bluuebunny/crossref_metadata_2025 huggingface dataset:
The multiarm optimization of stroke thrombolysis phase 3 acute stroke randomized clinical trial: Rationale and methods
Authors: Deeds S Iris , Barreto Andrew , Elm Jordan , Derdeyn Colin P , Berry Scott , Khatri Pooja , Moy Claudia , Janis Scott , Broderick Joseph , Grotta James , Adeoye Opeolu
Published: December 2020

Background

Intravenous recombinant tissue plasminogen activator is the only proven effective medication for the treatment of acute ischemic stroke. Two approaches that may augment recombinant tissue plasminogen activator thrombolysis and prevent arterial reocclusion are direct thrombin inhibition with argatroban and inhibition of the glycoprotein 2b/3a receptor with eptifibatide.

Aim

The multi-arm optimization of stroke thrombolysis trial aims to determine the safety and efficacy of intravenous therapy with argatroban or eptifibatide as compared with placebo in acute ischemic stroke patients treated with intravenous recombinant tissue plasminogen activator within 3 h of symptom onset.

Sample size estimate

A maximum of 1200 randomized subjects to test the superiority of argatroban or eptifibatide to placebo in improving 90-day modified Rankin scores.

Methods and design

Multiarm optimization of stroke thrombolysis is a multicenter, multiarm, adaptive, single blind, randomized controlled phase 3 clinical trial conducted within the National Institutes of Health StrokeNet clinical trial network. Patients treated with 0.9 mg/kg intravenous recombinant tissue plasminogen activator within 3 h of stroke symptom onset are randomized to receive intravenous argatroban (100 µg/kg bolus followed by 3 µg/kg/min for 12 h), intravenous eptifibatide (135 µg/kg bolus followed by 0.75 µg/kg/min infusion for 2 h) or IV placebo. Patients may receive endovascular thrombectomy per usual care.

Study outcomes

The primary efficacy outcome is improved modified Rankin score assessed at 90 days post-randomization.

Discussion

Multiarm optimization of stroke thrombolysis is an innovative and collaborative project that is the culmination of many years of dedicated efforts to improve outcomes for stroke patients.
Synthesis of 3-alkyl-1,2,3-triazol-1-ium hydrogen sulphate derivatives
Authors: González-Perdomo Pilar , González Jaime , Martínez-Otero Diego , Unnamatla MV Basavanag , García-Eleno Marco A , Corona-Becerril David , Cuevas-Yañez Erick
Published: December 2020

An array of 3-alkyl-1,2,3-triazol-1-ium hydrogen sulphate derivatives was obtained from the reaction between some 1,4-disubstituted-1,2,3-triazoles and H2SO4 through a simple protocol in good yields. The molecular structure of a triazolium salt (R1 = PhCH2, R2 = CH2O(4-CHO)C6H4) was unambiguously determined from X-ray diffraction studies, showing a remarkable triazole N3–H bond.
Reliability modeling and analysis for systems governed by multiple competing failures processes
Authors: Gao Hongda , Kong Dejing , Sun Yixin
Published: December 2020

Due to that the operating environment is becoming more and more complex and rigorous, the multiple competing failure modes for the reliability system is much commonly seen. In order to improve the system performance, a sensor-based degradation calibration policy (SBDC policy) is presented in this paper. The model considers the competing failure process which is described by the soft and hard failure modes. In detail, the soft failures occur when the degradation of the system exceeds the failure threshold, and the hard failures are caused by the same shock process. We use the Wiener process model to describe the soft failure and the shock process to describe the catastrophic failure. Meanwhile, in the shock process, the damage associated with the system is normal distributed which is related to the duration of the adjacent shocks. This extended model with calibrations has a good application value for the corresponding complex reliability systems which are subject to the dependent competing failure modes. By the model in this article, the system reliability and safety can be improved and the risk of the abrupt damage shall be reduced as the circumstance changes.
Diffeomorphic unsupervised deep learning model for mono- and multi-modality registration
Authors: Theljani Anis , Chen Ke
Published: December 2020

Different from image segmentation, developing a deep learning network for image registration is less straightforward because training data cannot be prepared or supervised by humans unless they are trivial (e.g. pre-designed affine transforms). One approach for an unsupervised deep leaning model is to self-train the deformation fields by a network based on a loss function with an image similarity metric and a regularisation term, just with traditional variational methods. Such a function consists in a smoothing constraint on the derivatives and a constraint on the determinant of the transformation in order to obtain a spatially smooth and plausible solution. Although any variational model may be used to work with a deep learning algorithm, the challenge lies in achieving robustness. The proposed algorithm is first trained based on a new and robust variational model and tested on synthetic and real mono-modal images. The results show how it deals with large deformation registration problems and leads to a real time solution with no folding. It is then generalised to multi-modal images. Experiments and comparisons with learning and non-learning models demonstrate that this approach can deliver good performances and simultaneously generate an accurate diffeomorphic transformation.
Awareness of Human Factors in the operating theatres during the COVID-19 pandemic
Authors: Britton Carolina Relvas , Hayman Gareth , Stroud Nicola
Published: December 2020

One of the priorities at our large Operating Theatres Department is to support awareness and basic education of the multi-disciplinary teams in clinical Human Factors, to help build competence and capacity in healthcare towards a resilient system. From May 2019 until February 2020, our Human Factors Champions embarked on a project called Observation of Non-technical Skills and Teamwork in the operating theatres (ONSeT), to monitor and evaluate the benefits of local Human Factors education. In September 2020, six months after the COVID-19 pandemic hit the UK and caused a major disruption of surgical services, we decided to investigate the usefulness of the project and the impact of COVID-19 in the operating theatres, looking through the eyes of the Human Factors Champions. Results pointed to a consensus about ONSeT having helped during the pandemic, with regards to how teams worked and in enabling team leaders to be more responsive. Human Factors Champions found that feedback on performance was received in a non-threatening way and observation of performance became ‘second nature’. As organisations need to develop critical thinking, we think that the ONSeT project has helped us build some capacity for this, from the front-line onwards.
Moderate to severe leukocytosis with vasopressor use is associated with increased mortality in trauma patients
Authors: Hasjim Bima J , Grigorian Areg , Stopenski Stephen , Swentek Lourdes , Sun Beatrice , Livingston Joshua K , Williams Barbara , Nastanski Frank , Nahmias Jeffry
Published: December 2020

Background

Leukocytosis is a rise in white blood cell (WBC) count and clinical outcomes of moderate to severe leukocytosis in trauma patients have not been described. We hypothesized that trauma patients with severe leukocytosis (SL; ≥40.0 × 109 leukocytes/L) have higher rates of in-hospital complications and mortality than those with moderate leukocytosis (ML; 25.0–39 × 109 leukocytes/L).

Methods

We performed a retrospective analysis (2010-2017) on trauma patients developing ML or SL at a single Level-I trauma center. A multivariable logistic regression analysis for risk factors were performed.

Results

From 15,807 trauma admissions, 332 (2.1%) had ML or SL. Of these, 308 (92.8%) were ML and 24 (7.2%) were SL. Patients with ML and SL reached their peak WBC count in 1 and 10 days after admission respectively (p < 0.001). SL patients suffered higher rates of in-hospital complications (p < 0.05) and mortality compared to those without ML or SL (14.5% vs. 3.3%, p < 0.001). Between ML and SL, mortality rates rose with leukocytosis severity (13.3% vs. 29.2%, p = 0.03). Among all patients with ML or SL, vasopressor use was the strongest independent risk factor for mortality (OR 12.61, p < 0.001).

Conclusion

Clinicians should be weary of the increased mortality rates and in-hospital complications in SL patients. Among patients with ML or SL, vasopressor use, rather than SL, was the strongest predictor of mortality. Patients with ML had a quicker time course to peak leukocytosis compared to SL, suggesting these two entities to be distinct in etiology and outcome, warranting future research.
Covering surgical instruments with single- or double-layer drape pending surgery: an experimental study in a perioperative setting
Authors: Qvistgaard Maria , Almerud-Österberg Sofia , Lovebo Jenny
Published: December 2020

Background:

Surgical site infections (SSI) constitute a severe threat to surgery patients. The surgical environment must be as free of contaminating microorganisms as possible. Using sterile surgical instruments while performing surgery is an absolute necessity for ensuring quality of care in perioperative settings.

Aim:

To compare bacterial contamination of agar plates after 15 h on set surgical instrument tables covered with a single- or double-layer drape.

Methods:

An experimental design was used consisting of set instrument tables with six agar plates on each table: four instrument tables were covered with a single-layer drape and four instrument tables were covered with a double-layer drape. This set-up was repeated on nine occasions during the period of data collection, making 76 set instrument tables in total. As a control, one instrument table was uncovered on four of those occasions.

Results:

The double-layer drape cover showed a significantly ( P = 0.03) lower number of colony forming units (CFU) per agar plate than the single-layer drape covering. As expected, the uncovered instrument tables were highly contaminated.

Discussion:

Our results indicate that it is good practice to cover instruments properly with at least a single-layer drape before a surgical procedure. If there is difficulty achieving optimal conditions while setting the instrument tables (e.g. positioning the patient for general anaesthesia), it is a better option to set the instrument tables earlier and cover them with a double-layer drape. These precautions will help protect the patient from harm and unnecessary SSI by lowering microbiological burden, a key factor in developing SSI.
Shoulder hydrodilatation for primary, post-traumatic and post-operative adhesive capsulitis
Authors: Makki Daoud , Al-Yaseen Mustafa , Almari Fayez , Monga Puneet , Funk Lennard , Basu Subhasis , Walton Michael
Published: December 2020

Background

Adhesive capsulitis (frozen shoulder) is characterised by pain and loss of range of motion of the glenohumeral joint. It can be present as primary (idiopathic) or secondary to surgery, trauma or other conditions that restrict the use of the shoulder joint. Various treatment options have been adopted including physiotherapy, manipulation under anaesthetic, hydrodilatation and arthroscopic or open capsular release but the optimal form of management remains uncertain.

Objectives

The purpose of the study was to assess the clinical outcome of glenohumeral hydrodilatation in three cohorts of patients with different aetiologies with adhesive capsulitis.

Study design & methods

We carried out a retrospective study of patient who underwent hydrodilatation for adhesive capsulitis between 2013 and 2015. The procedure was performed by a specialist musculoskeletal radiologist under radiological guidance. The injection consisted of steroids, local anaesthetics and NaCl solution with a target volume around 35 mL. Our outcome measures were range of motion, and pre- and post-operative pain. Patients were divided into three groups based on the presumed cause of their stiffness: idiopathic, post-traumatic and post-surgical.

Results

Two hundred fifty patients were included, with a mean age of 59 years (range: 20–79). Of these, 180 had idiopathic primary adhesive capsulitis (27 were diabetic), 23 were post-traumatic, and 20 following surgical procedures. Thirty-four required further intervention following initial hydrodilatation with 8 undergoing repeat hydrodilatation, and 26 requiring arthroscopic capsular release. The diabetic group accounted for 16 capsular releases and 4 repeat procedures, while the idiopathic group accounted for 9 and 4, respectively. One patient required capsular release in the surgical group. An improvement was recorded in ROM in all groups with mean abduction improving from 59° to 110°, flexion from 50° to 120° and external rotation from 20° to 50°. With regards to pain, the majority showed an improvement from severe or moderate pain to no or mild pain.

Conclusions

Results show that hydrodilatation resulted in an improvement in all outcome measures, with only a small number of patients, especially those with diabetes, needing further procedures or showing no improvement in range of motion and pain. There was no difference between the post-traumatic and post-surgical groups.
Comparative efficacy and safety of radiotherapy/cetuximab versus radiotherapy/chemotherapy for locally advanced head and neck squamous cell carcinoma patients: a systematic review of published, primarily non-randomized, data
Authors: Mei Mei , Chen Yu-Huan , Meng Tian , Qu Ling-Han , Zhang Zhi-Yong , Zhang Xiao
Published: December 2020

Background:

Cetuximab (CTX) has been approved to be administered concurrently with radiotherapy (RT) to treat locally advanced head and neck squamous cell carcinoma (HNSCC). The aim of this study was to assess the efficacy and safety of concurrent CTX with RT (ExRT).

Method:

The PubMed, Cochrane Library, EMBASE databases were systematically searched to find relevant articles. The combined hazard ratio (HR), risk ratio (RR) and 95% confidence interval were calculated to assess the efficacy and safety of ExRT in contrast to concurrent platinum-based chemotherapy with RT (ChRT).

Results:

In total, 32 articles with 4556 patients were included. The pooled HRs indicated that ExRT achieved an unfavorable overall survival (HR: 1.86, p < 0.0001), disease-specific survival (HR: 2.58, p = 0.002), locoregional control (HR: 1.94, p < 0.00001), and progression-free survival (HR: 2.04, p = 0.003) compared with ChRT for locally advanced HNSCC patients. In human papillomavirus-positive patient subgroups, ExRT showed inferior disease-specific survival (HR: 2.55, p = 0.009) and locoregional control (HR: 2.27, p < 0.0001) in contrast to ChRT. Additionally, ExRT increased the occurrence of mucositis (RR: 1.17, p < 0.005), skin toxicity (RR: 6.26, p < 0.00001), and infection (RR: 2.27, p = 0.04) compared with non-CTX groups (ChRT and RT), and was associated with lower incidence of anemia (RR: 0.35, p = 0.009), leukocytopenia (RR: 0.17, p < 0.0001), neutropenia (RR: 0.06, p < 0.0001), nausea/vomiting (RR: 0.23, p < 0.0001), and renal toxicity (RR: 0.14, p = 0.007).

Conclusion:

ChRT should remain the standard treatment for locally advanced HNSCC patients. ExRT was recognized as an effective alternative treatment for locally advanced HNSCC patients who experienced unbearable toxicities caused by non-CTX treatments.
Effects of Schisandra chinensis Extract on the Learning and Memory Ability of Mice With Learning and Memory Disorders
Authors: Lili Zhao , Jing Tang , Ying Chen , Ligang Jiang
Published: December 2020

The effect of Schisandra chinensis extract (SCE) on the learning and memory ability of mice with learning and memory disorders was investigated. After mice were given SCE prophylactically, different methods were used to establish mouse learning and memory disorders, and the radial maze test was used for the observation of SCE on the learning and memory ability of mice with learning and memory disorders. A mouse aging model was established by subcutaneously injecting d-galactose. The antiaging, antifatigue, and antioxidant effects of SCE were evaluated by weight change, the loaded swimming test, and changes in total antioxidant capacity and superoxide dismutase (SOD) levels in the serum and brain of mice. The result showed that SCE could significantly improve the learning and memory behavior of mice with learning and memory disorders induced by scopolamine, chloramphenicol, and 40% ethanol, respectively, maintain normal weight gain, prolong the loaded swimming time, improve the antioxidant capacity, and increase the activity of SOD in the serum and brain of aging mice. SCE can significantly improve the learning and memory ability of mice with learning and memory disorders, which may be related to its antioxidant effect.
Diffuse Cerebral Edema After Moyamoya Disease-Related Intracerebral Hemorrhage: A Case Report
Authors: Das Alvin S. , Regenhardt Robert W. , Patel Nirav , Feske Steven K. , Bevers Matthew B. , Vaitkevicius Henrikas , Izzy Saef
Published: December 2020

Moyamoya disease (MMD) is a rare, progressive occlusive disease characterized by bilateral internal carotid artery hypoplasia that often presents with ischemic stroke and intracerebral hemorrhage (ICH). Although MMD-related ICH is generally managed similarly to spontaneous ICH, we present a case in which standard management strategies may have led to an unprecedented devastating outcome. A 37-year-old female without any previous medical history presented with headache and right-sided weakness. A computed tomography (CT) scan revealed a large left basal ganglia ICH. Vessel imaging revealed diffuse narrowing of the entire anterior circulation with prominent leptomeningeal collaterals consistent with MMD. The patient’s systolic blood pressure was kept under 140 mmHg. During the hospitalization, she became hypocarbic while being trialed on pressure support ventilation. Several hours later, she developed fixed and dilated pupils. Repeat CT head showed new diffuse cerebral edema with tonsillar herniation. Despite hyperosmolar therapy, paralytics, pentobarbital, and cerebrospinal fluid diversion, no improvement was noted. Unfortunately, brain MRI revealed multifocal brainstem infarcts with superimposed Duret hemorrhages. Herein, we report diffuse cerebral edema as a complication of MMD-related ICH. We hypothesize that disruptions of delicate cerebral autoregulatory mechanisms led to extensive hypoxic-ischemic injury. In the setting of ICH, aggressive blood pressure management coupled with relative hypocapnia may have likely caused vasoconstriction of poorly compliant arteries leading to worsened cerebral blood flow and ischemia. Therefore, because of its complex pathophysiology, strict adherence to eucapnia should be maintained in MMD-related ICH.
The Idea of the University as Incubator
Authors: Staley David J.
Published: December 2020

We have been advised for some time now that, in order to withstand the economic, demographic, and other challenges they face, universities must continually innovate. Presidents and vice-chancellors must foster “disruptive innovation” if they are to ensure that their institutions survive and thrive. But how to create an innovative university, especially when institutional change of any kind proves to be a complex process with limited success stories. In order to bring about the kind of disruptive innovation that the current environment seemingly demands requires rethinking the idea of a university incubator. Universities might develop incubators not to generate new technologies or new businesses but new, innovative forms of the very idea of the university itself. In this model, the idea of the university becomes that entity that engages in the creation and nurturing of organizational novelty, novelty here referring to new forms of epistemological organization. The design and implementation of new organizational forms becomes the raison d'etre of the university.
A Public University Futures Collaboratory: A Case Study in Building Foresightfulness and Community
Authors: Nissen Laura , Appleyard Melissa M. , Enders Jeanne , Gómez Cynthia Carmina , Guzman Andres , Mudiamu Sally Strand , Mullooly Sheila
Published: December 2020

What happens when a public university decides to construct a cross-disciplinary, cross-functional initiative to explore the future, build capacity to be more “future ready” and resilient, and serve as a resource for the university and broader community to help them do the same? This article presents a case study of a “Futures Collaboratory” launched at a Pacific Northwest public, urban university in the 2019 to 2020 academic year. The three intersecting goals of the effort were to: explore and cultivate interest and capacity among interested individuals across campus; develop institution-wide “foresightfulness” as a collective; and end the year in a position to make thoughtful, creative, and well-reasoned recommendations about being more future-facing as a university. The dual pandemics of Covid-19 and white supremacy proved to deepen the commitment to learn and practice futures thinking. A primary goal was to ensure that the university would benefit from efforts to democratize foresight activities while taking practical steps to navigate our own systemic volatility, uncertainty, ambiguity, and complexity. This article discusses the effort, early work, disruptions, and risks during the Collaboratory’s first year, as well as the emergent reflections, opportunities, and recommendations prepared for university leadership. Special attention is paid to the consideration of equity and social justice in the future of higher education and the tools and resources needed by the sector to build liberatory futures.
Pericarditis masking a localised thoracic aorta dissection: Making a point for point-of-care ultrasound
Authors: Raja Shariff Raja Ezman , Farook Ahmad , Lim Chiao Wen , Kasim Sazzli
Published: December 2020

Early detection of aortic dissection (AD) remains essential due to high mortality rates. We report a case of localised thoracic AD initially misdiagnosed as pericarditis, but subsequently diagnosed through point-of-care ultrasound (POCUS). A 35-year-old gentleman presented with sudden-onset jaw and chest pain. An initial electrocardiogram revealed changes consistent with pericarditis, and high-sensitive troponin levels on admission were not raised. An initial diagnosis of pericarditis was made. However, due to persistent symptoms despite treatment, an urgent POCUS was performed, revealing a prominently dilated aortic root, with evidence of an intimal flap near the coronary cusps. Computed tomography imaging revealed a focal aortic root dissection confined within the sinus of Valsalva, with no involvement of coronary arteries or descending thoracic or abdominal aorta. This case highlights how commonly a misdiagnosis of AD can occur and how concurrent pericarditis can often mask AD. Our report highlights the need for better incorporation of POCUS in the initial assessment of acute chest pain, as studies have shown both high sensitivity and specificity in diagnosing AD, with no additional burden on treatment start-up time and mortality.
Are educational materials on medicinal products reaching out and useful to physicians? A survey of Singapore prescribers’ experiences and preferences
Authors: Han Phey-Yen , Limenta Michael , Tan Liesbet Li-Bei , Ho Christine Su-Ching , Poh Jalene Wang-Woon
Published: December 2020

Background:

Effective benefit–risk communication to healthcare professionals plays a vital role in promoting the rational use of medicinal products. The Health Sciences Authority (HSA) of Singapore has implemented Physician Educational Materials (PEMs) and Patient Medication Guides (PMGs) as educational materials to support informed decision-making. To evaluate their effectiveness as a safety communication tool, we sought to understand prescribers’ experiences and preferences with these materials.

Methods:

Invitations to an online survey were emailed to 387 healthcare professionals who had recently purchased the 22 medicinal products with requirements for educational materials in Singapore (“Purchasers”). The survey scope included their experiences with the receipt and usage of the materials, and their preferences towards the types of content and distribution channels for these materials.

Results:

The survey invitation reached 367 purchasers, of which 89 (24%) responded, including 66 who indicated that they had prescribed the surveyed products (“Prescribers”). Although only 47% of prescribers recalled receiving the educational materials, the majority who had used them found them useful in their clinical practice. However, the PMG was used less frequently than the PEM (59% vs 96%), and there was a mismatch between current and preferred distribution methods (mostly hard copies vs electronic copies).

Conclusions:

Prescribers who had received educational materials generally perceived them as being useful in raising awareness on treatment-associated safety concerns. The publication of educational materials on the HSA website and encouraging more routine distribution of PMGs by prescribers may improve their accessibility and facilitate safety communication on medicinal products to healthcare professionals and patients.
The EU Whistleblower Directive and its Transposition: Part 1
Authors: Gerdemann Simon , Colneric Ninon
Published: December 2020

On 16 December 2019, Directive (EU) 2019/1937 of the European Parliament and of the Council of 23 October 2019 on the protection of persons who report breaches of Union law entered into force (hereinafter: Whistleblower Directive; WBD). Based on a Commission proposal of 23 April 2018 and accompanied by an intensive policy debate, the final version of the Directive represents the most far-reaching piece of European Union legislation in the field of whistleblowing law to date, both in terms of depth and scope of regulation. The Member States of the European Union are now obliged to transpose the Directive’s provisions essentially by 17 December 2021. For most Member States, this will mark the first time they will adopt a comprehensive whistleblowing law. Hence, the transposition of the WBD will bring with it various challenges, but also multiple opportunities to improve the current legal framework and its practical implications, both of which are discussed in this two-part article series. Part 1 of the series will first discuss the Directive’s background and the main regulatory elements, followed by an in-depth analysis of its material and personal scope as well as the general conditions for whistleblower protection.
Notes on the ECHR and the Disunited Kingdom ‘After’ Brexit – In memoriam Scott Crosby
Authors: Robinson Gavin
Published: December 2020

When the idea of this special edition occurred to the team behind the New Journal of European Criminal Law, my first thought was to go back through all of Scott Crosby’s contributions in print as editor-in-chief and see whether a mini-retrospective on the themes and views therein would be worthy of inclusion here – by Scott’s own standards. These notes focus on what gradually became the single biggest concern expressed in Scott’s editorials: the perilous position of the European Convention on Human Rights (ECHR) in a post-Brexit UK – in concreto, the prospect of what he labelled ‘Brexit plus’: a British exit from the ECHR system. I begin with Scott’s views on the European Union (EU) Referendum and the Brexit process. Next comes the great uncertainty currently surrounding the future of Convention rights in the United Kingdom, set against the emphasis placed by the editorials on the instrumental role of the ECHR in fostering peace across the whole of Europe, within and beyond the territory of the EU. In the event that Brexit plus should materialise, writing in the wake of polls showing all-time record support in Scotland for secession from the United Kingdom I close by asking whether Scotland might be able to ‘leave a light on for Strasbourg’.
Molecular analysis of a rare case of low-grade primary peritoneal serous carcinoma in a male
Authors: Makarenko Vladislav V , Kandil Dina , Cosar Ediz F , Hutchinson Lloyd , Khan Ashraf
Published: December 2020

Primary peritoneal serous carcinomas (PPSC) are exceedingly rare in male patients. Only a few cases were reported, and mostly with the limited immunophenotypical characterization. No molecular analysis of PPSC in males has been previously performed. We here describe another case of PPSC in a male patient. A comprehensive molecular analysis of the tumor revealed SF3B1 gene mutation as a possible driver.
Situated conversations during video game play and the understanding of viral replication
Authors: Corredor Javier , Sanchez-Mora Johanna , Bustamante-Barreto Andry
Published: December 2020

This article explores why certain types of conversations are effective to develop disciplinary knowledge during video game play while others are not. In particular, we analyze conversations among students playing an educational video game that focuses on the process of viral replication. To do so, we use an emergent qualitative coding strategy. In this process, we identify three different types of conversational patterns: general, content and situated conversations. General conversations are not related to biology or other class topic. Content conversations are related to class content, but they do not involve the different sources of information available for students. Situated conversations delve into disciplinary knowledge by connecting gameplay with the information available in the educational materials. Situated conversations support the development of disciplinary knowledge by presenting the symbolic devices of the domain and bringing expert knowledge to the learning situation.
Care: Cartographies of power and politics in ECEC
Authors: Ailwood Joanne
Published: December 2020

Early childhood educators’ work is embedded in the complexities of relations and relationships, and this relational work is entangled in care. Care can be difficult to define and is often assumed as an inherent ‘good’ in education. In heavily feminised work environments such as early childhood education, it is easily assumed to be part of what naturally occurs amongst educators and children. However, I suggest that it is dangerous to assume we understand a concept as complex and value laden as care without also engaging in reflection and analysis about the complexity and multiplicity of care. In this paper I will explore some threads of care in early childhood education and care. I make use of Braidotti’s concept of cartographies to critically examine aspects of care in early childhood education. A cartography enables an exploration of power and knowledge in relation to care. Care, like classrooms, is messy, relational, in action, situated and contextual. This examination of care enables the perceived connection between care as a necessary ‘good’ to be contested. Instead, care is mapped across multiple threads and potentials, threads that might sometimes be warm and sustaining, while sometimes being oppressive and stressful.
Inhaled iloprost as third add‐on therapy in idiopathic pulmonary arterial hypertension
Authors: Fernandes Caio J.C.S. , da Silva Taysa A.F. , Alves Jose L. , Jardim Carlos V.P. , de Souza Rogerio
Published: December 2020

Triple combination therapy is suggested in current pulmonary arterial hypertension guidelines in case of unsatisfactory treatment with oral double combination therapy. However, there is a lack of evidence concerning some of the drug combinations currently employed. We demonstrate the clinical and hemodynamical benefits of inhaled iloprost as third add‐on therapy in idiopathic pulmonary arterial hypertension.
Prostate cancer in the British Asian population: A case-control study
Authors: Forster Luke R , Jelley Clare , Breeze Charles E , Singh Rajindra , Chahal Rohit , Addla Sanjai K
Published: December 2020

Objectives:

To study demographic and disease variables at presentation, diagnosis and treatment of prostate cancer in British South Asian (SA) men and compare with their Caucasian counterparts.

Methods:

A retrospective review of prostate cancer cases between 2010 and 2015 identified patients of SA descent who were matched for age, residential location and year of diagnosis with two Caucasian patients. Disease characteristics, treatment and short-term outcomes were recorded and compared.

Results:

A total of 1274 patients were diagnosed, of which 50 (3.9%) were SA. SA patients had less screen-detected prostate cancer (12% versus 31%, p=0.02), more co-morbidity and more high-risk disease (57% versus 37%, p=0.03). Active surveillance was the preferred treatment option (32%) with 2% having surgery compared with 22% ( p=0.003) from the Caucasian cohort. Logistic regression showed these disparities to be related to the different presentations.

Conclusion:

SA men with prostate cancer are less likely to be diagnosed following asymptomatic screening and the majority have high-risk disease at presentation. These differences lead to SA men preferring active surveillance to radical surgery. Given the increasing British Asian population, the findings demonstrate a need for research and public health interventions to better understand and address the differences noted between these groups.
COVID-19: What does it mean for digital social protection?
Authors: Masiero Silvia
Published: December 2020

COVID-19 has hit a world in which social protection schemes are increasingly augmented with digital measures. Digital identity schemes are especially being adopted to match citizens’ data with social protection entitlements, enabling authentication through demographic and, increasingly, biometric data at the point of access. In this commentary, I discuss three sets of implications that COVID-19 has yielded on digital social protection, whose central trade-off – increasing the probabilities of accurate user identification, at the cost of greater exclusions – has become even more problematic during the crisis. I argue that three forms of data injustice – legal, informational and design-related, previously identified in datafied social protection schemes, will need to be monitored in the post-pandemic scenario. I finally observe that the crisis exposes the long-term need to place digitality within social protection schemes that expand user entitlements rather than constraining them. Implications of such reflections are drawn for the study of data-based social welfare interventions.
Joining semantic and augmented reality to design smart homes for assistance
Authors: Haidon Corentin , Pigot Hélène , Giroux Sylvain
Published: December 2020

Introduction

Smart homes for assistance help compensate cognitive deficits, thus favoring aging in place. However, to be effective, the assistance must be adapted to the abilities, deficits, and habits of the person. Beside the elder, caregivers are the ones who know the person’s needs best. This article presents a Do-it-Yourself approach for helping caregivers designing a smart home for assistance.

Methods

A co-construction process between a caregiver and a virtual adviser was designed. The knowledge of the virtual adviser about smart homes, activities of daily living and assistance is organized in an ontology. The caregiver interacts with the virtual adviser in augmented reality to describe the home and the resident’s habits inside it. The process is illustrated with an ordinary activity: ‘Drink water’.

Results

The proposed process highlights two main steps: describing the environment and determining the resident’s habits and the assistance required to improve activity performance. Visual guidance and feedback are provided to ease the process.

Conclusion

Designing a co-construction process with a virtual adviser allows interactive knowledge sharing with the caregivers who are experts of the person’s needs. Future work should focus on evaluating the prototype presented and providing deeper advice such as highlighting incomplete or incorrect scenarios, or navigation aid.
Social Media Posts About Racism Leads to Evaluative Backlash for Black Job Applicants
Authors: Howard Simon , Kennedy Kalen , Tejeda Francisco
Published: December 2020

Black Americans post about race and race-related issues on social media more than any other racial group. In this study, we investigated whether Black Americans who post about racism on social networking sites (i.e., Facebook) experience evaluative backlash during the employee selection process. Participants ( N = 154) were given a Black job candidate’s cover letter, resume, and a scanned printout of their social media. Depending on what condition they were randomly assigned to, the applicant’s social media contained posts about racism or posts that were race neutral. Results indicated that Black individuals whose posts were about racism were evaluated less favorably than Black individuals whose posts were race neutral. Specifically, they were perceived as being less likable. In addition, Black individuals whose social media posts were related to racism were less likely to be offered an interview for a job. Implications, limitations, and future directions are discussed.
Deconstructing hyper-selectivity: Are the socioeconomic attainments of second-generation Asian Americans only due to their class background?
Authors: Sakamoto Arthur , Wang Sharron Xuanren
Published: December 2020

Recent studies by Jennifer Lee and Min Zhou claim that “hyper-selectivity” is the primary causal factor accounting for the high average educational attainment of second-generation Asian Americans. We critically assess hyper-selectivity, which has not been carefully evaluated in prior research. We argue that hyper-selectivity is inadequately conceptualized and is not clearly supported by data on immigration or income mobility. Hyper-selectivity ignores accumulated facts about Asian American family processes relating to cultural factors and educational attainment. Rather than being a class phenomenon, Asian cultural factors have important effects for most second-generation Asian Americans regardless of the socioeconomic status of their parents. Overemphasizing hyper-selectivity inadequately acknowledges the cultural heritage of Asian Americans and ignores the agency of immigrant Asian American families.
Learning ethics from an echidna: Embedding Indigenous knowledges at the core of ethical research practice
Authors: Dickson Michelle
Published: December 2020

I am an Australian Aboriginal and Torres Strait Islander2 (Koori3) researcher and am privileged to work at the Cultural Interface with Koori ontologies, epistemologies and axiologies within a Western academic paradigm. I deeply engage with my Koori ways of seeing and ways of knowing the world and those things sustain me as I navigate working in the Cultural Interface. However, I feel my Koori ontologies, epistemologies and axiologies are not often valued or understood as ways of being, knowing and doing within a Western academic space. This is particularly the case when I share a Yarn4 that I learned somewhere in my lifespan and apply it to teaching or research within a Western context. However, many of those Yarns are the foundation of my learning and knowledge, have inspired me and inform and guide my research. This article describes how Yarns learned through my own life have informed my development as a researcher and have guided the ethics, methodology and methods in my research. Throughout the article I will share several Yarns (in a written form) that I used as part of my doctoral research methodology, as I Yarned with Team Members,5 about navigating research ethics, about establishing my own research methodology and about how I ensure respectful research practice founded on Indigenous knowledges.
Understanding offender managers’ views and experiences of psychological consultations
Authors: Blinkhorn Victoria , Petalas Michael , Walton Mark , Carlisle Julie , McGuire Frank , Kane Sarah , Moore Julie
Published: December 2020

Few studies have investigated the effectiveness of the psychological consultation process specifically for offender managers. This study involves a total of 23 offender managers’ views and perceptions of the consultation process within four areas of the North West of England. Within each location, a focus group was conducted involving between four and eight participants and interpretative phenomenological analysis was used to analyse the responses. The analysis revealed four main themes: validation of thoughts, feelings and practice; professional support; a personal touch; and room for improvement. These findings are discussed along with implications for further research.
The New Economy in China: An Intercity Comparison
Authors: Deng Zhongqi , Zhang Yu , Yu Ao
Published: December 2020

Today, the world is witnessing an enormous new economic wave, which has become an important and growing contributor to economic development. However, few studies compare the overall development of all new economic sectors in different cities or countries. Therefore, the purpose of this study is to contribute to the literature on the 21st century new economy in China, which is viewed as a crucial development direction. Accordingly, the new economic situation in 2018 in 15 major cities of China is evaluated by constructing an index system and adopting some new big-data technologies, whereby a new economy comprehensive index (NECI) for each city is obtained. This study finds that the cities ranked from high to low in the NECI are Beijing, Shanghai, Shenzhen, Guangzhou, Hangzhou, Wuhan, Chengdu, Nanjing, Chongqing, Suzhou, Zhengzhou, Wuxi, Tianjin, Qingdao, and Xi’an. Among them, Beijing, Shanghai, and Shenzhen belong to the first hierarchy. The findings provide a nuanced perspective on the intercity comparison of the new economy, and the index system presented in the study is urgently-needed for policy makers. Finally, based on the case study of Chengdu the study offers rich insights to city administrators in terms of how to promote the new economy.
External Debt Distress in South Asia: Evidence from Panel Data Analysis
Authors: Abbas Shujaat , Wizarat Shahida , Mansoor Sadia
Published: December 2020

This study is an attempt to explore social and economic determinants of external debt distress in five selected South Asian countries, that is, Bangladesh, India, Nepal, Pakistan and Sri Lanka, from 1980 to 2018, by using the contemporary panel fixed effect model and system generalized methods of moments. The findings revealed that the major determinants of external debt distress in selected South Asian countries are large and increasing current account deficits, lower gross capital formation, foreign direct investment and large military expenditures. Among selected socio-economic variables, the increase in life expectancy increases external debt distress, whereas urbanization reduces it considerably. The study urges selected South Asian countries to correct highly unfavourable current account balance, resolve regional conflicts leading to the reduction of the arms race and make the macroeconomic environment friendly for domestic and foreign investment to reduce exploding external debt distress.

JEL Classification: C33, E22, F32, H63
Effect of nodule size on symptoms and the choice of surgical technique in patients with bladder endometriosis
Authors: Abdalla Ribeiro Helizabet Salomão , da Costa Porto Beatriz Taliberti , Bassoi Luisa , Ninomiya Graziela Y , Tomasi Mariana C , Cervantes Graziele V , Ribeiro Paulo Ayroza
Published: December 2020

Introduction:

In this study, we evaluated the relationships between symptoms of bladder endometriosis (EDT), lesion size, and the subsequent surgical technique used to excise the lesion.

Methods:

This is retrospective observational study of patients who underwent surgery in the Gynecological Endoscopy and Endometriosis Section at Hospital da Santa Casa of São Paulo, Brazil. A sample population of 39 women diagnosed with bladder EDT was included from 463 women presenting with deep pelvic EDT between January 2010 and March 2017. Clinical evaluations and surgical treatments for each EDT were performed.

Results:

Of the 39 women, 43.58% had dysmenorrhea or dyspareunia and 2.56% had hematuria. Furthermore, 21.10% presented with dysuria and endometriotic nodules on the bladder ( p < 0.04). The nodules had reached the muscle layer in 97.30% of patients, and a further 2.60% had reached the mucosal layer. In addition to bladder involvement, other pelvic regions were affected, including the left (15.8%) and right (13.2%) round ligament, left (68.4%) and right (65.8%) uterosacral ligament, retrocervical region (84.20%), and ureter (45.71%).

Conclusion:

The patients’ pain symptoms were found to be associated with bladder endometriosis and nodule size. Partial cystectomy with complete lesion excision might be an effective treatment option to relieve these symptoms. A study with a larger sample population is needed to confirm these findings.
Prognostic factors in High-Grade Localized Osteosarcoma of the Extremities: The Tunisian Experience
Authors: Letaief Feryel , Khrouf Salim , Yahiaoui Yosra , Hamdi Adel , Gabsi Azza , Ayadi Mouna , Mezlini Amel
Published: December 2020

Background:

Osteosarcoma is the most frequent bone cancer occurring in children and adolescents aged 10–20 years. Several prognostic factors have been identified by studies done at western centers. The aim of our study was to identify the prognostic factors in Tunisian patients in order to improve their management.

Methods:

We reviewed the data of localized limb osteosarcoma patients treated in Salah Azaïz Institute from January 1980 to December 2018. Patient’s treatment and survival variables were assessed. Patients received a neoadjuvant chemotherapy and underwent surgery in an expert center. They received afterward an adjuvant chemotherapy depending on the tumor necrosis assessed by Huvos.

Results:

Eighty-five patients were enrolled. Mean duration of follow-up was 30 months (range 1–297 months). Males were 1.6 times more frequent, median age was 17 (from 1 to 62 years). Conventional osteoblastic osteosarcoma was the most frequent histological subtype (77%). Median tumor size was 10 cm. Femoral location was the most frequent (60%). The overall average history of symptoms was 103 days (4 to 423 days). The 5-year overall-survival was 38% and the event free survival 32%. Tumor site, lactate dehydrogenase levels, high methotrexate levels at 24 h, clinical evaluation of the tumor perimeter, surgery type and delay of relapse were found to affect overall survival. Tumor site, Lactate dehydrogenase levels and clinical evaluation of the tumor perimeter affected the progression free survival.

Conclusion:

Demographic characteristics of Tunisian patients are mainly the same than worldwide. Femoral site, normal level of lactate dehydrogenase, a clinical response during neoadjuvant treatment, an R0 surgery, a delay of relapse over 2 years and Median H24 Methotrexate level superior to 4.4 µmol/l were associated with a better prognosis in our study.