bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantitative determination of organic adsorption capacity in the Palaeozoic shales from South China
Authors: Wang Sibo , Song Zhiguang , Xia Jia , Gao Yuan , Wang YaoPing , Cao Taotao
Published: January 2021

In this study, the methane adsorption capacity of kerogen isolated from the Cambrian, Silurian, and Permian shales and the impact of soluble organic matter (SOM) on the adsorption capacity of these shales were investigated. The results reveal that 1) the adsorption capacity of kerogen varies in a broad range, from 14.48 to 23.22 cm3/g for the Cambrian kerogens, from 15.50 to 36.06 cm3/g for the Silurian kerogens, and from 10.71 to 11.15 cm3/g for the Permian kerogens; 2) the kerogen adsorption accounts for 33.67–70.23% of the total adsorption capacity of these Palaeozoic extracted shales, demonstrating that kerogen is the primary adsorbing substance in shales; 3) the adsorption isotherms of kerogen in highly mature Cambrian and Silurian shales are similar to those of Triassic coal, while the isotherms of kerogen in the relatively immature Permian shales are similar to those of the immature oil shales; and 4) the SOM demonstrates a significant impact on the adsorption capacity of shales as the removal of SOM can cause a maximum increase of 34.29% or a decrease of 23.36% in the total adsorption capacity of shales. However, there is no clear understanding of the impact of SOM on the methane sorption of shales.
Automatic Lumen Border Detection in IVUS Images Using Deep Learning Model and Handcrafted Features
Authors: Li Kai , Tong Jijun , Zhu Xinjian , Xia Shudong
Published: January 2021

In the clinical analysis of Intravascular ultrasound (IVUS) images, the lumen size is an important indicator of coronary atherosclerosis, and is also the premise of coronary artery disease diagnosis and interventional treatment. In this study, a fully automatic method based on deep learning model and handcrafted features is presented for the detection of the lumen borders in IVUS images. First, 193 handcrafted features are extracted from the IVUS images. Then hybrid feature vectors are constructed by combining handcrafted features with 64 high-level features extracted from U-Net. In order to obtain the feature subsets with larger contribution, we employ the extended binary cuckoo search for feature selection. Finally, the selected 36-dimensional hybrid feature subset is used to classify the test images using dictionary learning based on kernel sparse coding. The proposed algorithm is tested on the publicly available dataset and evaluated using three indicators. Through ablation experiments, mean value of the experimental results (Jaccard: 0.88, Hausdorff distance: 0.36, Percentage of the area difference: 0.06) prove to be effective improving lumen border detection. Furthermore, compared with the recent methods used on the same dataset, the proposed method shows good performance and high accuracy.
A study of Turkish emotion classification with pretrained language models
Authors: Uçan Alaettin , Dörterler Murat , Akçapınar Sezer Ebru
Published: January 2021

Emotion classification is a research field that aims to detect the emotions in a text using machine learning methods. In traditional machine learning (TML) methods, feature engineering processes cause the loss of some meaningful information, and classification performance is negatively affected. In addition, the success of modelling using deep learning (DL) approaches depends on the sample size. More samples are needed for Turkish due to the unique characteristics of the language. However, emotion classification data sets in Turkish are quite limited. In this study, the pretrained language model approach was used to create a stronger emotion classification model for Turkish. Well-known pretrained language models were fine-tuned for this purpose. The performances of these fine-tuned models for Turkish emotion classification were comprehensively compared with the performances of TML and DL methods in experimental studies. The proposed approach provides state-of-the-art performance for Turkish emotion classification.
Engaging Underrepresented Communities in Health Research: Lessons Learned
Authors: Yu Zhiyuan , Kowalkowski Jennifer , Roll Anne E. , Lor Maichou
Published: January 2021

Members of marginalized communities experience health disparities or inequities and are underrepresented in health research. Community engagement in research is a catalyst for researchers to address health disparities while prioritizing community needs and strengthening community capacity. There is limited knowledge on how to engage underrepresented communities throughout the research process, particularly on initiating a partnership and planning research with a community. The purpose of this reflection piece is to share individual cases of research engagement within four communities: immigrant postpartum women, rural residents engaged in farming, low literate and non-English speaking adults, and individuals with intellectual disabilities in the United States. In each case, we explain how we initiated partnerships with the communities, continued to integrate community feedback to guide research questions, and implemented tailored methodologies. Finally, we discuss commonalities and differences in approaches used, tailoring within, and lessons learned when working with these diverse, underrepresented communities during the research process.
The UK’s hostile environment: Deputising immigration control
Authors: Griffiths Melanie , Yeo Colin
Published: January 2021

In 2012, Home Secretary Theresa May told a newspaper that she wanted to create a ‘really hostile environment’ for irregular migrants in the UK. Although the phrase has since mutated to refer to generalised state-led marginalisation of immigrants, this article argues that the hostile environment is a specific policy approach, and one with profound significance for the UK’s border practices. We trace the ‘hostile environment’ phrase, exposing its origins in other policy realms, charting its evolution into immigration, identifying the key components and critically reviewing the corresponding legislation. The article analyses the impact and consequences of the hostile environment, appraising the costs to public health and safety, the public purse, individual vulnerability and marginalisation, and wider social relations. We conclude by identifying the fundamental flaws of the policy approach, arguing that they led to the 2018 Windrush scandal and risk creating similar problems for European Economic Area nationals after Brexit.
Nobody’s Perfect: Making sense of a parenting skills workshop through ethnographic research in a low-income neighbourhood in Santiago de Chile
Authors: Murray Marjorie , Tapia Daniela
Published: January 2021

Nadie es Perfecto (Nobody’s Perfect, or NEP) is a parenting skills workshop aimed at ‘sharing experiences and receiving guidance on everyday problems to strengthen child development’. This article explores this workshop in terms of its relationship with the daily lives of participants, based on one year of fieldwork focused on families with young children in a low-income neighbourhood in Santiago. While caregivers frame their parenting efforts as aiming to ‘hacer lo mejor posible’ (do their best) under difficult circumstances, our study found that facilitators take an anachronistic and homogenizing view of participants. Embracing a universalistic perspective of child development, they discourage participation and debate, focusing instead on providing concrete advice that limits the potential of the workshops. This article argues that by ignoring the different living situations of families in this socioeconomic context, NEP reproduces a prejudiced view of poor subjects that sees them as deficient and incapable of change.
A randomised controlled clinical trial comparing the effectiveness of bandaging compared to the JuxtaCures™ device in the management of people with venous ulceration: Feasibility study
Authors: Stather Philip , Petty Carroll , Langthorne Helen , Rayner Emma , Zhang Jufen , Hayden Karen , Howard Adam
Published: January 2021

Introduction

The mainstay of treatment for venous ulceration remains compression therapy. Velcro Wrap devices are being increasingly used in these patients despite limited evidence. This feasibility study aimed to compare standard bandaging to the JuxtaCures™ Velcro wrap device.

Methods

A single centre, unblinded RCT compared participants with venous ulceration randomised to either the JuxtaCures™ device or short stretch bandaging. Participants were followed up for 26 weeks.

Results

160 participants were screened with 40 randomised. 3 participants in bandaging and 1 in JuxtaCures™ didn’t complete the study. 60% in JuxtaCures™ healed v 55% in bandaging despite larger ulcers in the JuxtaCures™ arm (9.33 cm2 v 6.97 cm2). There was no significant difference in time to healing (12.17 v 13.64 weeks). JuxtaCures™ showed improved ulcer reduction for those that didn’t heal (14.91–5.00 cm2 v 14.20–8.62 cm2; P = 0.06). JuxtaCures™ had more consistent sub-bandage pressure dropping from 39–36 mmHg versus 41–25 mmHg in bandaging between application and removal (P < 0.001). Quality of life (EQ5D) was improved in JuxtaCures at 3 months (mean difference 0.14, p = 0.04), but not at 1 and 6 months, or in disease specific quality of life. Cost was lower in JuxtaCures™ £842.47 v £1064.68. Duration of appointment was significantly shorter in JuxtaCures™ (41 minutes v 53 minutes; P = 0.003).

Conclusion

This study has shown the feasibility and necessity of running a multicentre trial to evaluate the use of Velcro wrap devices for venous ulceration. It highlights the potential benefits of more consistent pressure, increased self-care, and potential with regards to ulcer healing, cost, nursing resource and quality of life.
The need for a Net Zero Principles Framework to support public policy at local, regional and national levels
Authors: Turner Karen , Katris Antonios , Race Julia
Published: January 2021

Many nations have committed to midcentury net zero carbon emissions targets in line with the 2015 Paris Agreement. These require systemic transition in how people live and do business in different local areas and regions within nations. Indeed, in recognition of the climate challenge, many regional and city authorities have set their own net zero targets. What is missing is a grounded principles framework to support what will inevitably be a range of broader public policy actions, which must in turn consider pathways that are not only technically, but economically, socially and politically feasible. Here, we attempt to stimulate discussion on this issue. We do so by making an initial proposition around a set of generic questions that should challenge any decarbonisation action, using the example of carbon capture and storage to illustrate the importance and complexity of ensuring feasibility of actions in a political economy arena. We argue that this gives rise to five fundamental ‘Net Zero Principles’ around understanding of who really pays and gains, identifying pathways that deliver growing and equitable prosperity, some of which can deliver near-term economic returns, while avoiding outcomes that simply involve ‘off-shoring’ of emissions, jobs and gross domestic product.
Reflective insights from developing a palliative care children and young people’s advisory group
Authors: Roach Anna , Braybrook Debbie , Marshall Steve
Published: January 2021

Background:

The importance of actively involving patient and public members throughout the different stages of palliative care and health research projects is widely acknowledged, however patient and public involvement work rarely considers insight from children and young people. Although this is becoming increasingly recognised in other areas of research, there is currently no structured guidance on how to best involve children and young people in palliative care research.

Aim:

To plan and deliver a Young People’s Advisory Group in palliative care and health research at a secondary school.

Findings:

Attending an after-school ‘Health and Social Research Methods Club’ for 11 weeks benefitted children and researchers. Children were taught about data collection methods, data analysis and ethics in health research and used these skills to provide valuable feedback which has been implemented in current palliative care research projects. Children took part in considered discussions around palliative care topics and enjoyed attending the group.

Conclusion:

This project has equipped researchers with skills and provided a structured template for future Young People’s Advisory Groups, ensuring the unique voices of children and young people are considered and valued in future palliative care research.
Cerebral arterial pulsatility is linked to hippocampal microvascular function and episodic memory in healthy older adults
Authors: Vikner Tomas , Eklund Anders , Karalija Nina , Malm Jan , Riklund Katrine , Lindenberger Ulman , Bäckman Lars , Nyberg Lars , Wåhlin Anders
Published: January 2021

Microvascular damage in the hippocampus is emerging as a central cause of cognitive decline and dementia in aging. This could be a consequence of age-related decreases in vascular elasticity, exposing hippocampal capillaries to excessive cardiac-related pulsatile flow that disrupts the blood-brain barrier and the neurovascular unit. Previous studies have found altered intracranial hemodynamics in cognitive impairment and dementia, as well as negative associations between pulsatility and hippocampal volume. However, evidence linking features of the cerebral arterial flow waveform to hippocampal function is lacking. We used a high-resolution 4D flow MRI approach to estimate global representations of the time-resolved flow waveform in distal cortical arteries and in proximal arteries feeding the brain in healthy older adults. Waveform-based clustering revealed a group of individuals featuring steep systolic onset and high amplitude that had poorer hippocampus-sensitive episodic memory (p = 0.003), lower whole-brain perfusion (p = 0.001), and weaker microvascular low-frequency oscillations in the hippocampus (p = 0.035) and parahippocampal gyrus (p = 0.005), potentially indicating compromised neurovascular unit integrity. Our findings suggest that aberrant hemodynamic forces contribute to cerebral microvascular and hippocampal dysfunction in aging.
Regional and depth-dependence of cortical blood-flow assessed with high-resolution Arterial Spin Labeling (ASL)
Authors: Taso Manuel , Munsch Fanny , Zhao Li , Alsop David C
Published: January 2021

Methods for imaging of cerebral blood flow do not typically resolve the cortex and thus underestimate flow. However, recent work with high-resolution MRI has emphasized the regional and depth-dependent structural, functional and relaxation times variations within the cortex. Using high-resolution Arterial Spin Labeling (ASL) and T1 mapping acquisitions, we sought to probe the effects of spatial resolution and tissue heterogeneity on cortical cerebral blood flow (CBF) measurements with ASL. We acquired high-resolution (1.6mm) 3 whole brain ASL data in a cohort of 10 volunteers at 3T, along with T1 and transit-time (ATT) mapping, followed by group cortical surface-based analysis using FreeSurfer of the different measured parameters. Fully resolved regional analysis showed higher than average mid-thickness CBF in primary motor areas (+15%,p<0.002), frontal regions (+17%,p<0.01) and auditory cortex, while occipital regions had lower average CBF (-20%,p<10−5). ASL signal was higher towards the pial surface but correction for the shorter T1 near the white matter surface reverses this gradient, at least when using the low-resolution ATT map. Similar to structural measures, fully-resolved ASL CBF measures show significant differences across cortical regions. Depth-dependent variation of T1 in the cortex complicates interpretation of depth-dependent ASL signal and may have implications for the accurate CBF quantification at lower resolutions.
Imaging biomarkers of vascular and axonal injury are spatially distinct in chronic traumatic brain injury
Authors: Haber Margalit , Amyot Franck , Lynch Cillian E , Sandsmark Danielle K , Kenney Kimbra , Werner John K , Moore Carol , Flesher Kelley , Woodson Sarah , Silverman Erika , Chou Yiyu , Pham Dzung , Diaz-Arrastia Ramon
Published: January 2021

Traumatic Brain Injury (TBI) is associated with both diffuse axonal injury (DAI) and diffuse vascular injury (DVI), which result from inertial shearing forces. These terms are often used interchangeably, but the spatial relationships between DAI and DVI have not been carefully studied. Multimodal magnetic resonance imaging (MRI) can help distinguish these injury mechanisms: diffusion tensor imaging (DTI) provides information about axonal integrity, while arterial spin labeling (ASL) can be used to measure cerebral blood flow (CBF), and the reactivity of the Blood Oxygen Level Dependent (BOLD) signal to a hypercapnia challenge reflects cerebrovascular reactivity (CVR). Subjects with chronic TBI (n = 27) and healthy controls (n = 14) were studied with multimodal MRI. Mean values of mean diffusivity (MD), fractional anisotropy (FA), CBF, and CVR were extracted for pre-determined regions of interest (ROIs). Normalized z-score maps were generated from the pool of healthy controls. Abnormal ROIs in one modality were not predictive of abnormalities in another. Approximately 9-10% of abnormal voxels for CVR and CBF also showed an abnormal voxel value for MD, while only 1% of abnormal CVR and CBF voxels show a concomitant abnormal FA value. These data indicate that DAI and DVI represent two distinct TBI endophenotypes that are spatially independent.
Differences in Implementation Outcomes of a Shared Decision-Making Program for Men with Prostate Cancer between an Academic Medical Center and County Health Care System
Authors: Li Kevin D. , Saigal Christopher S. , Tandel Megha D. , Kwan Lorna , Inkelas Moira , Alden Dana L. , Frencher Stanley K. , Gollapudi Kiran , Blumberg Jeremy , Nabhani Jamal , Bergman Jonathan
Published: January 2021

Background

Shared decision making (SDM) has long been advocated as the preferred way for physicians and men with prostate cancer to make treatment decisions. However, the implementation of formal SDM programs in routine care remains limited, and implementation outcomes for disadvantaged populations are especially poorly described. We describe the implementation outcomes between academic and county health care settings.

Methods

We administered a decision aid (DA) for men with localized prostate cancer at an academic center and across a county health care system. Our implementation was guided by the Consolidated Framework for Implementation Research and the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. We assessed the effectiveness of the DA through a postappointment patient survey.

Results

Sites differed by patient demographic/clinical characteristics. Reach (DA invitation rate) was similar and insensitive to implementation strategies at the academic center and county (66% v. 60%, P = 0.37). Fidelity (DA completion rate) was also similar at the academic center and county (77% v. 80%, P = 0.74). DA effectiveness was similar between sites, except for higher academic center ratings for net promoter for the doctor (77% v. 37%, P = 0.01) and the health care system (77% v. 35%, P = 0.006) and greater satisfaction with manner of care (medians 100 v. 87.5, P = 0.04). Implementation strategies (e.g., faxing of patients’ records and meeting patients in the clinic to complete the DA) represented substantial practice changes at both sites. The completion rate increased following the onset of reminder calls at the academic center and the creation of a Spanish module at the county.

Conclusions

Successful DA implementation efforts should focus on patient engagement and access. SDM may broadly benefit patients and health care systems regardless of patient demographic/clinical characteristics.
Loss or Gain? Unpacking Nonprofit Autonomy-Interdependence Paradox in Collaborations
Authors: Xu Chengxin , Kim Mirae
Published: January 2021

Nonprofit organizations interested in collaborating with other entities find it difficult to strike a balance between keeping their autonomy and reaping the benefits from collaborating with other organizations. Although interorganizational collaborations come with various benefits, such as reducing competition over limited resources, participating in collaborative relationships can also damage the autonomy of individual nonprofits. Using an original survey of 275 nonprofits, we examine how various dimensions of collaborative relationships affect an individual nonprofit’s autonomy. Our findings suggest that having highly specified administrative arrangements and stronger trust as well as reciprocity among partner organizations serve as critical factors to secure the autonomy of individual organizations. We also find that nonprofit organizations engaged in mostly informal relationships and in partnerships across sectors feel less threatened about maintaining their autonomy. Our post hoc analysis further suggests that organizational autonomy is a significant antecedent for seeking more collaborations. To this end, we discuss how nonprofits can keep their organizational autonomy without giving up collaborating with other entities by strategically managing several aspects of the collaborative relationships.
Studying Emotive Effects in Poetry by Quantifying Open-Ended Impressions
Authors: Gafni Chen , Tsur Reuven
Published: January 2021

Poems, as aesthetic objects, generate a subjective experience, which can be different for different readers. In this paper, we propose a method to quantify these subjective experiences. We gave participants three parallel excerpts and asked them to describe, in free text, the perceived emotive qualities of these excerpts. The descriptions were analysed quantitatively according to the dimensions of the Valence-Arousal-Dominance model of emotion. With the help of additional rating tasks and a structural theory of phonetic symbolism, we attribute the perceived emotive qualities to an interaction between the meaning of words, patterns of alliteration, and metric deviation.
Coinfection by Talaromyces marneffei and Mycobacterium abscessus in a human immunodeficiency virus-negative patient with anti-interferon-γ autoantibody: a case report
Authors: Jin Weizhong , Liu Jianhong , Chen Kuang , Shen Ling , Zhou Yan , Wang Limin
Published: January 2021

Patients with anti-interferon (IFN)-γ autoantibodies have weakened immune defenses against intracellular pathogens. Because of its low incidence and non-specific symptoms, diagnosis of anti-IFN-γ autoantibody syndrome is difficult to establish during the early stages of infection. Here, we report a patient with high titers of serum anti-IFN-γ autoantibodies suffering from opportunistic infections. The patient presented with intermittent fever for 2 weeks. During his first hospitalization, he was diagnosed with Talaromyces marneffei pulmonary infection and successfully treated with antifungal therapy. However, multiple cervical lymph nodes subsequently became progressively enlarged. Mycobacterium abscessus infection was confirmed by positive cervical lymph node tissue cultures. High-titer serum anti-IFN-γ antibodies were also detected. Following anti- M. abscessus therapy, both his symptoms and lymph node lymphadenitis gradually improved. Anti-IFN-γ autoantibody syndrome should be considered in adult patients with severe opportunistic coinfections in the absence of other known risk factors.
Clinical characteristics and indications for surgery for bezoar-induced small bowel obstruction
Authors: Wang Shuai , Yang Xiaohui , Zheng Yixiong , Wu Yulian
Published: January 2021

Background

To evaluate the clinical characteristics and indications for surgery for bezoar-induced small bowel obstruction (BI-SBO).

Methods

Forty patients with BI-SBO were treated at our hospital from January 2017 to December 2019, and these patients’ clinical and computed tomography (CT) data were analyzed.

Results

Twenty-seven and 13 BI-SBO patients constituted the non-ST group and ST group, respectively. The clinical manifestations of BI-SBO in both groups were abdominal pain, nausea, vomiting, and lack of defecation. Comparing the non-ST vs ST groups, respectively: mean age (years): 63.15 ± 16.15 vs 60.38 ± 12.47; duration of symptoms (hours): 55.11 ± 44.08 vs 59.33 ± 72.90; mean bezoar length (cm): 5.31 ± 0.74 vs 3.72 ± 0.53; mean bezoar width (cm): 3.74 ± 0.48 vs 2.9 ± 0.64; bezoar CT maximum Hounsfield units (HU): 97.23 ± 12.36 vs 21.11 ± 7.27; total hospital stay (days): 5.56 ± 4.23 vs 7.12 ± 6.12 (mean: 8.62 ± 2.81); and total hospitalization costs (RMB): 6378.02 ± 3015.68 vs 8213.71 ± 5564.29. Mean operation time was 85.00 ± 8.90 minutes, and mean operation blood loss was 32.31 ± 19.64 mL. Bezoars were located 60 to 160 cm from the ileocecal junction. Univariate analysis demonstrated that bezoar length and width and maximum CT value were significant risk factors for surgery.

Conclusion

Large bezoar size and high CT values may be indications for surgery. Surgery is necessary and effective when nonsurgical treatment is ineffective.
Epidemiological investigation of hospitalized patients with traumatic fractures: a cross-sectional study
Authors: Jin Zeyue , Lv Hongzhi , Li Ming , Hou Zhiyong , Lian Xiaodong , Chen Wei , Zhang Yingze
Published: January 2021

Objective

This study was performed to explore major risk factors for traumatic fracture by comparing related data of hospitalized patients with traumatic fracture and patients with lumbar disc herniation.

Methods

Patients with traumatic fracture and patients with lumbar disc herniation requiring surgical treatment in the orthopedics department of our hospital from March to May 2018 were divided into a fracture group and a non-fracture group. Clinical data were collected from the two groups by questionnaires. Major risk factors for traumatic fracture were analyzed using multivariate logistic regression.

Results

Univariate analysis showed statistically significant differences in family history of fracture, smoking history, drinking history, sex, sleep duration, chronic disease history, osteoporosis history, age, body mass index, occupation, and education level between the two groups. Multivariate logistic regression analysis showed that patients aged 25 to 44 years were more prone to traumatic fracture than patients aged ≥65 years, male patients were more prone to fracture than female patients, drinking alcohol was a risk factor for traumatic fracture, and sufficient sleep duration (>7 hours/night) was a protective factor for traumatic fracture.

Conclusion

Young age, male sex, and drinking are risk factors for traumatic fracture, whereas sufficient sleep duration is a protective factor.
Predicted CD4+ T cell infiltration levels could indicate better overall survival in sarcoma patients
Authors: Bi Qing , Liu Yang , Yuan Tao , Wang Huizhen , Li Bin , Jiang Ye , Mo Xingkui , Lei Yonghong , Xiao Yanbin , Dong Suwei , Shen Hongmei , Lv Li , Yang Yihao , Dong Hua , Wang Jing , Li Fugen , Zhang Dadong , Ai Yiqin , Lin Jie
Published: January 2021

Objective

The role of tumor-infiltrating lymphocytes (TILs) has not yet been characterized in sarcomas. The aim of this bioinformatics study was to explore the effect of TILs on sarcoma survival and genome alterations.

Methods

Whole-exome sequencing, transcriptome sequencing, and survival data of sarcoma were obtained from The Cancer Genome Atlas. Immune infiltration scores were calculated using the Tumor Immune Estimation Resource. Potential associations between abundance of infiltrating TILs and survival or genome alterations were examined.

Results

Levels of CD4+ T cell infiltration were associated with overall survival of patients with pan-sarcomas, and higher CD4+ T cell infiltration levels were associated with better survival. Somatic copy number alterations, rather than mutations, were found to correlate with CD4+ T cell infiltration levels.

Conclusions

This data mining study indicated that CD4+ T cell infiltration levels predicted from RNA sequencing could predict sarcoma prognosis, and higher levels of CD4+ T cells infiltration indicated a better chance of survival.
Failure of multiple surgical procedures and adjuvant chemotherapy in early-stage steroid-cell ovarian tumor treatment: a case report and literature review
Authors: Vasilevska Danuta , Rudaitis Vilius , Vasilevska Dominika , Mickys Ugnius , Wawrysiuk Sara , Semczuk Andrzej
Published: January 2021

Ovarian steroid-cell tumors (SCTs) are a rare subgroup of sex-cord tumors of the ovary, accounting for less than 0.1% of all ovarian tumors. Not otherwise specified (NOS) tumors are the most common subtype. More than half of patients with SCTs-NOS show hyperandrogenic symptoms. The primary treatment for SCTs is surgery, as most cases are early-staged and benign. Because of the low incidence of metastatic disease, there is insufficient reliable information on the role of adjuvant therapy and the most effective treatment regimen. In this report, a rare case of a recurrent SCT-NOS in a 36-year-old female patient without endocrine symptoms is presented, highlighting the significance of appropriate pathological evaluation and immunohistochemical testing for the accurate diagnosis of this malignancy, particularly in the case of hormonally “silent” tumors. The metastatic tumor described here showed no response to four courses of adjuvant chemotherapy after several debulking surgeries. Based on the clinical findings, the neoplastic etiology should always be considered during the resection of ovarian tumors to prevent possible disease dissemination due to inappropriate surgical techniques.
Clinical analysis of 40 cases of external cephalic version without anesthesia
Authors: Zhi Zheng , Xi Lin
Published: January 2021

Objective

This study aimed to investigate the success rate, complications, and success-related factors of external cephalic version (ECV) of singleton breech pregnancies after 37 gestational weeks without anesthesia.

Methods

We studied 40 singleton breech pregnancies in women who underwent ECV without anesthesia after 37 gestational weeks from October 2018 to March 2020. On the basis of success of ECV, the women were divided into two groups of the successful group and the failed group. Various factors were analyzed to determine those that affect the success of ECV.

Results

Of the 40 attempts of ECV, 24 (60.0%) were successful and 16 (40.0%) failed. With regard to success-related factors, parity was significantly different between the two groups, with more multiparous women in the successful group than in the failed group. However, none of the other factors were significantly different between the groups. Fetal outcome was good in all of the cases. Ultimately, 3 cesarean sections were performed in the successful group and 16 were performed in the failed group.

Conclusions

ECV of breech presentation after the 37th week of pregnancy without anesthesia is an effective and relatively safe alternative, and can effectively reduce the cesarean section rate.
Erector spinae plane block in chronic pain management: a scoping review
Authors: Viderman Dmitriy , Sarria-Santamera Antonio
Published: January 2021

Chronic pain is reaching epidemic levels. Chronic pain represents a significant burden for patients, healthcare systems, and society, given its impact on quality of life, increased disability, and risk of hospitalization and mortality. Unmet needs of chronic pain management are also significant as only a small percentage of patients respond to medical (drug) therapy. Erector spinae plane block (ESPB) was rapidly adapted in clinical practice and numerous cases have been published assessing its effectiveness, but no systematic review of evidence on ESPB in chronic pain management is available. The purpose of this scoping review is to perform a comprehensive overview of existing evidence on ESPB in chronic pain management. We analyzed cases and case series reporting 43 patients. ESPB was performed in patients with severe pain and in all cases resulted in some degree of pain relief. However, because there was heterogeneity in mechanisms and underlying causes of chronic pain, preprocedural analgesic therapy, and pain assessment in reporting the cases, with the information currently available (case reports) we cannot make a definitive conclusion regarding efficacy and safety of ESPB in chronic pain management. Lack of homogeneity was present in medication use before the procedure, indicating a significant variation in how patients with chronic pain are managed. Variation in clinical practice can indicate the need to improve the quality of care to alleviate the chronic pain burden. Randomized controlled clinical trials are warranted to establish efficacy and safety of ESPB in chronic pain management.
Gender Equality and Female Offending: Evidence From International Data Sources
Authors: Chu Doris C. , Hebenton Bill , Toh Albert
Published: January 2021

This paper examines the nature of female offending patterns in relationship to societal gender equality using cross-national analysis of 27 European countries for the year 2006. Importantly, our analysis uses a conceptually innovative indicator (the World Economic Forum’s Global Gender Gap Index) to determine relative levels of gender equality. Results show that countries with a narrower gender gap in the Global Gender Gap indexes of political empowerment were likely to have a higher female prosecution rate, and that political empowerment was also significantly associated with female conviction rates as well as rates of property offending. The pattern of results generally supports the liberation thesis. Finally, limitations and suggestions for future study are addressed.
Methodological reflections on geographies of blackness
Authors: Bledsoe Adam
Published: January 2021

This article argues that work on geographies of Blackness and Black Geographies emphasizes different aspects of Black experiences and relies on different methodologies in making these emphases. I focus on the work of six prominent geographers who engage with questions of Blackness and examine the different data sources they draw on. I show that they all employ a multi-method, interdisciplinary approach in their scholarship and that all of them, regardless of emphasis or method, foreground the experiences of black populations. I argue that this collective multi-method approach pushes the conceptual boundaries of the wider discipline of Geography.
Effect of lockdown during COVID-19 on migraine: A longitudinal cohort study
Authors: Verhagen Iris E , van Casteren Daphne S , de Vries Lentsch Simone , Terwindt Gisela M
Published: January 2021

Background

The objective of this study was to assess whether migraine-related outcomes changed during intelligent lockdown when compared with the prior period.

Methods

This was a cohort study evaluating the first month of intelligent lockdown in the Netherlands (12 March to 8 April 2020) compared with one baseline month (13 February to 11 March 2020). We identified 870 migraine patients treated at the Leiden Headache Center with headache e-diaries during the period of interest. Adherence to the e-diary had to be ≥80%, yielding 592 enrolled patients.

Results

Intelligent lockdown led to a decrease in monthly migraine days (−0.48; 95% CI: −0.78 to −0.18, p = 0.002) and acute medication days (−0.48; 95% CI: −0.76 to −0.20, p < 0.001), and an increase in general well-being (0.11; 95% CI: 0.06 to 0.17, p < 0.001). No differences in non-migrainous headache days and pain coping were observed. Consistent results were found in a subset that was followed for 4 months.

Conclusions

Our findings imply that intelligent lockdown measures can improve migraine disability despite of the potential negative effects of COVID-19 and lockdown. We hypothesise that this effect is a combined result of working from home, scaling down demanding social lives, and freedom to choose how to organise one’s time.
Occipital ischaemic stroke after visual snow phenomenon – a case report
Authors: Catarci Teresa
Published: January 2021

Background

Persistent migraine with aura and neuroimaging examinations revealing ischaemia in the contralateral cortex may be associated with migrainous infarction. Despite being a neurological symptom that is distinct from migraine with aura, the visual snow phenomenon may also be associated with cerebral ischaemia. Here we describe a patient who reported short-lasting daily symptoms of visual snow that affected his entire visual field before becoming continuous and left-sided following acute occipital brain ischaemia.

Case report

In February 2017, a 74-year-old retired male was referred to our headache outpatient clinic with a diagnosis of recent right occipital cerebral ischaemia and migraine with aura. The patient reported visual snow symptoms that had changed from being bilateral and temporary to left-sided and permanent one day upon awakening; after being admitted to hospital a few hours later, he discovered he had had a stroke. He said he had never had any symptoms of migraine with aura. The visual snow phenomenon disappeared completely after about 1 year.

Conclusions

In our patient, a temporary daily visual snow phenomenon reversed to a persistent one. This phenomenon occurred in the part of his visual field that had been affected by the ischaemic occipital stroke, as typically happens in migrainous infarction. We hypothesise that the occipital lesion disrupted the inhibitory circuits, leading to a quadrantopic persistent visual snow. Since the mechanism may be the same as that observed in migrainous infarction, though with a different pathophysiology, it is possible to speculate that the aura in this case is the result, as opposed to the cause, of stroke in most patients.
Review of Tunnel Fire Damage Assessment Methods and Techniques
Authors: Hua Nan , Elhami-Khorasani Negar , Tessari Anthony
Published: January 2021

Major tunnel fires can have catastrophic consequences, including loss of life, property damage, and long-term service disruptions. The rapid rise of gas temperature in excess of 1,000°C (1,832°F) inside a confined tunnel space as well as long fire duration because of limited emergency responder access necessitate special design considerations when evaluating the structural response to fire. Although tunnel stability is not challenged in most cases, severe damage to the concrete lining is observed after major fire events. This paper provides a detailed review of assessment methodologies and techniques of fire damage in concrete tunnel linings, including guidance on the determination of fire scenarios, concrete spalling, and tunnel safety from existing codes and guidelines, experiments, and numerical models. Based on the review, the need to develop relevant guidelines is emphasized, the knowledge gaps in the existing research are identified, and future research directions are proposed.
Osteochondral Allograft Transplant for Focal Cartilage Defects of the Femoral Condyles: Clinically Significant Outcomes, Failures, and Survival at a Minimum 5-Year Follow-up
Authors: Gilat Ron , Haunschild Eric D. , Huddleston Hailey P. , Tauro Tracy M. , Patel Sumit , Wolfson Theodore S. , Parvaresh Kevin C. , Yanke Adam B. , Cole Brian J.
Published: January 2021

Background:

Osteochondral allograft (OCA) transplant for symptomatic focal cartilage defects in the knee has demonstrated favorable short- to midterm outcomes. However, the reoperation rate is high, and literature on mid- to long-term outcomes is limited.

Purpose:

To analyze clinically significant outcomes (CSOs), failures, and graft survival rates after OCA transplant of the femoral condyles at a minimum 5-year follow-up.

Study Design:

Case series; Level of evidence, 4.

Methods:

Review of a prospectively maintained database of 205 consecutive patients who had primary OCA transplant was performed to identify patients with a minimum of 5 years of follow-up. Outcomes including patient-reported outcomes (PROs), CSOs, complications, reoperation rate, and failures were evaluated. Failure was defined as revision cartilage procedure, conversion to knee arthroplasty, or macroscopic graft failure confirmed using second-look arthroscopy. Patient preoperative and surgical factors were assessed for their association with outcomes.

Results:

A total of 160 patients (78.0% follow-up) underwent OCA transplant with a mean follow-up of 7.7 ± 2.7 years (range, 5.0-16.3 years). Mean age at the time of surgery was 31.9 ± 10.7 years, with a mean symptom duration of 5.8 ± 6.3 years. All mean PRO scores significantly improved, with 75.0% of patients achieving minimal clinically important difference (MCID), and 58.9% of patients achieving significant clinical benefit for the International Knee Documentation Committee score at final follow-up. The reoperation rate was 39.4% and was associated with a lower probability of achieving MCID. However, most patients undergoing reoperation did not proceed to failure at final follow-up (63.4% of total reoperations). A total of 34 (21.3%) patients had failures overall, and the 5- and 10-year survival rates were 86.2% and 81.8%, respectively. Failure was independently associated with greater body mass index, longer symptom duration, number of previous procedures, and previous failed cartilage debridement. Athletes were protected against failure. Survival rates over time were not affected by OCA site ( P = .154), previous cartilage or meniscal procedure ( P = .287 and P = .284, respectively), or concomitant procedures at the time of OCA transplant ( P = .140).

Conclusion:

OCA transplant was associated with significant clinical improvement and durability at mid- to long-term follow-up, with 5- and 10-year survival rates of 86.2% and 81.8%, respectively. Maintenance of CSOs can be expected in the majority of patients at a mean of 7.7 years after OCA transplant. Although the reoperation rate was high (39.4%) and could have adversely affected chances of maintaining MCID, most patients did not have failure at long-term follow-up.
Outcomes of Open and Endoscopic Repairs of Chronic Partial- and Full-Thickness Proximal Hamstring Tendon Tears: A Multicenter Study With Minimum 2-Year Follow-up
Authors: Maldonado David R. , Annin Shawn , Lall Ajay C. , Krych Aaron J. , Athey Alexander G. , Spinner Robert J. , Hartigan David E. , Emblom Benton A. , Ryan Michael K. , Domb Benjamin G.
Published: January 2021

Background:

The preponderance of literature on the repair of proximal hamstring tendon tears focuses on the acute phase (<4 weeks). As such, there is a paucity of data reporting on the outcomes of chronic proximal hamstring tears.

Purpose:

To report minimum 2-year postoperative patient-reported outcome (PRO) scores, visual analog scale (VAS) for pain, and patient satisfaction from patients who underwent open or endoscopic repair of partial- and full-thickness chronic proximal hamstring tendon tears.

Study Design:

Case series study; Level of evidence, 4.

Methods:

Between April 2002 and May 2017, prospectively collected data from 3 tertiary care institutions were retrospectively reviewed for patients who underwent open and endoscopic repair of partial- and full-thickness chronic proximal hamstring tendon tears. Patients were included only if they had a chronic proximal hamstring tear (defined as ≥4 weeks from symptom onset to surgery). Patients were excluded if they had a tear treated <4 weeks after injury, underwent hamstring reconstruction, or claimed workers’ compensation. Patients who reported minimum 2-year follow-up for VAS, patient satisfaction, and the following PROs had their outcomes analyzed: the modified Hip Harris Score, Non-arthritic Hip Score, iHOT-12 (International Hip Outcome Tool), and Hip Outcome Score–Sports Specific Subscale.

Results:

Fifty patients (34 females and 16 males) were included in this study. There were 19 endoscopic repairs and 31 open repairs. Within the cohort, 52.0% had a full-thickness tendon tear on magnetic resonance imaging, and 48.0% had a partial tear. Average follow-up time was 58.07 ± 37.27 months (mean ± SD; range, 24-220 months). The mean age and body mass index of the group were 46.13 ± 13 years and 25.43 ± 5.14. The average time from injury to surgery was 66.73 weeks (range, 5.14-215.14 weeks). Average postoperative PROs were as follows: modified Hip Harris Score, 91.94 ± 9.96; Non-arthritic Hip Score, 91.33 ± 9.99; iHOT-12, 87.17 ± 17.54; Hip Outcome Score–Sports Specific Subscale, 87.15 ± 18.10; and VAS, 1.16 ± 1.92. Patient satisfaction was 8.22 ± 1.20.

Conclusion:

Patients who underwent open and endoscopic repairs for chronic partial- and full-thickness proximal hamstring tendon tears reported high PROs and satisfaction at a minimum 2-year follow-up with low rates of complications.
The Lateral Femoral Notch Sign Is Correlated With Increased Rotatory Laxity After Anterior Cruciate Ligament Injury: Pivot Shift Quantification With A Surgical Navigation System
Authors: Lucidi Gian Andrea , Grassi Alberto , Di Paolo Stefano , Agostinone Piero , Neri Maria Pia , Macchiarola Luca , Dal Fabbro Giacomo , Zaffagnini Stefano
Published: January 2021

Background:

The lateral femoral notch sign (LNS) is a bony impression on the lateral femoral condyle correlated with anterior cruciate ligament (ACL) injury. Its presence is associated with lateral meniscal injury and higher cartilage degradation on the lateral femoral condyle.

Purpose/Hypothesis:

The purpose was to investigate the effect of the presence and magnitude of LNS on rotatory instability. The hypothesis was that a positive LNS is correlated with a high-grade pivot shift (PS).

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A total of 90 consecutive patients with complete ACL tears between 2013 and 2017 underwent intraoperative kinematic evaluation with the surgical navigation system and were included in the present study. The same surgeon performed a standardized PS under anesthesia. The PS was quantified through the acceleration of the lateral compartment during tibial reduction (PS ACC) and the internal-external rotation (PS IE). Presence and depth of LNS were evaluated on sagittal magnetic resonance images (1.5-T).

Results:

In 47 patients, the LNS was absent; in 33, the LNS depth was between 1 mm and 2 mm; and in 10 patients, it was deeper than 2 mm. Patients with a notch deeper than 2 mm showed increased PS ACC and PS IE compared with the group without the LNS. However, no significant differences were present between the group with a notch between 1 and 2 mm and the patients without LNS. Receiver operating characteristic curve analysis showed that 2 mm was the most predictive cutoff value to identify the “high-grade rotatory instability” group, with an accuracy of 77.8% and 74.4% and a specificity of 95.5% and 93.9% referred to the PS ACC and PS IE, respectively.

Conclusion:

The presence of a lateral LNS deeper than 2 mm could be used for the preoperative identification of patients with a high risk of increased rotatory instability.