bluuebunny/crossref_metadata_2025 huggingface dataset:
Complete puborectalis, puboperinealis muscle and urethral rhabdomyosphincter preservation in laparoscopic radical prostatectomy: Anatomical landmarks to achieve early urinary continence
Authors: Laucirica Oscar , Gomez Esther , Hajianfar Ramin , Vilanova Joan C , Muniesa Marta
Published: April 2020

Objectives

To describe our surgical technique of “muscle‐sparing” laparoscopic radical prostatectomy and to review relevant anatomical landmarks during the procedure.

Methods

This was a prospective non‐controlled case series of 120 consecutive patients who underwent laparoscopic radical prostatectomy, always carried out by the same surgeon (OL). The median follow‐up period was 33 months. Dissection of the puboperinealis and puborectalis muscle consists of the precise dissection of the puborectalis and puboperinealis muscles from the periprostatic fascia. Rhabdomyo‐dissection consists of an approach that spares the external urethral sphincter from the ventral surface of the prostate and membranous urethra. Clinical data were collected in a dedicated database. Intraoperative variables, postoperative complications and outcomes of urinary continence were assessed. A descriptive statistical analysis was carried out.

Results

Continence rates were 70.8%, 83.3% and 92.5%, at 0–2, 3–4 and 5–8 weeks after removal of the urethral catheter, respectively; 96.6% and 98.3% at 6 and 12 months after surgery. The positive surgical margin rate associated with rhabdomyo‐dissection was 8.3%.

Conclusions

Laparoscopic radical prostatectomy with dissection of the puboperinealis and puborectalis muscle, and rhabdomyo‐dissection is an oncologically safe procedure, associated with very early recovery urinary continence in most patients. It is a technique that can be applied in most cases, as long as there is no invasion of the ventral side of the prostate.
Predictors of pelvic muscle exercise on the self‐efficacy of women giving birth
Authors: Shin Gisoo , Kim Hye Jin , Kim Miok
Published: April 2020

This article is a reported of a study of the relationship between lower urinary tract symptoms and pelvic muscle exercise attitudes as well as effects on the self‐efficacy in childbirth women. Pregnancy and childbirth are normal physiological processes, but their effects on the genitourinary system are great. The enlarged uterus resulting from foetal growth is a major cause of urinary incontinence because it affects the tissues supporting the female pelvis and causes relaxation of the pelvic floor muscle and lower urinary function. A descriptive research study was performed from August to November 2017. Overall, 141 women after childbirth were conducted who living in South Korea. The outcome measure was the lower urinary tract symptoms, attitudes toward pelvic muscle exercise and self‐efficacy for pelvic muscle exercise. In this study, even though the women after childbirth had moderate level of lower urinary tract symptoms, their self‐efficacy for pelvic muscle exercise was low. Also, the gestational diabetes history and exercise duration after birth were identified as variables affecting self‐efficacy for pelvic muscle exercise. The present study showed that nurses should provide knowledge and strategies about pelvic muscle exercise to enhance self‐efficacy for post‐partum women.
E‐cadherin deregulation in breast cancer
Authors: Corso Giovanni , Figueiredo Joana , De Angelis Simone Pietro , Corso Federica , Girardi Antonia , Pereira Joana , Seruca Raquel , Bonanni Bernardo , Carneiro Patricia , Pravettoni Gabriella , Guerini Rocco Elena , Veronesi Paolo , Montagna Giacomo , Sacchini Virgilio , Gandini Sara
Published: April 2020

E‐cadherin protein (CDH1 gene) integrity is fundamental to the process of epithelial polarization and differentiation. Deregulation of the E‐cadherin function plays a crucial role in breast cancer metastases, with worse prognosis and shorter overall survival. In this narrative review, we describe the inactivating mechanisms underlying CDH1 gene activity and its possible translation to clinical practice as a prognostic biomarker and as a potential targeted therapy.
Protein disulphide isomerase can predict the clinical prognostic value and contribute to malignant progression in gliomas
Authors: Hu Qing , Huang Kai , Tao Chuming , Zhu Xingen
Published: April 2020

Increasing evidence from structural and functional studies has indicated that protein disulphide isomerase (PDI) has a critical role in the proliferation, survival and metastasis of several types of cancer. However, the molecular mechanisms through which PDI contributes to glioma remain unclear. Here, we aimed to investigate whether the differential expression of 17 PDI family members was closely related to the different clinicopathological features in gliomas from The Cancer Genome Atlas (TCGA) and Chinese Glioma Genome Atlas data sets. Additionally, four subgroups of gliomas (cluster 1/2/3/4) were identified based on consensus clustering of the PDI gene family. These findings not only demonstrated that a poorer prognosis, higher WHO grade, lower frequency of isocitrate dehydrogenase mutation and higher 1p/19q non‐codeletion status were significantly correlated with cluster 4 compared with the other clusters, but also indicated that the malignant progression of glioma was closely correlated with the expression of PDI family members. Moreover, we also constructed an independent prognostic marker that can predict the clinicopathological features of gliomas. Overall, the results indicated that PDI family members may serve as possible diagnostic markers in gliomas.
Abdominal aortic aneurysms: pathophysiology and clinical issues
Authors: Lattanzi Simona
Published: April 2020

Click here to view the Original article by Dr. Langenskiöld et al.
Assessment of glucosinolate‐derived isothiocyanates as potential natural antifungal compounds against citrus sour rot disease agent Geotrichum citri‐aurantii
Authors: Kara Merve , Soylu Emine Mine
Published: April 2020

In this study, the antifungal effects of six different isothiocyanate (ITCs) compounds (methyl, allyl, butyl, ethyl, benzyl and 2‐phenylethyl ITCs) were investigated to be use against the citrus sour rot disease caused by Geotrichum citri‐aurantii in vitro and semi‐commercial (in vivo) conditions. Antifungal activities of the vapour phases of different ITC compounds were examined on the arthroconidia germination and mycelial growth of G. citri‐aurantii. Mycelial growth of G. citri‐aurantii was inhibited in a concentration‐dependent way. The minimum inhibitory concentrations of benzyl, methyl, allyl and ethyl ITCs on mycelial growth were 0.06, 0.08, 0.10 and 0.10 µl/L, respectively. Arthroconidia germination of G. citri‐aurantii was completely inhibited by benzyl, methyl, allyl and ethyl ITCs at concentrations of 0.05, 0.07, 0.07 and 0.07 µl/L, respectively. Light microscopy observations revealed that the ITC compounds, at completely inhibiting concentrations, caused considerable morphological changes in the fungal hyphae. Under in vivo conditions, the average rotting area caused by G. citri‐arantii was inhibited 100% by ethyl, methyl and allyl ITC compounds at concentrations of 8.0, 12.0 and 12.0 µl/L, respectively. Results suggest that ITC’s may be useful and effective natural antifungal compounds to control the citrus sour rot disease agent.
The effect of health-related information seeking and financial strain on medication nonadherence among patients with diabetes and/or hypertension in central Texas
Authors: Appiah Bernard , Burdine James N , Cummings Shelby , Poudyal Anubhuti , Hutchison Robert W , Forjuoh Samuel N , McLeroy Kenneth R
Published: April 2020

Objective

To assess self-reported financial strain and persistence in asking treatment- and medication-related questions in relation to medication nonadherence.

Method

Data were analysed from a cross-sectional study of adults with diabetes, hypertension or both in central Texas in 2013. Measures of medication nonadherence in the past 12 months, financial strain and patients' persistence in asking treatment- and medication-related questions were identified. Medication nonadherence resulting from cost, transportation or work was compared with medication nonadherence resulting from other reasons. Binary and multinomial regression models were fitted to identify factors associated with medication nonadherence among the respondents.

Key findings

In the bivariate model, medication nonadherence from any cause was significantly associated with financial strain, not asking questions about treatments or medications, and all demographic characteristics. However, in the multinomial model, medication nonadherence resulting from cost, work or transportation was only associated with not asking medication-related question about financial strain, lack of health insurance, age and gender. This was true for nonadherence resulting from other reasons except that ethnicity was significant while gender was not.

Conclusions

While removing financial strain could aid medication adherence, clinicians should also encourage patients to be persistent in asking questions about their medications until they understand the purpose for taking them. Our findings have implications for empowering patients to be more proactive in enhancing their adherence to medications.
Antisocial Behavior in Soccer Players: Using an Integrated Mediation Model of Personal Control and Social Learning Theory
Authors: Kabiri Saeed , Shadmanfaat Seyyedeh Masoomeh (Shamila) , Smith Hayden , Choi Jaeyong
Published: April 2020

Objective

We aim to explore antisocial behavior in sports using an integrated criminological framework that includes self‐control theory, control balance theory, and social learning theory.

Methods

A total of three‐hundred and ninety‐seven (n = 397) professional soccer players in Iran were surveyed.

Results

Structural equation modeling was used to assess these data, with results indicating that antisocial behavior occurs via a process of learning. The concepts of differential associations, differential reinforcement, imitation, and definitions all emerged as important factors in the development of antisocial behaviors.

Conclusion

While prosocial behaviors represent a basic requirement of sports, the presence was antisocial behaviors remains prevalent. The employment of integrated criminological theory can serve as an effective means to measure and explain antisocial behavior using a sample of Iranian soccer players. This study indicates that antisocial behaviors are learned through social interactions and therefore policy remedies must focus on the social dynamics that drive these negative behaviors.
Detection of novel and confirmation of very rare and rare HLA alleles by next generation sequencing in Croatia
Authors: Burek Kamenaric Marija , Maskalan Marija , Grubic Zorana , Stingl Jankovic Katarina , Zunec Renata
Published: April 2020

Routine HLA typing in clinical practice encompassing solid organ and hematopoietic stem cells transplantation programs, disease association typing, volunteer marrow donor typing and population studies, provided a large dataset for studying HLA allele polymorphism in the Croatian population which led to the identification of new, very rare and rare HLA alleles. Over the last 4 years we have identified six new HLA alleles (HLA‐A*01:200, A*02:836, A*11:01:01:44, B*08:251, B*18:169 and C*05:46:01:02) and a number of very rare (HLA‐B*08:78, DRB1*12:39, DRB1*13:23:02 and DQB1*06:09:04) or rare (HLA‐A*24:41, B*39:40:01N, B*51:78:01, DRB1*01:31 and DRB1*14:111) alleles using sequence‐based typing methods. The reported data enhance the knowledge about HLA polymorphisms in the Croatian population and provide a foundation for further studies in population genetics.
Novel HLA‐DPB1*10:01:05 allele, identified by next‐generation sequencing in a Saudi individual
Authors: Jawdat Dunia , Fakhoury Hana A. , Cereb Nezih , Alaskar Ahmed S. , Hajeer Ali H.
Published: April 2020

HLA‐DPB1*10:01:05 differs from HLA‐DPB1*10:01:01:01 by a single synonymous nucleotide substitution in exon 2, 38 G>A.
Case report: A kidney transplant patient with mild COVID‐19
Authors: Arpali Emre , Akyollu Basak , Yelken Berna , Tekin Suda , Turkmen Aydin , Kocak Burak
Published: April 2020

Coronavirus Disease 2019 (COVID‐19) is currently a pandemic with a mortality rate of 1%‐6% in the general population. However, the mortality rate seems to be significantly higher in elderly patients, especially those hospitalized with comorbidities, such as hypertension, diabetes, or coronary artery diseases. Because viral diseases may have atypical presentations in immunosuppressed patients, the course of the disease in the transplant patient population is unknown. Hence, the management of these patients with COVID‐19 is an area of interest, and a unique approach is warranted. Here, we report the clinical features and our treatment approach for a kidney transplant patient with a diagnosis of COVID‐19. We believe that screening protocols for SARS‐Cov‐2 should be re‐evaluated in patients with solid‐organ transplants.
Assessment of COVID‐19 exposure risk in the blood transfusion laboratory
Authors: Nadarajan Veera Sekaran , Lee Christina Lai Ling , Ponnampalavanar Sasheela Sri La Sri
Published: April 2020

Healthcare workers run the risk of contracting COVID‐19 during the course of their work if required precautions and usage of appropriate personal protective equipment is not adhered to. In the transfusion testing laboratory, indirect exposure to COVID‐19 may result from environmental contamination that may occur through surface contact or be airborne. Handling of potentially contaminated surfaces, such as sample tubes and sample packaging, and subsequent self‐inoculation through the mucous membranes of mouth, nose and eyes may occur. Information on the risk of indirect contact transmission of COVID‐19 from such surfaces is limited. When risk assessments are conducted in the laboratory, assumptions often need to be based on studies derived from other coronaviruses and respiratory viruses such as HCoV‐229E, SARS‐CoV, MERS‐CoV and Influenza. The other mode of potential indirect transmission is through aerosols generated from certain laboratory processes. The risk of inhaling aerosolized blood containing COVID‐19 viral RNA is unresolved. Laboratories need to perform risk assessment of their activities before appropriate decisions can be made with regards to COVID‐19 exposure risk reduction or elimination.
Motohashi’s fourth moment identity for non-archimedean test functions and applications
Authors: Blomer Valentin , Humphries Peter , Khan Rizwanur , Milinovich Micah B.
Published: April 2020

Motohashi established an explicit identity between the fourth moment of the Riemann zeta function weighted by some test function and a spectral cubic moment of automorphic $L$-functions. By an entirely different method, we prove a generalization of this formula to a fourth moment of Dirichlet $L$-functions modulo $q$ weighted by a non-archimedean test function. This establishes a new reciprocity formula. As an application, we obtain sharp upper bounds for the fourth moment twisted by the square of a Dirichlet polynomial of length $q^{1/4}$. An auxiliary result of independent interest is a sharp upper bound for a certain sixth moment for automorphic $L$-functions, which we also use to improve the best known subconvexity bounds for automorphic $L$-functions in the level aspect.
Reproducing ear-canal reflectance using two measurement techniques in adult ears
Authors: Nørgaard Kren Monrad , Fernandez-Grande Efren , Schmuck Constanze , Laugesen Søren
Published: April 2020

Clinical diagnostic applications of ear-canal reflectance have been researched extensively in the literature, however, the measurement uncertainty associated with the conventional measurement technique using an insert ear probe is unknown in human ear canals. Ear-canal reflectance measured using an ear probe is affected by multiple sources of error, including incorrect estimates of the ear-canal cross-sectional area and oblique ear-probe insertions. In this paper, ear-canal reflectance measurements are reproduced in an occluded-ear simulator and in 54 adult ear canals using two different measurement techniques: a conventional ear probe and a two-microphone probe that enables the separation of reverse- and forward-propagating plane waves. The two-microphone probe is inserted directly into test subjects' ear canals, and the two-microphone method is distinguished by not requiring the ear-canal cross-sectional area to calculate the ear-canal reflectance. The results show a reasonable agreement between the two measurement techniques. The paper further examines the influence of oblique ear-probe insertions and the compensation for such oblique insertions, which results in an improved agreement between the two measurement techniques.
Cytokine release syndrome in severe COVID-19
Authors: Moore John B. , June Carl H.
Published: April 2020

Lessons from arthritis and cell therapy in cancer patients point to therapy for severe disease
Epidemiological Study on Prevalence, Serovar Diversity, Multidrug Resistance, and CTX-M-Type Extended-Spectrum β-Lactamases of
Salmonella
spp. from Patients with Diarrhea, Food of Animal Origin, and Pets in Several Provinces of China
Authors: Wang Wei , Zhao Li , Hu Yujie , Dottorini Tania , Fanning Séamus , Xu Jin , Li Fengqin
Published: April 2020

A total of 2,283
Salmonella
isolates were recovered from 18,334 samples, including samples from patients with diarrhea, food of animal origin, and pets, across 5 provinces of China. The highest prevalence of
Salmonella
spp. was detected in chicken meats (39.3%, 486/1,237). Fifteen serogroups and 66 serovars were identified, with
Salmonella enterica
serovars Typhimurium and Enteritidis being the most dominant. Most (85.5%, 1,952/2,283) isolates exhibited resistance to ≥1 antimicrobial, and 56.
Rates of knee arthroplasty in patients with a history of arthroscopic chondroplasty: results from a retrospective cohort study utilising the National Hospital Episode Statistics for England
Authors: Abram Simon G F , Palmer Antony J R , Judge Andrew , Beard David J , Price Andrew J
Published: April 2020

Objective

The purpose of this study was to analyse the rate of knee arthroplasty in the population of patients with a history of arthroscopic chondroplasty of the knee, in England, over 10 years, with comparison to general population data for patients without a history of chondroplasty.

Design

Retrospective cohort study.

Setting

English Hospital Episode Statistics (HES) data.

Participants and interventions

Patients undergoing arthroscopic chondroplasty in England between 2007/2008 and 2016/2017 were identified. Patients undergoing previous arthroscopic knee surgery or simultaneous cruciate ligament reconstruction or microfracture in the same knee were excluded.

Outcomes

Patients subsequently undergoing a knee arthroplasty in the same knee were identified and mortality-adjusted survival analysis was performed (survival without undergoing knee arthroplasty). A Cox proportional hazards model was used to identify factors associated with knee arthroplasty. Relative risk of knee arthroplasty (total or partial) in comparison to the general population was determined.

Results

Through 2007 to 2017, 157 730 eligible chondroplasty patients were identified. Within 1 year, 5.91% (7984/135 197; 95% CI 5.78 to 6.03) underwent knee arthroplasty and 14.22% (8145/57 267; 95% CI 13.94 to 14.51) within 5 years. Patients aged over 30 years with a history of chondroplasty were 17.32 times (risk ratio; 95% CI 16.81 to 17.84) more likely to undergo arthroplasty than the general population without a history of chondroplasty.

Conclusions

Patients with cartilage lesions of the knee, treated with arthroscopic chondroplasty, are at greater risk of subsequent knee arthroplasty than the general population and for a proportion of patients, there is insufficient benefit to prevent the need for knee arthroplasty within 1 to 5 years. These important new data will inform patients of the anticipated outcomes following this procedure. The risk in comparison to non-operative treatment remains unknown and there is an urgent need for a randomised clinical trial in this population.
Prevalence and determinants of anaemia in children aged6–59months in Africa: a protocol for systematic review and meta-analysis
Authors: Simo Larissa Pone , Agbor Valirie Ndip , AgborNdip Ettamba , Ekaney Domin Sone M , Mbeng Emmanuel Njang , Etombi Christie Linonge , Neba Kilton Nforchu , Kemah Ben-Lawrence Ayong , Mbanya Dora
Published: April 2020

Introduction

Anaemia, especially in children aged <5 years, is a global health problem disproportionately affecting populations in low-income and middle-income countries. It is associated with high disability and death rates and has a negative effect on development. This study seeks to evaluate the prevalence and determinants of anaemia in children aged 6–59 months residing in Africa.

Methods and analysis

This protocol was prepared using the 2015 Preferred Reporting Items for Systematic Reviews and Meta-analyses for Protocols guidelines. Relevant citations will be identified by searching EMBASE, Web of Science, PubMed, Global Medicus Index and African Journals Online from inception to 30 September 2019 with no language restrictions. Two authors will independently screen and select eligible studies for the review. Random-effect meta-analytic methods will be used to pool study-specific estimates and heterogeneity will be assessed and quantified using the χ2test on Cochrane’s Q and I2statistics, respectively. Publication bias will be evaluated using funnel plots and Egger’s test. Subgroup analysis and multiple meta-regression using backward elimination will be performed to investigate sources of substantial heterogeneity.

Ethics and dissemination

No ethical approval is required for this study as it is based on already published data. The findings of the review will be published in a peer-reviewed journal and presented at conferences.
eClinic: increasing use of telehealth as a risk reduction strategy during the covid-19 pandemic
Authors: Kemp Michael T , Williams Aaron M , Alam Hasan B
Published: April 2020

Prior to the covid-19 pandemic, telehealth was already being rapidly adopted nationally by healthcare systems. During the covid-19 pandemic, increased use of telehealth may be considered as a risk reduction strategy. Benefits of this strategy may be conferred to both patients and health providers.
Training in motivational interviewing improves cattle veterinarians’ communication skills for herd health management
Authors: Svensson Catarina , Wickström Hans , Emanuelson Ulf , Bard Alison M , Reyher Kristen K , Forsberg Lars
Published: April 2020

Background

Communication skills to promote changes in management routines are especially important in veterinary herd health management (VHHM). Motivational interviewing (MI) is a communication methodology shown to be effective in stimulating client behaviour change. This study aimed to evaluate a 6‐month MI‐training programme for veterinarians.

Methods

Thirty‐eight cattle veterinarians gathered in groups of four to eight at six workshops separated by 3–4 weeks, during which they read literature and practised their skills. MI skills were evaluated before and after training using audio recordings of role‐play conversations with professional actors. Recordings were coded using the MI Treatment Integrity Code (MITI) V.4.2.1. The effect of training was evaluated by 16 regression models. Participants filled in questionnaires about their experiences.

Results

All participants improved their MI skills after training in at least one parameter and significant improvements were found in all but 3 of the 16 statistically evaluated MITI variables. The mean (25th–75th percentiles) ratings of the veterinarians’ perceived relevance of MI skills in their work was 4.9 (4.0–6.0) and of their satisfaction with the programme was 5.1 (5.0–6.0) on a 6‐point Likert scale.

Conclusions

Results show that MI training was perceived to be useful and relevant and successfully improved veterinarians’ communication skills in VHHM.
Estimation of the prevalence of idiopathic epilepsy and structural epilepsy in a general population of 900 dogs undergoing MRI for epileptic seizures
Authors: Hall Rachel , Labruyere Julien , Volk Holger , Cardy Thomas James
Published: April 2020

Due to variation in study designs the prevalence of idiopathic epilepsy (IE) and structural epilepsy (SE) in dogs is largely unknown. The objective was to provide estimates of the prevalence of IE and SE in a large population of dogs undergoing MRI for epileptic seizures. A retrospective study on 900 dogs undergoing MRI for seizures was performed. MRI scans, summary clinical history and neurological examination from the VetCT database were reviewed and a diagnosis assigned by board‐certified radiologists. Structural lesions were identified as a cause of seizures in 45.1 per cent (n=406) of cases. No structural lesions were identified in 54.9 per cent (n=494) of cases with presumed IE diagnosed in 53.8 per cent (n=484) of dogs. Dogs between six months and six years were more often associated with IE (P<0.001), small breeds were overrepresented with suspected inflammatory brain disease (P=0.001) and large entire dogs more often diagnosed with extra‐axial neoplasms (P=0.001). Over 31.0 per cent of dogs with suspected IE were six years or older. This study is the largest of its kind in dogs and provides accurate estimates of underlying causes of epilepsy. MRI findings should be considered in the context of a detailed clinical history and neurological examination.
Paralytic shellfish poisoning and palytoxin poisoning in dogs
Authors: Bates Nicola , Morrison Cassandra , Flaig Leah , Turner Andrew D
Published: April 2020

Background

Fatal cases of exposure to paralytic shellfish toxins and palytoxins have occurred in companion animals but are poorly described.

Methods

We describe one case of paralytic shellfish poisoning (PSP) and three cases of palytoxin poisoning in dogs.

Results

Mild PSP occurred following ingestion of crab while walking on a beach. Analysis confirmed the presence of paralytic shellfish toxins, particularly decarbamoyl saxitoxin, in clinical samples and marine organisms. This case occurred shortly after an outbreak of PSP in dogs on the eastern coast of England. Palytoxin poisoning occurred in a dog after it chewed coral removed from an aquarium. Signs included collapse, hypothermia, bloody diarrhoea and respiratory distress. The dog was euthanised due to rapid deterioration and poor prognosis. Palytoxin was not detected in a premortem blood sample. Two other dogs in a separate incident developed only mild signs (fever and respiratory distress) after suspected exposure to aerosolised palytoxin and recovered within a few hours.

Conclusion

Cases of PSP are episodic and not common in dogs. Cases of palytoxin exposure are reportedly increasing in humans, and there is presumably also an increased risk to pets. There is no specific treatment for PSP or palytoxin poisoning.
How do veterinary students engage when reflecting on their development towards being veterinary surgeons?
Authors: Armitage‐Chan Elizabeth , Reissner Stefanie
Published: April 2020

Background

Reflection has been widely acknowledged to contribute to professional development, the ability to manage tension and enhanced resilience. However, many practitioners struggle to reflect productively due to a lack of clarity of what constitutes effective reflection.

Methods

To help develop reflective competence among future professionals, 30 veterinary students’ reflective assignments were analysed by thematic text analysis. Theoretical frameworks were based on published criteria for critical and core reflection.

Results

Reflection was described through resources (the tools used), practices (the ways of using these tools) and outcomes (what was achieved). This helped to distinguish simple skills based reflection from higher‐level core reflection. Simple skills‐based reflection was associated with an identity of expert learner: students perceive that their task is to identify a knowledge deficit that can be easily rectified through new learning. Core reflection was associated with students articulating an identity of adaptable professionals: rather than veterinary challenges being resolved simply through application of a body of knowledge, wider complexities of professional practice are recognised, including a need to resolve tension between their own and other stakeholders’ priorities, values and beliefs.

Conclusion

Scaffolding an iterative, cyclical reflection process may support outcomes oriented towards resilience and the management of tension.
Michael Henry Woodford
Authors: Kock Richard , Karesh William B. , Chardonnet Philippe
Published: April 2020

After working in rural practice in Dorset, he spent much of his career abroad, becoming a figurehead for a substantial community of wildlife vets.
A SIMPLE review
Authors: Felizardo M.
Published: April 2020

The Superheated Instrument for Massive ParticLe searches (SIMPLE) consists of an astroparticle dark matter search experiment with large active mass superheated droplet detectors (SDDs), that are installed at the underground low noise laboratory in France (LSBB). Several factors made the use of SDDs an attractive approach for the detection of weakly interacting massive particles (WIMPs), namely their intrinsic insensitivity to minimally ionizing particles, high fluorine content, low cost and operation at near ambient pressure and temperature. The signal that arises from the droplet phase transition generates a millimetric-sized gas bubble that is recorded by acoustic means. I describe the SIMPLE detectors, their acoustic instrumentation and signal analysis, which generated several science measurements executed through several phases over the last 20 years: the Pilot Phase with an exposure of 0.19 kgd, Phase I with an exposure of 0.42 kgd, Phase II with an exposure of 18.24 kgd and, an intended Phase III with an expected exposure increasing from 100 to 2500 kgd to be executed with a bubble chamber.
Geometrical particles and Legendrian dualities related to null curves
Authors: Wang Chunxiao , Zhou Qingxin , Wang Zhigang
Published: April 2020

In this paper, we investigate the special properties of geometrical particles with null paths in de Sitter 3-space–time, new Frenet equations and an important invariant associated with null paths are presented. By means of unfolding theory, the local topological structure of the lightlike dual surfaces is revealed. It is found that the lightlike dual surface has some singularities whose types can be determined by the invariant. Based on the theory of Legendrian dualities on pseudospheres and the theory of contact manifolds, it is shown that there exists the [Formula: see text]-dual relationship between the lightlike transversal trajectory of the particle and the lightlike dual surface. In addition, an interesting and important fact mentioned is that the contact of lightlike transversal trajectory with lightcone quadric and the contact of lightlike transversal trajectory with null hyperplane have the same order when they are related to the same type of singularities of the lightlike dual surface.
Structural Design for Vibration Distribution: Limit of Performance
Authors: Wang Jiqiang
Published: April 2020

The vibration distribution across a structure at different nodes represents an emerging and challenging problem to be addressed. Conventional optimization-based approaches can be utilized, yet they are relatively difficult to handle the issue of performance limit or to evaluate the influence of constraints on the best achievable performance, particularly over discrete frequencies. A new approach is proposed in this paper, which possesses a distinctive visibility feature towards issues such as solution existence, uniqueness, optimality, and limit of performance. A number of results are obtained to illustrate treatment on these fundamental issues. The important problem of design constraints arising from realization of physical parameters is also addressed. A geometric design framework is thus established that does not require any iterative procedures to approaching the performance limit. These claims have been illustrated and validated through the numerical examples and simulations.
India’s Capital Cusp in US–China Tensions
Authors: PANDA JAGANNATH P. , SARKAR MRITTIKA GUHA
Published: April 2020

The intensifying trade war between the United States and China has been the focal point of geoeconomics as well as geopolitics, in the purview of the current times. Trump’s unilateral trade tariffs imposed on China and the latter’s retaliation with further duties against the United States has jostled the global trade chains, which has had repercussions beyond the two largest economies. Furthermore, while the G20 summit in Osaka witnessed the US and China returning to the negotiating table to end the tariffs and the Phase One deal between both the countries provided some amnesty, the tensions are much deeper rooted and are far from being resolved. However, as the implications of the trade war move beyond the stratagem of the US–China tug-of-war, many countries like India maneuver through the tussle to find a delicate equilibrium between national interests and global power politics. In this regard, this paper tends to analyze India’s perspective towards the trade war, arguing that New Delhi is taking a non-confrontational, measured approach to surpass the fluid international affairs; in a way that is letting New Delhi shape its decisions on the basis of its national interests and concerns, rather than taking sides.
Self-Immolation in Early Indian Buddhism
Authors: KIM HAN-SANG
Published: April 2020

Self-immolation refers to ascetic Buddhist practices that include the voluntary termination of one’s life or the offering of parts of one’s body usually by setting oneself ablaze. In both the Northern (Mahāyāna) and Southern (Theravāda) Buddhist traditions, self-immolation has been considered a heroic bodhisattva act to end one’s life with a spiritual motivation and strong sense of determination. In modern times, self-immolation is often used as an extreme form of protest or an act of martyrdom. In early Indian Buddhism, self-immolation was not justifiable for the following reasons: First, self-immolation cuts short one’s opportunity to attain liberation before having made proper use of one’s life to its fullest potential. Second, self-immolation is a form of self-modification or severe asceticism because it causes extreme physical pain and may lead to death. Third, self-immolation is an act motivated by a craving for non-existence (vibhava-taṇhā) and is rooted in the “personality-view” (sakkāya-diṭṭhi) or “ego-view” (atta-diṭṭhi). Lastly, self-immolation goes against the concept of “self-love” (attā-piya) or “self-affection” (atta-kāma), which is considered a necessary prerequisite for expressing “loving-kindness” (mettā) toward other beings. Thus, I can safely say that self-immolation is not in keeping with the original teachings of the Buddha and that self-immolation cannot in any way be recognized as heroic or noble.
Review—Corrosion-Resistant Metastable Al Alloys: An Overview of Corrosion Mechanisms
Authors: Esquivel J. , Gupta R. K.
Published: April 2020

Commercial aluminum alloys exhibit localized corrosion when exposed to environments containing aggressive anions. Alloying of Al with specific elements (M: Cr, Mo, V, Nb, etc) using non-equilibrium processing techniques has been reported to result in significantly improved corrosion resistance due to the formation of a supersaturated solid solution and uniform distribution of M in the matrix. Several theories describing the corrosion behavior of Al–M alloys have been postulated. This paper presents an overview of the most common non-equilibrium alloying techniques implemented for the production of the metastable Al–M alloys and posited corrosion mechanisms for the improved corrosion resistance.
Accounting for Non-Ideal, Lithiation-Based Active Material Volume Change in Mechano-Electrochemical Pouch Cell Simulation
Authors: Pereira Drew J. , Fernandez Miguel A. , Streng Kathryn C. , Hou Xu Xian , Gao Xiujie , Weidner John W. , Garrick Taylor R.
Published: April 2020

Automotive battery manufacturers are working to improve individual cell and overall pack design by increasing their safety, performance, durability, and range, while reducing cost; and active material volume change is one of the more complex aspects that needs to be considered during this process. In the study shown here, thermodynamically non-ideal, lithiation-based volume change behavior for the anode and cathode active materials were incorporated into a previously developed mechano-electrochemical model. The changing thickness of an automotive-relevant, large-format pouch cell was predicted while simulating cell discharge. Measurements were taken using an experimental setup capable of simultaneous mechanical and electrochemical operation and observation. The electrochemical and mechanical measurements prove to agree well with simulation when using non-ideal lithiation-based volume change as opposed to the previously assumed ideal volume change behavior. The resulting model was used to simulate other mechano-electrochemical phenomena including the effects of anode/cathode capacity ratio and changing pressure/porosity during cell discharge. This mechano-electrochemical model shows promise to help define operational parameters to mitigate negative effects from active material volume change and may act as a tool for developers reduce the extensive electrochemical and mechanical testing required for the design of promising new batteries.
The Difference in Repeatability of Automated Superficial Retinal Vessel Density according to the Measurement Area Using OCT Angiography
Authors: Lim Hyung Bin , Kang Tae Seen , Won Yeo Kyoung , Kim Jung Yeul
Published: April 2020

Purpose. To evaluate the difference in the repeatability of automated superficial retinal vessel density and foveal avascular zone (FAZ) metrics according to the measurement area of optical coherence tomography angiography (OCTA). Methods. A total of 127 normal eyes from 127 healthy subjects were included. Macular angiography images were acquired from all subjects using the Zeiss Cirrus 5000 with AngioPlex™ OCTA software. Scans of 3 × 3 mm and 6 × 6 mm were each performed twice in a randomly arranged sequence. Vessel density (VD), perfusion density (PD), and FAZ metrics of the superficial capillary plexus were calculated automatically for all scans, and the repeatabilities for both scan patterns were assessed based on intraclass correlation (ICC), coefficient of variation (CV), and coefficient of repeatability (CR) parameters. The average measured values in the two scan patterns were also compared. Results. VD was significantly greater in the 3 × 3 mm scan than in the 6 × 6 mm scan according to all parameters, whereas PD was significantly less in the 3 × 3 mm scan than in the 6 × 6 mm scan. The ICCs for VDs in the central fovea were 0.826 and 0.741 for the 3 × 3 and 6 × 6 mm scans, respectively, and the CVs were 8.00% and 12.75%. For PDs, the ICCs were 0.839 and 0.762 and the CVs were 9.32% and 14.90%. The FAZ metrics in the 3 × 3 mm scan showed good repeatability with an ICC >0.75 and a CV <10.0%. However, all ICCs for the 6 × 6 mm scans were <0.75, and the CVs were all >10%. Conclusions. The 6 × 6 mm macular angiography scans resulted in lower repeatabilities than the 3 × 3 mm scans according to all OCTA parameters, particularly in the central fovea and FAZ metrics. The 3 × 3 mm scan was more suitable than the 6 × 6 mm scan for analyzing macular microvascular density and FAZ metrics.
Procedure of Direct Hepatic Artery Puncture for the Treatment of Hepatocellular Carcinoma: Two Case Reports
Authors: Takashima Hidetaka , Moriguchi Michihisa , Yasui Kohichiroh , Hayashi Natsuko , Ikeda Kyohei , Ogiso Kiyoshi , Yokomizo Chihiro , Uejima Hirokazu , Tomioka Hideo , Itoh Tadashi , Mizuno Shigeto , Shimizu Seiji , Itoh Yoshito
Published: April 2020

Recently, treatment options for hepatocellular carcinoma (HCC) have expanded due to the development of the tyrosine kinase inhibitor ramucirumab and immune checkpoint inhibitors. Transcatheter arterial chemoembolization is the standard therapy for intermediate-stage HCC; however, in cases with anatomical problems, normal approaches are not possible. In such rare cases, direct hepatic puncture may be considered as an effective therapy and an indispensable treatment. We report our novel method of direct hepatic artery puncture in this case report. In 2011 and 2017, we reported 2 cases in the journal of the Japan Society of Hepatology in Japanese. This therapy is difficult and is associated with a high risk of complications; however, we succeeded in both cases in a similar way. We believe this method may provide an alternative treatment when standard treatment is not possible or when urgent therapy is required. In case 1, direct hepatic artery puncture was performed under ultrasonographic guidance, and we were able to control the disease with percutaneous lipiodol chemotherapy. Case 2 was an emergency case of ruptured HCC. Direct hepatic puncture successfully stopped tumor bleeding; furthermore, tumor necrosis also occurred, as seen on the enhanced computed tomography image. Our new method requires advanced puncture techniques and is not the treatment of choice if there are other safe alternatives available. However, it can be considered as an option if there are no other viable, effective treatments.
Ferrous Sulfate-Induced Esophageal Injury Leading to Esophagitis Dissecans Superficialis
Authors: Nasir Umair M. , Rodgers Brandon , Panchal Dayna , Choi Catherine , Ahmed Shahida , Ahlawat Sushil
Published: April 2020

Medication-induced esophagitis is a well-known but relatively rare clinical diagnosis, most common in patients with preexisting esophageal dysmotility, obstruction, or altered anatomy. Esophagitis dissecans superficialis (EDS) is a rare endoscopic finding characterized by sloughing of large fragments of the esophageal mucosal lining. The causes of EDS include prior trauma, heavy smoking history, ingestion of alcoholic and hot beverages, and immunosuppression. We present a unique case of EDS secondary to ferrous sulfate-induced pill esophagitis. The patient was a 94-year-old male who presented with dysphagia to solids, odynophagia, and weight loss. Esophagogastroduodenoscopy (EGD) revealed EDS. Biopsies demonstrated vacuolar degeneration at the midlevel of the epithelium with overlying hyperkeratosis and parakeratosis, with noted black/brown pigment present at the level of the split in the epithelium. The patient was started on a liquid diet with no oral administration of pills. EGD was repeated and showed a significant improvement in esophageal mucosa and resolution of strictures. Although medication-induced esophagitis is not classically associated with EDS, specific circumstances that are associated with pill esophagitis may lead to progression to EDS. In the case of our patient, prolonged contact of ferrous sulfate to the esophageal mucosa is thought be a result of an enlarged left atrium and pulmonary arteries secondary to longstanding coronary artery disease and an enlarged left bronchus secondary to chronic obstructive pulmonary disease and right pneumonectomy. These anatomical changes likely led to an extended duration of contact and are believed to have led to erosion of the superficial esophageal mucosa, eventually progressing to EDS.
Adrenal Gland and Gastric Malignant Melanoma without Evidence of Skin Lesion Treated with the Oncolytic Virus Rigvir
Authors: Proboka Guna , Tilgase Andra , Isajevs Sergejs , Zablocka Tatjana , Olmane Evija , Rasa Agnija , Alberts Pēteris
Published: April 2020

Adrenal gland melanoma is an extremely rare diagnosis with less than 20 cases reported. The criteria for diagnosing adrenal gland melanoma include involvement of only one adrenal gland, presence of melanin pigment in the histological examination of the tumor tissue, no primary melanoma tumor in any other organ, and no history of resection of pigmented lesions. However, it is complicated to rule out melanoma of unknown primary origin. Here we report a female patient who at the age of 75 years was admitted to hospital due to suspicion of adrenal and gastric tumor. The largest tumor was found in the adrenal gland, thus leading to the diagnosis of primary adrenal gland melanoma presenting metastases in the stomach. The melanoma was BRAF wild type. Due to the rarity of this disease, there is no standard treatment. After two subsequent surgeries, treatment with the ECHO-7 oncolytic virus Rigvir was started. The patient has received oncolytic virotherapy for 5 years and 1 month and has been stable since then with good tolerability. The therapy is still ongoing. Adrenal gland melanoma is an extremely rare diagnosis and therefore it is important to discuss the diagnostic criteria and possible treatments.
Utility of the Absolute Lymphocyte Count and Neutrophil/Lymphocyte Ratio for Predicting Survival in Patients with Metastatic Breast Cancer on Eribulin: A Real-World Observational Study
Authors: Ueno Ayako , Maeda Reina , Kin Takanori , Ito Mitsuya , Kawasaki Kensuke , Ohtani Shoichiro
Published: April 2020

Introduction: Previous studies have suggested that the efficacy of eribulin is influenced by the activity of antitumor immunity of patients. Absolute lymphocyte count (ALC) and the neutrophil/lymphocyte ratio (NLR) are easily available parameters associated with the immunological status of patients. Objective: Here we tried to classify patients’ immunological status by using the scatter plot of ALC and NLR, and investigated its utility for predicting survival among patients with metastatic breast cancer receiving eribulin. Methods: The medical records of 125 patients who received eribulin for metastatic breast cancer at our hospital between July 2011 and April 2019 were retrospectively reviewed. Uni- and multivariate analyses were performed to determine the association between baseline ALC/NLR and progression-free survival (PFS)/overall survival (OS). The cutoff values for ALC and NLR were determined using scatter plot analysis. Results: The entire cohort was classified into immunologically favorable (ALC ≥1,500/µL, 30 patients), intermediate (ALC <1,500/µL, NLR <5.0, 76 patients), and unfavorable (NLR ≥5.0, 19 patients) groups. Univariate analysis showed significant differences in PFS and OS between the groups, whereas multivariate analysis revealed that ALC ≥1,500/µL and NLR ≥5.0 were independent predictors of PFS, with adjusted hazard ratios (95% CI) of 0.57 (0.33–0.99) and 1.78 (1.00–3.15), respectively. NLR ≥5.0 was also associated with worse OS (adjusted hazard ratio: 0.55; 95% CI 0.35–0.88; p = 0.013). Conclusions: Among patients with metastatic breast cancer receiving eribulin, survival outcomes were well stratified according to baseline peripheral blood ALC and NLR. Accordingly, high ALC and NLR can be used as predictive markers for longer disease control and worse survival, respectively.