bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel bearing fault diagnosis method with feature selection and manifold embedded domain adaptation
Authors: Yang Songyu , Zheng Xiaoxia
Published: April 2022

Traditional fault diagnosis models assume that the training and test data sets have the same feature distribution, but in practice the distribution between the training and test sets varies considerably, making it difficult to achieve the desired fault diagnosis performance. Thus, a diagnosis method based on feature selection and manifold embedding domain adaptation is proposed in this paper. First, the signal is decomposed by variational modal decomposition to obtain multiple modal components, and the entropy, time domain and frequency domain features of each modal component are extracted to form a mixed feature set. Second, it proposes a feature evaluation index based on Fisher scores and feature domain differences to select features that are conducive to cross-domain fault diagnosis and transfer learning. Then, the geodesic flow core is constructed to learn the transformation feature representation in the Grassmann manifold space to avoid features are distorted. Finally, the domain adaptation is performed by minimizing the discrepancy in the joint probability distribution between the same category and maximizing the discrepancy between the different categories. Based on the results of multi-index experiments, the method in this paper is superior to other existing methods.
Experimental and computational studies on the effects of reduced fuel injection pressure and spark plug protrusion on the performance and emissions of a small-bore gasoline direct-injection engine
Authors: Jose Jubin V , Mittal Mayank , Ramesh Asvathanarayanan
Published: April 2022

Application of direct injection (DI) technology in small-bore engines, the type used in two- and three-wheelers, could improve their performance significantly. It is recognised that the use of high fuel injection pressure is beneficial in large-bore engines for a good mixture preparation. However, simple systems incorporated with low-pressure DI are desirable in small-engine segment of automobiles. Further, high fuel pressures will result in excessive wall wetting when cylinder dimensions are small. Extensive studies were carried out to investigate the minimum fuel injection pressure required for homogeneous and lean modes of operation in such small bore DI engine. The effect of spark plug protrusion in the combustion chamber was also investigated under the spray-guided configuration. Comprehensive experiments and CFD simulations were performed for estimating the engine efficiency, emissions, mixture preparation characteristics, fuel spray and fuel impingement on combustion chamber walls. Results have demonstrated that engine performance and emissions did not deteriorate when fuel injection pressure was reduced from 150 to 50 bar at full load. However, at very low pressures, like 20–30 bar, THC, CO and smoke emissions increased. Fuel injection pressure did not influence the lean limit, that is, equivalence ratio of about 0.77, but influenced the thermal efficiency at lean conditions. In order to attain high efficiency, under lean conditions, a minimum fuel pressure of 80 bar was required. The spark plug protrusion that resulted in a gap of 0.75 mm with respect to the incoming fuel spray cone has given the best engine performance, while higher protrusions affected the tumble flow and led to the stratification of charge near the spark plug, which resulted in elevated CO and smoke emissions. Hence, this work highlights that relatively lower direct injection pressures are suitable in small bore engines, which will impact the development of cost effective components for such applications.
Effectiveness of grouted layer in the mitigation of subway-induced vibrations
Authors: Sadeghi Javad , Haghighi Ehsan , Esmaeili Morteza
Published: April 2022

As a practical countermeasure against generally destructive subway-induced vibrations, the injection of a continuous thin layer of soft materials into the soil under adjacent receivers is investigated in this paper for the first time. To this aim, simulations were carried out using a finite/infinite element model of a railway track, tunnel, and surrounding soil. A straightforward analytical approach was implemented to model the dynamic excitation of the moving train. In addition, the effect of a soft V-shaped grouted layer on vibration mitigation on the ground was evaluated via a parametric analysis that determined the impacts of soil type, grout specifications, and train speed. The obtained results clearly indicated that a softer isolator (i.e., the grouted layer) in combination with a stiffer soil provides the best configuration for attenuating the subway-induced vibrations. Furthermore, the injection angle and train speed were shown to have minimal impacts on the isolator performance. Other contributions of the present paper include developing a simple equation to estimate the grouted layer effectiveness and describing how the isolator works in layered soils.
Managing Chineseness: neurasthenia and psychiatry in Taiwan in the second half of the twentieth century
Authors: Wang Wen-Ji
Published: April 2022

The present study investigates the role of Taiwanese psychiatrists in turning neurasthenia into a culture-specific disease in the late twentieth century. It first delineates the shift in both explanatory models of psychoneuroses and patient population in post-World War II Taiwan. Neurasthenia became a focus of international attention in the 1970s and 1980s with the advance of cultural psychiatry, and, as China was closed to the outside world, Taiwanese psychiatrists were influential in framing the cultural meaning of neurasthenia. With the rise of post-socialist China, Taiwan lost its status as a key laboratory of Chinese studies. This paper argues that the history of neurasthenia during the period was closely associated with the professional development and national identity of Taiwanese psychiatrists.
Experimental analysis and thermal management of solar air heater roughened with sine wave baffles
Authors: Sharma Sachin , Das Randip K , Kulkarni Kishor
Published: April 2022

In the present study, a thermo-hydraulic performance (THP) of solar air heater (SAH) has been assessed by placing sine wave-shaped baffles on the heat-absorbing surface. The experiments have been performed by varying Reynolds number ([Formula: see text]) ranging from 3000-18,000, relative pitch ([Formula: see text]) ranging from 8 to 14, relative height ([Formula: see text]) ranging from 0.4 to 0.55, relative baffle length [Formula: see text] ranging from 0.054 to 0.081 and angle of attack(α) ranging from 10° to 45° while the duct aspect ratio has been kept fixed at 12. The best set of geometric parameters has been decided based on Nusselt number [Formula: see text] and friction factor [Formula: see text] characteristics of the roughened SAH and compared with the smooth surface SAH, under analogous experimentation conditions. The cost analysis has also been performed and results revels that roughened SAH is more cost-effective than smooth SAH. The correlation for Nusselt number [Formula: see text], friction factor [Formula: see text], and thermo-hydraulic performance parameters (η) have been developed using regression analysis and found an average deviation of ±9.15%, ±7%, and ±9.2% respectively, from experimental results.
The effects of subconjunctival bevacizumab, ranibizumab, and aflibercept on corneal neovascularization
Authors: Eski MT , Teberik Kuddusi , Oltulu Pembe , Ankaralı Handan , Kaya Murat , Alpay Merve
Published: April 2022

Purpose

To investigate the effects of subconjunctival bevacizumab, ranibizumab, and aflibercept in an experimental corneal neovascularization model.

Materials and methods

The eyes of 24 rats were chemically cauterized and randomly divided into four groups: bevacizumab group (0.05 mL/1.25 mg bevacizumab), ranibizumab group (0.05 mL/0.5 mg ranibizumab), aflibercept group (0.05 mL/1.25 mg aflibercept), and control group (0.05 mL saline solution). Plasma vascular endothelial growth factor (VEGF) levels were among the major measurement outcomes to assess corneal neovascularization. The collected plasmas were analyzed using the SIGMA RAB0511 Rat VEGF Elisa kit. The PCR technique and VEGF amplification procedures were used for molecular analysis. Each cornea was removed and histologically examined on day 21. Corneal images were evaluated by image analyzer software.

Results

In the post-injection period, the number of major corneal arteries decreased significantly in the injection groups when compared to the control group ( p = 0.037), but no statistically significant differences were noted among the injection groups ( p > 0.05). The aflibercept group had the lowest area of neovascularization. Immunohistochemical staining revealed substantially lower VEGF percentages in neovascularized arteries of the injection groups than the control group ( p = 0.015). In TUNEL staining, the mean TUNEL value (number/1hpf) was substantially greater in the control group than in the injection groups, but the mean TUNEL values were similar between the injection groups ( p = 0.019, p > 0.05, respectively). No statistically significant differences were observed between the groups in terms of corneal surface area with increased cellularity, edema, and inflammation ( p = 0.263). The mean plasma VEGF concentration in the control group was statistically greater than those in the injection groups ( p = 0.001).

Conclusion

Subconjunctival bevacizumab, ranibizumab, and aflibercept crossed the blood and seemed to be effective in inhibiting corneal neovascularization without causing epitheliopathy in an experimental rat model compared to the controls. However, no significant results were noted between these three anti-VEGF molecules.
Health care utilization and costs of systemic lupus erythematosus in the United States: A systematic review
Authors: Lin Dora H , Murimi-Worstell Irene B , Kan Hong , Tierce Jonothan C , Wang Xia , Nab Henk , Desta Barnabas , Hammond Edward R , Alexander G Caleb
Published: April 2022

Objectives

To evaluate health care utilization and costs for patients with systemic lupus erythematosus (SLE) by disease severity.

Methods

We searched PubMed and Embase from January 2000 to June 2020 for observational studies examining health care utilization and costs associated with SLE among adults in the United States. Two independent reviewers reviewed the selected full-text articles to determine the final set of included studies. Costs were converted to 2020 US $.

Results

We screened 9224 articles, of which 51 were included. Mean emergency department visits were 0.3–3.5 per year, and mean hospitalizations were 0.1–2.4 per year (mean length of stay 0.4–13.0 days). Patients averaged 10–26 physician visits/year. Mean annual direct total costs were $17,258–$63,022 per patient and were greater for patients with moderate or severe disease ($19,099–$82,391) compared with mild disease ($12,242–$29,233). Mean annual direct costs were larger from commercial claims ($24,585–$63,022) than public payers (Medicare and Medicaid: $18,302–$27,142).

Conclusions

SLE remains a significant driver of health care utilization and costs. Patients with moderate to severe SLE use more health care services and incur greater direct and indirect costs than those with mild disease.
Social impact of disease parameters and damage accrual in adult Brazilian patients with childhood-onset Systemic Lupus Erythematosus
Authors: Tanigava Nicolas Y , Sakamoto Ana P , Franco André S , Balbi Gabriela GM , Sales Lucas P , Aikawa Nadia E , Terreri Maria T , Pereira Rosa MR
Published: April 2022

Objectives

To describe the frequency and investigate potential associations of unemployment, need of financial assistance and health-related quality of life in adult patients with childhood-onset Systemic Lupus Erythematosus (cSLE).

Methods

In this multicenter cross-sectional retrospective cohort study including cSLE adult patients, questionnaires were applied evaluating demographic characteristics, medical history, treatment, receipt of government financial assistance, work status, quality of life, economic classification, disease activity, and damage accrual. Disease activity and disease damage were measured at the study visit.

Results

Sixty-nine cSLE patients with a median age of 21 years from two Brazilian tertiary centers were included (median disease duration 9 years). Twenty-eight (40.6%) patients were unemployed and 16 (23.2%) were receiving financial assistance or retirement pension. Work unemployment was associated with higher damage scores (OR 1.83, 95% CI 1.08 to 3.09, p = 0.024), and the need of financial assistance was associated with longer disease duration (OR 1.15, 95% CI 1.00 to 1.31, p = 0.045) and worse economic score (OR 0.87, 95% CI 0.77 to 0.99, p = 0.038). Emotional health and body image perception were the most compromised domains of quality of life but showed no association with disease parameters. Disease activity, on the other hand, was inversely associated with symptoms scores (β = −1.377, p = 0.014) and scores of adverse effects of medications (β = −1.286, p = 0.020).

Conclusion

cSLE is a disease with severe outcomes and high social burden that profoundly impacts patients. Damage accrual is a major contributor to unemployment during adulthood and its prevention must be central in the management of cSLE.
Impact of COVID-19 on Small- and Medium-sized Enterprises
Authors: Sarker Md. Rayhan , Rahman S. M. Abidur , Islam A. K. M. Hedaitul , Bhuyan Md. Farhan Fuad , Supra Sunjida Enam , Ali Kauser , Noor K. M. Asadun
Published: April 2022

The COVID-19 pandemic has severely impacted global business operations. Most importantly, practitioners of small- and medium-sized enterprises (SMEs) have been facing devastating economic shocks emanated from the COVID-19 pandemic. The purposes of this study are to explore the business status of SMEs, business sustenance period, types of problems faced by the practitioners and impact on production volume, due to the COVID-19 pandemic. For these purposes, primary survey data from 284 SMEs in Bangladesh are collected in this study. The survey data are descriptively analyzed using appropriate graphs. This study finds that SMEs are facing several problems such as demand fall (92.96%), cancellation of orders (85.56%), liquidity crisis (74.30%), delayed transportation (72.53%), unsecured working environment (68.31%), raw material shortage (63.73%) and employees’ absenteeism (62.67%). The SMEs face beyond 40% decrease in production volume against the pre-pandemic year. Furthermore, this study formulates several strategic measures, which will certainly guide policymakers and practitioners to combat the COVID-19 economic shocks for the SMEs and also for other industries.
Corruption in sports: Lessons from Montenegro
Authors: Begović Marko
Published: April 2022

This paper represents a pioneering attempt to study corruption in sports within the Western Balkans countries. Even though it is not a new phenomenon, as such, it aims to contribute to the existing literature on corruptive practices associated with the sports by exploring its nature, reach and magnitude. A mixed-method approach is employed using two levels of analysis – document analysis followed by semi-structured interviews. From 2006, Montenegro's official political orientation was towards membership within the European Union (EU). That said, for a country currently undergoing the process of EU integration, the control of corruption represents an essential element of the legitimization of both parties, Montenegro and the EU. However, as found, the form of corruption enables continuity of the dominant position of the long-standing political structure in power – the Democratic Party of Socialists (DPS). The DPS utilizes a range of undemocratic practices, combining clientelism and corruption to spread its influence outside of politics, on the broader socio-economic realms. The significance of the empirical study is in offering new perspectives and insights from a specific country within the Western Balkans, confirming the existence of a strong clientelist network established in the sports movement in Montenegro. The presence of politically exposed persons within sports governing bodies influences decisions at all levels in favor of political interest, including allocation of resources, public funds and media protection.
Comfort with Pharmacogenetic Testing Amongst Pediatric Oncology Providers and Their Patients
Authors: Mowbray Catriona , Turner Joyce , Gai Jiaxiang , Jacobs Shana
Published: April 2022

Background: Pharmacogenetic (PGx) testing, a component of personalized medicine, aims to ensure treatment efficacy while reducing side effects and symptoms. Before this testing becomes routine in the pediatric oncology population, nurses need to understand the knowledge and concerns of providers, patients, and family members with regard to the timing, extent, interpretation, and incorporation of PGx testing. Methods: As part of a comprehensive PGx study (larger study) for children diagnosed with cancer, we surveyed providers and caregivers of children with cancer about their knowledge of and comfort with PGx testing. Caregivers who declined to participate in the larger PGx study were also asked to participate in the survey. Chi-square tests and a two-sample t-test were used to compare variables. Results: One hundred and two participants from the larger PGx study and 12 families who refused (response rate of 77% and 54%, respectively) as well as 29 providers (88%) completed surveys. Families not on the study were less interested in and comfortable with PGx results. Both groups were concerned about health or life insurance discrimination and payment. Providers would like support in ordering PGx testing and interpreting PGx. Discussion: Providers remain wary of most PGx testing, uncomfortable with interpreting and applying the results. Families are interested in the possibilities of personalized prescribing while worried about who has access to their child's genetic information. Further education on relevant tests for providers, including nurses, and the testing process for families, including details on privacy and sharing of genetic information, appear necessary.
Ninja Training Meets Management Education: Integrating Taijutsu into an MBA Complexity Leadership Course
Authors: Norris Julian
Published: April 2022

In this paper I describe the integration of taijutsu, a martial art emerging from the Japanese ninja tradition, into an MBA complexity leadership course. There is broad consensus amongst leadership scholars that intangible qualities such as humility, courage, and uncertainty tolerance are particularly important in complex contexts. There is, however, little consensus as to how such qualities can be effectively cultivated. I review the literature related to martial arts training in management education and discuss the pedagogical challenges of developing both the competencies and capacities required to lead in complexity. I introduce taijutsu and describe several training drills and a facilitation methodology intended to help students develop practical fluency with systems thinking and its implications for leadership and decision-making. Student reflections highlight increased engagement along with potential perspectival and behavioral shifts as promising areas for further investigation. I close by making a case for deeper integration of informational and transformational learning within management education.
Subverting Whiteness and Amplifying Anti-Racisms: Mid-Level District Leadership for Racial Justice
Authors: Shah Vidya , Aoudeh Nada , Cuglievan-Mindreau Gisele , Flessa Joseph
Published: April 2022

This counternarrative study positions two distinct bodies of literature in conversation: mid-level district leadership in the literature on educational change and anti-racist approaches to leadership framed through Critical Race Theory and Critical Whiteness Studies. Interviews with twelve, mid-level district leaders committed to anti-racism in Ontario, Canada, reveal fundamental differences in leaders’ knowledges and capacities compared to those identified in the literature on educational change and promoted in the corresponding leadership frameworks in Ontario. In centering power, racialization, and whiteness as a logic of oppression, anti-racist approaches to leadership fundamentally reconstitute conceptions and enactments of leadership. Findings speak to the importance of knowledge(s) about race and racialization, racism and intersecting oppressions, and how whiteness subverts anti-racist efforts. Findings also speak to developing capacities such as: visioning that both owns historical injustices and imagines future possibilities; organizing and collectivizing as a means of power sharing and decentering the individual leader; facilitating difficult learning in the face of racist resistance and multiple frameworks; securing accountability for rights by building informal accountability structures while advocating for formal ones; aligning resources and creating structures in support of students from historically oppressed communities; and, sustaining the self in the face of the impending harm in doing this work. With a focus on whiteness, this study invites scholars and practitioners to turn the gaze upward and consider what might need to be undone and unlearned from multiple and intersecting systems of oppression, what the authors refer to as unleading.
Customized Tray for Impression Taking in Children With Cleft Lip and Palate
Authors: Felício Carvalho Carrara Cleide , Jorge Paula Karine , Costa Beatriz , Machado Maria Aparecida Andrade Moreira , Oliveira Thais Marchini , da Silva Dalben Gisele
Published: April 2022

The assessment of rehabilitation outcomes requires a patient documentation protocol, including records obtained at standardized ages, to compare different types of surgeries, their effects, as well as between different rehabilitation centers. The aim of this paper was to present proper trays for babies with different types of cleft lip and palate, which are used in the outpatient routine at Hospital of Rehabilitation of Craniofacial Anomalies/USP (HRAC/USP). The customized trays are made with self-curing acrylic resin. The tray must have suitable depth to copy the buccal sulcus, and wax is usually applied to contour the tray edge, and the adjustment of the tray to the fornix, making the tray specific for each child. The impression precludes the utilization of dental casts for diagnosis, treatment plan, and research measurements. In the clinical practice at HRAC-USP, it was observed that customized trays increased the quality of impression, accurately reproducing anatomical features of dental arches of babies with oral clefts.
High School Students’ Social Jetlag, Lifelong Competency, and Academic Stress During the COVID-19 Pandemic: A Cross-Sectional Study
Authors: Lee Soo Yeon , Jang Sun Joo
Published: April 2022

With the prolongation of non-ordinary situations such as school closures due to the coronavirus disease 2019 (COVID-19) pandemic, high school students have experienced irregular sleep-wake cycles and elevated academic stress resulting from reduced academic achievement and widened gaps in academic performance. This cross-sectional study aimed to investigate the associations among chronotype, social jetlag, lifelong learning competency, and academic stress in high school students during the COVID-19 pandemic. Data were collected through an online survey from May–June 2021. The mean social jetlag was found to be 2 h and 9 min, and multiple regression analysis revealed that social jetlag and lifelong competency affected academic stress. Thus, measures to minimize social jetlag and improve lifelong learning competencies should be implemented to reduce academic stress among high school students. School nurses should identify students with severe social jetlag and provide guidance and interventions to promote sleep hygiene and regular lifestyles.
Effectiveness and Safety of Lower Dose of Rivaroxaban for Cancer-Related Venous Thromboembolism: A Retrospective Cohort Study
Authors: Chang Chia-Ling , Lin Yi-Jei , Pan Chia-Chia , Kuo Chun-Nan
Published: April 2022

Background

Primary and recurrent venous thromboembolism (VTE) commonly occur in patients with cancer. However, because of the National Health Insurance regulations, available dosage forms, and clinical conditions, the prescribed dose of rivaroxaban may not be consistent with its recommended dose.

Objective

To evaluate the 6-month recurrence rate of VTE and safety of rivaroxaban for patients with cancer.

Methods

Patients with new cancer diagnosis or recurrence from 2014 to 2018 who initiated rivaroxaban for VTE from January 2015 to January 2019 were included. We set the rivaroxaban initiation date as the index date and followed up the patients for 180 days. We collected information regarding the starting and maintenance dose/frequency and the treatment duration. The efficacy outcome was the recurrence of VTE within 180 days. The safety outcome included the major bleeding rate and clinically relevant nonmajor bleeding (CRNMB) rate.

Results

Approximately, 46.2% of the 65 included patients received a standard starting dose, and 45% of patients received a maintenance dose above 15 mg (median: 23.9 and 13.1 mg per day, respectively). Two-thirds of the patients stopped treatment within 180 days. Recurrent VTE occurred in 2 (3.1%) patients within 6 months. The major bleeding rate was 7.7%, and the CRNMB rate was 3.1%.

Conclusion and Relevance

The 6-month recurrence rate of VTE and safety profile were similar between the lower and standard dose of rivaroxaban. This result may be applied to the institutions with dosage availability limited by formulary regulation and patients who cannot use full dose because of clinical considerations.
Outcome for Neoadjuvant Treatment of Parotid Gland Adamantinoma-Like Ewing Sarcoma: Case Report and Review of Literatures
Authors: Wei Christina H. , Thompson Lester D. R. , Lee Kyle , Chow Warren , Liang Yu
Published: April 2022

Adamantinoma-like Ewing sarcoma typically shows t(11;22) EWSR1::FLI1 translocation and complex epithelial differentiation. It poses a diagnostic challenge, especially in the head and neck region, due to its under-recognition and significant histologic overlap with other malignancies. Neoadjuvant and adjuvant treatment information on head and neck Adamantinoma-like Ewing sarcoma is limited. Herein, we report a case of a 78-year-old female with Adamantinoma-like Ewing sarcoma of the parotid gland, including the imaging findings and clinical response to neoadjuvant therapy followed by surgery. The efficacy of neoadjuvant therapy in the treatment of Adamantinoma-like Ewing sarcoma is discussed in the context of a review of pertinent literature. Adamantinoma-like Ewing sarcoma in the head and neck is frequently misdiagnosed as poorly differentiated squamous cell carcinoma or a basaloid salivary gland carcinoma. Adamantinoma-like Ewing sarcoma is a EWS1::FLI1 translocation driven tumor; frequently misdiagnosed on head and neck biopsies as poorly differentiated carcinoma, or squamous cell carcinoma. Ewing sarcoma-specific chemoregimen appears effective for this entity. If diagnosed early, patient may be amenable to neoadjuvant therapy, which may improve surgical and cosmetic outcomes. This is especially important in head and neck regions.
Spindle Cell/Sclerosing Rhabdomyosarcoma With PAX8::PPARG Fusion
Authors: Rakheja Dinesh , Park Jason Y. , Alhasan Mustafa , Uddin Naseem
Published: April 2022

The spindle cell/sclerosing subtype of rhabdomyosarcoma is classified based on genetic features into the three categories of MYOD1-mutated, gene fusion-driven, and a subset without a currently identified genetic driver event. The gene fusion-driven spindle cell/sclerosing rhabdomyosarcomas are heterogenous and characterized by increasing numbers of gene fusions, the most common gene partners being VGLL2, NCOA2, and TFCP2. Here we report a spindle cell/sclerosing rhabdomyosarcoma that arose in the orbit of a 4-year-old male. This tumor harbored a unique PAX8::PPARG fusion. PAX8::PPARG fusions have previously only been described in follicular thyroid carcinoma and follicular variant of papillary thyroid carcinoma. Our report adds to the growing number of gene fusions in spindle cell/sclerosing rhabdomyosarcomas.
Ciliated Hepatic Foregut Cysts: Not as Rare as Previously Believed
Authors: Hughes Daniel Ll , Tsakok Maria , Patel Nikhil , Rendek Aniko , Bungay Helen , Silva Michael A
Published: April 2022

Background. Ciliated hepatic foregut cysts (CHFCs) are uncommon cystic lesions within the liver. CHFCs can undergo a malignant transformation to form a primary squamous cell carcinoma of the liver. The true incidence and natural history of CHFCs is unknown and the risk of malignant transformation is unclear. We present a single centre's experience of CFHC management. Methods. A retrospective review of a departmental database identified all patients with CHFCs over a 4 year time period. Patients with CHFCs confirmed on histological assessment or suspected on radiological imaging were included in this study. Clinical information regarding patient demographics, symptomatic presentation, surgical management and histopathological features were noted. The radiological characteristics of CHFCs were recorded and the malignant transformation rate was calculated. Results. 15 patients with CHFC were identified (7 histologically confirmed and 8 radiologically suspected cases). All patients were asymptomatic and the CHFCs were incidental findings. No CHFC developed an interval change in cyst features or underwent a malignant transformation during follow up. MRI serves as the most sensitive modality to diagnose CHFC. Conclusions. CHFCs may be more prevalent than previously reported. Definitive management should encompass a patient centred discussion regarding the merits of long term follow up with serial imaging versus resection on an individual basis once CHFC is diagnosed.
Metastatic Neuroendocrine Tumors to Parotid Gland: Where Do They Come From?
Authors: Braun Ankica , Cheng Lin , Reddy Swathi , Gattuso Paolo , Yan Lei
Published: April 2022

Background. Metastasis to parotid gland occurs mostly from skin cancers of the head and neck region. Metastatic neuroendocrine tumors to the parotid gland are rare and not well studied so far. In this study, we undertook a retrospective review of secondary neuroendocrine tumors of the parotid diagnosed in our institution. The most common entities, primary tumor locations, their clinical presentations and histopathological features were analyzed. Methods. Cases of secondary neuroendocrine tumors to parotid diagnosed from August 1995 to Jan 2021 were retrieved from our institution's pathology databases, and their clinicopathological features were reviewed. Results. About 29% (120 of 420 cases) of parotid neoplasms were malignant, including 70 cases of parotid primary malignant tumors and 50 cases of metastases to parotid glands. Among metastatic tumors to the parotid glands, squamous cell carcinoma and melanoma of the head and neck region together accounted for about 78% of the cases. Only 11 of 50 metastatic tumors to the parotid were neuroendocrine carcinomas (22%). The most common primaries were poorly differentiated neuroendocrine carcinoma of lung (5 of 11 cases), including 4 cases of small cell carcinoma and one case of large cell neuroendocrine carcinoma. The second most common secondary tumor was Merkel cell carcinoma (4 of 11 cases, 36%) including one case of direct invasion from overlying skin. Medullary carcinoma of the thyroid comprised the rest of the metastases to the parotid (2 of 11 cases, 18%). Conclusion. Our results show that metastatic neuroendocrine carcinomas to the parotid gland account for about 22% of all metastatic tumors to the organ. Lung is the most common primary neuroendocrine carcinoma location. It is not uncommon for metastatic neuroendocrine carcinoma to present as the first sign of systemic clinical manifestation. Merkel cell carcinoma is the second most common entity that metastasizes to parotid, followed by medullary carcinoma of the thyroid.
Relationship Between Preoperative PROMIS Scores and Postoperative Outcomes in Hallux Rigidus Patients Undergoing Cheilectomy
Authors: Rajan Lavan , Conti Matthew S. , Cororaton Agnes , Fuller Robert , Ellis Scott J.
Published: April 2022

Background:

Previous studies have demonstrated that preoperative patient-reported outcome measures are associated with postoperative outcomes in foot and ankle surgery, and also in specific procedures such as bunionectomy, flatfoot reconstruction, and total ankle replacement. The primary purpose of this study was to determine if preoperative Patient-Reported Outcomes Measurement Information System (PROMIS) physical function, pain interference, pain intensity, and depression scores were associated with the ability of patients undergoing cheilectomy for hallux rigidus to achieve a minimal clinically important difference (MCID) of improvement.

Methods:

This retrospective study included preoperative and ≥2-year postoperative PROMIS physical function, pain interference, pain intensity, and depression scores for 125 feet in 118 patients undergoing cheilectomy collected from an institutional review board (IRB)–approved foot and ankle registry database. MCIDs were established using distribution-based methods to determine clinical significance of improvements in PROMIS scores. Receiver operating characteristic (ROC) curves and area under the curve analyses were used to determine which preoperative PROMIS scores were associated with patients meeting the MCID.

Results:

ROC analysis found statistically significant areas under the curve (AUCs) for the physical function domain (AUC 0.71), pain intensity (AUC 0.70), and depression (AUC 0.79) PROMIS domains. Subsequent analyses were unable to identify clinically useful 95% sensitivity and specificity preoperative thresholds, with the exception of the 95% sensitivity PROMIS physical function threshold. A preoperative physical function score of greater than 53.2 resulted in a 63% probability of achieving the MCID. The pain interference PROMIS domain did not demonstrate a statistically significant AUC.

Conclusion:

Preoperative PROMIS physical function, pain interference, pain intensity, and depression scores are minimally associated with preoperative to 2-year postoperative improvement in patients undergoing cheilectomy. It may be difficult to determine which patients improve from a cheilectomy based on the severity of symptoms they exhibit preoperatively.

Level of Evidence:

Level IV, retrospective case series.
Circulating Clusterin Levels and Cancer Risk: A Systematic Review and Meta-Analysis
Authors: Beheshti Namdar Ali , Kabiri Mona , Mosanan Mozaffari Homan , Aminifar Elham , Mehrad-Majd Hassan
Published: April 2022

Introduction

The previous reports on clusterin (CLU) levels in various types of cancer have been controversial and heterogeneous. The present meta-analysis has aimed to evaluate the association between soluble CLU levels and the risk of different human cancers based on observational studies.

Methods

A systematic literature review was conducted to determine the relevant eligible studies in English language from health-related electronic databases up to January 2021. Random effects models were used to calculate the summary standard mean difference (SMD) with 95% confidence intervals (CIs) to identify the correlation between CLU levels and cancer risk. The meta-regression, sensitivity, Galbraith, and subgroup analyses were performed to explore the source of between-study heterogeneity. Furthermore, the funnel plot and Egger’s linear regression tests were carried out to evaluate the risk of publication bias.

Results

According to 16 eligible articles, 3331 patients and 839 healthy controls were included in our meta-analysis. Overall, the CLU levels were significantly higher in various cancer cases compared to the healthy groups (SMD = 1.50, 95% CI = 0.47–2.53). Moreover, subgroup analysis based on types of cancer showed a significant correlation between CLU levels and the risk of digestive system cancers (SMD = 1.54, 95% CI = 0.91–2.18, P <0.001), especially in HCC (SMD = 1.89, 95% CI = 0.76–3.03, P = 0.001), and CRC (SMD = 1.63, 95% CI = 0.0–3.23, P = 0.048).

Conclusion

The present meta-analysis indicates a significant association of CLU levels with the risk of digestive system cancers such as hepatocellular carcinoma and colorectal cancer. Therefore, CLU can be monitored as a novel molecular biomarker for the prognosis and diagnosis of various types of cancers particularly in the digestive system.
Taking the Long View: Understanding the Rate of Second Job Holding Among Long-Term Care Workers
Authors: Dill Janette , Frogner Bianca , Travers Jasmine
Published: April 2022

We analyze the 2004, 2008, and 2014 longitudinal panels of the Survey of Income and Program Participation (SIPP) to compare the percentage of long-term care (LTC) workers who held a second job in an LTC setting or in any industry at the first panel observation versus over a longer time period. We find that around 5% to 7% of LTC workers held a second job in another LTC setting in their first panel observation. However, we found that 20% to 30% of LTC workers held a second job in LTC during the survey period of 3 to 4 years, and 30% to 40% of LTC workers held a second job in any industry during the survey period. Our findings suggest that second job holding is widespread among LTC workers. Future research should focus on how facilities and organizations can reduce the spread of infectious disease among workers who are working in multiple settings.
Pulmonary embolism and bradycardia in a NSCLC patient treated with crizotinib for a rare mutation
Authors: Shi Yunjing , Qiu Zeping , Ding Yongjie , Chen Yanjia , Zhang Andi , Jin Wei
Published: April 2022

Introduction

Lung cancer is a major global health problem because of its high incidence and mortality. Targeted therapies have transformed treatment of driver-mutated metastatic non-small cell lung cancer (NSCLC). Nevertheless, recent studies demonstrated that cardiovascular disease (CVD) was the second leading cause of mortality in cancer survivors now, management of patients’ cardiovascular health during the course of anticancer therapy has become a great challenge faced by the oncologists. Anticancer related cardiovascular (CV) complications are not limited to traditional chemotherapy, but are also increasingly recognized in targeted therapy.

Case Report

We present a case of pulmonary embolism (PE) and bradycardia in a 91-year-old NSCLC patient treated with crizotinib for a rare MET Y1003S mutation. To our knowledge, this is the second report to show antitumor response of crizotinib in lung cancer patients with such a rare mutation. However, the patient complained chest tightness and shortness of breath after a month of standard dose crizotinib therapy. Non-invasive examination revealed new onset bradycardia and PE.

Management & Outcome

Such clinical manifestations were associated with targeted therapy-related CV toxicity, on which the emerging discipline cardio-oncology focused, and a multidisciplinary investigation and treatment was conducted.

Discussion

This case highlights the CV adverse events of novel therapies and the current challenges to be tackled in cardio-oncology.
Identifying Feigned ADHD in College Students: Comparing the Multidimensional ADHD Rating Scale to Established Validity Measures
Authors: Potts Heather E. , Lewandowski Lawrence J. , Lovett Benjamin J.
Published: April 2022

Objective:

There is increased concern for malingering in ADHD evaluations due to presence of incentives such as accommodations and medications. Although several validity tests are available to classify malingering in non-ADHD populations, there is no test with proven effectiveness to detect feigned ADHD. This study investigated the ability of the MARS Symptom Validity Index 4 (MARS SV-index 4) and two published validity tests (the Word Memory Test [WMT] and Clinical Assessment of Attention Deficit-Adult [CAT-A] Infrequency scale) to detect malingered ADHD.

Method:

The participants consisted of 68 young adults, 34 with ADHD. Participants completed the MARS, CAT-A, and WMT validity measures.

Results:

The MARS SV index-4 demonstrated higher sensitivity rates for simulated malingering (61.8%) at close to optimal specificity (88.2%) compared to two published tests (which had sensitivity <42% at specificity >90%).

Conclusion:

The MARS shows good ability to detect feigned ADHD and appears to be useful for adult ADHD assessments.
Experimental and numerical research on flexural behavior of fiber metal laminate sandwich composite structures with 3D woven hollow integrated core
Authors: Lin Yanyan , Li Huaguan , Kuang Ning , Chen Shuyun , Tao Jie
Published: April 2022

The face–core debonding of sandwich structures under bending will affect the overall load-bearing capacity. Fiber metal laminate (FML) sandwich composite structures with 3D woven hollow integrated core (3D core) were prepared by vacuum resin infusion method and thermal molding process. The flexural behavior of the structures was experimentally studied by a three-point bending test and investigated by evaluation of specific flexural strength, flexural rigidity, and ductility. Numerical simulation finite element models of structures with different cores under three-point bending were calculated by ABAQUS/Explicit. Results showed that plastic rotation of the “8”-shaped fibers in the 3D core was the main reason for the failure modes of asymmetric densification. FML as the faceplate of the 3D core can significantly improve its flexural strength, rigidity, and ductility.
Metabolites Associated With Fatigue and Physical Activity in Childhood Cancer
Authors: Withycombe Janice S. , Eldridge Ronald , Jin Yan , Gu Haiwai , Castellino Sharon M. , Sears Dorothy D.
Published: April 2022

Introduction: Children and adolescents with cancer report increased fatigue and decreased physical activity, introducing risk factors for chronic disease and suppressed quality of life. Research suggests an inverse relationship between fatigue and physical activity, but the biological explanation is not well understood. The purpose of this study was to 1) explore metabolites associated with fatigue or physical activity and 2) to identify any shared metabolomic elements. Methods: Children, ages 8–17 years, attending a pediatric oncology summer camp provided Patient-Reported Outcome Measurement System® (PROMIS) Pediatric Fatigue assessments, physical activity data (steps/day), and urine samples pre- and post-camp. Differences in PROMIS Pediatric Fatigue scores and average daily steps were calculated using paired t-tests. Liquid chromatography-tandem mass spectrometry was conducted using a targeted metabolomic approach. Results: Thirty-two enrolled children had complete data. Fatigue scores decreased (pre-camp 45.1; post-camp 42.1; p = 0.04) while steps-per-day increased (pre-camp 6699; post-camp 16,021; p < 0.001). Twenty-seven metabolites significantly differentiated (false discovery rate <0.20) between low, medium, or high physical activity, while 8 metabolites discriminated between high and low fatigue. Indole-3-lactic acid, a tryptophan metabolite, was significantly associated with both physical activity and fatigue. Conclusion: This study provides evidence of metabolome associations with fatigue and physical activity in children with cancer. Overlapping metabolomic elements provide evidence of biological inter-connectivity and suggest areas for future research. Given the known evidence regarding the benefits of physical activity, and the potential interaction with fatigue, nurses should routinely assess patient reports of these elements and provide patient/family education related to fatigue management and physical activity goals.
The Association of Electronic Cigarette Use With SARS-CoV-2 Infection and COVID-19 Disease Severity
Authors: Burnett-Hartman Andrea N , Goldberg Scott Shauna , Powers J David , Clennin Morgan N , Lyons Jason A , Gray Mark , Feigelson Heather Spencer
Published: April 2022

BACKGROUND

Although combustible cigarette use is an established risk factor for severe COVID-19 disease, there is conflicting evidence for the association of electronic cigarette use with SARS-CoV-2 infection and COVID-19 disease severity.

METHODS

Study participants were from the Kaiser Permanente Research Bank (KPRB), a biorepository that includes adult Kaiser Permanente members from across the United States. Starting in April 2020, electronic surveys were sent to KPRB members to assess the impact of the COVID-19 pandemic. These surveys collected information on self-report of SARS-CoV-2 infection and COVID-related risk factors, including electronic cigarette and combustible cigarette smoking history. We also used electronic health records data to assess COVID-19 diagnoses, positive PCR lab tests, hospitalizations, and death. We used multivariable Cox proportional hazards regression to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) comparing the risk of SARS-CoV-2 infection between individuals by e-cigarette use categories (never, former, and current). Among those with SARS-CoV-2 infection, we used multivariable logistic regression to estimate adjusted odds ratios (ORs) and 95% CIs comparing the odds of hospitalization or death within 30 days of infection between individuals by e-cigarette use categories.

RESULTS

There were 126,475 individuals who responded to the survey and completed questions on e-cigarette and combustible cigarette use (48% response rate). Among survey respondents, 819 (1%) currently used e-cigarettes, 3,691 (3%) formerly used e-cigarettes, and 121,965 (96%) had never used e-cigarettes. After adjustment for demographic, behavioral, and clinical factors, there was no association with SARS-CoV-2 infection and former e-cigarette use (hazard ratio (HR) = 0.99; CI: 0.83–1.18) or current e-cigarette use (HR = 1.08; CI: 0.76–1.52). Among those with SARS-CoV-2 infection, there was no association with hospitalization or death within 30 days of infection and former e-cigarette use (odds ratio (OR) = 1.19; CI: 0.59–2.43) or current e-cigarette use (OR = 1.02; CI: 0.22–4.74).

CONCLUSIONS

Our results suggest that e-cigarette use is not associated with an increased risk of SARS-CoV-2 infection or severe COVID-19 illness.
‘Without technology we’d be very stuck’: Ageing migrants’ differential (im)mobile practices during a lockdown
Authors: Cabalquinto Earvin
Published: April 2022

Ubiquitous mobile communication technologies have played an integral role in the way people navigated forced physical immobilities produced through restrictive measures during a pandemic. This paper critically investigates how 15 ageing people from Culturally and Linguistically Diverse (CALD) backgrounds in Victoria, Australia used a range of digital communication technologies and online platforms to cope during the 2020 lockdown. The study deploys the mobilities lens (Urry, 2007) in analysing a data set based on conducting remote and in-depth interviewing. It foregrounds how everyday and multi-scalar digital behaviours afford cultural and social connectedness, reflecting diverse forms of care practices. However, forced immobile practices emerged as shaped by disproportionate network capital. In sum, this study puts forward a nuanced perspective in understanding the scales and textures of (im)mobile practices of ageing migrants during a lockdown in Australia.