bluuebunny/crossref_metadata_2025 huggingface dataset:
Telomere Length and Arsenic: Improving Animal Models of Toxicity by Choosing Mice With Shorter Telomeres
Authors: Whitlock Brayden
Published: May 2021

Arsenic is both a chemotherapeutic drug and an environmental toxicant that affects hundreds of millions of people each year. Arsenic exposure in drinking water has been called the worst poisoning in human history. How arsenic is handled in the body is frequently studied using rodent models to investigate how arsenic both causes and treats disease. These models, used in a variety of arsenic-related testing, from tumor formation to drug toxicity monitoring, have virtually always been developed from animals with telomeres that are unnaturally long, likely because of accidental artificial selective pressures. Mice that have been bred in captivity in laboratory conditions, often for over 100 years, are the standard in creating animal models for this research. Using these mice introduces challenges to any work that can be affected by the length of telomeres and the related capacities for tissue repair and cancer resistance. However, arsenic research is particularly susceptible to the misuse of such animal models due to the multiple and various interactions between arsenic and telomeres. Researchers in the field commonly find mouse models and humans behaving very differently upon exposure to acute and chronic arsenic, including drug therapies which seem safe in mice but are toxic in humans. Here, some complexities and apparent contradictions of the arsenic carcinogenicity and toxicity research are reconciled by an explanatory model that involves telomere length explained by the evolutionary pressures in laboratory mice. A low-risk hypothesis is proposed which has the power to determine whether researchers can easily develop more powerful and accurate mouse models by simply avoiding mouse lineages that are very old and have strangely long telomeres. Swapping in newer mouse lineages for the older, long-telomere mice may vastly improve our ability to research arsenic toxicity with virtually no increase in cost or difficulty of research.
Controversies as method for ANTi-history: An inquiry into public administration practices
Authors: Tureta César , Américo Bruno Luiz , Clegg Stewart
Published: May 2021

Drawing on Actor-Network Theory and the cartography of controversies, we present a method for ANTi-History research to investigate the implementation of a contract between a labour services company and a public university hospital in Brazil. The research question focuses on how the past is enacted in the present. The method is a general guideline based on five focal points used to organize the fieldwork: identifying controversies; mapping the actor-network; drawing out the translation process; politics of actor-networks and multiple reality/power relations. The proposed method makes two contributions to ANTi-History literature. First, although these focal points have been discussed by ANTi-History scholars, they are scattered throughout the literature. We unite them to offer a guide to doing historically embedded research. Second, we show how controversy analysis can be helpful for mapping the politics of actor-networks and describing multiple realities in the construction of history.
From the tool to the spatial metaphor: Graphical user interface and audiovisual creation in new media
Authors: García-Crespo Oswaldo , Ramahí-García Diana , García-Mirón Silvia
Published: May 2021

This article is set within a technological paradigm shift that denotes a transition from hardware to software and that, by means of applications and operating systems, plays a central role in the sociocultural sphere, intervening in the creation, classification and distribution of cultural objects. The aim of this research is to delve into how the graphical user interface (GUI) integrates into contemporary audiovisual discourse, focusing on its potential as a spatial metaphor. To that end, a theoretical framework is built on the concept of space as a tool and its instrumentalization in the GUI throughout the years, with a view to design a taxonomy in relation to the different ways in which the GUI integrates into digital image composition. The article concludes that the ability to operate in the virtual and physical space, moving between the logic of the tool and its potential as spatial metaphor, provides the GUI with the necessary specificity to be considered a key cultural element for analysing new media’s visual identity.
Parental relationship status and age at autism spectrum disorder diagnosis of their child
Authors: Kalb Luther G , Holingue Calliope , Pfeiffer Danika , Reetzke Rachel , Dillon Emily , Azad Gazi , Freedman Brian , Landa Rebecca
Published: May 2021

A reliable autism spectrum disorder (ASD) diagnosis can occur as early as 18 months; however, the average age at diagnosis in the United States is over 2 years later. While there are numerous well-known barriers to seeking an ASD diagnosis, no research has examined if separation between a child’s biological parents affects timing of ASD diagnosis for their child. Data for this study were obtained from 561 children ( M age = 5.4 years, SD = 3.9 years) referred to an urban, outpatient ASD specialty clinic for their first ASD evaluation. Biological parents self-reported their relationship status during the evaluation, which was then categorized as either “together” (married or living together but not married) or “not together” (separated, divorced, or never married). An inverse-probability of exposure weighted linear regression model, which adjusted for 16 different child, family, and sociodemographic variables, was utilized to assess differences in child age of ASD diagnosis between groups. At the time of diagnosis, most children’s biological parents were together (69%) versus not together (31%). In the fully adjusted model, children of parents who were together were diagnosed 1.4 years earlier than those who were not together ( p < 0.001). Strategies for supporting these families and reducing age disparities are indicated.

Lay abstract

Autism spectrum disorder (ASD) can be diagnosed as early as 18 months of age. However, the average age at diagnosis in the United States is over 2 years later. A lot has been written about the many barriers families face when seeking a diagnosis for their child. One area of research that has received no attention is whether separation between a child’s biological parents affects the age at which a child is diagnosed with ASD. This study was conducted among 561 children who were receiving an ASD diagnosis for the first time. On average, these children were 5 years of age. The study took place in an urban, outpatient specialty autism clinic in the United States. Biological parents self-reported their relationship status during the evaluation. This was categorized as either “together” (married or living together but not married) or “not together” (separated, divorced, or never married). At the time of diagnosis, most children’s biological parents were together (69%). We found children of parents who were together were diagnosed 1.4 years earlier than those who were not together. These findings have important implications for providing support to families that separate early in a child’s life, with the goal of reducing the age at ASD evaluation among single parents and those who have been separated from their child’s other biological parent. Providing support to these families is important since earlier age at diagnosis leads to earlier intervention, which can improve long-term outcomes for the child, family, and community as a whole.
Crossing boundaries in rural research
Authors: Eversole Robyn
Published: May 2021

Rural places around the world share common issues related to their positioning outside social, political, and economic centres of power. More than simply tyranny of distance, many issues can be attributed to tyranny at distance: that is, the power of distant decision-makers to direct rural development from afar with little knowledge of rural contexts. In response to the challenge to progress a transformative research agenda for rural sociology, this article theorises a ‘cross-boundary’ approach to research for rural development, to address persisting issues of development ignorance. Cross-boundary knowledge production values the multiple, contextualised knowledges of rural people and brings these into dialogue with academic knowledges across disciplines to inform practical rural solutions. Rural sociologists, with their in-depth understanding of rural community dynamics and larger social structures, are ideally positioned to broker cross-boundary knowledge partnerships that equip rural communities to solve old problems in new ways.
Beyond authenticity: An ethnographic reflection on Italians in Australia and Italians in Italy
Authors: Marino Simone
Published: May 2021

This article highlights a divergence between equivalent cultural practices undertaken by Calabrians in Italy and by individuals originating from Calabria living in Australia. It offers a reflexive framework on identity and authenticity. Previous research on a group of Calabrian-Australian families living in Australia found a widespread feeling among participants that they were ‘more Italian’ than the Italians who live in Italy. On the other hand, similar claims were made in Italy, during a brief period of fieldwork in Calabria among the ‘sedentaries’ (those who did not emigrate). Data show differences between the modus operandi of equivalent cultural practices among the participants in Adelaide and in Calabria and a divergence in participants’ perceptions of ethnic identity and authenticity. In proposing the terms ‘Archetype village’ and ‘Alter Ego village’ to refer respectively to the migrants’ village of origin and their community overseas the article examines notions of authenticity utilising socio-anthropological theory.
Modern technology against falls – A description of the MoTFall project
Authors: Möller U Olsson , Fänge A Malmgren , J Kristensson , D Smedberg , F Falkvall , Hansson E Ekvall
Published: May 2021

To meet future challenges from an older and physically less active population innovative solutions are needed. Modern Technology against Falls (MoTFall) aims to prevent falls, increase physical activity and improve self-rated health among older people by means of an information and communication technology based system. The project has developed technology-based solutions, focusing on person-centred care. A participatory research design was applied in the development of a mobile application, a wearable inertial movement measurement unit (IMMU), called the Snubblometer (‘snubbla’ is ‘stumble’ in Swedish) and a web-based education programme for health care professionals. The mobile application includes a fall risk index, exercises and information related to falls prevention. By linking the app to the IMMU, person-centred interventions can be developed and implemented in various health care settings and with different target populations. The IMMU has shown good validity and reliability for measuring postural sway and high sensitivity and specificity for measuring a near fall. The education programme is directed at non-graduate health care professionals in nursing homes and home care. The technical solutions have potential for use in research and in clinical practice.
‘Stay home you murderer!’: populist policing of COVID-19 in Italy
Authors: Scalia Vincenzo
Published: May 2021

Italy was the first European country to experience the impact of COVID-19. In order to deal with the health emergency, in early March 2020, the Italian government enforced strict lockdown measures. The different Italian police forces, the Polizia di Stato, Carabinieri and city police forces (Polizia Municipale), patrolled the streets, ensuring that people stayed at home and non-essential shops remained closed. These police forces received unprecedented support from the public in enforcing lockdown. People were active in their neighbourhoods, taking pictures of alleged violators and reporting them to the police, as well as posting pictures of those violating the rules on social networks. Local administrators encouraged citizens to report lockdown violations and in the case of Rome, introduced an online reporting system. This article focuses on the policing of lockdown in Italy. The article develops the argument that public attitudes, defined as policing from below, combined with policing from above by local administrators, produced a populist policing of the lockdown. Qualitative methodology is used to discuss interviews with police officers and analyse newspaper articles. Populist political forces are hegemonising in Italy, relying on the feelings of insecurity that the virus has embittered. Populist hegemony strongly influenced the policing of problems related to COVID. The lack of community policing or plural policing models within the organisation of Italian police forces, which remain a combination of continental and colonial models, has been decisive in the development of populist policing. The consequence of this is a type of ‘policing on demand’, with the public providing the police with intelligence and demanding enforcement.
Temporal Analysis of Tachycardia During Catheter Directed Thrombolysis for Acute Pulmonary Embolism
Authors: Graif Assaf , Grilli Christopher J. , Scott Amanda L. , Patel Keval D. , Zimmermann Trelawny J. , Wimmer Neil J. , Kimbiris George , Leung Daniel A.
Published: May 2021

Purpose:

To evaluate the effect of catheter directed thrombolysis (CDT) on heart rate (HR) in patients with sinus tachycardia and acute pulmonary embolism (PE).

Methods:

A retrospective chart review was performed for patients who underwent CDT with tPA for acute massive or submassive PE between 12/2009 and 2/2020. Included were patients who presented with tachycardia at the time of initiation of CDT. Patients with chronic PE, atrial fibrillation, beta blocker therapy, adjunctive endovascular therapy, systemic thrombolysis, or who expired before conclusion of CDT were excluded. HR was measured approximately every hour during CDT. Graphs were plotted of HR as a function of CDT duration. Two interventional radiologists identified the point of plateau (POP) on the graph where CDT had maximized its benefit in decreasing the patient’s HR. Discrepancies were adjudicated by a third interventional radiologist and the median of the 3 measurements was selected. The primary endpoint was the duration of CDT from initiation until the POP.

Results:

48 patients were included (52.5 ± 14.7 years, 56.3% female). The POP occurred after 13.1 ± 6.1 hours, by which point HR had been reduced from 110 ± 9.2 bpm to 88 ± 10.6 bpm. Sinus tachycardia was not resolved in 10 patients even though they achieved maximal improvement in HR after 11.3 ± 6.7 hours.

Conclusion:

Patients presenting with sinus tachycardia related to acute PE achieved maximal, sustained reduction in heart rate from CDT, after approximately 13 hours of infusion. Patients who did not resolve their tachycardia by that point in time were unlikely to resolve it by the conclusion of CDT.
Management of Pancreaticoduodenal Artery Aneurysms Based on a Single-Institution Experience
Authors: Vani Kunal , Calligaro Keith D. , Maloni Krystal , Madden Nicholas , Troutman Douglas A. , Dougherty Matthew J.
Published: May 2021

Objectives:

Pancreaticoduodenal artery aneurysms (PDAAs) are rare and have a high propensity for rupture. Historically, management of PDAAs included surgical reconstruction but has evolved with advances in endovascular therapy. We report our experience with management of PDAAs during the last 30 years.

Methods:

We retrospectively reviewed our prospectively maintained registry between January 1, 1992 – March 30, 2020.

Results:

We identified 8 patients with PDAAs: 4 with associated celiac artery occlusive disease and 4 without identifiable etiologies. Four patients were treated with surgical resection of the PDAAs: 2 intact aneurysms underwent concomitant revascularization (superior mesenteric artery-to-hepatic artery Dacron bypass; supra celiac aorta-to-hepatic artery Dacron bypass) and 2 (1 intact, 1 rupture) underwent ligation alone. Four patients were treated with coil embolization of the PDAA: 2 with concomitant stent-graft exclusion of the aneurysm (1 non-rupture, 1 rupture) and 2 without adjunctive measures (intact). There were no deaths nor any significant procedure-related morbidity.

Conclusion:

Our large single-center experience shows that PDAAs can be successfully treated by open or endovascular intervention with selective revascularization.
Drawing Out Experiential Conflict Knowledge in Myanmar: Arts-Based Methods in Qualitative Research With Conflict-Affected Communities
Authors: Bliesemann de Guevara Berit , Refaie Elisabeth El , Furnari Ellen , Gameiro Sofia , Julian Rachel , Payson Alida
Published: May 2021

This article argues that arts-based methods such as drawing are particularly useful as means to explore experiential insights into how violent conflict impacts individuals and communities in specific sociocultural contexts and shapes their views of development and peace. It illustrates this through the discussion of a drawing workshop with members of violence-affected communities in Kachin state, Myanmar. Reflecting on the workshop findings and dynamics and on the positive impacts the methods’ adoption had on practices of an international civilian protection NGO in Myanmar, the article concludes that, when implemented with care, arts-based methods do not only help accessing deep context-specific insights to complement outsider-expert analyses, by creating a safe space to share experiences, but they also enable new engagements among local actors and with outside organisations, which can strengthen the primacy of local actors in peacebuilding and development initiatives.
Multi-task learning based Encoder-Decoder: A comprehensive detection and diagnosis system for multi-sensor data
Authors: Wu Junfeng , Yao Li , Liu Bin , Ding Zheyuan , Zhang Lei
Published: May 2021

As more and more sensor data have been collected, automated detection, and diagnosis systems are urgently needed to lessen the increasing monitoring burden and reduce the risk of system faults. A plethora of researches have been done on anomaly detection, event detection, anomaly diagnosis respectively. However, none of current approaches can explore all these respects in one unified framework. In this work, a Multi-Task Learning based Encoder-Decoder (MTLED) which can simultaneously detect anomalies, diagnose anomalies, and detect events is proposed. In MTLED, feature matrix is introduced so that features are extracted for each time point and point-wise anomaly detection can be realized in an end-to-end way. Anomaly diagnosis and event detection share the same feature matrix with anomaly detection in the multi-task learning framework and also provide important information for system monitoring. To train such a comprehensive detection and diagnosis system, a large-scale multivariate time series dataset which contains anomalies of multiple types is generated with simulation tools. Extensive experiments on the synthetic dataset verify the effectiveness of MTLED and its multi-task learning framework, and the evaluation on a real-world dataset demonstrates that MTLED can be used in other application scenarios through transfer learning.
Phonology-independent general orthographic knowledge
Authors: Kemény Ferenc , Landerl Karin
Published: May 2021

While reading is among the most important and well-researched topics of developmental psychology, sublexical regularities and how these regularities relate to reading skills have attracted less interest so far. This study tested general orthographic knowledge (GOK) using an indirect reaction time (RT)-based task, in which participants had to detect letters appearing within frequent and infrequent letter clusters. The aim of the method was to minimise the roles of phonological activation and metalinguistic decision. Three different age-groups of German-speaking individuals were tested: first graders ( N = 60), third graders ( N = 68), and adults ( N = 44). Orthographic regularity affected RTs in all three groups, with significantly lower RTs for frequent than for infrequent clusters. The indirect measure of GOK did not show an association with reading measures in first graders and adults, but in the case of third graders it explained variance over and above age and phonological skills. This study provides evidence for phonology-independent GOK, at least in third graders.
A global label and its local appropriations. Representations of the Righteous Among the Nations in contemporary European museums
Authors: Wóycicka Zofia
Published: May 2021

This paper, intended as a contribution to transnational memory studies, analyzes museums devoted to people who helped Jews during the Holocaust that recently opened in Bulgaria, France, Germany, Lithuania, and Poland. The author’s particular interest lies in the “traveling motifs” of the “Righteous” narratives. This category encompasses symbols such as a list of names of the help-providers, a fruit tree/orchard, or a wall with photographs of Holocaust victims, which recur in many of the examined exhibitions and are a clear reference to Yad Vashem and other well-established Holocaust memorials. At first sight, they seem to point to a “cosmopolitanization” of Holocaust remembrance and to the emergence of a common reservoir of historical notions and images. However, on closer inspection one discovers that the use of these symbols varies and that they refer to differing ways of understanding and telling history.
What Gets Measured Gets Improved—Setting Standards and Accreditation for Quality Improvement for Diabetes Services in Australia
Authors: Andrikopoulos Sofianos , James Steven , Wischer Natalie
Published: May 2021

The purpose of this article is to illustrate that setting standards of care is the cornerstone for excellence in diabetes management. This is underpinned by 3 activities: a standards and accreditation process, an audit and benchmarking program and a linked quality improvement plan. While there are many examples of local auditing and quality improvement programs, there are very few that are at a national level. The National Association of Diabetes Centres (NADC) was formed by the Australian Diabetes Society and the Australian Diabetes Educators Association to set standards of diabetes care in Australia. A rigorous accreditation process was put in place to recognize primary, secondary, and tertiary level diabetes centers that meet these standards. The NADC accreditation process is underpinned by a quality improvement plan, which must be submitted for accreditation to be granted and is informed by the Australian National Diabetes Audit (ANDA). ANDA is conducted annually to gather information about treatments, complications, self-care practices and quality of life outcomes and provides a national as well as an individual report to the participating center that is used to benchmark against other like centers. The ANDA reports are important to inform national policy and advocacy for diabetes care and to also provide information for quality improvement purposes for the individual participating center. We believe that the NADC Standards and Accreditation can be an exemplar for other countries to adapt and adopt to standardize diabetes care at the highest level.
The social dynamics of multiplayer online videogames in Argentinian and Chilean family contexts: The case of Fortnite
Authors: Albarello Francisco , Novoa Ángela , Castro Sánchez Mariángeles , Velasco Adriana , Novaro Hueyo María Victoria , Narbais Francisco
Published: May 2021

The popularity of multiplayer online videogames (MOVs) in the lives of young people has become a recurrent area of interest for parents and researchers. The use of these platforms has generated concerns regarding the potential negative effects on children’s personal and social development. Additionally, the ways in which players socialize through these games has raised questions concerning what are regarded as the most effective approaches to promote a constructive articulation of virtual and physical worlds. Fortnite, was created by Epic Games in 2017. It can be characterized as a social survival gaming experience and has the most remarkable use on a worldwide scale. The study reported here is a qualitative case study that explores the social dimension of the use of Fortnite and how it impacts on children’s and their parents’ perceptions regarding its use. A total of 82 in-depth interviews were conducted in 2019 with Argentinian and Chilean children between 9 and 18 years of age and their parents. Findings reveal that parents and children have diverging perspectives regarding the social dimension of the game’s immersive experience. The topic developed in this article is of particular relevance to parents and researchers given the current events and widescale use of online platforms due to the Covid-19 pandemic.
Central nervous system-related safety and tolerability of add-on ketamine to antidepressant medication in treatment-resistant depression: focus on the unique safety profile of bipolar depression
Authors: Włodarczyk Adam , Cubała Wiesław J. , Gałuszko-Węgielnik Maria , Szarmach Joanna
Published: May 2021

Background:

There is evidence supporting the use of ketamine in treatment-resistant depression (TRD). However, there are some safety and tolerability concerns associated with ketamine. This study aimed to investigate ketamine’s safety and tolerability to the central nervous system and to assess the relationship between dissociative symptomology and psychometric outcomes during and after intravenous ketamine treatment concurrent with treatment by varying psychotropic medications in treatment-refractory inpatients with major depressive disorder (MDD) and bipolar disorder (BP).

Methods:

A total of 49 patients with MDD and BP were included in this study. The subjects were administered ketamine and were assessed for changes using an observational protocol.

Results:

No antidepressants were associated with psychomimetic symptomatology except for citalopram ( p = 0.019). Patients treated with citalopram showed a higher intensity of psychomimetic symptomatology. The use of classic mood-stabilizers was significantly associated with an increase in psychomimetic symptomatology according to the Brief Psychiatric Rating Scale (BPRS; lamotrigine p = 0.009, valproate p = 0.048, lithium p = 0.012). No sequelae were observed.

Conclusions:

Despite the limitations that this study may be underpowered due to the small sample size, the sample consisted of a heterogeneous TRD population in a single site, and there no blinding of who underwent only acute ketamine administration, our observations indicate ketamine use requires close safety and tolerability monitoring with regards to psychomimetic and dissociative symptoms in TRD-BP and careful management for MDD patients. ClinicalTrials.gov identifier: NCT04226963
Acute Tubulointerstitial Nephritis in a Patient on Anti-Programmed Death-Ligand 1 Triggered by COVID-19: A Case Report
Authors: Buyansky Dimitry , Fallaha Catherine , Gougeon François , Pépin Marie-Noëlle , Cailhier Jean-François , Beaubien-Souligny William
Published: May 2021

Rationale:

Immune checkpoint inhibitors are monoclonal antibodies used in the treatment of various types of cancers. The downside of using such molecules is the potential risk of developing immune-related adverse events. Factors that trigger these autoimmune side effects are yet to be elucidated. Although any organ can potentially be affected, kidney involvement is usually rare. In this case report, we describe the first known instance of a patient being treated with an inhibitor of programmed death-ligand 1 (anti-PD-L1, a checkpoint inhibitor) who develops acute tubulointerstitial nephritis after contracting the severe acute respiratory syndrome coronavirus 2.

Presenting concerns of the patient:

A 62-year-old patient, on immunotherapy treatment for stage 4 squamous cell carcinoma, presents to the emergency department with symptoms of lower respiratory tract infection. Severe acute kidney injury is discovered with electrolyte imbalances requiring urgent dialysis initiation. Further testing reveals that the patient has contracted the severe acute respiratory syndrome coronavirus 2.

Diagnosis:

A kidney biopsy was performed and was compatible with acute tubulointerstitial nephritis.

Interventions:

The patient was treated with high dose corticosteroid therapy followed by progressive tapering.

Outcomes:

Rapid and sustained normalization of kidney function was achieved after completion of the steroid course.

Novel findings:

We hypothesize that the viral infection along with checkpoint inhibitor use has created a proinflammatory environment which led to a loss of self-tolerance to renal parenchyma. Viruses may play a more important role in the pathogenesis of autoimmunity in this patient population than was previously thought.
Do Supply Chain Performance Influence Firm Profitability? A Predictive Approach in the Context of the Indian Pharmaceutical Industry
Authors: Tripathi Saswati , Talukder Bijoy , Rangarajan Krishnamachari
Published: May 2021

The competitive nature of the pharmaceutical industry necessitates that its multifaceted supply-chain be cost-efficient and profitable. This paper aims to ascertain the critical supply-chain financial indicators influencing pharmaceutical-supply-chain (PSC) performance, revealing its unique features and assessing these indicators’ effect on profitability.

This paper measures the PSC performance of 55 public-limited Indian pharmaceutical firms, including multinational enterprises, integrating supply-chain financial variables and SCOR KPIs through a ten-year timeline. The critical supply-chain-performance indicators (SCPIs) are identified from the measured set through factor analysis. A panel data random effect model is developed, linking these critical SCPIs and profitability to understand their significant influence on profitability.

This paper has evidenced the existence of three critical SCPIs, revealing working capital efficiency, material flow efficiency and investment efficiency. It has also proved the significant influence of these SCPIs on firms’ profitability and has brought out the importance of material flow efficiency in terms of inventory and distribution efficiency as a leading contributing factor for profitability.

This paper contributes to finding key PSC performance features and their vital role in pharmaceutical firms’ profitability. Supply-chain managers can enhance PSC’s specific performance areas to be cost-efficient and can increase the firm’s profitability.
Antibiotic Prophylaxis in Alloplastic Breast Reconstruction: Regimens and Outcomes
Authors: Liu Edward H. , Tong Mary , Kim Grace Y. , Farrokhyar Forough , Dal Cin Arianna
Published: May 2021

Purpose:

Surgical site infections (SSI) in prosthesis-based breast reconstruction can have a significant impact on patient outcome. Despite current CDC (Centers for Disease Control and Prevention) guidelines recommending 24 hours of postoperative antibiotics, various perioperative antimicrobial regimens are reported in the literature. Consensus on the optimal duration of antibiotics remains unclear. In this study, the aim is to compare the incidence of surgical site infections following different antibiotic durations in alloplastic breast reconstruction.

Methods:

In this retrospective cohort study, all consecutive patients who underwent expander/implant-based breast reconstruction between January 2009 and December 2014 at a tertiary centre were included. Data on patient demographics, risk factors, operative time, choice and timing of antibiotic used before surgery, and the duration of postoperative antibiotic use were collected. The primary outcome, SSI, is defined according to CDC criteria.

Results:

A total of 507 consecutive expander/implant-based cases were included. Minimum follow-up time was 1 year. The overall infection incidence was 14% (95% CI: 11%-17%), and the rate of subsequent explantation was 8%. Of the infected cases, 80% (45/56) received 1 week of postoperative antibiotic, while 20% (11/56) had a prolonged course of antibiotics (2-3 weeks; P = .003, odds ratio [OR] = 2.9; 95% CI: 1.4-5.8). Most infections were superficial (65%). Prior history of radiation treatment was identified as a risk factor for developing surgical site infection ( P = .02).

Conclusion:

Overall infection rate and risk factors for infections are in keeping with current literature. Prescribing one week of postoperative antibiotic was found to be associated with a higher incidence of SSI compared to a more prolonged antibiotic regimen.
Diagnostic Accuracy of HemotypeSC as a Point-of-Care Testing Device for Sickle Cell Disease: Findings from a Southwestern State in Nigeria and Implications for Patient Care in Resource-Poor Settings of sub-Saharan Africa
Authors: Olatunya Oladele S. , Albuquerque Dulcinea M. , Fagbamigbe Adeniyi F. , Faboya Opeyemi A. , Ajibola Ayotunde E. , Babalola Oluwatoyin A. , Adebisi Adewale O. , Falusi Adeyinka G. , Adekile Adekunle , Costa Fernando F.
Published: May 2021

This study aimed to determine the performance of a rapid, point-of-care testing device (HemotypeSC)™ for diagnosing sickle cell disease (SCD) relative to 2 commonly-used methods compared to DNA polymerase chain reaction (PCR) as the reference standard. The diagnostic performance of (HemotypeSC)™ in diagnosing SCD and determining various other Hb genotypes relative to high performance liquid chromatography (HPLC) and cellulose acetate Hb electrophoresis in alkaline buffer (CAE) was investigated among 156 participants aged 4 to 23 years in Ekiti, Southwest Nigeria. PCR was considered as the reference method/gold standard. The sensitivity and specificity for SS, SC, AS, AC, and AA genotypes by HemotypeSC and HPLC when compared with PCR, were each 100%. Similarly, their positive and negative predictive values were each 100%. However, sensitivity and specificity for identifying these Hb genotypes by CAE were 100, 100, 96.5, 0, 99.2%, and 99, 100, 92.9, 0, 91.7%. Also, CAE did not identify any of the 2 HbAC individuals that were correctly identified by PCR and both HemotypeSC, and HPLC, thus representing 100% HbAC misdiagnosis. In conclusion, this study shows that HemotypeSC has perfect concordance with PCR and 100% accuracy in diagnosing SCD in the population tested. Its ease of use, accuracy and other attributes make it suitable for use in sub-Saharan Africa for rapid determination of Hb genotypes.
Effect of Geographical Diversities in Management Leadership with Special Reference to India
Authors: Majumdar Soumen
Published: May 2021

Effective top management leadership is the pillar of success in any organization. This is a widely shared view since the inception of industrial age. Though it is still valid in the current era, with the advancement of technology and workforce quality, leadership approaches are getting more sophisticated with every passing day. In today’s business context, success is no more associated with stereotyped leadership approaches. It is associated with the contingent approaches of leadership which are flexible and adaptive with varied socio-cultural aspects in different demographic regions. In this article, we focus on investigating how demographic factors influence the success or failure of top management leadership in the Indian context.

In the course of our research, we considered seven different factors (availability of raw material, market demand for finished goods, proper utilization of equipment, manpower utilization, salaries and wages, uninterrupted availability of energy and fuel, and investment in technology) as key factors for the success of any manufacturing unit. Our findings indicate that, among these seven factors, only two (utilization of equipment and manpower utilization) are associated with the demographic aspects of a business operation. Even after handling five factors successfully, if the senior leadership fails to address the social, cultural and political issues of a certain demography, it leads to ineffective utilization of manpower. In addition to this, the leader’s inability in realizing the level of education, knowledge, and intelligence of the workforce of a specific demographic region can lead to inefficient machine utilization. These elucidations guided us to conclude our research by pointing out demographic factors as key considerations in the recruitment, selection, and placement process of top management leadership positions in any manufacturing unit across the country.
Beyond-Use Dates Assignment for Pharmaceutical Preparations: Example of Low-Dose Amiodarone Capsules
Authors: Brun Damien , Curti Christophe , Lamy Edouard , Jean Christophe , Bertault-Peres Pierre , Broggi Julie , Tintori Guillaume , Vanelle Patrice
Published: May 2021

Background: Beyond-use dates (BUDs) in compounding practice are assigned from stability studies. The United States Pharmacopoeia (USP 42 NF 37) suggested to assign a 6 months BUD for dry oral forms. A new pediatric formula of amiodarone capsules was implemented in our hospital, with 3 dosages (5 mg, 20 mg, and 50 mg). Objective: BUD of these new formulas had to be determined by stability study. Methods: The method for the determination of amiodarone content was validated to be stability indicating, and a stability study was performed. Different excipients commonly used for capsule compounding were compared. Results: We found that, with microcrystalline cellulose as excipient, 50 mg amiodarone capsules were stable for 1 year, whereas 5 mg and 20 mg capsules were not. This difference was studied, and lactose or mannitol were found to be better excipients for 5 mg amiodarone capsules, despite their potential side effects. A potential drug-excipient interaction between microcrystalline cellulose and amiodarone hydrochloride is described. Conclusion: Amiodarone hydrochloride/microcrystalline cellulose capsules have a BUD of 1 month for 5 mg capsules, 6 months for 20 mg, and 1 year for 50 mg.
Shattering the Glass Podium: Successes and Setbacks of Women in Collegiate Choral Conducting
Authors: Baughman Melissa
Published: May 2021

The purpose of this study was to explore the status and experiences of women in collegiate choral conducting positions. Out of all collegiate choral conductors ( N = 992) at institutions accredited by the National Association of Schools of Music in the United States, 68.65% ( n = 681) were men and 31.35% ( n = 311) were women at the time of this study; I invited the women collegiate choral conductors to serve as study participants. Ninety-six respondents completed an online survey, resulting in a response rate of 30.86%. I collected data through a researcher-designed survey. First, I asked respondents to provide demographic information and respond to Likert-type and open-ended prompts related to three domains: gaining entry into the profession, navigating the profession, and issues surrounding gender. I analyzed data through descriptive statistics and qualitative methods of assigning codes, combining codes into themes, and displaying the data. I addressed general discrepancies in the self-reported attitudes of respondents. Although women reported an overall attitude of satisfaction as choral conductors in their Likert-type responses, many respondents detailed several instances of gender discrimination and other challenges in their open-ended responses. Implications for the music profession, including specific strategies to help empower women in collegiate choral conducting settings, are discussed.
Herlyn-Werner-Wunderlich Syndrome: A Case Report on a Congenital Uterine Anomaly With Literature Review
Authors: Sunyecz Alec , Snider Megan , Minniear Elizabeth , Duenas-Garcia Omar , Payton Amber , Shapiro Robert
Published: May 2021

During fetal development, abnormalities during Mullerian duct formation can lead to varied types of uterine, cervical, or vaginal anomalies. Herlyn-Werner-Wunderlich Syndrome (HWWS) is a rare, congenital Mullerian duct anomaly characterized by the triad of uterine didelphys, obstructed hemi-vagina, and ipsilateral renal agenesis. If the diagnosis is delayed or missed, permanent sequalae such as chronic pain, infection, and infertility can result. This is a case of a 16-year-old woman with heavy vaginal bleeding and menstrual cramping in which sonography was used in the diagnosis of HWWS. Sonography plays a vital role in this diagnosis, as it is the most common initial imaging examination. For this reason, it is important that the characteristics of uterine anomalies, like HWWS, be recognized with sonography. It is important that this diagnosis is made early and treatment can be initiated to prevent irreversible complications.
Core-binding factor leukemia hijacks the T-cell–prone PU.1 antisense promoter
Authors: van der Kouwe E. , Heller G. , Czibere A. , Pulikkan J. A. , Agreiter C. , Castilla L. H. , Delwel R. , Di Ruscio A. , Ebralidze A. K. , Forte M. , Grebien F. , Heyes E. , Kazianka L. , Klinger J. , Kornauth C. , Le T. , Lind K. , Barbosa I. A. M. , Pemovska T. , Pichler A. , Schmolke A.-S. , Schweicker C. M. , Sill H. , Sperr W. R. , Spittler A. , Surapally S. , Trinh B. Q. , Valent P. , Vanura K. , Welner R. S. , Zuber J. , Tenen D. G. , Staber P. B.
Published: May 2021

The blood system serves as a key model for cell differentiation and cancer. It is orchestrated by precise spatiotemporal expression of crucial transcription factors. One of the key master regulators in the hematopoietic systems is PU.1. Reduced levels of PU.1 are characteristic for human acute myeloid leukemia (AML) and are known to induce AML in mouse models. Here, we show that transcriptional downregulation of PU.1 is an active process involving an alternative promoter in intron 3 that is induced by RUNX transcription factors driving noncoding antisense transcription. Core-binding factor (CBF) fusions RUNX1-ETO and CBFβ-MYH11 in t(8;21) and inv(16) AML, respectively, activate the PU.1 antisense promoter that results in a shift from sense toward antisense transcription and myeloid differentiation blockade. In patients with CBF-AML, we found that an elevated antisense/sense transcript and promoter accessibility ratio represents a hallmark compared with normal karyotype AML or healthy CD34+ cells. Competitive interaction of an enhancer with the proximal or the antisense promoter forms a binary on/off switch for either myeloid or T-cell development. Leukemic CBF fusions thus use a physiological mechanism used by T cells to decrease sense transcription. Our study is the first example of a sense/antisense promoter competition as a crucial functional switch for gene expression perturbation by oncogenes. Hence, this disease mechanism reveals a previously unknown Achilles heel for future precise therapeutic targeting of oncogene-induced chromatin remodeling.
Toward prevention of childhood ALL by early-life immune training
Authors: Hauer Julia , Fischer Ute , Borkhardt Arndt
Published: May 2021

B-cell precursor acute lymphoblastic leukemia (BCP-ALL) is the most common form of childhood cancer. Chemotherapy is associated with life-long health sequelae and fails in ∼20% of cases. Thus, prevention of leukemia would be preferable to treatment. Childhood leukemia frequently starts before birth, during fetal hematopoiesis. A first genetic hit (eg, the ETV6-RUNX1 gene fusion) leads to the expansion of preleukemic B-cell clones, which are detectable in healthy newborn cord blood (up to 5%). These preleukemic clones give rise to clinically overt leukemia in only ∼0.2% of carriers. Experimental evidence suggests that a major driver of conversion from the preleukemic to the leukemic state is exposure to immune challenges. Novel insights have shed light on immune host responses and how they shape the complex interplay between (1) inherited or acquired genetic predispositions, (2) exposure to infection, and (3) abnormal cytokine release from immunologically untrained cells. Here, we integrate the recently emerging concept of “trained immunity” into existing models of childhood BCP-ALL and suggest future avenues toward leukemia prevention.
Fabrication of Rectification Nanosensors by Direct Current Dielectrophoresis Alignment of ZnO Nanowires
Authors: Sun Kai-Heng , Chien Wen-Ching , Hsu Hsun-Feng
Published: May 2021

This work demonstrates the fabrication and characterization of ZnO nanowire-based devices in a metal–nanowire–metal configuration using the direct current dielectrophoresis alignment across Au electrodes. The current–voltage characteristics of the devices revealed that they were rectifying, and the direction of rectification was determined by the direction of current due to the asymmetric Joule heating in the dielectrophoresis alignment process. Joule heating caused the Au atoms to diffuse from the Au electrodes to the inner ZnO NWs and the formation of Schottky contact at the Au/ZnO interface. A fast and sensitive photoresponse was achieved for the rectifying devices in reverse-biased mode due to the carrier injection and photocurrent gain under UV illumination. Such direct current dielectrophoresis alignment of ZnO nanowires is a facile method for fabricating rectification devices with application in sensitive and fast UV detecting sensors.
Severe, but not mild to moderate, non-alcoholic fatty liver disease associated with increased risk of subclinical coronary atherosclerosis
Authors: Hsiao Chia-Chi , Teng Pai-Hsueh , Wu Yun-Ju , Shen Yi-Wen , Mar Guang-Yuan , Wu Fu-Zong
Published: May 2021

Background

Non-alcoholic fatty liver disease (NAFLD) is associated with high risk of cardiovascular disease. The prevalence is increasing to 45–65% in the general population with routine health check-up, and most subjects have the mild degree NAFLD in recent years. Moreover, there are no studies on the association between NAFLD severity and coronary atherosclerosis in the real-world setting by ultrasonography.

Methods

The aim of this study was to determine the relationship between the severity of NAFLD and subclinical coronary atherosclerosis. Overall, 817 subjects meet criteria for NAFLD were enrolled in the retrospective cohort study (155 subjects were excluded). The severity of NAFLD was divided into the normal, mild, moderate and severe degree based on the finding of abdominal ultrasonography. The assessment of coronary atherosclerosis was based on CAC scan/coronary CT angiography finding in terms of CAC score ≧ 100, CAC score ≧ 400, CAD-RADS ≧ 3 and presence of vulnerable plaque(s).

Results

A significant linear trend was observed between the severity of NAFLD and subclinical coronary atherosclerosis. Compared with the reference group (including normal, mild, and moderate NAFLD), severe degree NAFLD was the independently associated risk of subclinical coronary atherosclerosis in term of CAC score ≧ 100, CAC score ≧ 400, CAD-RADS ≧ 3 and presence of vulnerable plaque(s) based on binary logistic regression after adjustment for FRS score and body fat percentage.

Conclusions

Severe degree, but not mild to moderate, was associated with high risk of subclinical coronary atherosclerosis, independently of FRS score and body-fat percentage.