bluuebunny/crossref_metadata_2025 huggingface dataset:
There Aint No Cowboys in Portishead (or Are There?): Story Fragments, Identity, and Singing the American Dream With an English Accent
Authors: Douglas Kitrina
Published: March 2021

In this performance autoethnography I explore how songs and cowboy images, typically American phenomena, have imprinted my life and have helped provide narrative resources for challenging available stereotypical gender scripts.
Pathologies of Professionalism: Invoking Controversial Dialectic—“Per Fas et Nefas,” Through a Performative Courtroom Drama
Authors: Hodkinson Alan
Published: March 2021

This article applies Schopenhauer’s stratagems to an examination of the professional, within a performative courtroom trial of critical analysis. The Defense submission seeks to sanctify the modern professional as a solidifying force in society. The prosecution employs Schopenhauer’s The Art of Being Right to bring a different definition and history to the concept of the professional. Through this application, the author hopes that you, the reader, might act as jury and so weigh the evidence to find your own guilt/innocence or truth/deceit in the operationalizations of professionalism within society.
One Size Doesn’t Fit All: Variant-Specific Effects in SCN8A Encephalopathy
Authors: Wengert Eric R. , Patel Manoj K.
Published: March 2021

[Box: see text]
Socioeconomic Status and Psychosocial Resources Mediate Racial/Ethnic Differences in Psychological Health Among Gay and Bisexual Men: A Longitudinal Analysis Using Structural Equation Modeling
Authors: Masa Rainier , Shangani Sylvia , Operario Don
Published: March 2021

A large body of research demonstrates disparities in psychological health attributed to sexual minority identity, racial/ethnic minority identity, and socioeconomic status (SES). Fewer studies have explicated the role of these multiple attributes on psychological health and explored the role of SES and psychosocial resources in determining outcomes. We analyzed data from Project STRIDE, a longitudinal survey involving a diverse sample of gay and bisexual adult men ( n = 198). Using structural equation modeling, we tested hypothesized direct and indirect effects of race/ethnicity, SES, and three psychosocial mediational variables (collective self-efficacy, everyday discrimination, internalized homophobia) on two outcome variables—psychological and social well-being—assessed at 1-year follow-up. Our model indicated that: (1) race/ethnicity and SES were significantly associated with each other and with each psychosocial mediator; (2) higher SES was directly and indirectly associated with both measures of well-being; and (3) collective self-esteem and everyday discrimination mediated the association between SES and both measures of well-being. The model also indicated that racial/ethnic associations with psychological mediators and outcomes are evident in the context of SES, but these effects might be suppressed when the model does not consider SES. Findings highlight the critical role of SES and race/ethnicity in determining the psychological and social well-being of sexual minority men. Specification of mediating variables—collective self-efficacy, everyday discrimination, internalized homophobia—indicates potential intervention targets to improve psychological and social health in sexual minority men. Associations between race/ethnicity and SES support the need for intersectional frameworks in addressing the health of sexual minority men.
Screening Older Adult Men for Abdominal Aortic Aneurysm: A Scoping Review
Authors: Bains Priya , Oliffe John L. , Mackay Martha H. , Kelly Mary T.
Published: March 2021

Abdominal aortic aneurysm (AAA) is a potentially fatal condition predominantly affecting older adult men (60 years or over). Based on evidence, preventative health-care guidelines recommend screening older males for AAA using ultrasound. In attempts to reduce AAA mortality among men, screening has been utilized for early detection in some Western countries including the UK and Sweden. The current scoping review includes 19 empirical studies focusing on AAA screening in men. The findings from these studies highlight benefits and potential harms of male AAA screening. The benefits of AAA screening for men include decreased incidence of AAA rupture, decreased AAA mortality, increased effectiveness of elective AAA repair surgery, and cost-effectiveness. The potential harms of AAA screening included lack of AAA mortality reduction, negative impacts on quality of life, and inconsistent screening eligibility criteria being applied by primary care practitioners. The current scoping review findings are discussed to suggest changes to AAA screening guidelines and improve policy and practice.
The influence of sad mood induction on task performance and metacognition
Authors: Culot Catherine , Fantini-Hauwel Carole , Gevers Wim
Published: March 2021

In many situations, the ability to make appropriate metacognitive judgements on our performance is essential to make decisions and adapt our behaviour. Past research suggests a strong relationship between metacognition and emotional disorders such as depression. Depressive disorders have been associated with an underestimation bias: depressive patients report lower confidence in their performance than healthy individuals. It is currently not clear whether the induction of a negative mood in healthy participants has similar consequences. Yet, such knowledge would permit to isolate the causal influence of the negative affect on metacognition, free of all the comorbidities associated with depression. In this study, we used a combination of films, pictures, and recalls to induce negative and neutral moods during a perceptual metacognitive task. Negative mood induction had no impact on the perceptual task. Participants did report lower confidence levels in the negative condition compared with a neutral condition. This study thus confirms a causal relationship between negative affect and metacognitive abilities.
Immediate self-information is prioritized over expanded self-information across temporal, social, spatial, and probability domains
Authors: Kim Hyunji , Florack Arnd
Published: March 2021

People construct self-representation beyond the experiential self and the self-concept can expand to interpersonal as well as intrapersonal dimensions. The cognitive ability to project oneself onto expanded selves in different time points and places plays a crucial role in planning and decision-making situations. However, no research to date has shown evidence explaining the early mechanism of how processing the experiential self-information differs from processing the expanded self-information across temporal, social, spatial, and probability domains. We report novel effects showing a systematic information prioritization toward the experiential selves (i.e., the self that is now, here, and with highest certainty) compared to the expanded selves (i.e., the self that is in the future, at a distant location, and with lower certainty; Experiments 1a, 2, and 3). Implicit prioritization biases lasted over time (Experiment 1b; i.e., 4 months) indicating a trait-like more than a state-like measure of individual differences. Different biases, however, did not consistently correlate with each other (Experiments 1a to 3) suggesting separate underlying mechanisms. We discuss potential links to the basic structure of self-representation and individual differences for implications.
On the tip of the pen: Effects of character-level lexical variables and handwriter-level individual differences on orthographic retrieval difficulties in Chinese handwriting
Authors: Huang Shuting , Lin Weihao , Xu Mengheng , Wang Ruiming , Cai Zhenguang G
Published: March 2021

In the past few decades, Chinese speakers have suffered from difficulties in handwriting, which include tip-of-the-pen (TOP) states (knowing a character but failing to fully handwrite it) and character amnesia in general (a general inability to handwrite a character despite being able to recognise it). The current study presents a systematic empirical investigation of the effects of character-level lexical characteristics and handwriter-level individual differences on TOP, character amnesia, and partial orthographic access in TOP states. Using a spelling-to-dictation task, we had 64 participants to handwrite 200 simplified Chinese characters. We showed that, at the lexical level, participants experienced more TOP and character amnesia in handwriting if a character was less frequent, was acquired later in life, was embedded in a less familiar word, or had more strokes; TOP but not character amnesia was additionally affected by phonetic radical order and spelling regularity. At the handwriter level, people also experienced more TOP and character amnesia if they had more digital exposure, less pen exposure, or less print exposure. In a TOP state, partial orthographic access was more likely if a character was acquired later in life, had fewer strokes, or had a left-right or top-down composition or, if a handwriter had less digital exposure.
Long-term written language experience affects grammaticality judgements and usage but not priming of spoken sentences
Authors: Favier Saoradh , Huettig Falk
Published: March 2021

“Book language” offers a richer linguistic experience than typical conversational speech in terms of its syntactic properties. Here, we investigated the role of long-term syntactic experience on syntactic knowledge and processing. In a preregistered study with 161 adult native Dutch speakers with varying levels of literacy, we assessed the contribution of individual differences in written language experience to offline and online syntactic processes. Offline syntactic knowledge was assessed as accuracy in an auditory grammaticality judgement task in which we tested violations of four Dutch grammatical norms. Online syntactic processing was indexed by syntactic priming of the Dutch dative alternation, using a comprehension-to-production priming paradigm with auditory presentation. Controlling for the contribution of nonverbal intelligence quotient (IQ), verbal working memory, and processing speed, we observed a robust effect of literacy experience on the detection of grammatical norm violations in spoken sentences, suggesting that exposure to the syntactic complexity and diversity of written language has specific benefits for general (modality-independent) syntactic knowledge. We replicated previous results by finding robust comprehension-to-production structural priming, both with and without lexical overlap between prime and target. Although literacy experience affected the usage of syntactic alternates in our large sample, it did not modulate their priming. We conclude that amount of experience with written language increases explicit awareness of grammatical norm violations and changes the usage of (prepositional-object [PO] vs. double-object [DO]) dative spoken sentences but has no detectable effect on their implicit syntactic priming in proficient language users. These findings constrain theories about the effect of long-term experience on syntactic processing.
Applications of deep learning in big data analytics for aircraft complex system anomaly detection
Authors: Ning Shungang , Sun Jianzhong , Liu Cui , Yi Yang
Published: March 2021

Big data analytics with deep learning approach have attracted increasing attention in transportation engineering, involving operations, maintenance, and safety. In commercial aviation sectors, operational, and maintenance data produced on modern aircraft is increasing exponentially, and predictive analysis of these data is an exciting and promising field in aviation maintenance, which has a potential to revolutionize aerospace maintenance industry. This study illustrates the state-of-the-art applications of deep learning in big data analytics for predictive maintenance and a real-world case study for commercial aircraft. A Long Short-Term Memory network based Auto-Encoders (LSTM-AE) is proposed for complex aircraft system fault detection and classification, which makes use of the raw time-series data from heterogeneous sensors. The proposed method uses nominal time-series samples corresponding to healthy behavior of the system to learn a reconstruction model based on LSTM-AE framework. Then the system health index (HI) and fault feature vectors are derived from the reconstruction error matrix for fault detection and classification. The proposed method is demonstrated on a real-world data set from a commercial aircraft fleet. The typical PCV faults as well as the 390 F sensor and 450 F sensor faults due to sense line air leakage are successfully detected and distinguished based on the extracted features. The case study results show that the computed HI can effectively characterize the health state of the aircraft system and different fault types can be identified with high confidence, which is helpful for line fault troubleshooting.
Safety and effectiveness of eculizumab in Japanese patients with generalized myasthenia gravis: interim analysis of post-marketing surveillance
Authors: Murai Hiroyuki , Suzuki Shigeaki , Hasebe Miki , Fukamizu Yuji , Rodrigues Ema , Utsugisawa Kimiaki
Published: March 2021

Background:

Eculizumab, a humanized monoclonal antibody targeted to terminal complement protein C5, is approved in Japan for treatment of patients with anti-acetylcholine receptor antibody-positive (AChR+) generalized myasthenia gravis (gMG) whose symptoms are difficult to control with high-dose intravenous immunoglobulin (IVIg) therapy or plasmapheresis.

Methods:

This interim analysis of mandatory post-marketing surveillance in Japan assessed the safety and effectiveness of eculizumab at 26 weeks after treatment initiation in patients with AChR+ gMG.

Results:

Data were available for 40 adult patients in Japan [62.5% (25/40) female; mean age at eculizumab initiation, 51.0 years]. Fifteen patients had a history of thymoma. Six patients were excluded from the effectiveness analysis set due to participation in the open-label extension part of the phase III, randomized, double-blind, placebo-controlled REGAIN study [ClinicalTrials.gov identifier: NCT02301624]. After 26 weeks’ follow up, 32 patients (80%) were continuing eculizumab treatment. Adverse drug reactions were reported by seven patients [most frequently headache ( n = 3)]. One death was reported during eculizumab treatment (relationship unclear as determined by the treating physician) and there was one death 45 days after the last dose (considered unrelated). No meningococcal infections were reported. Mean (standard deviation) changes from baseline in Myasthenia Gravis-Activities of Daily Living (MG-ADL) and Quantitative Myasthenia Gravis (QMG) scores were −3.7 (2.61) ( n = 27) and −5.6 (3.50) ( n = 26), respectively, at 12 weeks, and −4.3 (2.72) ( n = 26) and −5.6 (4.02) ( n = 24), respectively, at 26 weeks. Improvements in MG-ADL and QMG scores were generally similar in patients with/without a history of thymoma. Frequency of IVIg use decreased following eculizumab initiation.

Conclusion:

In a real-world setting, eculizumab was effective and well tolerated for the treatment of AChR+ gMG in adult Japanese patients whose disease was refractory to IVIg or plasmapheresis. These findings are consistent with the efficacy and safety results from the global phase III REGAIN study of eculizumab.
Peri-discharge complex interventions for reducing 30-day hospital readmissions among heart failure patients: overview of systematic reviews and network meta-analysis
Authors: Zhong CCW , Wong CHL , Cheung WKW , Yeoh E-K , Hung CT , Yip BHK , Wong ELY , Wong SYS , Chung VCH
Published: March 2021

Aims:

An overview of systematic reviews (SRs) and network meta-analysis (NMA) was conducted to synthesize evidence of comparative effectiveness of different peri-discharge complex interventions for reducing 30-day hospital readmissions among heart failure (HF) patients.

Methods:

We searched five databases for SRs from their inception to August 2019 and conducted additional search for randomized controlled trials (RCTs) published between 2003 and 2020. We used random-effect pairwise meta-analysis with pooled risk ratios (RRs) and 95% confidence intervals (CIs) to quantify the effect of complex interventions, and NMA to evaluate comparative effectiveness among complex interventions. Primary outcome was 30-day all-cause hospital readmissions, while secondary outcomes were 30-day HF-related hospital readmissions, 30-day mortality, and 30-day emergency department visits.

Results:

From 20 SRs and additional RCT search, 21 eligible RCTs ( n = 5362) assessing eight different peri-discharge complex interventions were included. Pairwise meta-analysis showed no significant difference between peri-discharge complex interventions and controls on all outcomes, except that peri-discharge complex interventions were significantly more effective than controls in reducing 30-day mortality (pooled RR = 0.68, 95% CI: 0.49–0.95, 5 RCTs). NMA indicated that for reducing 30-day all-cause hospital readmissions, supportive–educative intervention had the highest probability to be the best intervention, followed by disease management; while for reducing 30-day HF-related hospital readmissions, disease management is likely to be the best intervention.

Conclusions:

Our results suggest that disease management has the best potential to reduce 30-day all-cause and HF-related hospital readmissions. Benefits of the interventions may vary across health system contexts. Evidence-based complex interventions require local adaptation prior to implementation.
Surrogacy among Filipinos who have struggled with infertility: A discourse analysis
Authors: Liamzon Gabrielle Marie A. , Santos Andrea Mari P. , Tamayo Marie Ashley Margaret G. , Macapagal Ma. Elizabeth J.
Published: March 2021

Surrogacy continues to be practiced to address infertility in the Philippines; however, discussions on the method are sparse, given its limited accessibility and morally questionable procedures that may concern potential parents in a developing country. Using discourse analysis, the researchers interviewed ten (10) Filipino Roman Catholics who were struggling with infertility, to uncover how they construct the idea of surrogacy. The study shows the discourses on surrogacy are often approached in a detached manner, where potential parents describe the method as a last choice or one that is never considered. They articulate this position by highlighting the emotional factors surrogacy would entail; the women, in particular, described the involvement of another individual as “taking over” the role of the mother. Participants placed themselves in positions of both power and vulnerability, reconciling the split between surrogacy as a compassionate act or a transactional business. The ambiguous role of faith was also negotiated by the participants, where they argued for surrogacy using alternative teachings or through God-given “free will”. The discourses present considerations for the continued practice of surrogacy among key players in reproductive health in developing countries, recognizing the concerns of infertile couples to enable informed decision-making and policy creation.
On the notion of ‘worker’ under EU law: new insights
Authors: Gramano Elena
Published: March 2021

This contribution analyses the content and relevance of the of the ruling of the Court of Justice of the European Union (CJEU) in the B/Yodel Delivery Network Ltd case, and discusses its meaning and impact on the notion of ‘worker’ under the EU law.
An Analysis of Electronic Primary Dental Practice Tooth Wear Referrals
Authors: Khwaja Zohaib , Millar Brian J.
Published: March 2021

We evaluated the quality of general dental practitioner (GDP) tooth wear (TW) referrals to secondary care services in Kent, Surrey and Sussex.

Prospective consecutive referrals received via an electronic pathway were assessed from 1 June to 30 October 2019. Reasons for referral, patient demographics, quality of referral, opinion of the triaging clinician and outcome were assessed.

Of 671 referrals, 32% were for TW. Males were referred more commonly (1.7:1.0). The median age was 52. Patients were more likely to be referred from distant locations than places closer to the referral centre (p<0.001). Only 55% of referrals suggested a cause for the TW, 33% provided a clinical photograph and 1% recorded a tooth wear index of any type. Referring clinicians most commonly cited attrition as reason for referral (p<0.001). Those under 40 years were referred for erosion (p=0.001) and those over 40 years, attrition (p=0.019). The triaging clinician was more likely to allocate a tooth wear score of three for those under 40 years and a score of four for over 40 years (p<0.001). 47% of referrals were rejected. Males and referrals with photographs were more likely to be accepted for treatment (p=0.017 and p<0.001, respectively).

There is a high demand for specialist TW services. The number of referrals being rejected has not changed using the electronic referral system. We advocate the inclusion of mandatory fields for completion by GDPs as well as compulsory clinical photographs and tooth wear indices (Smith and Knight Tooth Wear Index or a basic erosive wear examination - BEWE index).
Dental Traumas – Things May Not Be as They Seem: A Case Report
Authors: Woolley Julian , Djemal Serpil
Published: March 2021

This case report describes a 52-year-old female patient who attended a specialist adult dental trauma clinic with a confusing history about a re-implanted avulsed maxillary left central incisor (UL1). Following examination, further investigations and clinical investigations, it was determined that the tooth had been re-implanted in the sub-periosteal space. The upper central incisor was extracted and re-implanted into the correct position and then managed by following the 2020 guidelines of the International Association for Dental Traumatology (IADT).

This case highlights an unusual complication of managing avulsed teeth and draws attention to the challenges posed by using two-dimensional radiographic imaging when assessing dental injuries.

A six-month follow-up appointment confirmed functional success and a reasonably satisfactory aesthetic outcome for the patient.
Impact of the coronavirus disease 2019 pandemic on the Palestinian family: A cross-sectional study
Authors: Abuzerr Samer , Zinszer Kate , Shaheen Amira , el Bilbeisi Abdel Hamid , Al Haj Daoud Ayman , Aldirawi Ali , Salem Alshaarawi
Published: March 2021

Introduction:

The current study aims to understand and assess the consequences of the coronavirus disease 2019 pandemic on Palestinian families.

Methods:

This online community-based cross-sectional descriptive study was conducted between 19 April 2020 and 5 June 2020, using a validated questionnaire. The questionnaire comprised of three sections: sociodemographic characteristics, living conditions, and impact of the coronavirus disease 2019 pandemic. A convenience sampling method was used to select participants.

Results:

A total of 570 adults aged ⩾18 years participated in the study. Of them, 258 (45.3%), 120 (21%), and 192 (33.7%) were residing in the Gaza Strip, West Bank, and East Jerusalem, respectively. A large portion of participants (73.2%) reported that the containment measures of the coronavirus disease 2019 pandemic had caused an excessive burden on their families; 549 (96.3%) revealed that water supplies were not always available at home. However, paying attention to personal hygiene and home cleaning was more than usual before the announcement of the coronavirus disease 2019 pandemic. The mean times of going out of their homes have dropped significantly following the onset of the pandemic, p value = 0.001 (95% confidence interval). In addition, 192 (33.7%) participants reported that they changed to working remotely from home with 66 (11.6%) having lost their employment.

Conclusion:

The coronavirus disease 2019 pandemic was associated with an additional burden on the Palestinian families. Moreover, we suggest discussing the obtained results with local and national stakeholders to ensure that they know to improve their actions.
Emotional artificial intelligence in children’s toys and devices: Ethics, governance and practical remedies
Authors: McStay Andrew , Rosner Gilad
Published: March 2021

This article examines the social acceptability and governance of emotional artificial intelligence (emotional AI) in children’s toys and other child-oriented devices. To explore this, it conducts interviews with stakeholders with a professional interest in emotional AI, toys, children and policy to consider implications of the usage of emotional AI in children’s toys and services. It also conducts a demographically representative UK national survey to ascertain parental perspectives on networked toys that utilise data about emotions. The article highlights disquiet about the evolution of generational unfairness, that encompasses injustices regarding the datafication of childhood, manipulation, parental vulnerability, synthetic personalities, child and parental media literacy, and need for improved governance. It concludes with practical recommendations for regulators and the toy industry.
CT and MRI characteristics of presumptive hypervitaminosis A in a cat
Authors: Yu Yoshihiko , Sugiyama Atsushi , Kuniya Takashi , Hasegawa Daisuke
Published: March 2021

Case summary

A rescued stray cat with an unknown history was examined for non-ambulatory paraparesis in the hindlimbs. Survey radiographs revealed typical findings of hypervitaminosis A, characterised by vertebral exostoses and extensive osteophytes, mainly in the cervicothoracic spine. CT findings were consistent with the radiographic findings, and CT-based volume rendering and virtual endoscopy into the vertebral canal were created for three-dimensional visualisation of the lesion. MRI revealed a focal and mild dilation of the central canal of the spinal cord. Although the clinical diagnosis of hypervitaminosis A is based on an unusual dietary history and characteristic radiographic findings, the history of this cat was unknown and serum concentrations of vitamin A were unremarkable, when measured >1 month after rescue. However, other possible differential diagnoses were thought to be unlikely and clinical signs never worsened, and thus, hypervitaminosis A was presumed.

Relevance and novel information

To our knowledge, this is the first report to present the CT and MRI characteristics of a cat with suspected hypervitaminosis A.
Introducing Family Medicine Clerkship to Medical Students’ Curriculum at a Saudi Medical University: An Impact Study
Authors: Al Shammari Malak A. , Al Shamlan Nouf A. , Darwish Magdy A. , Sebiany Abdelaziz M. , Sabra Amr A. , Al Almaie Sameeh M.
Published: March 2021

Background

Family Medicine was introduced as a major undergraduate clinical rotation in 2016 after the medical college at Imam Abdulrahman Bin Faisal University revised its curriculum.

Objective

Assessing how students’ medical knowledge has improved post Family Medicine introduction to the revised medical school curriculum.

Study Design

This was a cross-sectional epidemiological study among fifth year clinical medical students (n = 219). A pretest and post-test was distributed to all fifth year clinical medical students voluntarily during the period of October 2017 to May 2018. They were asked to rate the exam as well.

Results

The mean exam grades were 25.52 (SD = 4.44) and 34.16 (SD = 5.76) for pre-rotation and post-rotation, respectively. There was a statistically significant difference between post and pre rotation exam grade for the overall sample ( t (218) = 23.73, P < .0001) indicating that students had a statistically significantly higher exam grades post-rotation (M = 34.16, SD = 5.76) than pre-rotation (M = 25.52, SD = 4.44). Females had a statistically significantly larger difference in post-rotation and pre-rotation exam grade than males indicating that they improved more in the post rotation exam. It was found that nearly 60% (59.36%) of subjects considered the exam difficult before the rotation; however, only around 40% (40.18%) considered the exam difficult after the rotation.

Conclusion

Students benefited after taking the course of family medicine. This helps in advocating for both the importance of this specialty and for the university’s decision in incorporating family medicine as a major clinical rotation for undergraduates.
The Transmission Mechanism of China-Japan Economic Co-Movement and Stabilizing Measures for China’s Economy
Authors: Yang Wanping , Zhao Bingyu
Published: March 2021

How does the economy of China and Japan interact with each other? Through building vector autoregression (VAR) model, this study examines the transmission mechanism of economic synchronization among the two nations from three perspectives, namely foreign direct investment (FDI), bilateral trade, and political relation. Based on this, relevant stabilizing measures for China’s economy are proposed. The findings of this study are as follows: (a) There exists business cycle co-movement between China and Japan. (b) The transmission mechanism of this co-movement contains bilateral trade and FDI. Therein, import contributes the most to China’s economic fluctuation, which is followed by FDI and export. (c) Bilateral political relation exerts indirect influence on China-Japan economic synchronization. (d) The impact of Japan’s economic fluctuations on the economy of China would be mitigated by expanding international trade markets, reducing financial market access restrictions, strengthening the political mutual trust, and encouraging communications between China and Japan in science, technology, and education, etc.
Machine Learning to Classify Suicidal Thoughts and Behaviors: Implementation Within the Common Data Elements Used by the Military Suicide Research Consortium
Authors: Littlefield Andrew K. , Cooke Jeffrey T. , Bagge Courtney L. , Glenn Catherine R. , Kleiman Evan M. , Jacobucci Ross , Millner Alexander J. , Steinley Douglas
Published: March 2021

Suicide rates among military-connected populations have increased over the past 15 years. Meta-analytic studies indicate prediction of suicide outcomes is lacking. Machine-learning approaches have been promoted to enhance classification models for suicide-related outcomes. In the present study, we compared the performance of three primary machine-learning approaches (i.e., elastic net, random forests, stacked ensembles) and a traditional statistical approach, generalized linear modeling (i.e., logistic regression), to classify suicide thoughts and behaviors using data from the Military Suicide Research Consortium’s Common Data Elements (CDE; n = 5,977–6,058 across outcomes). Models were informed by (a) selected items from the CDE or (b) factor scores based on exploratory and confirmatory factor analyses on the selected CDE items. Results indicated similar classification performance across models and sets of features. In this study, we suggest the need for robust evidence before adopting more complex classification models and identify measures that are particularly relevant in classifying suicide-related outcomes.
International Capital Flows When Safe Assets Scarcity Matters
Authors: Hung Ly Dai , Hoan Nguyen Thi Thuy
Published: March 2021

In an open multi-country economy, the safe assets supply shapes the pattern of international capital flows. A higher productivity growth rate raises the net capital inflows for economies with abundant safe assets, but reduces the net capital inflows for economies with scarce safe assets. The cross-section analysis on a sample of 170 economies over 1980–2013 confirms the theory. The evidence is robust for instrument-variable (IV) analysis method.

JEL Classifications: F15, F36, F43
Lower Failure Rates and Improved Patient Outcome Due to Reconstruction of the MCL and Revision ACL Reconstruction in Chronic Medial Knee Instability
Authors: Alm Lena , Drenck Tobias Claus , Frings Jannik , Krause Matthias , Korthaus Alexander , Krukenberg Anna , Frosch Karl-Heinz , Akoto Ralph
Published: March 2021

Background:

Concomitant lesion of the medial collateral ligament (MCL) is associated with a greater risk of anterior cruciate ligament (ACL) graft failure.

Purpose:

The aim of this study was to compare two medial stabilization techniques in patients with revision ACL reconstruction (ACLR) and concomitant chronic medial knee instability.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

In a retrospective study, we included 53 patients with revision ACLR and chronic grade 2 medial knee instability to compare medial surgical techniques (MCL reconstruction [n = 17] vs repair [n = 36]). Postoperative failure of the revision ACLR (primary aim) was defined as side-to-side difference in Rolimeter testing ≥5 mm or pivot-shift grade ≥2. Clinical parameters and postoperative functional scores (secondary aim) were evaluated with a mean ± SD follow-up of 28.8 ± 9 months (range, 24-69 months).

Results:

Revision ACLR was performed in 53 patients with additional grade 2 medial instability (men, n = 33; women, n = 20; mean age, 31.3 ± 12 years). Failure occurred in 5.9% (n = 1) in the MCL reconstruction group, whereas 36.1% (n = 13) of patients with MCL repair showed a failed revision ACLR ( P = .02). In the postoperative assessment, the anterior side-to-side difference in Rolimeter testing was significantly reduced (1.5 ± 1.9 mm vs 2.9 ± 2.3 mm; P = .037), and medial knee instability occurred significantly less (18% vs 50%; P = .025) in the MCL reconstruction group than in the MCL repair group. In the logistic regression, patients showed a 9-times elevated risk of failure when an MCL repair was performed ( P = .043). Patient-reported outcomes were increased in the MCL reconstruction group as compared with MCL repair, but only the Lysholm score showed a significant difference (Tegner, 5.6 ± 1.9 vs 5.3 ± 1.6; International Knee Documentation Committee, 80.3 ± 16.6 vs 73.6 ± 16.4; Lysholm, 82.9 ± 13.6 vs 75.1 ± 21.1 [ P = .047]).

Conclusion:

MCL reconstruction led to lower failure rates in patients with combined revision ACLR and chronic medial instability as compared with MCL repair. MCL reconstruction was superior to MCL repair, as lower postoperative anterior instability, an increased Lysholm score, and less medial instability were present after revision ACLR. MCL repair was associated with a 9-times greater risk of failure.
The intersection of oncology, nephrology, and palliative care
Authors: Corona Antonio Gabriel D , Koncicki Holly M
Published: March 2021

Onconephrology patients share a common feature: decreased survival. This is where Palliative Care finds a role in managing for these patients. However, during the course of illness and its treatment, providers often overlook the importance of assessing prognosis, predicting disease trajectory, and addressing goals of care discussions with patients and their family. Knowing which factors portend a poor outcome in this population helps bind together the subspecialties of Oncology, Nephrology and Palliative Care and frame interventions within patients’ treatment goals. As the life expectancies of patients suffering from cancer and kidney disease is short, knowledge of these foreboding factors helps initiate end of life planning which has shown to be beneficial for our patients’ quality of life.
Older adults with newly diagnosed high-risk/secondary AML who achieved remission with CPX-351: phase 3 post hoc analyses
Authors: Lin Tara L. , Rizzieri David A. , Ryan Daniel H. , Schiller Gary J. , Kolitz Jonathan E. , Uy Geoffrey L. , Hogge Donna E. , Solomon Scott R. , Wieduwilt Matthew J. , Ryan Robert J. , Faderl Stefan , Cortes Jorge E. , Lancet Jeffrey E.
Published: March 2021

CPX-351, a dual-drug liposomal encapsulation of daunorubicin/cytarabine in a synergistic 1:5 molar ratio, is approved for the treatment of adults with newly diagnosed, therapy-related acute myeloid leukemia (t-AML) or AML with myelodysplasia-related changes (AML-MRC). In a pivotal phase 3 study, patients aged 60 to 75 years with newly diagnosed, high-risk/secondary AML were randomized to receive CPX-351 or conventional 7+3 chemotherapy. In the primary endpoint analysis, CPX-351 demonstrated significantly prolonged median overall survival (OS) vs 7+3. These exploratory post hoc subgroup analyses evaluated the impact of achieving complete remission (CR) or CR with incomplete neutrophil or platelet recovery (CRi) with CPX-351 (73/153 [48%]) vs conventional 7+3 (52/56 [33%]) on outcomes. CPX-351 improved median OS vs 7+3 in patients who achieved CR or CRi (25.43 vs 10.41 months; hazard ratio = 0.49; 95% confidence interval, 0.31, 0.77). Improved median OS was seen across AML subtypes (t-AML, AML-MRC), age subgroups (60 to 69 vs 70 to 75 years), patients with prior hypomethylating agent exposure, and patients who did not undergo transplantation. Patients who achieved CR or CRi with CPX-351 also had a higher rate of transplantation, a longer median OS landmarked from the date of transplantation (not reached vs 11.65 months; hazard ratio = 0.43; 95% confidence interval, 0.21, 0.89), and a safety profile that was consistent with the known safety profile of 7+3. These results suggest deeper remissions may be achieved with CPX-351, leading to improved OS. This study was registered at www.clinicaltrials.gov as #NCT01696084.
Regression patterns of uveal melanoma after iodine-125 plaque brachytherapy
Authors: Fang Rui , Wang Heng , Li Yang , Liu Yue-Ming , Wei Wen-Bin
Published: March 2021

Background

Tumor regression of uveal melanomas (UMs) after radiotherapy has been reported as a valuable prognostic factor for metastasis and metastatic death. But its effect on prognosis is questionable. The purpose of this study was to summarize the regression features of uveal melanoma after iodine-125 plaque brachytherapy and the relationship with prognosis.

Methods

Adult uveal melanoma patients who only received iodine-125 plaque brachytherapy between December 2009 and March 2018 at the Beijing Tongren Hospital, Capital Medical University were enrolled in this study. The regression rate was calculated as the percent change in tumor height, and each eye was classified for four main regression patterns: Decrease (D), Stable (S), Others (O), and Increase (I), according to the trend of height change. Statistical analysis was performed using one-way ANOVA and chi-square test, univariate and multivariate logistic regression, and Kaplan-Meier analysis.

Results

A total of 139 patients was included in the study. The median follow-up was 35 months. Regression patterns status was pattern D in 65 tumors (46.8%), pattern S in 50 tumors (36.0%), pattern O in 6 tumors (4.3%), and pattern I in 18 tumors (12.9%). Reductions of tumor mean height for each follow-up visit were 5.26% (3 months), 10.66% (6 months), 9.37% (12 months), and 14.68% (18 months). A comparison (D vs. S vs. O vs. I) revealed the preoperative height of pattern I was significantly lower than the pattern D, S and O (mean: 7.24 vs. 7.30 vs. 6.77 vs. 5.09 mm, respectively; P = 0.037). LBD (largest basal diameter) was strongly associated with the metastasis (P = 0.03). However, an association between the tumor regression and subsequent melanoma-related metastasis and mortality could not be confirmed (P = 0.66 and P = 0.27, respectively). The tumor regression rate increased with increasing tumor height (P = 0.04) and decreased with increasing of LBD (P = 0.01).

Conclusion

Our study showed a lack of association between the prognosis and the regression of uveal melanomas following I-125 plaque radiotherapy. The LBD and original height of the tumor have predictive value in tumor regression rate, and LBD was positively associated with metastasis.
Anti-influenza A virus activity of two Newtonia species and the isolated compound myricetin-3-o-rhamnoside
Authors: Motlhatlego Katlego E. , Mehrbod Parvaneh , Fotouhi Fatemeh , Abdalla Muna Ali , Eloff Jacobus N. , McGaw Lyndy J.
Published: March 2021

Background

Some viruses play a key role in the disturbance of the digestive system. The common viruses which cause infectious diarrhoea (gastroenteritis) include astrovirus, caliciviruses, coronavirus and torovirus which are single-stranded RNA viruses. Influenza A virus (H1N1) also causes diarrhoea in addition to being associated with respiratory symptoms. In preliminary studies, Newtonia hildebrandtii and N. buchananii leaf extracts had good antibacterial activity against some bacteria implicated in causing diarrhoea. The aim of this study was to evaluate the anti-influenza activity of two Newtonia species extracts and the isolated compound (myricitrin).

Methods

N. hildebrandtii and N. buchananii acetone, and MeOH: DCM (methanol-dichloromethane) leaf and stem extracts, and an antibacterial compound myricetin-3-o-rhamnoside (myricitrin), isolated from N. buchananii, were evaluated for their antiviral efficacy against influenza A virus (IAV) PR8/34/H1N1 as a model organism. The MTT and hemagglutination assays were used to assess the extracts and compound interference with cell viability and viral surface HA glycoprotein. The quantitative real-time PCR was performed to assess the viral load.

Results

Plant extracts of N. hildebrandtii and N. buchananii were effective against IAV. The extracts in combination with H1N1 showed highly significant antiviral activity (P < 0.01) and maintained cell viabilities (P < 0.05). Myricitrin was non-cytotoxic at concentration 104 μg/ml. Myricitrin was most effective against IAV in a co-penetration combined treatment, thereby confirming the inhibitory effect of this compound in the viral attachment and entry stages. Myricitrin treatment also resulted in the highest viability of the cells in co-penetration treatment. The activity of myricitrin indicates the potential of the extracts in controlling viral infection at the attachment stage. The antiviral effect of myricitrin on IAV load in MDCK cell culture was confirmed using quantitative real-time PCR.

Conclusion

Data from this study support further research and development on Newtonia hildebrandtii, Newtonia buchananii and myricitrin to address diarrhoea and related conditions caused by viruses in both human and veterinary medicine. Further work needs to be conducted on the activity of the extracts and the purified compound on other viruses of importance which have similar symptoms to influenza virus such as the coronavirus which led to a recent global pandemic.
Maternal healthcare utilization and full immunization coverage among 12–23 months children in Benin: a cross sectional study using population-based data
Authors: Budu Eugene , Seidu Abdul-Aziz , Agbaglo Ebenezer , Armah-Ansah Ebenezer Kwesi , Dickson Kwamena Sekyi , Hormenu Thomas , Hagan John Elvis , Adu Collins , Ahinkorah Bright Opoku
Published: March 2021

Background

Maternal and child health are important issues for global health policy, and the past three decades have seen a significant progress in maternal and child healthcare worldwide. Immunization is a critical, efficient, and cost-effective public health intervention for newborns. However, studies on these health-promoting indicators in low-income and middle-income countries, especially in sub-Sahara Africa are sparse. We investigated the association between maternal healthcare utilization and complete vaccination in the Republic of Benin.

Methods

We analysed data from the 2018 Benin Demographic and Health Survey (BDHS). Specifically, the children’s recode file was used for the study. The outcome variable used was complete vaccination. Number of antenatal care visits, assistance during delivery, and postnatal check-up visits were the key explanatory variables. Bivariate and multilevel logistic regression analyses were carried out. The results were presented as unadjusted odds ratios (uOR) and adjusted odds ratios (aOR), with their corresponding 95% confidence intervals (CIs) signifying their level of precision. Statistical significance was declared at p < 0.05.

Results

The prevalence of full immunization coverage in Benin was 85.4%. The likelihood of full immunization was lower among children whose mothers had no antenatal care visits, compared to those whose mothers had 1–3 visits [aOR = 0.11, 95% CI: 0.08–0.15], those who got assistance from Traditional Birth Attendants/other during delivery, compared to those who had assistance from Skilled Birth Attendants/health professionals [aOR = 0.55, 95% CI: 0.40–0.77], and mothers who had no postnatal care check-up visit, compared to those who had postnatal care check-up < 24 h after delivery [aOR = 0.49, 95% CI: 0.36–0.67]. With the covariates, religion, partner’s level of education, parity, wealth quintile, and place of residence also showed significant associations with full immunization.

Conclusion

The study has demonstrated strong association between full immunization and antenatal care, skilled attendance at birth, and postnatal care check-up visit. We found that full immunization decreases among women with no antenatal care visits, those who receive assistance from Traditional Birth Attendants during delivery, and those who do not go for postnatal care visits. To help achieve full immunization, it is prudent that the government of Benin collaborates with international organisations such as WHO and UNICEF to provide education to pregnant women on the importance of immunization after delivery. Such education can be embedded in the antenatal care, delivery and postnatal care services offered to pregnant women during pregnancy, delivery, and after delivery.
Human coronaviruses and therapeutic drug discovery
Authors: Song Lan-Gui , Xie Qing-Xing , Lao Hui-Lin , Lv Zhi-Yue
Published: March 2021

Background

Coronaviruses (CoVs) are distributed worldwide and have various susceptible hosts; CoVs infecting humans are called human coronaviruses (HCoVs). Although HCoV-specific drugs are still lacking, many potent targets for drug discovery are being explored, and many vigorously designed clinical trials are being carried out in an orderly manner. The aim of this review was to gain a comprehensive understanding of the current status of drug development against HCoVs, particularly severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Main text

A scoping review was conducted by electronically searching research studies, reviews, and clinical trials in PubMed and the CNKI. Studies on HCoVs and therapeutic drug discovery published between January 2000 and October 2020 and in English or Chinese were included, and the information was summarized. Of the 3248 studies identified, 159 publication were finally included. Advances in drug development against HCoV, especially SARS-CoV-2, are summarized under three categories: antiviral drugs aimed at inhibiting the HCoV proliferation process, drugs acting on the host's immune system, and drugs derived from plants with potent activity. Furthermore, clinical trials of drugs targeting SARS-CoV-2 are summarized.

Conclusions

During the spread of COVID-19 outbreak, great efforts have been made in therapeutic drug discovery against the virus, although the pharmacological effects and adverse reactions of some drugs under study are still unclear. However, well-designed high-quality studies are needed to further study the effectiveness and safety of these potential drugs so as to provide valid recommendations for better control of the COVID-19 pandemic.
A flexible multivariate model for high-dimensional correlated count data
Authors: Knudson Alexander D. , Kozubowski Tomasz J. , Panorska Anna K. , Schissler A. Grant
Published: March 2021

We propose a flexible multivariate stochastic model for over-dispersed count data. Our methodology is built upon mixed Poisson random vectors (Y1,…,Yd), where the {Yi} are conditionally independent Poisson random variables. The stochastic rates of the {Yi} are multivariate distributions with arbitrary non-negative margins linked by a copula function. We present basic properties of these mixed Poisson multivariate distributions and provide several examples. A particular case with geometric and negative binomial marginal distributions is studied in detail. We illustrate an application of our model by conducting a high-dimensional simulation motivated by RNA-sequencing data.