bluuebunny/crossref_metadata_2025 huggingface dataset:
Plasma Ablation vs Other Hot Techniques for Tonsillectomy: A Meta‐analysis
Authors: Liu Guo , Xiao Ciyun , Zhou Xu , Liu Feng
Published: May 2020

Objective

To evaluate whether plasma ablation tonsillectomy is superior to other hot techniques in reducing postoperative morbidity.

Data Sources

The databases of PubMed, EMBASE, and Web of Science were used to search the literature, from inception to January 2, 2020. Randomized controlled trials (RCTs) that compared plasma ablation tonsillectomy with any other hot techniques were eligible.

Review Methods

A modified Cochrane tool was used to assess the risk of bias. The standardized mean difference (SMD) and 95% confidence interval (CI) were used to estimate pooled effects of postoperative pain, and the risk ratio (RR) was used for postoperative bleeding. Subgroup analysis was prespecified to explore the source of heterogeneity. The evidence quality of each outcome was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Results

A total of 15 RCTs were included (n = 1293). Comparing with other hot techniques, plasma ablation tonsillectomy may cause less pain on postoperative day 7 (SMD, −0.53; 95% CI, −0.84 to −0.23). However, the magnitude of the difference may be clinically meaningless. There were no significant differences not only in terms of postoperative pain on day 1 and day 3 but also in the incidence of postoperative bleeding, reoperation hemostasis, and return to normal diet and activities between the 2 groups.

Conclusion

There is still substantial uncertainty on postoperative pain, bleeding, and recovery. The current evidence is insufficient to demonstrate that plasma ablation is superior to other hot techniques for tonsillectomy.
Application of a Modified Endoscopy Face Mask for Flexible Laryngoscopy During the COVID‐19 Pandemic
Authors: Narwani Vishal , Kohli Nikita , Lerner Michael Z.
Published: May 2020

Diagnostic flexible laryngoscopy (DFL) is a critical tool in the armamentarium of an otolaryngologist. However, in the midst of the COVID‐19 pandemic, DFL represents a high‐risk procedure for patients and otolaryngologists due to the risk of aerosolization. In cases where DFL is required, in patients with COVID‐19 positivity or unknown COVID‐19 status, we describe the use of a modified endoscopy face mask as an adjunct to personal protection equipment to reduce occupational transmission of COVID‐19 while performing DFL. Our modified endoscopy mask provides an additional barrier against the transmission of airborne pathogens. The modified endoscopy face mask may also serve as a useful tool for otolaryngologists as they return to performing more aerosol‐generating procedures in the outpatient setting.
Olfactory Dysfunction and Sinonasal Symptomatology in COVID‐19: Prevalence, Severity, Timing, and Associated Characteristics
Authors: Speth Marlene M. , Singer‐Cornelius Thirza , Oberle Michael , Gengler Isabelle , Brockmeier Steffi J. , Sedaghat Ahmad R.
Published: May 2020

Objective

Olfactory dysfunction (OD)—hyposmia or anosmia—is a symptom of coronavirus disease 2019 (COVID‐19), caused by the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). We sought to better determine prevalence, severity, and timing of OD in COVID‐19 relative to other sinonasal and pulmonary symptoms.

Study Design

Prospective, cross‐sectional.

Setting

Regional/cantonal hospital.

Subjects

In total, 103 patients diagnosed with COVID‐19 with reverse transcription polymerase chain reaction (RT‐PCR)–based testing.

Methods

All patients testing positive for COVID‐19 at Kantonsspital Aarau over a 6‐week period were approached. Timing and severity (at its worst, on scale of 0 [none], 1 [mild], 2 [moderate], and 3 [severe]) of OD, loss of taste, nasal obstruction, rhinorrhea/mucus production, fever, cough and shortness of breath (SOB) were assessed for each patient.

Results

Prevalence of OD was 61.2%, and severity of OD was strongly correlated with severity of loss of taste experienced (ρ = 0.87, P <. 001). OD was experienced on the first day of COVID‐19 by 8.7% and overall occurred at median infection day 3 (mean, 3.4; range, 0‐12). Most experiencing OD reported anosmia, and mean severity of all with OD was moderate to severe (mean [SD], 2.7 [0.6]). Nasal obstruction (49.5%) and rhinorrhea (35.0%) were frequently reported but not correlated with OD. SOB was more severe in patients with OD. OD was associated negatively with older age (OR, 0.96; 95% CI, 0.93‐0.99; P =. 007) and positively with female sex (OR, 2.46; 95% CI, 0.98‐6.19; P =. 056).

Conclusions

OD is highly prevalent during COVID‐19, occurring early and severely, often in conjunction with loss of taste. OD is associated negatively with older age and positively with female sex. Patients with OD may also experience more severe SOB.
Cadaveric Simulation of Endoscopic Endonasal Procedures: Analysis of Droplet Splatter Patterns During the COVID‐19 Pandemic
Authors: Sharma Dhruv , Rubel Kolin E. , Ye Michael J. , Shipchandler Taha Z. , Wu Arthur W. , Higgins Thomas S. , Burgin Sarah J. , Ting Jonathan Y. , Illing Elisa A.
Published: May 2020

Objective

The primary mode of viral transmission of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is thought to occur through the spread of respiratory droplets. The objective of this study was to investigate droplet and splatter patterns resulting from common endoscopic endonasal procedures.

Study Design

Cadaver simulation series.

Setting

Dedicated surgical laboratory.

Subjects and Methods

After instilling cadaver head specimens (n = 2) with fluorescein solution, endoscopic endonasal procedures were systematically performed to evaluate the quantity, size, and distance of droplets and splatter following each experimental condition.

Results

There were no observable fluorescein droplets or splatter noted in the measured surgical field in any direction after nasal endoscopy, septoplasty with microdebrider‐assisted turbinoplasty, cold‐steel functional endoscopic sinus surgery (FESS), and all experimental conditions using an ultrasonic aspirator. Limited droplet spread was noted with microdebrider FESS (2 droplets, <1 mm in size, within 10 cm), drilling of the sphenoid rostrum with a diamond burr (8, <1 mm, 12 cm), and drilling of the frontal beak with a cutting burr (5, <1 mm, 9 cm); however, the use of concurrent suction while drilling resulted in no droplets or splatter. The control condition of external activation of the drill resulted in gross contamination (11, 2 cm, 13 cm).

Conclusion

Our results indicate that there is very little droplet generation from routine rhinologic procedures. The droplet generation from drilling was mitigated with the use of concurrent suction. Extreme caution should be used to avoid activating powered instrumentation outside of the nasal cavity, which was found to cause droplet contamination.
Aggregate Prevalence of Chemosensory and Sinonasal Dysfunction in SARS‐CoV‐2 and Related Coronaviruses
Authors: Lehrich Brandon M. , Goshtasbi Khodayar , Raad Richard A. , Ganti Ashwin , Papagiannopoulos Peter , Tajudeen Bobby A. , Kuan Edward C.
Published: May 2020

Much of the published literature regarding the novel coronavirus disease 2019 (COVID‐19) constitutes lower respiratory system symptomatology, while there exists a paucity of data describing the complicated sequelae of the upper respiratory system, including chemosensory and/or sinonasal dysfunction. This study utilized the National Library of Medicine’s PubMed/MEDLINE database to query for articles describing COVID‐19, SARS‐CoV‐2, SARS‐CoV‐1, MERS‐CoV, and other coronaviruses, with any mention of smell, taste, or other chemosensory or sinonasal dysfunction. Aggregate analysis demonstrated an incidence of 49.6% (n = 497 of 1002; 95% CI, 46.5%‐52.7%), 47.9% (n = 480 of 1002; 95% CI, 44.8%‐51.0%), and 17.9% (n = 880 of 4909; 95% CI, 16.9%‐19.0%) for smell loss, taste loss, and smell or taste loss, respectively, in patients infected with SARS‐CoV‐2. Additionally, there were significantly higher incidences of runny nose/rhinorrhea/rhinitis and nasal congestion/obstruction/blockage in other coronaviruses as compared with SARS‐CoV‐2 (P <. 001). Understanding these less well‐characterized symptoms may help develop measures for estimating early markers of disease prevalence and/or resolution. Level of evidence: 4.
Management of the Clinical and Academic Mission in an Urban Otolaryngology Department During the COVID‐19 Global Crisis
Authors: Batra Pete S. , LoSavio Phillip S. , Michaelides Elias , Revenaugh Peter C. , Tajudeen Bobby A. , Al‐khudari Samer , Husain Inna , Papagiannopoulos Peter , Smith Ryan , Stenson Kerstin M. , Wiet R. Mark
Published: May 2020

Objective

The objective of this study was to assess the strategic changes implemented in the departmental mission to continue safe delivery of otolaryngology care and to support the broader institutional mission during the COVID‐19 pandemic response.

Study Design

Retrospective assessment was performed to the response and management strategy developed to transform the clinical and academic enterprise.

Setting

Large urban tertiary care referral center.

Results

The departmental structure was reorganized along new clinical teams to effectively meet the system directives for provision of otolaryngology care and support for inpatient cases of COVID‐19. A surge deployment schedule was developed to assist frontline colleagues with clinical support as needed. Outpatient otolaryngology was consolidated across the system with conversion of the majority of visits to telehealth. Operative procedures were prioritized to ensure throughput for emergent and time‐critical urgent procedures. A tracheostomy protocol was developed to guide management of emergent and elective airways. Educational and research efforts were redirected to focus on otolaryngology care in the clinical context of the COVID‐19 crisis.

Conclusion

Emergence of the COVID‐19 global health crisis has challenged delivery of otolaryngology care in an unparalleled manner. The concerns for preserving health of the workforce while ethically addressing patient career needs in a timely manner has created significant dilemmas. A proactive, thoughtful approach that reorganizes the overall departmental effort through provider and staff engagement can facilitate the ability to meet the needs of otolaryngology patients and to support the greater institutional mission to combat the pandemic.
Factors Associated With Intubation and Prolonged Intubation in Hospitalized Patients With COVID‐19
Authors: Hur Kevin , Price Caroline P. E. , Gray Elizabeth L. , Gulati Reeti K. , Maksimoski Matthew , Racette Samuel D. , Schneider Alexander L. , Khanwalkar Ashoke R.
Published: May 2020

Objective

To identify risk factors associated with intubation and time to extubation in hospitalized patients with coronavirus disease 2019 (COVID‐19).

Study Design

Retrospective observational study.

Setting

Ten hospitals in the Chicago metropolitan area.

Subjects and Methods

Patients with laboratory‐confirmed COVID‐19 admitted between March 1 and April 8, 2020, were included. We evaluated sociodemographic and clinical characteristics associated with intubation and prolonged intubation for acute respiratory failure secondary to COVID‐19 infection.

Results

Of the 486 hospitalized patients included in the study, the median age was 59 years (interquartile range, 47‐69); 271 (55.8%) were male; and the median body mass index was 30.6 (interquartile range, 26.5‐35.6). During the hospitalization, 138 (28.4%) patients were intubated; 78 (56.5%) were eventually extubated; 21 (15.2%) died; and 39 (28.3%) remained intubated at a mean ± SD follow‐up of 19.6 ± 6.7 days. Intubated patients had a significantly higher median age (65 vs 57 years, P <. 001) and rate of diabetes (56 [40.6%] vs 104 [29.9%], P =. 031) as compared with nonintubated patients. Multivariable logistic regression analysis identified age, sex, respiratory rate, oxygen saturation, history of diabetes, and shortness of breath as factors predictive of intubation. Age and body mass index were the only factors independently associated with time to extubation.

Conclusion

In addition to clinical signs of respiratory distress, patients with COVID‐19 who are older, male, or diabetic are at higher risk of requiring intubation. Among intubated patients, older and more obese patients are at higher risk for prolonged intubation. Otolaryngologists consulted for airway management should consider these factors in their decision making.
Telehealth Opportunities for the Otolaryngologist: A Silver Lining During the COVID‐19 Pandemic
Authors: Shipchandler Taha Z. , Nesemeier B. Ryan , Parker Noah P. , Vernon Dominic , Campiti Vincent J. , Anthony Benjamin P. , Alwani Mohamedkazim M. , Illing Elisa A. , Ting Jonathan Y.
Published: May 2020

The utilization of telemedicine has seen a relatively slow progression over the past 50 years in the US health care system. Technological challenges limiting the ease of use of robust video platforms have been a major factor. Additionally, the perception by many health care providers that telehealth is reserved for only the rural population or that it provides limited value due to the inability to perform in‐depth physical examinations contributes to the slow adoption. The COVID‐19 pandemic, with its massive disruption in social interaction by way of “stay at home” orders, is serving as a catalyst for improving telehealth. Large health systems are investing millions of dollars and increasing telehealth visit numbers 100‐fold to access patients. The “telehealth movement” is here to stay and will undoubtedly be incorporated into providers’ daily lives years after the COVID‐19 pandemic. By embracing virtual access to health care, otolaryngologists will be able to influence improvements to these systems and broaden access options for patient care well into the future.
Association Between COVID‐19 and Kawasaki Disease: Vigilance Required From Otolaryngologists
Authors: Sandhaus Henya , Crosby Dana , Sharma Arun , Gregory Stacie R.
Published: May 2020

With the onset of the COVID‐19 pandemic, many novel presentations of known conditions are occurring. In the pediatric population, new instances of Kawasaki disease have recently been singled out as presenting in conjunction with or soon after diagnosis of COVID‐19. This poses a novel situation, particularly for otolaryngologists, who may be the first to encounter these patients. Otolaryngologists should be cognizant of the coexistence of conditions to allow for timely recognition and optimal management.
Mutations of RNF213 are responsible for sporadic cerebral cavernous malformation and lead to a mulberry-like cluster in zebrafish
Authors: Lin Jing , Liang Jie , Wen Jun , Luo Man , Li Jiaoxing , Sun Xunsha , Xu Xiaowei , Li Jianli , Wang Dongxian , Wang Jie , Chen Huimin , Lai Rong , Liang Fengyin , Li Chuan , Ye Fei , Zhang Jingjing , Zeng Jinsheng , Yang Shulan , Sheng Wenli
Published: May 2020

Although familial forms of cerebral cavernous malformation are mainly attributed to three CCM genes ( KRIT1, CCM2 and PDCD10), no mutation is identified in sporadic cerebral cavernous malformation cases with a unique lesion, indicating additional genes for sporadic cerebral cavernous malformation. To screen the candidate genes, we conducted whole exome sequencing in 31 sporadic cerebral cavernous malformation patients and 32 healthy controls, and identified 5 affected individuals carrying 6 heterozygous deleterious mutations in RNF213 but no RNF213 mutation in healthy individuals. To further confirm RNF213 was associated with cerebral cavernous malformation, we generated rnf213a homozygous knockout zebrafish and found mutation of rnf213a in zebrafish led to a mulberry-like cluster of disordered-flow vascular channels which was reminiscent of human cerebral cavernous malformation. In addition, we revealed kbtbd7 and anxa6 were significantly downregulated due to rnf213a mutation through transcriptomic sequencing and RT-qPCR analysis. Based on the mulberry-like phenotype partly rescued by mRNA of kbtbd7 as well as anxa6, we suggested that rnf213a promoted mulberry-like cluster via downregulation of kbtbd7 and anxa6. Altogether, we firstly demonstrate RNF213is a novel candidate gene for sporadic cerebral cavernous malformation and the mutation of rnf213a is responsible for the mulberry-like cluster in zebrafish.
A non-human primate model of stroke reproducing endovascular thrombectomy and allowing long-term imaging and neurological read-outs
Authors: Debatisse Justine , Wateau Océane , Cho Tae-Hee , Costes Nicolas , Mérida Inés , Léon Christelle , Langlois Jean-Baptiste , Taborik Fabrice , Verset Michaël , Portier Karine , Aggour Mohamed , Troalen Thomas , Villien Marjorie , Makris Nikolaos , Tourvieille Christian , Bars Didier Le , Lancelot Sophie , Confais Joachim , Oudotte Adrien , Nighoghossian Norbert , Ovize Michel , Vivien Denis , Contamin Hugues , Agin Véronique , Canet-Soulas Emmanuelle , Eker Omer Faruk
Published: May 2020

Stroke is a devastating disease. Endovascular mechanical thrombectomy is dramatically changing the management of acute ischemic stroke, raising new challenges regarding brain outcome and opening up new avenues for brain protection. In this context, relevant experiment models are required for testing new therapies and addressing important questions about infarct progression despite successful recanalization, reversibility of ischemic lesions, blood–brain barrier disruption and reperfusion damage. Here, we developed a minimally invasive non-human primate model of cerebral ischemia ( Macaca fascicularis) based on an endovascular transient occlusion and recanalization of the middle cerebral artery (MCA). We evaluated per-occlusion and post-recanalization impairment on PET-MRI, in addition to acute and chronic neuro-functional assessment. Voxel-based analyses between per-occlusion PET-MRI and day-7 MRI showed two different patterns of lesion evolution: “symptomatic salvaged tissue” (SST) and “asymptomatic infarcted tissue” (AIT). Extended SST was present in all cases. AIT, remote from the area at risk, represented 45% of the final lesion. This model also expresses both worsening of fine motor skills and dysexecutive behavior over the chronic post-stroke period, a result in agreement with cortical-subcortical lesions. We thus fully characterized an original translational model of ischemia–reperfusion damage after stroke, with consistent ischemia time, and thrombus retrieval for effective recanalization.
The cellular basis of increased PET hypoxia tracer uptake in focal cerebral ischemia with comparison between [18F]FMISO and [64Cu]CuATSM
Authors: Little Philip V , Arnberg Fabian , Jussing Emma , Lu Li , Ingemann Jensen Andreas , Mitsios Nicholas , Mulder Jan , Tran Thuy A , Holmin Staffan
Published: May 2020

PET hypoxia imaging can assess tissue viability in acute ischemic stroke (AIS). [18F]FMISO is an established tracer but requires substantial accumulation time, limiting its use in hyperacute AIS. [64Cu]CuATSM requires less accumulation time and has shown promise as a hypoxia tracer. We compared these tracers in a M2-occlusion model (M2CAO) with preserved collateral blood flow. Rats underwent M2CAO and [18F]FMISO ( n = 12) or [64Cu]CuATSM ( n = 6) examinations. [64Cu]CuATSM animals were also examined with MRI. Pimonidazole was used as a surrogate for [18F]FMISO in an immunofluorescence analysis employed to profile levels of hypoxia in neurons (NeuN) and astrocytes (GFAP). There was increased [18F]FMISO uptake in the M2CAO cortex. No increase in [64Cu]CuATSM activity was found. The pimonidazole intensity of neurons and astrocytes was increased in hypoxic regions. The pimonidazole intensity ratio was higher in neurons than in astrocytes. In the majority of animals, immunofluorescence revealed a loss of astrocytes within the core of regions with increased pimonidazole uptake. We conclude that [18F]FMISO is superior to [64Cu]CuATSM in detecting hypoxia in AIS, consistent with an earlier study. [18F]FMISO may provide efficient diagnostic imaging beyond the hyperacute phase. Results do not provide encouragement for the use of [64Cu]CuATSM in experimental AIS.
20th Anniversary Ottawa Decision Support Framework: Part 3 Overview of Systematic Reviews and Updated Framework
Authors: Stacey Dawn , Légaré France , Boland Laura , Lewis Krystina B. , Loiselle Marie-Chantal , Hoefel Lauren , Garvelink Mirjam , O’Connor Annette
Published: May 2020

Introduction. The Ottawa Decision Support Framework (ODSF) has guided practitioners and patients facing difficult decisions for 20 years. It asserts that decision support interventions that address patients’ decisional needs improve decision quality. Purpose. To update the ODSF based on a synthesis of evidence. Methods. We conducted an overview of systematic reviews, searching 9 electronic databases. Eligible reviews included decisional needs assessments, decision support interventions, and decisional outcome measures guided by the ODSF. We extracted data and synthesized results narratively. Eight ODSF developers/expert users from 4 disciplines revised the ODSF. Results. Of 4656 citations, we identified 4 eligible reviews (>250 studies, >100 different decisions, >50,000 patients, 18 countries, 5 continents). They reported current ODSF decisional needs and their most frequent manifestations in the areas of inadequate knowledge/information, unclear values, decisional conflict/uncertainty, and inadequate support. They uncovered 11 new manifestations of 6 decisional needs. Using the Decisional Conflict Scale (DCS) to assess decisional needs, average scores were elevated at baseline and declined shortly after decision making, even without information interventions. Patient decision aids were superior to usual care in reducing total DCS scores and improving decision quality. We revised the ODSF by refining definitions of 6 decisional needs and adding new interventions to address 4 needs. We added a decision process outcome and eliminated secondary outcomes unlikely to improve across a range of decisions, retaining the implementation/continuance of the chosen option and appropriate use/costs of health services. Conclusions. We updated the ODSF to reflect the current evidence and identified implications for practice and further research.
Management of a metal foreign body entering the thyroid via the esophagus: a case report
Authors: Wang Songxiang , Xu Chaoyang
Published: May 2020

The entry of a metallic foreign body into the thyroid gland via the esophagus is a rare occurrence, with no previously reported cases. We present a 42-year-old woman who was admitted to hospital with right-sided neck pain, reporting that she had inadvertently swallowed a fish bone. She underwent laryngoscopy, which showed no fish bone in the throat, and no obvious bleeding in the bilateral tonsils and pear-shaped fossa. X-ray examination showed a needle-shaped foreign body in the neck, and a computed tomography scan of her neck showed a 0.1-cm diameter, 2.0-cm long foreign body in the right thyroid. She underwent emergency surgery and a needle of the corresponding size was found in the thyroid gland. This case demonstrates the importance of adequate preoperative assessment and an appropriate surgical approach for thyroid metallic foreign bodies.
Ligamentum arteriosum calcification that presented as an esophageal perforation caused by duck bone ingestion
Authors: Chu Xiang-Yu , Cui Yong , Gao Zhi
Published: May 2020

Ligamentum arteriosum calcification is the calcification or ossification of arterial ligaments. However, on computed tomography images, ligamentum arteriosum calcification is often mistaken for esophageal perforation when a patient has a medical history of foreign body ingestion. Ligamentum arteriosum calcification is uncommon in clinical practice. In this case report, we confirm the presence of this condition intraoperatively, which has seldom been reported previously. Increased awareness of the clinical characteristics of this uncommon disease can help thoracic surgeons with proper patient management.
Recent understanding of Antarctic supraglacial lakes using satellite remote sensing
Authors: Arthur Jennifer F , Stokes Chris , Jamieson Stewart SR , Carr J Rachel , Leeson Amber A
Published: May 2020

Supraglacial lakes (SGLs) are now known to be widespread in Antarctica, where they represent an important component of ice sheet mass balance. This paper reviews how recent progress in satellite remote sensing has substantially advanced our understanding of SGLs in Antarctica, including their characteristics, geographic distribution and impacts on ice sheet dynamics. Important advances include: (a) the capability to resolve lakes at sub-metre resolution at weekly timescales; (b) the measurement of lake depth and volume changes at seasonal timescales, including sporadic observations of lake drainage events and (c) the integration of multiple optical satellite datasets to obtain continent-wide observations of lake distributions. Despite recent progress, however, there remain important gaps in our understanding, most notably: (a) the relationship between seasonal variability in SGL development and near-surface climate; (b) the prevalence and impact of SGL drainage events on both grounded and floating ice and (c) the sensitivity of individual ice shelves to lake-induced hydrofracture. Given that surface melting and SGL development is predicted to play an increasingly important role in the surface mass balance of Antarctica, bridging these gaps will help constrain predictions of future rapid ice loss from Antarctica.
Ranking the critical sections of railway networks
Authors: Meesit Ratthaphong , Andrews John
Published: May 2020

Railway systems are now facing an increasing number of threats such as aging infrastructures and climate changes. The identification of critical network sections provides infrastructure managers with the ability to understand the impact of a disruption and creates a suitable preventive strategy to counter such threats. To this end, various vulnerability analysis methods have been proposed for railway networks. Two main types of methods, network topological analysis and network flow-based analysis, have been developed. Both approaches are constructed based on macroscopic models, which take only some railway properties such as network structure, train and passenger flow into account. Thus, the results obtained are high level approximations. This study proposes a new analysis method, which is developed based on the stochastic-microscopic railway network simulation model. The method can be applied to identify the critical sections of a railway network. The effect of impact levels and occurrence times of a disruption on the network section criticality is presented. An application of the proposed model is demonstrated using the Liverpool railway network in the UK.
Home Country Innovation Performance: Moderating the Local Knowledge and Inward Foreign Direct Investment
Authors: Viglioni Marco Túlio Dinali , Calegario Cristina Lelis Leal
Published: May 2020

The inward foreign direct investment (FDI) has been emphasized in the literature, and although the benefits related to innovation are known, there is not much information about their effects on emerging economies. This study investigates how local domestic factors such as research and development (R&D), exports and foreign technology acquisition moderate with inward FDI to improve the innovation performance. The empirical findings from a generalized method of moments (GMM) estimator suggest, at short term, that the FDI has a positive effect in the Brazilian manufacturing industry. As a complementary effect, there is an interaction between FDI inflows and exports, increasing the innovation performance. However, improvements in R&D-related FDI is not observed. For this reason, the results suggest FDI-related exports could indicate a mere product adaptation to the foreign market. There is a predominance in import substitution of machines, equipment and software and no evidence of internal R&D investments or R&D-related FDI. Our results suggest managerial and policy implications, once it was observed the high-technology intensity industry sectors show better innovation performance than medium- and low-technology industries. Policymakers should implement better policies to encourage more R&D-related FDI to decrease import substitution and improve the local innovation performance to strengthen the local industry R&D investments.
Peer Influence on Aggression at School: How Vulnerable Are Higher Risk Adolescents?
Authors: Hofmann Verena , Müller Christoph Michael
Published: May 2020

Adolescent students with high levels of antisocial behavior are at increased risk for future psychosocial problems and can be expected to be especially vulnerable to negative peer influence. This study therefore examined whether higher risk students are more susceptible than lower risk students to classroom peer influence on aggression. Analyses were based on anonymous self-reports from 792 students in 55 classrooms at four data collection points that span the beginning (T1) to the end (T4) of Grade 7. The mean age at T1 was 13.12 years ( SD = 0.48 years) and 52.7% of the participants were boys. Students’ risk status was assessed using a norm-based cutoff score from a standardized screening instrument. Multilevel analyses revealed that the aggression scores of higher risk students showed larger increases than those of other adolescents and that this difference was dependent on higher aggression levels among classmates. These results suggest that higher risk students may be particularly vulnerable to high levels of aggression in classrooms, whereas low levels of aggression in classrooms may be protective.
Intrasinusoidal HHV8-EBV–Positive Large B-Cell Lymphoma With Features of Germinotropic Lymphoproliferative Disorder
Authors: Martinez-Ciarpaglini Carolina , Valkov Andrey , Hurtado Mercedes , Agustí Jaime , Malave Giomer , Ferrández Antonio
Published: May 2020

Germinotropic lymphoproliferative disorder (GLPD) is a poorly characterized lymphoproliferative entity, recently included in the World Health Organization classification of hematolymphoid neoplasms. The histological pattern of this disease comprises monotypic plasmablasts that involve the germinal centers of the lymphoid follicles (germinotrophism), forming confluent aggregates positive for both human herpes virus type 8 (HHV8) and Epstein-Barr virus. Currently, after 17 years of its first description, only 18 cases have been reported. In this article, we describe a case of a GLPD presenting in an immunocompetent 79-year-old woman with localized axillary lymphadenopathy, showing a prominent sinusoidal growth pattern, with no evidence of germinotrophism or extrasinusoidal spread. Stinking pleomorphism in tumor cells was also noted. An extension study has not revealed involvement of other groups of lymph nodes or extralymphoid sites. The patient is alive and has shown no relapse after 8 years follow-up (the longest follow-up reported period for this entity). This previously unrecognized pure sinusoidal growth pattern along with the striking pleomorphism in neoplastic cells closely mimics the appearance of an anaplastic large cell lymphoma. GLPD is not usually considered in such a setting, but it should be included in the differential diagnosis of sinusoidal proliferations. Our findings contribute to the expansion of the morphological spectrum of HHV8-associated lymphoproliferative lesions and aids in the characterization of the very infrequent GLPD entity.
Rethinking alternative youth identities in Izmir: ‘Indifferently cool’ manifestations
Authors: Sahin Ture
Published: May 2020

This article discusses the self-identification and meaning-making processes of ‘alternative’ youth in Izmir, Turkey, by focusing on their own narratives and the microcosmos of their everyday life practices. The research argues that while alternative young individuals benefit from the global subcultural scene, particularly hipster subculture, they also create complex signifiers within their cultural environments to emphasise both individual subjectivities and shared ‘alternative’ group identities. The article claims that subcultures, with their styles, images and music that are consumed in imaginative ways, become productive and creative spheres of cultural production that are constantly at interplay with broader cultural forms in a given society. Hence, opening up a debate on youth subcultures has the potential to give salient clues about the transformations of society at large and its cultural values and beliefs. In this sense, the study formulates subcultures as offshoots – even forms of resistance – both drawing on and feeding mainstream cultural forms. The study is based on field research conducted among alternative youth in Izmir, Turkey – through participant observation, semi-structured interviews with youth groups and in-depth interviews with the owners and workers of the places where ‘alternative’ youth hang out. Since contemporary youth cultures in Turkey are a highly under-researched area, this article aims at mapping out a general framework towards a better understanding of the everyday practices and meaning worlds of alternative young people. It is hoped that this, in turn, will serve to pave the way for further research on youth subcultures in Turkey.
Investigation of the incremental and deformation theories of plasticity on the elastoplastic postbuckling of plates
Authors: Soltani HM , Kharazi M
Published: May 2020

This article investigates the elastoplastic response of buckling and postbuckling behavior of plates under uniaxial and biaxial end-shortening considering incremental theory and deformation theory of plasticity. According to elastoplastic buckling and postbuckling behavior of plates, the finite element code considering geometrically and material nonlinearities is developed based on incremental theory and deformation theory of plasticity. The results show that boundary conditions, loading ratios, and aspect ratios of a plate have a significant effect on the discrepancy between incremental theory and deformation theory. Moreover, differences in estimating the buckling point using incremental theory and deformation theory are less than 10%, while in a number of plates at the last loading steps, postbuckling paths determined by incremental theory and deformation theory are diverted from each other. Also the difference between these two theories in the postbuckling region is more noticeable by increasing the thickness of plates.
Global deinstitutionalisation policy in the post-Soviet space: A comparison of child-welfare reforms in Russia and Kazakhstan
Authors: An Sofia , Kulmala Meri
Published: May 2020

This article compares how the global policy of deinstitutionalisation (DI) of child welfare travelled, was translated and institutionalised in two post-Soviet countries – Russia and Kazakhstan. These countries share a Soviet legacy of child-welfare systems dominated by residential care and have recently introduced similar DI reforms based on the global child rights framework. However, despite similar institutional legacies and post-Soviet conditions, the DI reforms have produced different outcomes in terms of the scope and pace of the institutionalisation of DI policy. In Russia, the DI of child welfare has been a fast-moving and sweeping reform, while in Kazakhstan, the implementation of DI has been an incremental and gradual process. We argue that the institutionalisation of the DI policy in two post-Soviet contexts was an outcome of the interplay between structural factors and the agency of policy actors who translated global DI ideology into domestic policy discourses. Yet, they were ‘sold’ with quite different discursive frames – one nationalist, another one trans-nationalist – in these two countries. We claim that the geopolitical position of a country is also a significant factor for framing and thus, in the end, in how child-welfare systems have been reformed.
Beaches and Muslim belonging in France: liberty, equality, but not the burkini!
Authors: Nielson Samuel P
Published: May 2020

Drawing on Marco Antonsich’s framework for analyzing belonging while also engaging critical legal geographies, this article applies a legal lens to Muslim belonging. It does so through discourse analysis of court, legislative, and political pronouncements regarding burkini bans that surfaced in France shortly after a terror attack by a self-identified Muslim, and with ‘burkini’ serving as a proxy for Islam in their rhetoric. The article focuses on the language used by France’s highest administrative court in overturning one city’s ban, as well as language used by French political leaders in supporting the bans, to examine the message of belonging conveyed to Muslims in France. Legal language is the focus because of its ability to frame conversations regarding societal norms, with the language explored here framing the broader debate on Muslim belonging in French public space and arguably what the French population believes is necessary to belong in French society. This exploration provides a foundation for further research by scholars exploring issues of identity, migration, belonging, race, and religion, using methodologies such as feminism and critical race theory that can readily connect with the critical legal approach applied here.
Identification of patients with embolic stroke of undetermined source and low risk of new incident atrial fibrillation: The AF-ESUS score
Authors: Ntaios George , Perlepe Kalliopi , Lambrou Dimitris , Sirimarco Gaia , Strambo Davide , Eskandari Ashraf , Karagkiozi Efstathia , Vemmou Anastasia , Korompoki Eleni , Manios Efstathios , Makaritsis Konstantinos , Vemmos Konstantinos , Michel Patrik
Published: May 2020

Background and aims

Only a minority of patients with Embolic Stroke of Undetermined Source (ESUS) receive prolonged cardiac monitoring despite current recommendations. The identification of ESUS patients who have low probability of new diagnosis of atrial fibrillation (AF) could potentially support a strategy of more individualized allocation of available resources and hence, increase their diagnostic yield. We aimed to develop a tool that can identify ESUS patients who have low probability of new incident AF.

Methods

We performed multivariate stepwise regression in a pooled dataset of consecutive ESUS patients from three prospective stroke registries to identify predictors of new incident AF. The coefficient of each independent covariate of the fitted multivariable model was used to generate an integer-based point scoring system.

Results

Among 839 patients (43.1% women, median age 67.0 years) followed-up for a median of 24.3 months (2999 patient-years), 125 (14.9%) had new incident AF. The proposed score assigns 3 points for age ≥ 60 years; 2 points for hypertension; −1 point for left ventricular hypertrophy reported at echocardiography; 2 points for left atrial diameter >40 mm; −3 points for left ventricular ejection fraction <35%; 1 point for the presence of any supraventricular extrasystole recorded during all available 12-lead standard electrocardiograms performed during hospitalization for the ESUS; −2 points for subcortical infarct; −3 points for the presence of non-stenotic carotid plaques. The rate of new incident AF during follow-up was 1.97% among the 42.3% of the cohort who had a score of ≤0, compared to 26.9% in patients with > 0 (relative risk: 13.7, 95%CI: 5.9--31.5). The area under the curve of the score was 84.8% (95%CI: 79.9--86.9%). The sensitivity and negative predictive value of a score of ≤0 for new incident AF during follow-up were 94.9% (95%CI: 89.3--98.1%) and 98.0% (95%CI: 95.8--99.3%), respectively.

Conclusions

The proposed AF-ESUS score has high sensitivity and high negative predictive value to identify ESUS patients who have low probability of new incident AF. Patients with a score of 1 or more may be better candidates for prolonged automated cardiac monitoring.

Clinical trial registration

URL: https://www.clinicaltrials.gov / Unique identifier: NCT02766205.
Cornifronone: A cadinane-type sesquiterpene from a mason bee (Osmia cornifrons)–derived Streptomyces sp
Authors: Li Guo-Li , Xu Ze-Yu , Li Nan , Wang Zhe , Tian Tian , Shen Tong
Published: May 2020

A new cadinane-type sesquiterpene named cornifronone is isolated from the body surface of a mason bee ( Osmia cornifrons)–derived Streptomyces sp. OC1611-8A. Its structure is identified by high-resolution electrospray ionization mass spectrometry data and nuclear magnetic resonance spectroscopic analysis. The absolute configuration of cornifronone was determined by electronic circular dichroism spectra calculations. Cornifronone inhibits hexokinase activity with a mean IC50 of 124.3 μM.
Surgical Treatment of Ossifications of the Cervical Anterior Longitudinal Ligament: A Retrospective Cohort Study
Authors: Glinski Alexander von , Takayanagi Ariel , Elia Christopher , Ishak Basem , Listmann Mishan , Pierre Clifford A. , Blecher Ronen , Hayman Erik , Chapman Jens R. , Oskouian Rod J.
Published: May 2020

Study Design:

Retrospective cohort study

Objectives:

The study aims to evaluate anterior cervical discectomy and fusion (ACDF) in the treatment of patients with ossification of the anterior longitudinal ligament (OALL).

Methods:

We retrospectively reviewed cases performed at our institution between January 2015 and December 2018; adult (age ≥18 years) patients who underwent anterior cervical decompression and fusion in the presence of dysphagia and OALL. Ten patients (9 male, 1 female, mean age 64.4 years) with OALL who underwent ACDF were included. Charts were reviewed for demographics and comorbidities. Primary outcomes assessed were intra- and postoperative complications. Secondary outcomes were fusion rates, instrumentation failure, postsurgical instability/deformity, and readmission rates.

Results:

The average duration of symptoms prior to surgery was 12.3 months. All patients presented with dysphagia (mean Bazaz score 2.0). The average number of levels with OALL was 4.7 (±1.67). All patients underwent ACDF and 3 patients underwent additional posterior cervical fusion for kyphotic deformity correction or when extensive laminectomy was required. We did not encounter any intraoperative complications. Eight patients (72%) had solid fusion demonstrated on the lateral x-rays and no evidence of progressive kyphotic deformity. We did not encounter any instrumentation failure or loosening. Two patients developed recurrence of dysphagia (Bazaz scores 2 and 3 respectively).

Conclusion:

ACDF for OALL with dysphagia and concomitant myelopathy in our small series of 10 patients demonstrate good fusion and clinical outcomes. Larger studies will be necessary to determine the optimal treatment for patients with dysphagia due to OALL.
Exploring Takfir, Its Origins and Contemporary Use: The Case of Takfiri Approach in Daesh’s Media
Authors: Kadivar Jamileh
Published: May 2020

Muslims have been the primary targets of Daesh’s attacks since 2014 in different countries such as Afghanistan, Iraq, and Syria. These attacks were based on its takfiri ideology. As Daesh official media and documents indicate, kufr (unbelief, infidelity) in Daesh’s approach is not limited to non-Muslims (original disbelievers), but Muslims are the most significant parts of kuffar (unbelievers) in its view and defined as incidental disbelievers. Through studying Daesh’s official documents and various Arabic, English, and Persian media productions, in an explanatory research, this article attempts to display Daesh’s takfiri approach toward Muslims and explains its historical and ideological roots, difference with Al-Qaeda’s takfiri approach, different approaches to takfir inside Daesh, main targets of Daesh’s takfir, and the reasons behinds its takfiri view. This article displays that for Daesh, the Muslims are limited only to Sunni Muslims who are accepting and following its approach. Other Sunni and non-Sunni Muslims are thus kuffar. This study also shows that the assertion of takfir has become a method for Daesh to discredit its opponents, such as Shi’a Muslims and other Muslim groups.
Association of Demographics and Hospital Stay Characteristics With Patient Experience in Hospitalized Pediatric Patients
Authors: Chen Jerome Gene , Lee Stacey , Khallouq Bertha Ben
Published: May 2020

There is limited research on patient experience in hospitalized pediatric patients. Our aim was to investigate the association of patient demographics and hospital stay characteristics with experience in a tertiary-care, freestanding children’s hospital. We conducted a retrospective cross-sectional study of patient experience surveys. We designated the highest rating as “top-box” and examined data across 8 domains, including overall assessment (OA). A total of 4602 surveys were analyzed. Top-box percentages were lower for younger patients in 6 domains, including OA (0-<1 year old: 57.6%; 1-<4 years old: 61.3%; 4-<12 years old: 68.4%; ≥12 years old: 70.2%; P < .001), and were lower for patients with private insurance in 5 domains, including OA (private 63.2%, public 68.9%; P < .001). There was no association between other demographics (gender, race/ethnicity, primary language) and OA. Overall assessment was also not associated with length of stay ( P = .071) and number of consulting services ( P = .703). The most important domain predictor of OA was personal issues (odds ratio = 4.79), which assessed concern, sensitivity, and communication from staff. In conclusion, patient experience was associated with age and insurance status but not hospital stay characteristics.
Investigation of the In Vitro Antioxidant Potential Of Polyphenolic-Rich Extract of Artocarpus heterophyllus Lam Stem Bark and Its Antidiabetic Activity In Streptozotocin-Induced Diabetic Rats
Authors: Ajiboye Basiru Olaitan , Ojo Oluwafemi Adeleke , Oyinloye Babatunji Emmanuel , Okesola Mary Abiola , Oluwatosin Adeyonu , Boligon Aline Augusti , Kappo Abidemi Paul
Published: May 2020

Artocarpus heterophyllus Lam (Moraceae) stem bark has been used locally in managing diabetes mellitus with sparse scientific information. This study investigates the in vitro antioxidant potential of polyphenolic-rich extract of A heterophyllus stem bark as well as its antidiabetic activity in streptozotocin-induced diabetic rats. Fifty male Wistar rats were used with the induction of diabetes by a single intraperitoneal injection of streptozotocin (45 mg/kg body weight) and were orally administered 400 mg/kg free and bound phenols of A heterophyllus stem bark. The animals were sacrificed on the 28th day of the experiment using the cervical dislocation method; antihyperglycemia and anti-inflammatory parameters were subsequently assessed. The polyphenolic extracts demonstrated antioxidant potentials (such as hydrogen peroxide and diphenyl-1-picrylhydrazyl), as well as strong inhibitory activity against amylase and glucosidase. There was a significant ( P < .05) increase in glycogen, insulin concentration, pancreatic β-cell scores (HOMA-β), antioxidant enzymes and hexokinase activities, as well as glucose transporter concentration in diabetic animals administered the extracts and metformin. Also, a significant ( P < .05) reduction in fasting blood glucose, lipid peroxidation, glucose-6-phosphatase, and all anti-inflammatory parameters were observed in diabetic rats administered the extracts and metformin. The extracts demonstrated antidiabetic potential, which may be useful in the management of diabetes mellitus