bluuebunny/crossref_metadata_2025 huggingface dataset:
Direct Oral Anticoagulants in Select Patients With Hypercoagulable Disorders
Authors: Valanejad Sara M. , Davis Kyle A.
Published: October 2020

Objective:

To summarize the literature assessing the safety and efficacy of direct oral anticoagulants (DOACs) for the acute treatment and secondary prevention of venous thromboembolism (VTE) in select patients with hypercoagulable disorders.

Data Sources:

An electronic PubMed literature search was conducted from January 2010 to July 2020 using the following keywords: DOAC, rivaroxaban, apixaban, dabigatran, edoxaban, thrombophilia, cancer, antiphospholipid syndrome, protein C deficiency, protein S deficiency, antithrombin deficiency, factor V Leiden, prothrombin G20210A gene mutation, congenital thrombophilia, hypercoagulable, hereditary thrombophilia, acquired thrombophilia.

Study Selection and Data Extraction:

Articles were included if they reported clinical outcomes associated with cancer-associated VTE, antiphospholipid syndrome (APS), and other hereditary thrombophilias.

Data Synthesis:

The safety and efficacy of using a DOAC is highly dependent on the type of hypercoagulable disease state. Current trials support the use of edoxaban, rivaroxaban, and apixaban for the treatment of cancer-associated thrombosis (CAT), with apixaban being preferred because of lower bleeding rates compared with standard of care. The use of DOACs, especially rivaroxaban, have been associated with worse outcomes in patients with APS, whereas data on DOAC use in hereditary thrombophilia remains scarce and limited to low-risk patients.

Relevance to Patient Care and Clinical Practice:

This review evaluates the literature assessing the safety and efficacy of DOACs in patients with various hypercoagulable disorders.

Conclusions:

The current body of evidence supports the use of select DOACs for the treatment of CAT. In contrast, DOAC use in patients with APS and hereditary thrombophilia should be avoided at this time.
Christ as Infinite and Finite: Rowan Williams’ Christ the Heart of Creation
Authors: Sonderegger Katherine
Published: October 2020

In this splendid volume, Rowan Williams offers a modern Christology re-presenting and interpreting the Cyrillian theology as expressed in the councils of Constantinople II and III. A “single Subject” Christology is built up from Scriptural, Patristic, and Scholastic sources, drawing heavily on Maximus the Confessor, Thomas Aquinas, and Nicholas Cusanus. The conceptual framework for the whole is provided by Austin Farrer, especially in his early essay, Infinite and Finite, and in his later Bampton Lectures, The Glass of Vision. Whether a Christology adhering closely to axioms of incommensurability and non-competition between Creator and creature can undergird a fully Chalcedonian Christology is the demanding query posed at the heart of Christ the Heart of Creation.
The Poynting effect in elastomeric bars undergoing chemo-mechanical evolution
Authors: Wineman Alan S
Published: October 2020

This work considers a rubber cylinder under zero axial force that elongates in response to the normal stresses produced during torsion (the Poynting effect). The combined elongation and twisting deformation occurs at an elevated temperature at which the rubber undergoes time-dependent scission and re-crosslinking of its macromolecular network junctions. A constitutive theory accounting for this microstructural change is used in an analytical and numerical study of the interaction of the deformation and the scission or re-crosslinking process. Examples show the time-dependence of elongation for several twist histories.
“Hey, Black Child. Do You Know Who You Are?” Using African Diaspora Literacy to Humanize Blackness in Early Childhood Education
Authors: Wynter-Hoyte Kamania , Smith Mukkaramah
Published: October 2020

This article examines the partnership between a teacher and teacher educator disrupting a colonized early childhood curriculum that fosters a dominance of whiteness by replacing it with the beauty and brilliance of Blackness. We explore the following research question: “What are the affordances of teaching from an Afrocentric stance in a first-grade classroom?” We employ Afrocentrism, which includes African cultural principles as the paradigm, and our theoretical lenses are Critical Race Theory and Black Critical Theory. Our Sankofa methodology revealed that African Diaspora literacies fostered (a) positive racial and gender identities, (b) community, and (c) positive linguistic identities in the work to help children to love themselves, their histories, and their peoples. We close with implications.
Transient elastohydrodynamic analysis of finite line contact under load impulse
Authors: Chippa SP , Borse NV
Published: October 2020

Numerical analysis is performed to study the transient behavior of EHL finite line contact of a cylindrical roller and flat plane under load impulse. In the present work, effect of pressure on the density and viscosity of lubricant is considered. Finite difference method is used to discretize the governing equations. Multilevel Multi-integration method is used to calculate the elastic deformation. Moreover, Multigrid method is implemented to accelerate the convergence process. Uniqueness of this finite line contact analysis is that it provides an ability to determine the transient behavior of lubricated contact even at the edges of roller. Results show that the load impulse causes squeezing and separation movement within the contact that develops film dimple and pressure ripples at the inlet region, which propagate towards the exit region due to the entrainment motion. It is noticed that the time taken by oil film [Formula: see text] to travel the Hertzian contact width and the time period [Formula: see text] of load impulse decides the behavior of lubricated contacts. Firstly, under a relatively heavy load when the contact width is large enough so that [Formula: see text], then a significant rise in central film thickness (CFT), central minimum film thickness (CMFT) and minimum film thickness (MFT) occurs after the execution of load impulse. Further, under the light load generating a relatively small contact width such that [Formula: see text], then comparatively a small rise in CFT occurs right during the load impulse. Lastly, for a given load if the time period of impulse [Formula: see text] is large enough satisfying the condition [Formula: see text], then a considerable reduction in CFT, CMFT and MFT takes place during the application of load impulse. Moreover, as compare to other cases, for [Formula: see text] the steady state condition is reestablished after a relatively more number of time cycles. It is observed that the maximum pressure and MFT occurs at the contact edges of roller which can be controlled by a proper choice of the radius of end profile [Formula: see text].
Noise reduction performance of a low energy façade-integrated mechanical ventilator
Authors: Oliveira Marco A , Bragança Luis , Silva Sandra M , Paixão Dinara , António Julieta
Published: October 2020

Acoustic comfort and indoor air quality are essential for the health and wellbeing of the occupants of the building. Thus, the façade must guarantee enough sound insulation and ventilation conditions. However, these aspects conflict because opening windows or using ventilation openings reduces the sound insulation of the envelope and allows the exterior noise entrance. To limit noise transmission into the building, ventilators use passive, active or hybrid noise control techniques. This work addresses the noise reduction performance of a mechanical ventilator for façades, evaluating the effect of different options of passive noise control strategies in the sound insulation of the proposed ventilator. In addition, the air change rate and energy consumption of the ventilator were also investigated. Three prototypes were fabricated and tested at an acoustic chamber, along with ventilation tests carried out in a room equipped with a blower door. CFD simulations were used to enhance the aeraulic geometry of the prototypes, prior to its fabrication. The acoustic experiments showed Dn,e,w values up to 55 dB and noise emission levels lower than 25 dB(A). The use of resistive sound absorbers proved to be more effective in mitigating noise than reactive absorbers, over the entire frequency range. The ventilation tests revealed air change rates of 3.7 h−1 at 50 Pa, while the ventilator’s annual energy consumption was 17.52 kWh. The results highlight the proposed device as a viable alternative for decentralised mechanical ventilation, capable of ensuring noise protection and satisfactory ventilation rates, under a sustainable perspective of minimum energy demand.
Ethnic minority cultural festival experience: Visitor–environment fit, cultural contact, and behavioral intention
Authors: Zou Yong-Guang , Meng Fang , Li Ningqiao , Pu Enling
Published: October 2020

This study aims to identify significant factors that influence visitors’ experience in ethnic minority cultural festival and to examine the underlying relationship between attendees’ experience and their future behavioral intention. The study used an exploratory sequential mixed method combining qualitative and quantitative stages. A grounded theory approach was adopted in analyzing the qualitative data collected from 20 in-depth interviews with past festival attendees and 453 online review posts from social network platforms. The developed conceptual framework was empirically tested by a quantitative study of 276 additional festival attendees through intercept data collection. The results indicate that cultural contact determines festival attendees’ future behavioral intention, while visitor–environment fit, including facilities, environmental functions, and activity knowledge, influences attendees’ experience of cultural contact. The study provides a non-Western perspective regarding ethnic minority cultural festival experience.
An embodied distress: African asylum seekers’ experiences of mental health difficulties while awaiting an asylum outcome in Ireland
Authors: Murphy Rebecca , Keogh Brian , Higgins Agnes
Published: October 2020

The mental health of asylum seekers has attracted significant interest and examination. Quantitative studies have consistently indicated that asylum seekers experience mental distress at a higher rate than both host populations and their refugee counterparts. Qualitative insight into asylum seekers’ embodied experience of mental distress is limited. This qualitative narrative study aimed to explore African asylum seekers’ everyday embodied experiences of mental distress. Sixteen semi-structured one-to-one interviews were conducted with African asylum seekers who had experienced mental distress and were receiving mental health care services in Ireland. Narrative data were analysed using a holistic analysis framework of narrative form and content. Participants described their everyday endurance of relentless rumination, shame, self-loathing, anger, and mistrust, and of becoming demoralised and hopeless. Study findings indicate that asylum seekers’ mental distress interweaves the physical, psychological, emotional, and social realms, thus impacting on the whole of their being. Consequences for asylum seekers include feeling anaesthetised, having a severely diminished capacity to connect and interact with their external surroundings and other people, and, for some, efforts to end their life.

Examinations of, and responses to, asylum seekers’ mental distress must delve beyond the confines of diagnostic categorisations and codifications of symptomology. To achieve heightened understanding and efficacious interventions, we must empathetically listen and engage with asylum seekers’ narratives of distress and the socio-cultural and socio-political context they inhabit.
A proposed two-stage quarantine containment scheme against spreading of novel coronavirus (SARS-CoV-2)
Authors: Chow W. K. , Chow C. L.
Published: October 2020

Novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spreading rapidly all over the world with over 23 million infected near the end of August 2020. There are also asymptomatic patients (APs) who are difficult to identify, but they are infectious and believed to be one of the transmission sources. No specific medicine, no vaccine and even no reliable quick identification tests on SARS-CoV-2 are available yet. Workable safety management must be implemented to stop such global pandemic resulting from disease transmission, including those infected through APs. A two-stage containment scheme is proposed with quarantining people into units within blocks. The units inside a block is to be open after being closed for quarantine for an agreed period such as 14 days. The blocks would then be sealed for another period before opening. Argument of the proposal was supported by a simple mathematical approach with parameters deduced from observations on a cruise ship to estimate the infection constant. The proposed containment scheme is believed to be effective in controlling the spreading of SARS-CoV-2 and identifying APs by a more targeted screening test for the suspected group with a more acceptable environment at the second stage of containment.
Evaluation of the effect of cover layer on radon exhalation from building materials
Authors: Wang Chenhua , Xie Dong , Yu Chuck Wah , Wang Hanqing
Published: October 2020

Radium, which is naturally present in many building materials, decays to the radioactive gas radon, which is exhaled from the surface of concrete block and is a major source of human exposure to radioactivity. In this study, an experimental evaluation of radon exhalation was conducted on a concrete block covered with mortar and acrylic render. Factors such as sand aggregates content and water content of the mortar cover layer, the thickness of the double cover layer were considered. Results showed that the radon exhalation rate was increased with an increase of sand content in mortar cover layer, and the radon exhalation rate was reduced with an increase of the thickness and water content. Besides, indoor radon concentration and effective dose estimation involving concrete block with cover layer were evaluated. The calculated indoor radon concentration was reduced from 234.9 to 201.1 Bq m−3 as the thickness of the cover layer was increased from 15 to 35 mm, and the effective dose was reduced by 0.61 mSv y−1. Therefore, the addition of a cover layer on the indoor walls, floors and ceilings could reduce the indoor radon concentration and the radon dose on exposure to occupants.
Reduced Number of Pediatric Orthopedic Trauma Requiring Operative Treatment during COVID-19 Restrictions: A Nationwide Cohort Study
Authors: Raitio A. , Ahonen M. , Jääskelä M. , Jalkanen J. , Luoto T. T. , Haara M. , Nietosvaara Y. , Salonen A. , Pakkasjärvi N. , Laaksonen T. , Sinikumpu J. J. , Syvänen J.
Published: October 2020

Background and Aims:

The coronavirus outbreak significantly changed the need of healthcare services. We hypothesized that the COVID-19 pandemic decreased the frequency of pediatric fracture operations. We also hypothesized that the frequency of emergency pediatric surgical operations decreased as well, as a result of patient-related reasons, such as neglecting or underestimating the symptoms, to avoid hospital admission.

Materials and Methods:

Nationwide data were individually collected and analyzed in all five tertiary pediatric surgical/trauma centers in Finland. Operations related to fractures, appendicitis, and acute scrotum in children aged above 16 years between March 1 and May 31 from 2017 to 2020 were identified. The monthly frequencies of operations and type of traumas were compared between prepandemic 3 years and 2020.

Results:

Altogether, 1755 patients were identified in five tertiary hospitals who had an emergency operation during the investigation period. There was a significant decrease (31%, p = 0.03) in trauma operations. It was mostly due to reduction in lower limb trauma operations (32%, p = 0.006). Daycare, school, and organized sports–related injuries decreased significantly during the pandemic. These reductions were observed in March and in April. The frequencies of appendectomies and scrotal explorations remained constant.

Conclusion:

According to the postulation, a great decrease in the need of trauma operations was observed during the peak of COVID-19 pandemic. In the future, in case similar public restrictions are ordered, the spared resources could be deployed to other clinical areas. However, the need of pediatric surgical emergencies held stable during the COVID-19 restrictions.
Treating a Cluster of Internalizing Disorders With the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: A Case Study
Authors: Altman Brianna R. , Earleywine Mitch
Published: October 2020

Psychotherapy outcome research rarely focuses on the ideographic application of treatment manuals, though some modules might prove markedly more important for a client than others. Clients in need of psychoeducation, emotion regulation skills, and changes in maladaptive patterns of thinking might balk at portions of the Unified Protocol for the Treatment of Emotional Disorders that seem irrelevant to their concerns. The current case study focused on emotion dysregulation and perfectionism given their role in anxiety, depression, obsessions, and compulsions. The Overall Anxiety Severity and Impairment Scale (OASIS), Overall Depression Severity and Impairment Scale (ODSIS), and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) confirmed qualitative reports and therapist observations of improvement. Additional sessions focused on fostering self-compassion and processing the termination of a romantic relationship rather than completing every section of the manual. This case demonstrates that flexible adaptation of a transdiagnostic treatment manual, in conjunction with a strong working alliance and other non-specifics of therapy, can produce beneficial outcomes even when other modules are not applied. These results might support ideographic application of select modules from treatment manuals and support a symptoms approach to psychotherapy.
Ethics as Obligation: Reconciling Diverging Research Practices With Marginalized Communities
Authors: McCracken Jill
Published: October 2020

This article argues that research design is impacted by ideological frameworks, and when conducting community-based participatory research (CBPR), can create challenges and conflicts throughout the Institutional Review Board (IRB) and other institution’s approval processes. I explore the ideological frameworks that underpin conventional and CBPR methodologies to show how collaboration can influence the questions asked and answered, the roles of researchers in the project, and how research findings can better impact the community at the center of the research. I offer a snapshot of our CBPR project with women who were currently and formerly incarcerated and document the challenges we encountered given our CBPR methodology and the unique population at the center of our study. I explore the ethical challenges, complications, and delays that emerged from these conflicting ideologies and methodologies. I propose that how we engage in research and our research practices impact the questions we ask and answer, how people are represented, and ultimately the material conditions of people’s lives. I conclude with recommendations for researchers and IRBs, and even more importantly, community partners to make CBPR projects more inclusive and ethically sound and to hold researchers and IRBs accountable to more inclusive research practices that can create more effective research outcomes and greater community impact.
Stroke in COVID-19: A systematic review and meta-analysis
Authors: Nannoni Stefania , de Groot Rosa , Bell Steven , Markus Hugh S
Published: October 2020

Background

Coronavirus disease 2019 (COVID-19) has become a global pandemic, affecting millions of people. However, the relationship between COVID-19 and acute cerebrovascular diseases is unclear.

Aims

We aimed to characterize the incidence, risk factors, clinical–radiological manifestations, and outcome of COVID-19-associated stroke.

Methods

Three medical databases were systematically reviewed for published articles on acute cerebrovascular diseases in COVID-19 (December 2019–September 2020). The review protocol was previously registered (PROSPERO ID = CRD42020185476). Data were extracted from articles reporting ≥5 stroke cases in COVID-19. We complied with the PRISMA guidelines and used the Newcastle–Ottawa Scale to assess data quality. Data were pooled using a random-effect model.

Summary of review

Of 2277 initially identified articles, 61 (2.7%) were entered in the meta-analysis. Out of 108,571 patients with COVID-19, acute CVD occurred in 1.4% (95%CI: 1.0–1.9). The most common manifestation was acute ischemic stroke (87.4%); intracerebral hemorrhage was less common (11.6%). Patients with COVID-19 developing acute cerebrovascular diseases, compared to those who did not, were older (pooled median difference = 4.8 years; 95%CI: 1.7–22.4), more likely to have hypertension (OR = 7.35; 95%CI: 1.94–27.87), diabetes mellitus (OR = 5.56; 95%CI: 3.34–9.24), coronary artery disease (OR = 3.12; 95%CI: 1.61–6.02), and severe infection (OR = 5.10; 95%CI: 2.72–9.54). Compared to individuals who experienced a stroke without the infection, patients with COVID-19 and stroke were younger (pooled median difference = −6.0 years; 95%CI: −12.3 to −1.4), had higher NIHSS (pooled median difference = 5; 95%CI: 3–9), higher frequency of large vessel occlusion (OR = 2.73; 95%CI: 1.63–4.57), and higher in-hospital mortality rate (OR = 5.21; 95%CI: 3.43–7.90).

Conclusions

Acute cerebrovascular diseases are not uncommon in patients with COVID-19, especially in those whom are severely infected and have pre-existing vascular risk factors. The pattern of large vessel occlusion and multi-territory infarcts suggests that cerebral thrombosis and/or thromboembolism could be possible causative pathways for the disease.
Differences in anthropometric and physical performance characteristics between U17, U19, and Senior Irish female international football players
Authors: Doyle Brian , Browne Declan , Horan Dan
Published: October 2020

This study aimed to compare the anthropometric physical performance characteristics of Irish female international footballers at U17, U19, and Senior age groups. Fifty-five (U17, n =24, U19, n =21, Senior, n = 10) female international football players participated in this study. The subjects underwent anthropometric measurements (height and body mass) and physical performance tests countermovement jump (CMJ), reactive strength index (RSI), 10-m, 20-m, 30-m linear sprint, and yo-yo intermittent recovery test level 1 (YYIR1). No significant differences were identified between any age groups for the anthropometric measures of height and body mass. Concerning the physical tests, senior players displayed greater CMJ scores in comparison with the U17 (P = 0.040). Senior players also possessed higher levels of reactive strength with large effect sizes present (ES = 0.83 - 0.92) in comparison to all age groups. No significant differences were identified between any of the age groups across the 10-m, 20-m, 30-m, and rolling 20-m linear speed assessments. Senior players covered the greatest distance in the YYIR1 (P = 0.0001) versus the U19 and U17. These results indicate there was no difference in the anthropometric profile of the age groups assessed. However, differences in physical performance characteristics were present between age groups, thus suggesting improvements in lower limb power and aerobic endurance are achievable in adulthood as players physically mature.
Identification of key genes and novel immune infiltration-associated biomarkers of sepsis
Authors: Xu Chao , Xu Jianbo , Lu Ling , Tian Wendan , Ma Jinling , Wu Meng
Published: October 2020

Sepsis is the major cause of mortality in the intensive care unit. The aim of this study was to identify the key prognostic biomarkers of abnormal expression and immune infiltration in sepsis. In this study, a total of 36 differentially expressed genes were identified to be mainly involved in a number of immune-related Gene Ontology terms and Kyoto Encyclopedia of Genes and Genomes pathways. The hub genes ( MMP9 and C3AR1) were significantly related to the prognosis of sepsis patients. The immune infiltration analysis indicated a significant difference in the relative cell content of naive B cells, follicular Th cells, activated NK cells, eosinophils, neutrophils and monocytes between sepsis and normal controls. Weighted gene co-expression network analysis and a de-convolution algorithm that quantifies the cellular composition of immune cells were used to analyse the sepsis expression data from the Gene Expression Omnibus database and to identify modules related to differential immune cells. CEBPB is the key immune-related gene that may be involved in sepsis. Gene set enrichment analysis revealed that CEBPB is involved in the processes of T cell selection, B cell–mediated immunity, NK cell activation and pathways of T cells, B cells and NK cells. Therefore, CEBPB may play a key role in the biological and immunological processes of sepsis.
A pilot project: handwashing educational intervention decreases incidence of respiratory and diarrheal illnesses in a rural Malawi orphanage
Authors: Rissman Lauren , Deavenport-Saman Alexis , Corden Mark H. , Zipkin Ronen , Espinoza Juan
Published: October 2020

Children who live in orphanages represent a population particularly vulnerable to transmissible diseases. Handwashing interventions have proven efficacy for reducing the rate of transmission of common infectious diseases. Few studies have analyzed the delivery of health interventions for children in orphanages in sub-Saharan Africa. To address this gap, we conducted an ecological assessment and piloted a handwashing intervention in an orphanage in rural Malawi, focusing on caregiver knowledge and behaviors, child handwashing behaviors, and disease incidence. A secondary study aim was to demonstrate program feasibility for a future randomized controlled trial. Orphanage caregivers participated in a three-module educational intervention on handwashing based on WHO recommendations and workshops on how to teach the curriculum to children. Seventeen orphanage caregivers and 65 children were monitored for handwashing behavior and child disease incidence. Friedman’s tests were conducted to compare changes in caregiver knowledge and behaviors. Child handwashing behaviors and surveillance of child disease incidence were measured pre- and post-intervention. There were significant increases in caregiver hand hygiene knowledge. At six months post-intervention, handwashing with soap increased significantly among caregivers ( p < 0.001) and was observed in children. The incidence of acute respiratory infections decreased from 30% to 6% post-intervention, resulting in an 80% decrease. The incidence of diarrhea decreased from 9.2% to 6.2% post-intervention, resulting in a 33% decrease. A brief educational intervention may improve handwashing knowledge and behaviors and help to decrease the incidence of common infectious diseases in an orphanage in rural Malawi. In addition, the caregiver uptake of the intervention demonstrated feasibility for future studies.
Postoperative stiffness after reverse total shoulder arthroplasty
Authors: Ghoraishian Mohammad , Hill Brian W , Nicholson Thema , Ramsey Matthew L , Williams Gerald R , Namdari Surena
Published: October 2020

Purpose

The purpose of this study was to evaluate the rate and risk factors for stiffness after reverse shoulder arthroplasty and the ramifications on the patient-reported outcomes.

Method

A consecutive series of patients who underwent reverse shoulder arthroplasty were prospectively followed for one year. Passive range of motion was measured preoperatively and at regular intervals postoperatively. Patients with passive forward elevation of less than 100° or passive external rotation of less than 30° were defined as stiff. Radiographic parameters and postoperative patient-reported outcome scores were collected.

Results

Seventy-six patients were available for review. The prevalence of postoperative stiffness following reverse shoulder arthroplasty was 47% at three months, 31% at six months, and 25% at one year. Preoperative shoulder stiffness was associated with three-month postoperative stiffness only. In patients with one-year stiffness, smaller ( p = 0.03) and less lateralized glenospheres ( p = 0.024) were more common. Stiffness was not associated with one-year patient-reported outcome scores.

Conclusion

Stiffness is common after reverse shoulder arthroplasty and often improves at one-year after surgery. Implant design and selection may be important determinants of passive range of motion. While stiffness does not appear to influence patient-reported outcome scores, one of four patients will potentially have stiffness one year following reverse shoulder arthroplasty. Level of evidence: Level III; retrospective study.
A brave, post–COVID-19 Europe
Authors: Samadashvili Salome
Published: October 2020

This article addresses the challenges to the EU’s future posed by the novel coronavirus disease (COVID-19). Its main argument is that if the EU finds the political will and resources to address these challenges, the crisis posed by COVID-19 can be turned into an opportunity to strengthen the Union. To develop this argument, the article responds to the criticisms of the EU’s response to COVID-19 voiced so far. It assesses how justified these criticisms are, as well as how they have been manipulated for anti-EU propaganda purposes. It reviews how—given the economic, political and institutional structures of the EU—COVID-19 presents a unique challenge, and what the EU’s response has been thus far, from the financial and economic, as well as security perspectives. In particular, focusing on the newly published EU Security Union Strategy, the article reviews how the novel coronavirus disease has impacted European thinking about security. The article suggests that the way forward is to address the institutional gaps which have limited the EU’s response to the challenge of COVID-19 and to invest more resources in countering propaganda efforts that focus on this response with the aim of undermining the Union.
HbA1c Is Disproportionately Higher in Women and Older People With Type 1 Diabetes Compared With Flash Glucose Monitoring Metrics of Glycemic Control
Authors: Stimson Roland H. , Dover Anna R. , Forbes Shareen , Strachan Mark W. J. , McKnight John A. , Gibb Fraser W.
Published: October 2020

Aims:

Discrepancy between HbA1c and glucose exposure may have significant clinical implications. We sought to assess predictors of disparity between HbA1c and flash monitoring metrics and how these relate to microvascular complications.

Methods:

We conducted a cross-sectional study of adults with type 1 diabetes ( n = 518). We assessed the relationship between clinic HbA1c and flash monitoring metrics, predictors of discrepancy between these measurements, and whether discrepancy was associated with microvascular complications.

Results:

Actual HbA1c and estimated HbA1c were strongly correlated ( r = .779, P < .001). The likelihood of having a higher actual HbA1c than estimated HbA1c was greater with increasing age (OR = 1.055 per year, P < .001) and lower in men (OR = .208, P < .001). HbA1c was significantly lower in men (58 mmol/mol [51-67]) (7.5% [6.8-8.3]) compared to women (61 mmol/mol [54-70], P = .021) (7.7% [7.1-8.6]), despite no significant differences in any flash monitoring metrics. Whereas HbA1c was not different between younger (≤39 years) and older individuals (>39 years) despite significantly higher glucose exposure, in younger people, based on multiple flash monitoring metrics. Having a lower estimated than actual HbA1c was independently associated with a lower prevalence of retinopathy (OR = .55, P = .004).

Conclusions:

HbA1c appears to overestimate glucose exposure in women and older people with type 1 diabetes. This has potentially important clinical implications, as is hinted at by the independent relationship with retinopathy prevalence. It may also be of relevance when considering the use of HbA1c for the diagnosis of diabetes.
The history of the land: a relational and place-based approach for teaching (more) radical food geographies
Authors: Brown Jabari , Connell Kevin , Firth Jeanne , Hilton Theo
Published: October 2020

The History of the Land (Brown et al., 2019) is a workshop, field trip, and pedagogical lens developed at Grow Dat Youth Farm in New Orleans and led with teenagers and adults. Using popular education methods, the lesson explores the relational biography of the land on which the farm currently resides. We argue that the history of the land is essential to understanding the spatial and social configurations of contemporary foodscapes; however, critical land histories are not engaged with in many alternative food initiatives and food justice organizations. We offer the adaptable pedagogical apparatus of the History of the Land as a tool for others to further the generative convergence of food geographies and anti-oppression work. In addition to discussing the workshop at Grow Dat, we reflect upon our own learning and healing from participating in an ongoing series of history of the land field trips to rural Mississippi where several of us hold deep personal ties to the land. We coauthors are a collective of farmers, food activists, educators, and academics. Across differences of gender, race, sexuality, class, location, and history, learning about the land together has brought us into intimate conversation about loss, memory, narration, transformation, and how we imagine alternate, liberatory futures.
DMOG Negatively Impacts Tissue Engineered Cartilage Development
Authors: Falcon Jessica M. , Chirman Dylan , Veneziale Alyssa , Morman Justin , Bolten Katherine , Kandel Shital , Querido William , Freeman Theresa , Pleshko Nancy
Published: October 2020

Objective

Articular cartilage exists in a hypoxic environment, which motivates the use of hypoxia-simulating chemical agents to improve matrix production in cartilage tissue engineering. The aim of this study was to investigate whether dimethyloxalylglycine (DMOG), a HIF-1α stabilizer, would improve matrix production in 3-dimensional (3D) porcine synovial-derived mesenchymal stem cell (SYN-MSC) co-culture with chondrocytes.

Design

Pellet cultures and scaffold-based engineered cartilage were grown in vitro to determine the impact of chemically simulated hypoxia on 2 types of 3D cell culture. DMOG-treated groups were exposed to DMOG from day 14 to day 21 and grown up to 6 weeks with n = 3 per condition and time point.

Results

The addition of DMOG resulted in HIF-1α stabilization in the exterior of the engineered constructs, which resulted in increased regional type II collagen deposition, but the stabilization did not translate to overall increased extracellular matrix deposition. There was no increase in HIF-1α stabilization in the pellet cultures. DMOG treatment also negatively affected the mechanical competency of the engineered cartilage.

Conclusions

Despite previous studies that demonstrated the efficacy of DMOG, here, short-term treatment with DMOG did not have a uniformly positive impact on the chondrogenic capacity of SYN-MSCs in either pellet culture or in scaffold-based engineered cartilage, as evidenced by reduced matrix production. Such 3D constructs generally have a naturally occurring hypoxic center, which allows for the stabilization of HIF-1α in the interior tissue. Thus, short-term addition of DMOG may not further improve this in cartilage tissue engineered constructs.
Vitrification of Intact Porcine Femoral Condyle Allografts Using an Optimized Approach
Authors: Wu Kezhou , Laouar Leila , Elliott Janet A. W. , Jomha Nadr M.
Published: October 2020

Objective

Successful preservation of articular cartilage will increase the availability of osteochondral allografts to treat articular cartilage defects. We compared the effects of 2 methods for storing cartilage tissues using 10-mm diameter osteochondral dowels or femoral condyles at −196°C: (a) storage with a surrounding vitrification solution versus (b) storage without a surrounding vitrification solution. We investigated the effects of 2 additives (chondroitin sulfate and ascorbic acid) for vitrification of articular cartilage.

Design

Healthy porcine stifle joints ( n = 11) from sexually mature pigs were collected from a slaughterhouse within 6 hours after slaughtering. Dimethyl sulfoxide, ethylene glycol, and propylene glycol were permeated into porcine articular cartilage using an optimized 7-hour 3-step cryoprotectant permeation protocol. Chondrocyte viability was assessed by a cell membrane integrity stain and chondrocyte metabolic function was assessed by alamarBlue assay. Femoral condyles after vitrification were assessed by gross morphology for cartilage fractures.

Results

There were no differences in the chondrocyte viability (~70%) of 10-mm osteochondral dowels after vitrification with or without the surrounding vitrification solution. Chondrocyte viability in porcine femoral condyles was significantly higher after vitrification without the surrounding vitrification solution (~70%) compared to those with the surrounding vitrification solution (8% to 36%). Moreover, articular cartilage fractures were not seen in femoral condyles vitrified without surrounding vitrification solution compared to fractures seen in condyles with surrounding vitrification solution.

Conclusions

Vitrification of femoral condyle allografts can be achieved by our optimized approach. Removing the surrounding vitrification solution is advantageous for vitrification outcomes of large size osteochondral allografts.
Sevoflurane augmentation in treatment-resistant depression: a clinical case study
Authors: Wang Shikai , Cheng Shanfei , Feng Min , Guo Ping , Qian Mincai , Shen Xinhua , Chen Runsen , Wang Gang
Published: October 2020

Compared with other inhaled anaesthetics, sevoflurane has a faster onset and offset, causes less irritation to the mucous membranes, and has a better safety profile. These characteristics warrant investigating the effect of sevoflurane in depression. In this Case Report, we describe that sevoflurane treatment was feasible and well tolerated by a patient with treatment-resistant depression (TRD). Sevoflurane had rapid and durable antidepressant effects, with few adverse effects. Moreover, the patient showed significant improvements in neurocognitive measurements. Our preliminary results suggest that further clinical trials are needed to determine the independent efficacy and safety of sevoflurane in patients with TRD.
Is Voting Patterns at the United Nations General Assembly a Useful Way to Understand a Country’s Policy Inclinations: Bangladesh’s Voting Records at the United Nations General Assembly
Authors: Khan Mohammad Zahidul Islam
Published: October 2020

This article explores Bangladesh’s voting coincidences at the United Nations General Assembly (UNGA) with China, India, Russia, and the United States for the period 2001–2017 to draw inferences about country’s political proximity and policy preferences on global issues. Although Bangladesh’s voting coincidence shifted from China toward India since 2013, country’s “opposite” votes with India remained 3 times higher compared with that of China, suggesting that the post-2013 change in voting coincidence is more about the types and content of the resolutions and not fundamental. Bangladesh maintained a principled position on disarmament, conventional arms control, nuclear nonproliferation, and prohibition of chemical weapons resolutions, which are greatly at odds with India and China. Such voting coherency suggests that the small developing countries can maintain a higher level of voting consistency on issues that are of great interest to them. However, Bangladesh’s voting inconstancy in the country-specific human rights resolutions reflects a selective adherence to the policy of non-interference, particularly with respect to neighbors. Bangladesh’s voting records on the human rights situation in Myanmar, reveals that it joined the majority member states condemning Myanmar only when the resolutions started mentioning Bangladesh as an affected country. Although the voting coincidence alone may not capture the whole dynamics of a state’s leanings, this article has revealed that systematic research of UNGA voting records has the capacity to add to the knowledge of political proximity and policy preferences of states in terms of the way they weigh their choices and chart their path through idealism and opportunism.
Setting a New Industry Standard that Accomodates Robotics
Authors: Astle Tom
Published: October 2020

The Society of Biomolecular Screening Proposes New Design Standards for one of the Industry's Most Used Tools - the 96-Well Plate.
One Small Step in the Lecture Hall, One Big Step for Student Motivation: Short Bursts of In-Class Small Group Work
Authors: Anderson Angela S.
Published: October 2020

Great teachers are continually introducing strategies to engage students, especially those who teach large-lecture classes, whose format can limit active learning and student motivation to engage in learning. Implementation of active teaching strategies must be assessed for effectiveness. Using the simple MUSIC model postcourse assessment survey, student motivation to engage in learning was statistically quantified. A simple short intervention of in-class group work led to significant areas of improvement, which included the students’ perception of the class’ Usefulness towards their future career ( p < .01), their perceived ability for Success in the class ( p < .01), their Interest in the material ( p < .01), and their perception of the instructor Caring about their success ( p < .05). No change was seen in e Mpowerment. In addition, students rated the ease of the class ( p < .01) and the overall satisfaction with the course ( p < .01) significantly higher than the previous semester, prior to the in-class group work implementation. The implementation of this short simple intervention of in-class group work was highly successful in increasing student motivation in a large-lecture, in-major required exercise and health class and can be easily adapted to other large-lecture classes.
Human mutational constraint as a tool to understand biology of rare and emerging bone marrow failure syndromes
Authors: Oved Joseph H. , Babushok Daria V. , Lambert Michele P. , Wolfset Nicole , Kowalska M. Anna , Poncz Mortimer , Karczewski Konrad J. , Olson Timothy S.
Published: October 2020

Inherited bone marrow failure (IBMF) syndromes are rare blood disorders characterized by hematopoietic cell dysfunction and predisposition to hematologic malignancies. Despite advances in the understanding of molecular pathogenesis of these heterogeneous diseases, genetic variant interpretation, genotype–phenotype correlation, and outcome prognostication remain difficult. As new IBMF and other myelodysplastic syndrome (MDS) predisposition genes continue to be discovered (frequently in small kindred studies), there is an increasing need for a systematic framework to evaluate penetrance and prevalence of mutations in genes associated with IBMF phenotypes. To address this need, we analyzed population-based genomic data from >125 000 individuals in the Genome Aggregation Database for loss-of-function (LoF) variants in 100 genes associated with IBMF. LoF variants in genes associated with IBMF/MDS were present in 0.426% of individuals. Heterozygous LoF variants in genes in which haploinsufficiency is associated with IBMF/MDS were identified in 0.422% of the population; homozygous LoF variants associated with autosomal recessive IBMF/MDS diseases were identified in only .004% of the cohort. Using age distribution of LoF variants and 2 measures of mutational constraint, LOEUF (“loss-of-function observed/expected upper bound fraction”) and pLI (“probability of being loss-of-function intolerance”), we evaluated the pathogenicity, tolerance, and age-related penetrance of LoF mutations in specific genes associated with IBMF syndromes. This analysis led to insights into rare IBMF diseases, including syndromes associated with DHX34, MDM4, RAD51, SRP54, and WIPF1. Our results provide an important population-based framework for the interpretation of LoF variant pathogenicity in rare and emerging IBMF syndromes.
Gender does not impact the short- or long-term outcomes of home-based pulmonary rehabilitation in patients with COPD
Authors: Grosbois Jean-Marie , Gephine Sarah , Diot Anne Sophie , Kyheng Maeva , Machuron François , Terce Gaelle , Wallaert Benoit , Chenivesse Cécile , Le Rouzic Olivier
Published: October 2020

Pulmonary rehabilitation, whether performed at home or in a specialised centre, is effective in the management of COPD. As gender-related differences in COPD were previously reported, we aimed to evaluate the impact of gender on pulmonary rehabilitation outcomes in the short, medium and long term.

In this retrospective observational study of 170 women and 310 men with COPD, we compared the outcomes of an 8-week home-based pulmonary rehabilitation programme including an individualised plan of retraining exercises, physical activities, therapeutic education, and psychosocial and self-management support. Exercise tolerance, anxiety, depression, and quality of life (QOL) were assessed using the 6-min stepper test (6MST), Hospital Anxiety and Depression Scale (HADS) and Visual Simplified Respiratory Questionnaire (VSRQ), respectively. Assessments were carried out before, immediately after the pulmonary rehabilitation programme (T2) and at 8 (T8) and 14 months (T14).

At baseline, women were younger (mean 62.1versus65.3 years), more often nonsmokers (24.7%versus7.7%) and had a higher body mass index (28versus26.4 kg·m−2). They more often lived alone (50.6%versus24.5%) and experienced social deprivation (66.7%versus56.4%). They had significantly lower exercise tolerance (−34 strokes, 6MST) and higher anxiety and depression (+3.2 HADS total score), but there were no between gender differences in QOL (VSRQ). Both groups showed similar improvements in all outcome measures at T2, T8 and T14 with a tendency for men to lose QOL profits over time.

Despite some differences in baseline characteristics, women and men with COPD had similar short-, medium- and long-term benefits of a home-based pulmonary rehabilitation programme.