recommendations could be refined. The response rates were 76.9% for ven/aza and 70.5% for IC. The median overall survival (OS) was 884 days for IC compared with 483 days for ven/aza (P = .0020). A propensity-matched cohort was used to compare outcomes in the setting of equivalent baseline variables, and when matched for age, biological risk, and transplantation, the median OS was 705 days for IC compared with not reached for ven/aza (P = .0667). Variables that favored response to ven/aza over IC included older age, secondary AML, and RUNX1 mutations. AML M5 favored response to IC over ven/aza. In the propensity-matched cohort analyzing OS, older age, adverse risk, and RUNX1 mutations favored ven/aza over IC, whereas intermediate risk favored IC over ven/aza. In conclusion, patients receiving IC have improved OS compared with those receiving ven/aza. However, in a propensity-matched cohort of patients with equivalent baseline factors, there was a trend toward favorable OS for ven/aza. Specific variables, such as RUNX1 mutations, reported here for the first time, can be identified that favor ven/aza or IC, helping to guide treatment decisions for patients who may be eligible candidates for either therapy.
Prognostic factors for development of acute respiratory distress syndrome following traumatic injury: a systematic review and meta-analysis
Authors: Tran Alexandre , Fernando Shannon M. , Brochard Laurent J. , Fan Eddy , Inaba Kenji , Ferguson Niall D. , Calfee Carolyn S. , Burns Karen E.A. , Brodie Daniel , McCredie Victoria A. , Kim Dennis Y. , Kyeremanteng Kwadwo , Lampron Jacinthe , Slutsky Arthur S. , Combes Alain , Rochwerg Bram
Published: October 2021

Background

Our purpose was to summarise the prognostic associations between various clinical risk factors and development of acute respiratory distress syndrome (ARDS) following traumatic injury.

Methods

We conducted this review in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and CHARMS (Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modeling Studies) guidelines. We searched six databases from inception through December 2020. We included English language studies describing the clinical risk factors associated with development of post-traumatic ARDS, as defined by either the American–European Consensus Conference or Berlin definition. We pooled adjusted odds ratios for prognostic factors using the random effects method. We assessed risk of bias using the QUIPS (Quality in Prognosis Studies) tool and certainty of findings using GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology.

Results

We included 39 studies involving 5 350 927 patients. We identified the amount of crystalloid resuscitation as a potentially modifiable prognostic factor associated with development of post-traumatic ARDS (adjusted OR 1.19, 95% CI 1.15–1.24 for each additional litre of crystalloid administered within the first 6 h after injury; high certainty). Non-modifiable prognostic factors with a moderate or high certainty of association with post-traumatic ARDS included increasing age, non-Hispanic White race, blunt mechanism of injury, presence of head injury, pulmonary contusion or rib fracture and increasing chest injury severity.

Conclusions

We identified one important modifiable factor, the amount of crystalloid resuscitation within the first 24 h of injury, and several non-modifiable factors associated with development of post-traumatic ARDS. This information should support the judicious use of crystalloid resuscitation in trauma patients and may inform development of risk stratification tools.