bluuebunny/crossref_metadata_2025 huggingface dataset:
Fragmented sinoatrial dynamics in the prediction of atrial fibrillation: the Multi-Ethnic Study of Atherosclerosis
Authors: Costa Madalena D. , Redline Susan , Soliman Elsayed Z. , Goldberger Ary L. , Heckbert Susan R.
Published: September 2020

This study is the first demonstration that heart rate fragmentation (HRF), a marker of anomalous sinoatrial dynamics, is an independent predictor of atrial fibrillation (AF). Traditional measures of heart rate variability and two widely used nonlinear measures were not associated with incident AF in the Multi-Ethnic Study of Atherosclerosis. Fragmentation measures added value to the strongest contemporary predictors of AF, including ECG-derived parameters, coronary calcification score, serum concentrations of NH2-terminal prohormone B-type natriuretic peptide, and supraventricular ectopy. The computational algorithms for quantification of HRF could be readily incorporated into wearable ECG monitoring devices.
Serum Soluble Interleukin-2 Receptor Does Not Differentiate Complex Regional Pain Syndrome from Other Pain Conditions in a Tertiary Referral Setting
Authors: Bharwani K. D. , Dirckx M. , Stronks D. L. , Dik W. A. , Huygen F. J. P. M. , Dozio Elena
Published: September 2020

Previously, we showed that serum soluble interleukin-2 receptor (sIL-2R) levels, a marker for T-cell activation, were higher in complex regional pain syndrome (CRPS) patients than in healthy controls, suggesting pathogenic T-cell activation in CRPS. Additionally, sIL-2R levels discriminated well between CRPS and healthy controls with a high sensitivity (90%) and specificity (89.5%), suggesting a possible role for sIL-2R in the diagnosis of CRPS. In order to further validate this marker in the diagnostic workup of CRPS, we conducted this prospective cohort study in which we determined sIL-2R levels in patients that were referred to our tertiary referral center with a suspicion of CRPS in a limb, and subsequently compared sIL-2R levels between the patients that were diagnosed with CRPS (CRPS group) and those who were not (no CRPS group). A group of anonymous blood bank donors were used as a healthy control group. Furthermore, we explored the relationship between sIL-2R and CRPS disease severity using the CRPS severity score. Median sIL-2R levels of both the CRPS group (2809.0 pg/ml; Q3-Q1: 3913.0-1589.0) and no CRPS group (3654.0 pg/ml; Q3-Q1: 4429.0-2095.5) were significantly higher than that of the control group (1515.0 pg/ml; Q3-Q1: 1880.0-1150.0): CRPS vs. controls,p<.001; no CRPS vs. controls,p<0.001. Serum sIL-2R levels did not differ significantly between the CRPS and no CRPS group. A statistically significant negative correlation was observed between sIL-2R levels and the CRPS severity score (rs=−0.468,p=0.024). Our results confirm our previous findings of higher sIL-2R levels in CRPS patients than in healthy controls. We further showed that serum sIL-2R cannot differentiate between CRPS and other pain conditions of a limb in a tertiary referral setting. Interestingly, a negative correlation was found between sIL-2R and CRPS disease severity; this finding warrants further research into the relationship between sIL-2R and CRPS disease severity.
The Impact of Insecticide Pre-Exposure on Longevity, Feeding Succession, and Egg Batch Size of Wild Anopheles gambiae s.l.
Authors: Msangi Grace , Olotu Moses I. , Mahande Aneth M. , Philbert Anitha , Kweka Eliningaya J. , Dash Aditya Prasad
Published: September 2020

Background. Insecticide resistance among the vector population is the main threat to existing control tools available. The current vector control management options rely on applications of recommended public health insecticides, mainly pyrethroids through long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS). Regular monitoring of insecticide resistance does not provide information on important factors that affect parasite transmission. Such factors include vector longevity, vector competence, feeding success, and fecundity. This study investigated the impacts of insecticide resistance on longevity, feeding behaviour, and egg batch size of Anopheles gambiae s.l. Method. The larval sampling was conducted in rice fields using a standard dipper (350 ml) and reared to adults in field insectary. A WHO susceptibility test was conducted using standard treated permethrin (0.75%) and deltamethrin (0.05%) papers. The susceptible Kisumu strain was used for reference. Feeding succession and egg batch size were monitored for all survivors and control. Results. The results revealed that mortality rates declined by 52.5 and 59.5% for permethrin and deltamethrin, respectively. The mortality rate for the Kisumu susceptible strain was 100%. The survival rates of wild An. gambiae s.l. was between 24 and 27 days. However, the Kisumu susceptible strain blood meal feeding was significantly higher than resistant colony (t = 2.789, df = 21,

P
=
0.011

). Additionally, the susceptible An. gambiae s.s. laid more eggs than the resistant An.gambiae s.l. colony (Χ2 = 1366, df = 1,

P
≤
0.05

). Conclusion. It can, therefore, be concluded that the wild An. gambiae s.l. had increased longevity, blood feeding, and small egg batch size compared to Kisumu susceptible colonies.
Steady-State Dynamical Response of a Strongly Nonlinear System with Impact and Coulomb Friction Subjected to Gaussian White Noise Excitation
Authors: Yang Guidong , Huang Dongmei , Li Wei , Su Meng , Pellicano Francesco
Published: September 2020

The paper is devoted to the steady-state dynamical response analysis of a strongly nonlinear system with impact and Coulomb friction subjected to Gaussian white noise excitation. The Zhuravlev nonsmooth transformation of the state variables combined with the Dirac delta function is utilized to simplify the original system to one without velocity jump. Then, the steady-state probability density functions of the transformed system are derived in terms of the stochastic averaging method of energy envelope. The effectiveness of the presented analytical procedure is verified by those from the Monte Carlo simulation based on the original system. Effects of different restitution coefficients, amplitudes of friction, and noise intensities on the steady-state dynamical responses are investigated in detail. Results show different intensities of Gaussian white noise can affect the peaks value of the probability density functions, whereas the variations of restitution coefficients and amplitudes of friction can induce the occurrence of stochastic P-bifurcation.
Intramucosal Poorly Differentiated Adenocarcinomas Detected in a Patient with Long-Standing Ulcerative Colitis
Authors: Zaitsu Junichi , Kuraoka Kazuya , Ishikawa Akira , Yamamoto Hideki , Taniyama Daiki , Saito Akihisa , Kuwai Toshio , Shimizu Yosuke , Tashiro Hirotaka , Taniyama Kiyomi
Published: September 2020

We report a case of long-standing ulcerative colitis with intramucosal well- and poorly differentiated adenocarcinomas detected over a 6-month duration. A Japanese man in his sixties with a 31-year history of ulcerative colitis had a 1.1-cm-sized intramucosal well-differentiated tubular adenocarcinoma in the rectum resected by endoscopic submucosal dissection. At the follow-up colonoscopy, a biopsy near the endoscopic submucosal dissection scar revealed poorly differentiated adenocarcinoma, and a total proctocolectomy was performed 6 months after the endoscopic submucosal dissection. The whole colorectal pathological exam showed 2 flat foci of intramucosal poorly differentiated adenocarcinoma, 4 and 2 mm in size each, near the endoscopic submucosal dissection scar in the rectum, and an increased number of Paneth cells, thickened muscularis mucosa, and widening of the distance between the gland base and muscularis mucosa in the transverse colon to the rectum. Adenocarcinomas were not found in areas where architecturally severe changes of the mucosa or the highest number of Paneth cells proliferation were detected. Multiple biopsies using magnifying narrow band imaging or crystal violet staining around the initial high-grade dysplasia or intramucosal adenocarcinoma were effective to find other lesions, such as poorly differentiated adenocarcinoma foci in the mucosa in a long-standing ulcerative colitis patient.
“Covidsubo”: Stress-Induced Cardiomyopathy by Novel Coronavirus Disease 2019
Authors: Koutroumpakis Efstratios , Taylor Travis , Damaraju Srikanth , Badruddin Mawji Shamim
Published: September 2020

Introduction: COVID-19 is a rapidly growing infectious disease that represents an immediate threat for the health of millions of people around the world, both in direct and indirect ways. Case Presentation: In the present report we describe the development of stress cardiomyopathy in a patient who was overwhelmingly stressed by watching the news coverage of the COVID-19 pandemic. Conclusion: Physicians and scientists around the globe should be aware of the psychological consequences of COVID-19 and their potential to cause physical illness.
Cuidado em saúde mental e atenção primária em saúde como campo formador para a enfermagem
Authors: Dias Bárbara Jéssica de Melo Cezar , Resende Fernanda Martinez de Oliveira , Regne Giulia Ribeiro Schettino , Reinaldo Amanda Márcia dos Santos , Pereira Maria Odete , Tavares Marcus Luciano de Oliveira
Published: September 2020

Objetivo: apresentar o olhar de duas acadêmicas do último ano do curso de enfermagem de uma instituição federal de ensino superior sobre um serviço da atenção primária em saúde em relação ao cuidado em rede à pessoa em sofrimento mental. Método: estudo descritivo do tipo relato de experiência apresentado por meio de narrativa, que foi construída a partir do registro em diários de campo. Resultados: observa-se a não articulação entre teoria e prática no atendimento em rede à pessoa em sofrimento mental; considera-se a necessidade de observar o cenário de prática articulado à realidade onde o serviço está inserido, apontando-se a necessidade de avaliação da formação do futuro enfermeiro nesse sentido. Conclusão: o ponto de vista do aluno contribui para pensar a prática docente no ensino da saúde mental enquanto componente que perpassa a saúde global.
Habilidades sociais de usuários de crack acolhidos em comunidades terapêuticas
Authors: Filho Adauto Motta , Sousa Andressa Aparecida Francisquini , Junior Randolfo Santos , André Julio Cesar , Santos Loiane Leticia
Published: September 2020

Objetivo: buscou-se, por meio deste estudo, avaliar as habilidades sociais de usuários de crack em abstinência, vide a caracterização do perfil sociodemográfico e identificação de possíveis déficits nas habilidades sociais. Método: amostra de conveniência de 39 dependentes químicos, com idade média de 40,7 anos (±10,48) e acolhidos em comunidades terapêuticas no interior do estado de São Paulo. O estudo caracteriza-se como descritivo, transversal e com delineamento quantitativo. Os instrumentos utilizadosforam Questionário Sociodemográfico e Padrão de Consumo; Escala de Apoio Social; Escala de Autoestima e Inventário de Habilidades Sociais (IHS). Resultados: este estudo apontou déficits em habilidades sociais no score geral (84,3%) dos participantes e nos subcomponentes do inventário de habilidades sociais. Nas correlações de habilidades sociais e apoio social, primordialmente os fatores afetivos (p ≤ 0,0156) e emocional (p ≤ 0,0299) apresentaram valor de significância estatística, ou seja, quanto maiores os índices de apoio social, maior os recursos em habilidades sociais. A idade avançada apresentou correlação negativa (p ≤ 0,0167) em habilidades sociais; quanto maior a idade, menor o repertório de HS. Conclusão: este estudo destaca a relevância do apoio social ao dependente químico como fator de melhor desempenho social, possibilitando subsídios para novas pesquisas na área.
Política de redução de danos e o cuidado à pessoa em situação de rua
Authors: Viana Lorenna Saraiva , Oliveira Eliany Nazaré , Costa Maria Suely Alves , Aguiar Claudine Carneiro , Moreira Roberta Magda Martins , Cunha Andriny Albuquerque
Published: September 2020

Objetivo: Realizar momentos de Educação Permanente em Saúde Mental acerca do cuidado à pessoa em situação de rua e Redução de Danos. Métodos: Pesquisa intervenção desenvolvida com doze profissionais do Centro de Referência Especializada à Pessoa em Situação de Rua e Centro de Atenção Psicossocial Álcool e outras Drogas, tendo como referencial o Arco de Maguerez. Resultados: Surgiram desafios relacionados ao estigma; fortalecimento da autonomia e fragilidades na articulação intersetorial. Citou-se também a parceria com o serviço especializado, Residência e Liga Interdisciplinar em Saúde Mental. Realizaram-se também momentos teórico-reflexivos e construção de um fluxo de cuidado. Conclusão: Compreende-se a importância de atividades de consciência crítica com os profissionais no intuito de aperfeiçoar o cuidado no âmbito da Redução de Danos.
Guia de diagnose para aulas práticas de fitopatologia
Authors:   Universidade de São Paulo, Escola Superior de Agricultura “Luiz de Queiroz”, Santos Ricardo Feliciano dos , Simões Ana Laura Toledo ,   Universidade de São Paulo, Escola Superior de Agricultura “Luiz de Queiroz”, Gonçalves Manoel Penachio ,   Universidade de São Paulo, Escola Superior de Agricultura “Luiz de Queiroz”, Lourenço Silvia de Afonseca ,   Universidade de São Paulo, Escola Superior de Agricultura “Luiz de Queiroz”, Amorim Lilian ,   Universidade de São Paulo, Escola Superior de Agricultura “Luiz de Queiroz”
Published: September 2020

Este Guia foi elaborado em 2020, para auxiliar as aulas remotas sobre diagnose de doenças de plantas. Nele, estão apresentados os sintomas e os agentes causais dos principais grupos de doenças de plantas que ocorrem nos estados do Sudeste do Brasil. A ordem em que os grupos de doenças de plantas aparecem no Guia segue a cronologia das aulas de Fitopatologia, ministradas na Escola Superior de Agricultura “Luiz de Queiroz” (ESALQ) da Universidade de São Paulo (USP). Como introdução a cada grupo de doenças, elaborou-se um breve texto sobre a importância daquele grupo, informações sobre o ciclo de relações patógeno-hospedeiro e um mapa com a distribuição mundial de uma das doenças típicas do grupo. Esta publicação não tem a pretensão de apresentar a sintomatologia de todas as doenças de plantas que ocorrem nas principais culturas do Sudeste brasileiro, e não pode abordar cada doença em detalhes. O objetivo é auxiliar o ensino da diagnose a alunos do curso de Engenharia Agronômica.
Systolic Blood Pressure Reduction and Acute Kidney Injury in Intracerebral Hemorrhage
Authors: Qureshi Adnan I. , Huang Wei , Lobanova Iryna , Hanley Daniel F. , Hsu Chung Y. , Malhotra Kunal , Steiner Thorsten , Suarez Jose I. , Toyoda Kazunori , Yamamoto Haruko ,   on behalf of Antihypertensive Treatment of Cerebral Hemorrhage 2 Trial Investigators
Published: September 2020

Background and Purpose:

We determined the rates and predictors of acute kidney injury (AKI) and renal adverse events (AEs), and effects of AKI and renal AEs on death or disability in patients with intracerebral hemorrhage.

Methods:

We analyzed data from a multicenter trial which randomized 1000 intracerebral hemorrhage patients with initial systolic blood pressure ≥180 mm Hg to intensive (goal 110–139 mm Hg) over standard (goal 140–179 mm Hg) systolic blood pressure reduction within 4.5 hours of symptom onset. AKI was identified by serial assessment of daily serum creatinine for 3 days post randomization.

Results:

AKI and renal AEs were observed in 149 patients (14.9%) and 65 patients (6.5%) among 1000 patients, respectively. In multivariate analysis, the higher baseline serum creatinine (≥110 μmol/L) was associated with AKI (odds ratio 2.4 [95% CI, 1.2–4.5]) and renal AEs (odds ratio 3.1 [95% CI, 1.2–8.1]). Higher area under the curve for intravenous nicardipine dose was associated with AKI (odds ratio 1.003 [95% CI, 1.001–1.005]) and renal AEs (odds ratio 1.003 [95% CI, 1.001–1.006]). There was a higher risk to death (relative risk 2.6 [95% CI, 1.6–4.2]) and death or disability (relative risk 1.5 [95% CI, 1.3–1.8]) at 90 days in patients with AKI but not in those with renal AEs.

Conclusions:

Intracerebral hemorrhage patients with higher baseline serum creatinine and those receiving higher doses of nicardipine were at higher risk for AKI and renal AEs. Occurrence of AKI was associated higher rates of death or disability at 3 months.

Registration:

URL:
https://clinicaltrials.gov
. Unique identifier: NCT01176565.
Antiphospholipid Antibody and Recurrent Ischemic Stroke
Authors: Kim Yerim , Kim Soo Young
Published: September 2020

Background and Purpose:

Although aPLs (antiphospholipid antibodies) are associated with thrombotic events, especially in young patients, the role of aPLs in recurrent ischemic strokes (RIS) is unclear. This systematic review and meta-analysis evaluated the association between aPLs and RIS.

Methods:

The systematic review was conducted by a computer-assisted search of literature in PubMed, EMBASE, and Cochrane library published in English or Korean from 1990, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). Review Manager 5.3 software was used for statistical analyses.

Results:

Of the 2272 identified articles, 8 studies were included (2510 subjects; 844 aPL positive). The meta-analysis revealed a relative risk of aPLs for RIS of 1.41 (95% CI, 0.91–2.17;
I
2
=54%). In the subgroup analysis, age <50 years, ethnicity, and type of aPL did not increase the risk of RIS.

Conclusions:

We found that aPLs are not an independent predictor for RIS in adults. However, considering the nonstandardized disease criteria, further well-designed prospective trials should be considered to confirm these findings.
FIFA DÜNYA KUPASI’NDA YARI FİNALE GİDEN YOL
Authors: ÇELİK Onur
Published: September 2020

Bu çalışmada, FIFA Erkekler Dünya Kupası finallerinde yarı final turuna ulaşabilmek için önem arz eden faktörleri belirlemek amacıyla 1998 ile 2018 yılları arasında düzenlenmiş olan son altı FIFA Erkekler Dünya Kupası finallerine katılan ülke millî takımlarına sağkalım analizi olarak koşullu tehlike kümesi modeli olan tabakalı Cox orantılı tehlikeler modeli uygulanmıştır. Ev sahibi ülke millî takımının turnuvadan elenme olasılığı, misafir ülke millî takımlarının elenme olasılığına göre yaklaşık dörtte üç oranında daha azdır. Benzer şekilde, ev sahibi ülkeyle aynı kıtada yer alan ülkelerin millî takımları da diğer kıtalardan gelen millî takımlara karşı bir avantaja sahiptir. Olimpiyat Oyunları’nda kazanılan madalya sayısını etkileyen en önemli iki faktörden biri olan ülke nüfusu, futbolun en üst düzey organizasyonunda da başarıyı olumlu yönde etkileyen bir faktördür.
Violent Compassions: Humanitarian Design and the Politics of Borders
Authors: Keshavarz Mahmoud
Published: September 2020

Based on a critical analysis of the two notions of “crisis” and “compassion,” this article outlines and problematizes the increasing engagement of design practices with refugees and vulnerable communities on the move. By contextualizing different historical and contemporary humanitarian design examples in an analysis of current European border politics, the article questions the ways in which designing in the aftermath of the so-called “refugee crisis” has been mobilized without due consideration of what types of politics it produces and what types of politics it eventually ignores. It suggests that designers instead need to develop a more political understanding of the current border regime that produces and regulates refugees, asylum seekers, and undocumented migrants worldwide and to think of practices that support the struggles of racialized people on the move in transgressing and questioning the borders.
An overview of the Syrphidae (Diptera) of Saudi Arabia
Authors: DAWAH HASSAN A. , ABDULLAH MOHAMMED A. , AHMAD SYED KAMRAN , AL-DHAFER HATHAL , TURNER JAMES
Published: September 2020

Despite the species richness of hoverflies (Diptera: Syrphidae) world-wide (about 6,200 species) and their role as agents for controlling plant pests, their significance as pollinators, and as bioindicators of site quality, hoverfly fauna of Saudi Arabia is poorly known. In exploring the biodiversity of Diptera in southwest Saudi Arabia a survey of the hoverfly fauna of Jazan, Asir, Najran and Al-Baha was performed mainly using Malaise traps, sweep nets and light traps from 2011 to 2014. Forty known species of Syrphidae were identified and recorded in this study, 19 of them new to Saudi Arabia. This makes the total number of Syrphidae species recorded in Saudi Arabia (including one species recorded by others) is 41. In addition, three taxa belonging to the genera Eumerus Meigen, Orthonevra Macquart, and Paragus Latreille that could not be identified safely to species level because there were no adequate identification keys or males were missing in the collected material. A key to the genera of Syrphidae occurring in Saudi Arabia is provided. The fauna of Syrphidae recorded in this study consists much more of Afrotropical zoogeographical elements than Palaearctic ones. A complete checklist of Syrphidae of Saudi Arabia is provided. Biological data, where known, and world-wide distribution of the studied taxa are provided. This paper is published with the purpose of assisting biogeographical, biological or ecological studies on syrphids in Saudi Arabia.
Poor outcome of patients with pulmonary arterial hypertension with insufficient response to phosphodiesterase‐5 inhibitors alone or in combination with other specific therapy: a registry‐based study
Authors: Hjalmarsson Clara , Butler Oisin , Hesselstrand Roger , Holl Katsiaryna , Jansson Kjell , Klok Rogier , Rådegran Göran , Söderberg Stefan , Kjellström Barbro
Published: September 2020

Phosphodiesterase‐5 inhibitors are commonly used in pulmonary arterial hypertension but, as suggested by the RESPITE study, phosphodiesterase‐5 inhibitor therapy (mono‐/combination) does not always have a satisfactory treatment effect. This study aimed to investigate the clinical course of pulmonary arterial hypertension patients not at treatment goal after at least 90 days of treatment with phosphodiesterase‐5 inhibitors, alone or in combination with other pulmonary arterial hypertension therapies. The study included 106 incident patients from the Swedish Pulmonary Arterial Hypertension Registry, treated with phosphodiesterase‐5 inhibitors for ≥90 days, who were not at a pre‐specified treatment goal, i.e. in World Health Organisation functional class III, with 6‐min walking distance 165–440 m, and N‐terminal prohormone of brain natriuretic peptide >300 ng/L. Changes in World Health Organisation functional class, 6‐min walking distance, N‐terminal prohormone of brain natriuretic peptide, and risk group between index and follow‐up were assessed. Of patients with complete follow‐up data, (n = 53) 77% were on combination therapy and risk assessment yielded 98% at intermediate risk at index. At follow‐up, 11 patients transitioned from World Health Organisation functional class III to World Health Organisation functional class II, the median (Q1; Q3) change in 6‐min walking distance was 6 (−30; 42) meters and in N‐terminal prohormone of brain natriuretic peptide 47 (−410; 603) ng/L, while 89% remained at an intermediate risk. Of those without complete follow‐up data, 11 patients died and 2 underwent lung transplantation. In conclusion, pulmonary arterial hypertension patients treated with phosphodiesterase‐5 inhibitors, as single or combination therapy and not achieving the pre‐specified treatment goals after ≥90 days have an unfavourable clinical course.
Towards formal models of psychopathological traits that explain symptom trajectories
Authors: Sharp Paul B. , Miller Gregory A. , Dolan Raymond J. , Eldar Eran
Published: September 2020

Background

A dominant methodology in contemporary clinical neuroscience is the use of dimensional self-report questionnaires to measure features such as psychological traits (e.g., trait anxiety) and states (e.g., depressed mood). These dimensions are then mapped to biological measures and computational parameters.

Researchers pursuing this approach tend to equate a symptom inventory score (plus noise) with some latent psychological trait.

Main text

We argue this approach implies weak, tacit, models of traits that provide fixed predictions of individual symptoms, and thus cannot account for symptom trajectories within individuals. This problem persists because (1) researchers are not familiarized with formal models that relate internal traits to within-subject symptom variation and (2) rely on an assumption that trait self-report inventories accurately indicate latent traits. To address these concerns, we offer a computational model of trait depression that demonstrates how parameters instantiating a given trait remain stable while manifest symptom expression varies predictably. We simulate patterns of mood variation from both the computational model and the standard self-report model and describe how to quantify the relative validity of each model using a Bayesian procedure.

Conclusions

Ultimately, we would urge a tempering of a reliance on self-report inventories and recommend a shift towards developing mechanistic trait models that can explain within-subject symptom dynamics.
Pembrolizumab- and ipilimumab-induced diabetic ketoacidosis and isolated adrenocorticotropic hormone deficiency: a case report
Authors: Porntharukchareon Thachanun , Tontivuthikul Borwonkhun , Sintawichai Nattaya , Srichomkwun Panudda
Published: September 2020

Background

Several human monoclonal antibodies directed against immune checkpoints, including T lymphocyte antigen 4 and programmed cell death protein 1, have been implemented for cancer treatment in order to promote effector T cell response to tumors. Despite the antitumor activity of these agents, a significant number of patients demonstrated immune-related adverse events that affected the functions of multiple organs, including the endocrine system. We report the first case of immune checkpoint inhibitor–induced simultaneous diabetic ketoacidosis and isolated adrenocorticotropic hormone deficiency following combination treatment with immune checkpoint inhibitors.

Case presentation

A 70-year-old Thai man with no previous history of diabetes mellitus was diagnosed with stage IVB non–small cell lung with pleural and liver metastases. After 14 weeks of combination treatment with pembrolizumab and ipilimumab, he presented with fatigue, nausea, and vomiting. Laboratory investigation revealed random plasma glucose 794 mg/dl, serum ketone 6.3 mmol/L, bicarbonate 13 mmol/L, and high anion gap 24 mmol/L. New-onset diabetes mellitus and diabetic ketoacidosis were diagnosed. Insulin therapy was initiated a favorable outcome within 10 hours. Despite improvement of hyperglycemia, the patient had persistent nausea and hyponatremia. Further investigation revealed cortisol 0.8 μg/dl and adrenocorticotropic hormone 21.7 pg/ml. His other pituitary hormone levels were normal, except for mild elevation of gonadotropin hormone. Magnetic resonance imaging of the pituitary showed a normal pituitary gland. Isolated adrenocorticotropic hormone deficiency was diagnosed, and corticosteroid replacement therapy was administered, resulting in an improvement of his symptoms.

Conclusion

Our patient developed new-onset diabetes mellitus, diabetic ketoacidosis, and isolated adrenocorticotropic hormone deficiency during cancer treatment with pembrolizumab and ipilimumab. The present case highlights the need for physicians to be aware that immune-related adverse events can occur in multiple organs at the same time.
Placing poverty-inequality at the centre of psychiatry
Authors: Byrne Peter , James Adrian
Published: September 2020

We examine epidemiological evidence for the central role of inequalities (principally economic) in driving the onset of mental disorders, physical ill health and premature mortality. We locate the search for solutions in current UK contexts, and include known and likely effects of the COVID-19 pandemic. Prevention of mental disorders and adverse outcomes such as premature mortality must begin with efforts to mitigate rising poverty-inequality.
Rising Drug Costs for Neurologic Diseases
Authors: Crowell Jason L. , Burns Ted M.
Published: September 2020

The cost of prescription drugs in the United States is rising like never before and has led to an inflection point where clinicians must consider the potential financial damage to the patient and to society related to the more expensive drugs available. Many of the highest-priced drugs are approved asorphan drugs,a legally defined status providing additional benefits to pharmaceutical companies that is intended to incentivize therapeutic development for rare diseases. The Orphan Drug Act has been a great success since it was enacted in 1983, resulting in the development of many innovative, life-changing, and even lifesaving drugs; however, high drug prices place patients at risk for personal bankruptcy, prescription abandonment, and higher rates of hospitalization. These negative consequences have become more widespread and severe because some companies exploit pricing via the market exclusivity granted to them under the provisions of the Orphan Drug Act. As more and more companies develop these drugs, the cost to society increases as does the capacity to tolerate unjustified prices. The societal effects of drug pricing must be considered through the prism of opportunity costs; that is, what benefit is lost by choosing to spend on one thing instead of another. Clinical- and economic-based analyses from independent groups such as the Institute for Clinical and Economic Review can help physicians understand the value of drugs (ie, the benefits relative to cost). When prescribing a high-priced medication, clinicians should discuss the drug’s value and the associated opportunity cost with patients and have an open discussion about patients’ ability to financially tolerate the treatment.
Borders Crossed
Authors: Adsit Janelle , Wilder Laura
Published: September 2020

The article reports on a nationwide survey- and interview-based study of creative writing instructors designed to identify the extent to which the field of rhetorics and composition and key aspects of rhetorical theory have influenced the teaching of creative writing.
Embodied Learning in a Digital Age
Authors: Gore Amy , Koelling Glenn
Published: September 2020

As digital tools radically alter the ways instructors teach and students learn, the material resources of special collections offer an opportunity to reflect on the pedagogical differences between online and material instruction. The authors theorize that an embodied learning experience with physical materials engages students’ intellects, bodies, and emotions in ways that encourage critical thinking about information formats.
Metacognition or “B.S.”?
Authors: King Carolyne M.
Published: September 2020

Recent reading scholarship suggests that instructors should carefully attend to their students’ reading practices. Although reading journals offer insight into student practices, we continue to treat reading journals as a mundane, process-based document and overlook the important metacognitive work that journals contribute. Through the examination of a corpus of student texts, this article argues for reenvisioning the work of the reading journal, demonstrating how this commonplace assignment contributes to students’ recognition of reading-writing connections and describes a new lens through which to approach reading journals.
Breaking Through the Prison Walls of Feedback
Authors: Mische Monica
Published: September 2020

This article examines how faculty at one college respond to student writing, how students interpret that feedback, and how through collective self-evaluation and community-building workshops some faculty paved a path toward more productive response. The first part of the findings resonate with what scholars in the 1980s discovered: that teachers’ feedback strategies often operate at cross-purposes with students’ motivations and understandings. Asking why, after forty years of scholarship, such counterproductive strategies still prevail, the study suggests burdensome workloads, lack of training, rigid applications of rubrics and genres, and isolation from peers are to blame. It then profiles three teachers who, despite these obstacles, provide deep-reaching feedback. Although their pedagogies and backgrounds differ, they share common bonds, teaching authentically from who they are, an approach that is open to all teachers once they feel freed to adopt it.
The Effect of Maternal Physical Activity and Gestational Weight Gain on Placental Efficiency
Authors: EVEREST CATHERINE , NAGPAL TANIYA S. , SOUZA SARA C. S. , DA SILVA DANILO F. , GAUDET LAURA , MOHAMMAD SHUHIBA , BHATTACHARJEE JAYONTA , ADAMO KRISTI B.
Published: September 2020

Introduction

Adherence to physical activity (PA) and gestational weight gain (GWG) recommendations during pregnancy has been shown to improve maternal and fetal health outcomes, including reducing the risk for chronic diseases. Limited research has evaluated the effect of meeting PA in combination with GWG recommendations on placental efficiency (Pl-E), a surrogate marker of the placenta’s ability to exchange nutrients and gas based on surface area. The purpose of this study was to measure and compare Pl-E based on meeting PA and GWG recommendations.

Method

Healthy pregnant women (n = 61) wore accelerometers in their second and third trimesters to objectively measure PA. Women were classified as active or inactive at each time point based on meeting the 2019 Canadian prenatal PA guidelines. Total GWG was calculated as weight measured in the third trimester minus self-reported prepregnancy weight, and were categorized as insufficient (n = 19), adequate (n = 22), and excessive (n = 20) according to the 2009 Institute of Medicine guidelines. Placental weight (PW) and birth weight (BW) were measured within 30 min of delivery and 24–48 h postdelivery, respectively. Pl-E was determined in three ways: BW:PW ratio, residual BW, and measured BW, with a higher value indicating better Pl-E. Pl-E was compared by PA and GWG status using a two-way ANOVA.

Results

No differences were found in the BW:PW ratio or residual BW corresponding to PA and GWG status. Measured BW was significantly higher in newborns of women who gained weight excessively compared with those who gained insufficient weight (P < 0.05).

Conclusion

These findings suggest that prenatal PA does not compromise Pl-E; however, further research is required to evaluate the potential mechanistic benefits of meeting PA and GWG guidelines on the placenta.
Patronage and Selection in Public Sector Organizations
Authors: Colonnelli Emanuele , Prem Mounu , Teso Edoardo
Published: September 2020

In all modern bureaucracies, politicians retain some discretion in public employment decisions, which may lead to frictions in the selection process if political connections substitute for individual competence. Relying on detailed matched employer-employee data on the universe of public employees in Brazil over 1997–2014, and on a regression discontinuity design in close electoral races, we establish three main findings. First, political connections are a key and quantitatively large determinant of employment in public organizations, for both bureaucrats and frontline providers. Second, patronage is an important mechanism behind this result. Third, political considerations lead to the selection of less competent individuals. (JEL D72, D73, J45, O17)
Σοπενχάουερ περί Θανάτου και Αυτοκτονίας
Authors: Papadaki (Λίνα Παπαδάκη) Lina
Published: September 2020

Schopenhauer is portrayed as the philosopher of pessimism, and for good reason. For him, life is suffering where ‘ultimately death must triumph’ (The World as Will and Representation vol. I, 311). However, his pessimism fades away when he contemplates death. He argues enthusiastically that, far from being an evil, death is in fact a friend we should welcome. Moreover, he believes it is possible for human beings to use their knowledge to fight the fear of death. Interestingly, however, at the point where the reader expects a philosophical defense of suicide, Schopenhauer vehemently argues against it. Suicide to avoid pain and suffering, according to him, is a mistake, a futile, foolish and egoistic act. Not only does suicide not offer a genuine solution to suffering, but also it hinders true salvation, the denial of the will.In this paper, I argue that Schopenhauer’s condemnation of suicide is in fact at odds with his views on death and can weaken his argumentation about why we must not fear death. It is my belief that Schopenhauer’s views on suicide stem - quite ironically - from his being, at times, overly optimistic about the possibility of genuine salvation. When it comes to freeing ourselves from the will, however, we are better off pessimists. This, I explain, will allow us to at least keep our optimism regarding death and find solace in the knowledge that - be it by old age, illness, accident, suicide or any other cause - death is not to be feared.
CRISPR, μια νέα τεχνολογία γενετικής παρέμβασης: Πρόταση αξιοποίησης σε ένα δημόσιο σύστημα υγείας
Authors: Kolisis (Νικόλαος Κολίσης) Nikolaos
Published: September 2020

The invention of CRISPR technology and its current and potential applications have been a subject of controversy among scientists, philosophers and legal theorists. After taking under consideration the current discussion concerning the use of CRISPR for editing human genome the article treats the question of a wider offer of CRISPR-based therapies from a Public Healthcare system and proposes method for a fair and financially sustainable way for adopting the new possibilities this new tool has to offer.
Η επανασύνδεση με ένα αγαπημένο πρόσωπο που έχει αποβιώσει, μέσω της εικονικής πραγματικότητας. Απόψεις και προβληματισμοί ενώπιον πρωτοφανούς προκλήσεως
Authors: Nikolaou (Νίκη Νικολάου) Niki
Published: September 2020

A team of documentary producers and computer programmers, while they were in a laboratory creating a virtual reality environment, could never have imagined how much impact their project would have not only to the family involved but also to a large percentage of humanity and other scientific fields. In particular, they created a virtual park and a virtual girl, who in real life had died, and, through the special equipment, they placed the living mother in this environment. The mother ‘‘met’’ her daughter, ‘‘touched’’ her, ‘‘talked’’ to her, they celebrated her daughter’s birthday together’’ and, at the end, they ‘‘said goodbye’’ to each other.This endeavor was the result of a combination of techniques and elements of various sciences. Of course it is admirable, but at the same time it raises doubts, intense concerns and many questions such as: ‘‘What are the limits of the technological applications?’’; ‘‘What aspects and at what extent of the human existence can they involved?’’; ‘‘How is the human existence affected?”; Can an application play with human emotions and, specifically, with the pain and misery of a human, in this case of a mother mourning her child?’’ The issue is difficult and even more difficult the moral and bioethical dilemmas that arise.All the above-mentioned will be presented and studied in this present article. In particular, initially reference will be made to the definition of virtual reality, to the means which lead to the achievement of a completely operational system, as well as to the areas of application of its systems. Therefore, the way of creation and the context of the documentary will be presented, to be followed by a very short reference to the thoughts that the mother of the girl had expressed. Afterwards various opinions will be presented, questions and dilemmas arising by the documentary will be mentioned and commented and alongside some questions will be asked for reflection. The conclusions will complete this present article.
Lipoma of the temporal region: a rare case series
Authors: Davies J , Srinivasan B , Brennan PA
Published: September 2020

Lipomas are common benign tumours that can occur in most parts of the body. Lipomas arising from the deep temporal fat pad, found between the two layers of the deep temporal fascia, are rare, however; there has been only one documented case report to our knowledge. We describe a second case arising from the temporal fat pad in a patient treated at our unit, having previously reported the first one, and discuss the relevant anatomy and management.
Chronic groin pain following open inguinal hernia repair: has consenting practice improved?
Authors: Sivarajah V , Farquharson BJM , Mahdi S , Cathcart P , Jeyarajah S
Published: September 2020

Introduction

Chronic groin pain following inguinal hernia surgery is a common and potentially debilitating complication, and yet patients are infrequently informed of this risk. This leaves surgeons open to negligence claims, especially given recent changes to case law, which for the first time highlighted the need for a more patient-centred approach to risk disclosure. We investigated how these changes have influenced our consenting practice with respect to the disclosure of this risk.

Methods

We compared how often surgeons discussed the risk of chronic groin pain with adults undergoing elective open unilateral inguinal hernia mesh repairs in 2019 and 2009. The first 50 patients in each of these two years were retrospectively compared. Discussions during the initial consultation and on the day of surgery were assessed by reviewing clinic letters, medical notes and consent forms.

Findings

The risk of chronic pain was discussed with significantly more patients in 2019 than in 2009 (96% v 54%, p<0.0001). Most of these discussions occurred on the day of surgery (92% v 54%, p<0.0001). Only a few patients had these discussions during their initial consultation (18% v 4%, p<0.025).

Conclusions

Discussing the risk of chronic groin pain has improved significantly over the past 10 years. However, these discussions occur mostly on the day of surgery, which gives patients very little time to weigh up the risk. This potentially invalidates the consent they give for surgery. Patients should be given an opportunity to discuss their operative risks in advance of their operation.
Refocusing cancer multidisciplinary team meetings in the United Kingdom: comparing urology with other specialties
Authors: Warner R , Hoinville L , Pottle E , Taylor C , Green JSA
Published: September 2020

Introduction

Multidisciplinary team (MDT) meetings have been the gold standard of cancer care in the UK since the 1990s. We aimed to identify the views of urology cancer MDT members in the UK on improving the functioning of meetings and compare them with those of other specialties to manage the increasing demand on healthcare resources and enhance the care of complex cancer cases.

Methods

We analysed data from 2 national surveys distributed by Cancer Research UK focusing on the views of 2,294 and 1,258 MDT members about cancer MDT meetings.

Findings

Most breast, colorectal, lung and urology cancer MDT members felt meetings could be improved in the following areas: time for meeting preparation in job plans, streamlining of patients, auditing meeting decisions and prioritising complex cases. Most urology respondents (87%) agreed some patients could be managed outside a full MDT discussion, but this was lower for other specialties (lung 78%, breast 75%, colorectal 64%).

Conclusions

To facilitate decisions on which patients require discussion in an MDT meeting, factors adding to case complexity across all tumour types were identified, including rare tumour type, cognitive impairment and previous treatment failure. This study confirms that urology MDT members are supportive of changing from reviewing all new cancer diagnoses to discussing complex cases but managing others with a more protocolised pathway. The mechanisms for how to do this and how to ensure the safety of patients require further clarification.
Das Thema in der Fuge Bachs
Authors: Souchay Marc-André
Published: September 2020

Darauf bezugnehmend: Marc-André Souchay: Das Thema in der Fuge Bachs II. BJ 1930, S. 1-48
Bach und das Symbol (2. Studie)
Authors: Schering Arnold
Published: September 2020

Bezugnehmend auf: Arnold Schering: Bach und das Symbol, insbesondere die Symbolik seines Kanons. BJ 1925, S. 40-63

Darauf bezugnehmend: Arnold Schering: Bach und das Symbol. 3. Studie: Psychologische Grundlegung des Symbolbegriffs aus Christian Wolffs "Psychologia empirica". BJ 1937, S. 83-95
Nachtrag zu dem Beitrag "Über die Vorlage zum Klavierkonzert d-moll"
Authors: Hirsch Paul
Published: September 2020

Ergänzend zu: Paul Hirsch: Über die Vorlage zum Klavierkonzert in d-moll. BJ 1929, S. 153-174
Zu den verschollenen Passionen Bachs
Authors: Dürr Alfred
Published: September 2020

Erwähnte Artikel: Max Schneider: Zur Lukaspassion. BJ 1911, S. 105-108

Arnold Schering: Zur Markus-Passion und zur "vierten Passion". BJ 1939, S. 1-32

Friedrich Smend: Bachs Markus-Passion. BJ 1940/48, S. 1-35
Zu den ältesten Sammlungen der vierstimmigen Choräle J. S. Bachs
Authors: Smend Friedrich
Published: September 2020

Erwähnter Artikel: Arnold Schering: Joh. Phil. Kirnberger als Herausgeber Bachscher Choräle. BJ 1918, S. 141-150.
"Vortrag und Besetzung Bach'scher Cantaten- und Oratorienmusik" - Ein unbekannter Brief von Moritz Hauptmann an Johannes Brahms (15. Februar 1859)
Authors: Jacobi Erwin R.
Published: September 2020

Darauf bezugnehmend: Erwin R. Jacobi: Nochmals: "Vortrag und Besetzung Bach'scher Cantaten- und Oratorienmusik". Ein Nachtrag zum gleichnamigen Artikel im BJ 1969. BJ 1971, S. 82-90
Johannes Brahms und Johann Sebastian Bach
Authors: Helms Siegmund
Published: September 2020

Vergleiche auch: Hans-Joachim Schulze: Hamburg - Wien - Leipzig - Berlin: Bachiana auf Ab- und Umwegen. BJ 2012, S. 203-216
Zur Entstehungsgeschichte des 5. Brandenburgischen Konzerts
Authors: Dürr Alfred
Published: September 2020

Die Frühversion des 5. Brandenburgischen Konzerts BWV 1050, wie in NBA VII/2 wiedergegeben, ist unvollständig. Daher wurde für den Krit. Bericht Material hinzugefügt und eine erste Ausgabe dieser Version als Beilage zur Partitur geplant. Während die frühe Fassung vermutlich einige Zeit vor 1721 (dem Datum der Widmung an den Markgrafen von Brandenburg) verfasst wurde, sind die autografen Stimmen (Version B) und die Widmungspartitur (Version A) wahrscheinlich sowohl zeitlich als auch inhaltlich eng miteinander verbunden. (Übertragung des englischen Resümees am Ende des Bandes)
Über die Herkunft von zwei Sätzen der h-Moll-Messe
Authors: Häfner Klaus
Published: September 2020

Bei der Komposition der fünf Messen BWV 232-236 stützte sich Johann Sebastian Bach weitgehend auf frühere Werke: 27 von insgesamt 50 Sätzen lassen sich als Parodien identifizieren. Andere können aus verschiedenen Gründen als Parodien angesehen werden, obwohl es keine früheren (erhaltenen) Versionen gibt, die diese Annahme belegen. In diese Kategorie gehören sowohl das Duett "Domine Deus" BWV 232ii/8 als auch der Chor "Et Resurrexit" BWV 232ii/6. Das Duett BWV 193a/5 und der Chor BWV Anh. 9/1, beides Sätze aus Kantaten, deren Musik verloren ist, können als mögliche Modelle für diese beiden Werke betrachtet werden, da ihre vorhandenen Texte so genau zu den Stücken aus der h-Moll-Messe passen, dass eine Parodieverbindung vermutet werden kann. (Übertragung des englischen Resümees am Ende des Bandes)
Musikalische Figuren als satztechnische Freiheiten in Bachs Orgelchoral "Durch Adams Fall ist ganz verderbt"
Authors: Budday Wolfgang
Published: September 2020

Die Stimmführung im Orgelchoral Durch Adams Fall is ganz verderbt (BWV 637) wird aus der Sicht der theoretischen Konzepte der Bachzeit analysiert. Die Analyse zeigt, dass in diesem Stück, dessen musikalische Idee ganz auf die negativen Implikationen des Textes ausgerichtet ist, die Normen des regelrechten Satzes außer Acht gelassen werden. Abweichungen in der Stimmführung werden unter Bezugnahme auf die Figurenlehre diskutiert. (Übertragung des englischen Resümees am Ende des Bandes)